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PubMed1995

Determination of stereospecific assignments, torsion-angle constraints, and rotamer populations in proteins using the program AngleSearch.

A general program, AngleSearch, which calculates coupling constants and interproton distances for any molecular fragment and does a grid search to find torsion angles, rotamer populations, and stereospecific assignments which fit the measured data has been developed. The program takes full advantage of the fact that ratios of cross-peak intensities (measured in HNHB and HN(CO)HB experiments) can provide accurate ratios of coupling constants even for large molecules. AngleSearch is capable of: (a) analyzing any type of residue including protein, RNA, DNA, and ligand residues; (b) conformational grid searching in dihedral-angle space using 6 degree steps; (c) averaging coupling constants and (l/r6) distances for rotamers undergoing fast exchange; (d) grid or Monte Carlo searching for populations of staggered rotamers; (e) using all available distance-related data from ROESY and/or NOESY spectra; (f) using any available coupling constant data having known relationships to corresponding dihedral angles; and (g) directly using cross-peak intensities related to values of coupling constants. The program can also assist in the stereospecific assignment of the alpha-CH2 protons of glycine residues. The effects of the quality of the input data on the results of the AngleSearch calculations have been assessed.

Alanine↗
PubMedDate not supplied

Using a focus group to design a diabetes education program for an African American population.

PURPOSE: The purpose of this project was to determine what factors need to be considered in planning a diabetes education program to better meet the needs of African Americans with diabetes in a community served by a suburban community hospital. METHODS: Two focus group sessions were conducted. The sessions were recorded, transcribed, and analyzed by members of the research team. RESULTS: Four themes emerged that had bearing on program development: (1) a sense of personal powerlessness, (2) fear related to complications, (3) recognition of knowledge deficits accompanied by an inability to link behavior to outcomes, and (4) a clear vision of what kind of educational setting would interest and benefit the group. CONCLUSIONS: There were significant differences between what was being offered for diabetes education at the facility and what was desired according to the focus group, including factors of cost and leadership. Recommendations for future program planning are given.

Adult↗
PubMed1993

Developing community-based program alternatives for the seriously and persistently mentally ill elderly.

The deinstitutionalization movement in the United States has traditionally neglected the rehabilitation potential of the seriously mentally ill elderly. With the proliferation of the elderly population, unique programs and community-based settings must be created and expanded to meet the mental health needs of this population in a cost-effective and humane manner. The mental health continuum presented is a model composed of programs that target the seriously mentally ill elderly in a variety of community placements including residential treatment facilities, nursing homes, retirement homes, and permanent housing.

Aged↗
PubMed1998

[Quality control of data produced in biological population surveillance studies on the risk of environmental lead poisoning].

The biological surveys of the general population against the risk of lead intoxication carried out in Italy--in accomplishment both of the EEC directive EEC 77/312 and the Presidential Decree 496/1982--have been always conceived as multicentric activities. Therefore, starting from the first campaign carried out in 1979, strict quality control procedures have been adopted. In brief, each participant laboratory used internal quality control samples and took part in external quality assessment exercises. In addition, ten percent of the blood samples collected during the campaign were analyzed as blind duplicate by both participating laboratories and a reference laboratory. In this paper the quality control procedures adopted will be presented and discussed in detail together with the quality of results obtained in each campaign.

Environmental Exposure↗
PubMed1982

Evaluating the rehabilitation process: an example with the blind.

The research methods presented here were developed for the evaluation of the CBRC (Central Blind Rehabilitation Center) at Hines. These methods are applicable to the evaluation of other blind rehabilitation programs. In addition, most of the strategies are applicable to other kinds of rehabilitation programs. The process of defining goals and of determining outcome variables is a necessary step in effective evaluation regardless of the population and program in question. It is essential to measure the influence of patient variables on treatment outcomes for all populations undergoing rehabilitation. The measures to evaluate these out-come and patient variables must be demonstrably reliable and valid. The methods used to identify and define variables, the research design and methods to produce reliable measures all can be used to evaluate a variety of programs as well as individual treatments and devices.

Blindness↗
PubMedDate not supplied

Implementing program evaluation and accountability for population health: progress of a national diabetes control effort.

Diabetes affects some 16 million Americans at a cost estimated at $100 billion. The Centers for Disease Control and Prevention funds a diabetes control program (DCP) in every state as part of the National Diabetes Control Program (NDCP). In 1999, a new policy added emphasis on evaluation and made NDCP and its DCPs accountable for achieving impacts related to the health of populations with diabetes. The article reports on the experiences of the NDCP in implementing a performance-based program evaluation paradigm. It also discusses potential future directions for national diabetes-control efforts.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

Simulation studies of detection of a complex disease in a partially isolated population.

Simulation studies were undertaken with POPGEN, a new population simulation program, to explore strategies for detecting loci underlying rare and common disorders in a small population that has been partially isolated for 10 generations. Haplotype-sharing analysis (HSA) and non-parametric linkage analysis (NPL) were applied to the simulated haplotype and pedigree data for 100 cases, 100 controls, and an average of 28 multiplex pedigrees from cases' families, for a 2-5 cM map of markers. When identity by descent (IBD) status was known (using unique founder marker allele designations assigned during simulation), a linkage disequilibrium (LD) signal could be detected under disease-generating models predicting relative risk to sibs of 11.8 (high-RR) or 2.67 (mod-RR). Detection was more difficult when marker alleles were down-coded to resemble microsatellites (heterozygosities 0.75-0.80). False-positive peaks on nondisease chromosomes were uncommon. NPL analysis was more powerful than HSA at this marker density using down-coded alleles and assuming availability of all affected relatives. LD mapping of common disorders is likely to require denser maps of highly polymorphic markers to approximate full IBD information. LD and linkage mapping provide independent information, and strategies that combine these two methods could be useful in studies of small isolated populations.

Computer Simulation↗
PubMed1980

Evaluation of an oral disease control program administered to a clinic population at a suburban dental school.

This study included 99 patients. Seventy-four of these participated in the Oral Disease Control program at Emory University School of Dentistry and 25 control patients did not. Those who completed the Oral Disease Control program were examined and scored from 2 to 24 months afterward. The Patient Hygiene Performance Scoring was used. It was found that there was no significant difference in levels of plaque between subjects who completed the Oral Disease Program and those who did not participate. Also, the patient's knowledge of the causes of dental caries and gingival disease bore no significant relationship to the amount of plaque present. Further, certain selected hygiene habits had no significant effect on plaque level. The patients studied were enthusiastic about the control program and developed an increased awareness of oral disease control. However, this study confirms others that demonstrate the need for repeated professional reinforcement in any effective oral disease control program.

Adolescent↗
PubMedDate not supplied

Do we need a "virtual" program infrastructure for worksite and population health promotion efforts?

As the demand for Worksite Health Promotion heats up, it is becoming clear that the traditional models of programming that work well in worksites with large number of employees will not meet the needs of small and medium size employer organizations. Additionally, the large number of individuals who are served by health plans are also likely to require different types of Health Promotion interventions. In presenting the concept of a "virtual" set of interventions that form a "program infrastructure" this article seeks to bridge the gap between large employer programming strategies and small employer and health plan settings. A set of eleven interventions are described and recommended technical specifications are presented.

Health Promotion↗
PubMed1997

The impact of a decade long opisthorchiasis control program in northeastern Thailand.

Based on the figures obtained from a regional survey in 1981, the overall prevalence of opisthorchiasis in northeastern Thailand was as high as 34.6%. Traditional consumption of improperly cooked fish dishes and unhygienic defecating habits among rural inhabitants have been recognized as significant factors determining such high prevalence of this liver fluke in that area. Following experience of Mahidol University's Faculty of Tropical Medicine in Thailand of treating liver fluke infected individuals with praziquantel, the Ministry of Public Health started a liver fluke control program in the northeast as special service units in 1984 in 4 provinces. In 1988, the program was expanded to cover all 19 northeastern provinces, services being rendered at a community level covering stool examination and treatment of positive cases. Intensive health education was integrated as one element of liver fluke control program. During the early phase of operation (attack phase) a mobile stool examination team was the crucial strategy for active service. Following the attack phase, passive service was operated at each health service facility provided that results of population based program evaluation in each area showed a low prevalence according to the set target. Regionwide assessments in 1991 and 1992 indicated a declining trend of prevalence from 34.6% to 30.19% and 24.01%, respectively. In 1994, a population-based sampling survey was carried out to measure the effect of the liver fluke control program over 10 years operation (1984-1994) on both behavioral outcomes and prevalence impact. Sample for the assessment of behavior were 1,268 individuals, while another 1,912 samples were used for determining disease prevalence. Health related behaviors regarding frequent consumption of uncooked fish dishes decreased from 14% in 1990 to 7% in 1994 while occasional consumption remains as high as 42%. The prevalence of opisthorchiasis is 18.5% with a large variation in infection rate (5.20-56.25%).

Adolescent↗
PubMed1994

Celiac disease and insulin-dependent diabetes mellitus. Screening in an adult population.

We screened for celiac disease, by means of IgA class anti-endomysium antibodies (EmA), 383 consecutive adults with insulin-dependent diabetes mellitus (IDDM). Two control populations entered the study as well: 151 adults with biopsy proven celiac disease, as true positives; and 520 controls (healthy and diseased) as true negatives. IgA-EmA positivity was found in 145 of 151 (96%) celiac disease patients but in none of the controls (100% specificity). EmA were positive in 12 of 383 (3.13%) IDDM patients: 10 of these positives underwent intestinal biopsy, which showed either partial or total villous atrophy. Only one patient presented with gastrointestinal complaints, but severe iron deficiency was found in all. The IDDM celiac patients were started on a gluten-free diet: four refused both the diet and the follow-up protocol. Approximately one year after gluten withdrawal no significant change in the degree of diabetes control was observed, while an increased requirement for insulin was observed in three of four patients who strictly complied with the diet. The prevalence of biopsy-proven celiac disease among adult IDDM patients (1:38), eight times higher than that recently estimated for the general Italian population and the absence, except in one case, of gastrointestinal symptoms emphasizes the benefit of screening programs on populations at risk.

Adolescent↗
PubMedDate not supplied

Delivering breast and cervical cancer screening services to underserved women: Part II. Implications for policy.

Many breast and cervical cancer screening (BCCS) programs for underserved women employ strategies to increase the use of preventive services. In Phase I of a two-phase study, strategies were identified and assessed. In Phase II, we further assess strategies previously identified and comment on policy implications. Site visits were conducted at BCCS programs that had used one successful strategy identified during Phase I, provided services to underserved women, and were located in different geographic regions. The federally funded National Breast and Cervical Cancer Early Detection Programs (NBCCEDP) were also considered for site visits. Interviews were completed and available data were reviewed. A descriptive and qualitative analysis was completed. Programs visited were found to be increasing the use of BCCS services for the defined target populations. Some programs focused on outreach and recruitment. Other programs focused on clinical preventive services with little emphasis on outreach and recruitment. Management information systems were used by most programs. We found that there continues to be a large number of women not receiving BCCS services. Some programs have had to limit outreach and recruitment because the clinical preventive services offered are at capacity. Programs need to have a balanced approach to providing services from the outset. Existing programs may need to establish partnerships to provide comprehensive BCCS services to underserved women. Because the unmet need (women who have not received BCCS services) exceeds available clinical preventive services, it is a challenge to know how to best use available resources.

Adult↗
PubMed2000

Antibiotic resistance monitoring in bacteria of animal origin: analysis of national monitoring programmes.

Methods of antibiotic resistance monitoring of bacteria from animals in 12 European countries were surveyed in 1998. Most laboratories used disk diffusion methods, usually expressing results qualitatively, although a few also expressed the results either as MICs or zone diameters. The number of antibiotics used ranged from 5 to 37 (mean 15) and the most common antibacterials were streptomycin, gentamicin, neomycin, ampicillin, tetracyclines, chloramphenicol and sulphonamides. Salmonellae were monitored by most centres but few-tested campylobacter regularly. Escherichia coli from a wide range of animal species were tested in nine countries. Enterococci were tested on a limited ad hoc basis in six countries. Staphylococci, streptococci and pasteurellae were also frequently monitored but the number of isolates tested showed wide variation. Overall the presentation of the results differed, but most programmes used disk diffusion, control strains and monitored similar bacteria. Thus, it may be possible to harmonise monitoring programmes within the EU.

Animal Population Groups↗
PubMedDate not supplied

Community health workers and primary health care in Honduras.

Community participation and utilization of community health workers (CHWs) are essential components of the primary health care model. The success of CHWs is dependent on their training and subsequent community support. Community-prepared nurses are ideal CHW educators. A training program for CHWs was implemented in Honduras emphasizing the principles of adult learning and problem-based learning. Following a 4-month program of training a primary health care clinic was opened and managed by CHWs for a population over 10,000. Approximately 80% of local health problems were managed by the CHWs proving that well-trained CHWs can have a significant impact on the delivery of health care.

Community Health Services↗
PubMed2004

A review of the HIV epidemic in India.

India has a population of more than 1 billion people. Although only about 0.7% of its population is infected with HIV, it has more cases than any other country in the world, with more than 4.5 million HIV-seropositive patients. The epidemic of HIV/AIDS in India is distributed between the urban and rural populations mainly in the southern and western states of the country (APAC-VHS, Community Prevalence of Sexually Transmitted Diseases in Tamil Nadu-A Report, 1998; Solomon, Kumarasamy, Ganesh, & Amalraj, 1998, International Journal of Medical Research, 85; 335-338). India has several different epidemics in various parts of the country. The epidemic in the western and southern states is primarily heterosexual. The northeastern states of India, being in geographical proximity to the Golden Triangle of Asia, initially experienced HIV in the injection drug user population and their sexual partners, but spread to the heterosexual population has been increasing. At present, the northern states, which are the most densely populated, appear to remain largely unaffected by the HIV epidemic. India has mounted a broad intervention program, including the government, and international, nongovernmental, and community-based organizations. The main barriers to effective control are insufficient resources, illiteracy, and stigma. Antiretroviral drugs are manufactured in the country and exported elsewhere, but their affordability (despite a drastic reduction in costs) and the feasibility of monitoring patients on drugs are in question. Starting April 1, 2004, the government of India has announced free provision of ART drugs to all who need it in the six most prevalent states of India.

Female↗
PubMed1981

[Xinjiang family planning].

Population growth rate in Xinjiang Autonomous Region dropped to 12/1000 last year, or 2.8/1000 less than 1979. Population growth rate among the people of Han nationality was dropped to 8.4/1000, or 5.5/1000 less than 1979. The autonomous region recently called a meeting to discuss family planning, population control, and population growth planning. A speech was delivered by Zhang Siming, vice chairman of the regional People's Government and head of the regional leading group for family planning. He urged all cadres for family planning to better perform their duties and make still greater contributions to promoting family planning in Xinjiang.

Asia↗