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PubMed1978

The design of a training program for adolescent medicine. Thoughts of fellows in training.

Program design for training in Adolescent Medicine is still in an evolutionary state. Postgraduate fellows and program directors have different perceptions with regard to the importance of various components of the ideal training program. Fellows indicate a higher priority for problems associated with the female reproductive system than do their mentors. Inpatient experience received lesser emphasis by the Fellows. Adolescent Medicine as a subspecialty discipline is discouraged.

Adolescent↗
PubMed1991

OVID and SUPER: two overlap programs for drug design.

Two programs, OVID and SUPER, for exploring the similarity of molecules with respect to their action at a receptor are described. OVID accepts two molecules as input and optimizes the three-dimensional overlap of specified atoms in one molecule with specified atoms in the second molecule. The result is expressed as a percent of the theoretical maximum. OVID gives a quantitative measure of the extent of a guessed correspondence between two molecules based on volume overlap of selected atoms. The Achilles' heel of OVID is that the correspondence between the two molecules has to be guessed. We realized that it would be better to systematically examine all possible correspondences of two structures to minimize the chance of overlooking a superior correspondence. We created SUPER to satisfy this need. SUPER accepts two molecules as input and finds the top twenty correspondences of their surfaces and charge distributions, giving a quantitative measure of the extent of each correspondence. An instructive example of the application of OVID and SUPER to the design of leukotriene D4 receptor antagonists is described. SUPER appears to be a practical brain-storming tool for the medicinal chemist trying to understand how molecules whose structures may not resemble one another in an obvious way can bind to the same site.

Acetophenones↗
PubMed1991

Object-oriented design and programming in medical decision support.

The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits.

Adult↗
PubMed1979

The Mayo Three-Community Hypertension Control Program. I. Design and initial screening results.

The Mayo Three-Community Hypertension Control Program implemented graduated programs for the control of high blood pressure in three rural southeastern Minnesota communities, beginning in 1974. Prevalence of hypertension (when defined as diastolic blood pressure, at initial screening, of 95 mm Hg or more) was similar to that found for comparable groups by age and sex in the United States generally, but an atypically high frequency of known but untreated hypertension was found. Programs of public and professional information, systematic household screening, continuing professional education (two communities), and a new community hypertension clinic (one community) were initiated, and plans were made to evaluate the programs simultaneously by means of total rescreening of persons found to be hypertensive initially. The present report describes in detail the design of the program and the results of initial screening in relation to findings in other populations at the time. Subsequent reports assess the impact of each program on its target community and of a community hypertension clinic within the one setting where this component of a model program was established.

Adult↗
PubMed1989

Directed blood procurement does not benefit patients who are enrolled in an autologous blood predeposit program.

Designated or directed blood transfusion (DD) is a controversial practice; its merits are currently debated on the basis of implications for the national blood supply and on the "safety" of directed blood compared with homologous blood. An equally compelling issue for the merits of DD is whether this practice results in its putative effect: to avoid volunteer homologous blood exposure. To study this, the authors reviewed 112 consecutive patients (73 orthopedic) who predeposited autologous blood for elective surgery. This group was compared with 17 patients (all orthopedic) who predeposited autologous blood and also requested storage of designated blood. Seven of 17 patients with DD subsequently received homologous blood, compared with 11 of 112 patients without designated blood (NDD, P less than 0.01) and 3 of 35 NDD orthopedic patients asked to predonate three or more units of blood, P = 0.015. DD and NDD patients were no different when analyzed for age, sex, or units blood stored; admission, nadir, or discharge hematocrit; autologous blood transfused; days in hospital; or surgical blood loss. The authors conclude that patient requests for DD are unjustified for elective surgical patients who are eligible to donate autologous blood because DD as practiced in this setting does not avoid subsequent homologous blood exposure. Maximizing autologous blood procurement is the preferred alternative for avoiding homologous blood transfusion.

Adolescent↗
PubMed1992

Comparison of role conception and role deprivation in LPN-transition students and traditional ADN students in a specially designed associate program.

This study compared differences in role orientation and role deprivation between 41 LPN-transition students and 123 basic traditional associate degree nursing (ADN) students upon entry and exit to a specially designed ADN program. The Corwin Role Conception Scale was used to assess role conception and deprivation. Statistically significant differences were noted upon entry between LPN-transition students and traditional ADN students in professional and service role conceptions and in role deprivation, upon exit in professional role conception and role deprivation between LPN-transition and traditional ADN students, and in professional role conception within the LPN-transition students. No differences were found within traditional ADN students from entry to exit of the program.

Adult↗
PubMed1990

DESIGN: computerized optimization of experimental design for estimating Kd and Bmax in ligand binding experiments. II. Simultaneous analysis of homologous and heterologous competition curves and analysis blocking and of "multiligand" dose-response surfaces.

We have developed a computer program, DESIGN, for optimization of ligand binding experiments to minimize the "average" uncertainty in all unknown parameters. An earlier report [G. E. Rovati, D. Rodbard, and P. J. Munson (1988) Anal. Biochem. 174, 636-649] described the application of this program to experiments involving a single homologous or heterologous dose-response curve. We now present several advanced features of the program DESIGN, including simultaneous optimization of two or more binding competition curves optimization of a "multiligand" experiment. Multiligand designs are those which use combinations of two (or more) ligands in each reaction tube. Such designs are an important and natural extension of the popular method of "blocking experiments" where an additional ligand is used to suppress one or more classes of sites. Extending the idea of a dose-response curve, the most general multiligand design would result in a "dose-response surface". One can now optimize the design not only for a single binding curve, but also for families of curves and for binding surfaces. The examples presented in this report further demonstrate the power and utility of the program DESIGN and the nature of D-optimal designs in the context of more complex binding experiments. We illustrate D-optimal designs involving one radioligand and two unlabeled ligands; we consider one example of homogeneous and several examples of heterogeneous binding sites. Further, to demonstrate the virtues of the dose-response surface experiment, we have compared the optimal surface design to the equivalent design restricted to traditional dose-response curves. The use of DESIGN in conjunction with multiligand experiments can improve the efficiency of estimation of the binding parameters, potentially resulting in reduction of the number of observations needed to obtain a desired degree of precision in representative cases.

Binding Sites↗
PubMed1991

A Macintosh computer program for designing DNA sequences that code for specific peptides and proteins.

A computer program (PINCERS) is described for use in the design of synthetic genes and mixed-probe DNA sequences. A protein sequence is reverse translated with generation of synonymous codons at each position producing a degenerate sequence. In order to locate potential restriction enzyme sites, the degenerate sequence is searched with a library of restriction enzymes for sites that utilize any combination of synonymous codons. These sites are indicated in a map so that they may be incorporated into the synthetic gene sequence. The program allows the user to select the appropriate codon usage table for the organism of interest and then to set a threshold usage frequency below which codons are not generated. PINCERS may also be used to assist in planning the synthesis of mixed-probe DNA sequences for cross-hybridization experiments. It can identify regions of specified length with the protein sequence that have the least overall degeneracy, thereby minimizing the number of probes to be synthesized and, therefore, maximizing the concentration of a given probe sequence.

DNA↗
PubMed1991

Factors affecting participation in external degree completion programs.

Although many dental hygienists have considered pursuing a baccalaureate degree, many barriers intervene to prevent accomplishment of this goal. The external degree is one option that could be available to overcome some of the barriers to accessibility. An external program is one that makes education accessible to students in nontraditional ways. A characteristic of these programs is that students can usually pursue academic credit toward a degree without being physically present on the degree-granting campus for the majority of the program. This paper reports the results of a 1988 survey of certificate and associate degree dental hygienists' interest in an external baccalaureate degree completion program. A questionnaire was mailed to 213 certificate and associate degree dental hygienists in Tennessee who had expressed an interest in degree completion. Two hundred six questionnaires were returned for a response rate of 96.7%. In order to determine the potential success of such programs, the following factors were explored: the motivations or reasons for participating; program design factors that might encourage or deter participation; degree of employer support; and individual characteristics relevant to participation, such as personal commitment and demographic information. Geographic location, flexibility in scheduling, and accessibility to course work were the program design factors most important to the likely participants. Likely participants indicated that they wanted to return to complete their baccalaureate degrees for personal satisfaction, for the status of the degree, and to increase their knowledge and skill in dental hygiene. They indicated that they did not want to change the focus of their careers. The area of study rated as most important was advanced clinical dental hygiene. The likely participants were found to resemble other nontraditional students. They averaged 34 years of age, were married with children living at home, and were able to study on a part-time basis only. The analysis of the data obtained from the questionnaire led to the conclusion that external program design factors would be essential for most certificate and associate degree dental hygienists to participate in a baccalaureate degree completion program.

Adult↗