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PubMed2007

Modeling the probability distribution of positional errors incurred by residential address geocoding.

BACKGROUND: The assignment of a point-level geocode to subjects' residences is an important data assimilation component of many geographic public health studies. Often, these assignments are made by a method known as automated geocoding, which attempts to match each subject's address to an address-ranged street segment georeferenced within a streetline database and then interpolate the position of the address along that segment. Unfortunately, this process results in positional errors. Our study sought to model the probability distribution of positional errors associated with automated geocoding and E911 geocoding. RESULTS: Positional errors were determined for 1423 rural addresses in Carroll County, Iowa as the vector difference between each 100%-matched automated geocode and its true location as determined by orthophoto and parcel information. Errors were also determined for 1449 60%-matched geocodes and 2354 E911 geocodes. Huge (> 15 km) outliers occurred among the 60%-matched geocoding errors; outliers occurred for the other two types of geocoding errors also but were much smaller. E911 geocoding was more accurate (median error length = 44 m) than 100%-matched automated geocoding (median error length = 168 m). The empirical distributions of positional errors associated with 100%-matched automated geocoding and E911 geocoding exhibited a distinctive Greek-cross shape and had many other interesting features that were not capable of being fitted adequately by a single bivariate normal or t distribution. However, mixtures of t distributions with two or three components fit the errors very well. CONCLUSION: Mixtures of bivariate t distributions with few components appear to be flexible enough to fit many positional error datasets associated with geocoding, yet parsimonious enough to be feasible for nascent applications of measurement-error methodology to spatial epidemiology.

Censuses↗

PubMedDate not supplied

Parent attitudes about pediatricians addressing parental smoking.

OBJECTIVE: Pediatricians have a great opportunity to intervene in parental smoking, but few do so consistently. Pediatricians consistently cite concern about negative parental reaction as one barrier to addressing parental smoking. This study investigated parent attitudes about pediatricians addressing parental smoking at pediatric visits. METHODS: Parents (N = 341) were interviewed immediately after a pediatric visit about their attitudes toward pediatricians addressing parental smoking. Chi-square analyses identified relevant factors in parents' responses. RESULTS: Most parents (99%; n = 337) said that asking about smoking is a very important part of a pediatrician's job (89%; n = 302) or felt that it did not matter one way or the other (10%; n = 35). There was no difference between attitudes of smoking and nonsmoking parents on this variable (chi(2) = 5.9, df = 1, P >.05). Very few nonsmokers (1%; n = 2) or smokers (5%; n = 2) believed that pediatricians have no business asking about parental smoking. The results support recent reports from adult practice that patient satisfaction ratings are improved when physicians ask about tobacco use and advise about quitting. CONCLUSIONS: Both smoking and nonsmoking parents strongly believe that pediatricians should address parental smoking in the context of pediatric visits.

Adolescent↗

PubMed2005

Addressing transition to adult health care for adolescents with special health care needs.

OBJECTIVE: To determine the factors associated with addressing the transition from pediatric to adult-oriented health care among US adolescents with special health care needs. METHODS: Data for 4332 adolescents, 14 to 17 years of age, from the 2000-2001 National Survey of Children With Special Health Care Needs were used. The adequacy of transition services was determined by parent self-report. Explanatory variables, including parental education, family poverty status, race/ethnicity, measures of the severity and complexity of conditions, health insurance status, having a personal doctor, and the quality of the parent's relationship with the adolescent's doctor, were entered into a regression model. RESULTS: Overall, 50.2% of parents reported that they had discussed transition issues with their adolescent's doctor and 16.4% had discussed and developed a plan for addressing those needs. In a multivariate regression analysis, correlates of the adequacy of transition services included older age, female gender, complexity of health care needs, and higher quality of the parent-doctor relationship. CONCLUSIONS: Among adolescents with special health care needs, those who were older and those with more complicated needs were more likely to have addressed the transition from a pediatric to adult-oriented system of care. Furthermore, this analysis demonstrated a strong association between a high-quality parent-provider relationship and the extent to which transition issues were addressed. The importance of transition services for adolescents with less complex needs and the overall impact of health care transition services were not assessed in this study and remain important questions for future investigations.

Adolescent↗

PubMed2001

Addressing multiple problems in the family practice office visit.

OBJECTIVES: The purpose of the study was to describe the number of problems addressed during family practice outpatient visits, the nature of additional problems raised, how they affect the duration of the visit, and how well they are reflected in the billing record. STUDY DESIGN: Cross-sectional. POPULATION: We studied a total 266 randomly selected adult patient encounters representing 37 physicians. OUTCOMES MEASURED: A problem was defined as an issue requiring physician action in the form of a decision, diagnosis, treatment, or monitoring. Visit duration and the number of billing diagnoses were also assessed. RESULTS: On average, 2.7 problems and 8 physician actions were observed during an encounter. More than one problem was addressed during 73% of the encounters; 36% of these additional problems were raised by the physician and 58% by the patient. On average, each additional problem increased the length of the visit by 2.5 minutes (P<.001). The concordance between the number of problems observed and the number of problems on the billing sheet indicated a trend toward underbilling the number of problems addressed. CONCLUSIONS: Multiple problems are commonly addressed during family practice outpatient visits and are raised by both the physicians and the patients. Our findings suggest that current views of physician productivity and the billing record are poor indicators of the reality of providing primary care.

Adult↗

PubMed2001

How to address patient complaints.

All patient complaints should be addressed appropriately, with the goal of improving care and boosting patient satisfaction. Address complaints immediately, while the patient is still in the ED. If a complaint is about quality of care, have the patient speak to an individual who can address both medical and risk management issues. Have a policy to address complaints. Make verbal contact with every patient who complains.

Efficiency, Organizational↗

PubMed2005

Ascertaining women's preferred mode of address and preferred choice of title during pregnancy and childbirth.

To determine how women in pregnancy would like to be addressed and to ascertain their preferred choice of title during pregnancy. A questionnaire was administered to 925 antenatal women. Midwifery and medical staff (183) were invited to respond to a similar questionnaire. The response rate was 71.2% from the survey of pregnant women. The vast majority (82.1%) preferred to be addressed by their first name. Women were in favour of being called 'patient' (32.8%) as their first choice. The staff survey yielded a response rate of 77%. The majority (81.8%) of health professionals preferred to address women by their first name. 'Mother' (28.7%) was the most popular first choice. We conclude that women in pregnancy do have a preference on how they would like to be addressed and this is predominantly by first name. Health professionals also prefer to call pregnant women by their first name. The term 'patient' was the most popular first choice of title of women in pregnancy but the term 'mother' was the preferred choice of the health professionals. Medical staff were more likely to choose 'patient' than midwives.

Adult↗

PubMed1990

[The use of RNAse H for digestion of alkylated 16S rRNA at the binding sites of addressed reagents--oligodeoxyribonucleotide derivatives].

It is demonstrated that 16S rRNA, complementary-addressed labelled with 2',3'-O-[4-N-methyl-N-(2-chloroethyl)-amino]benzylidene derivatives of oligonucleotides d(pACCTTGTT)rA and d(pTTTGCTCCCC)rA, can be cleaved by RNase H within the adducts, resulted from the modification. Comparative study of the 16S rRNA cleavage with RNase H within the above--mentioned covalent adducts, on the one hand, and within heteroduplexes with the same oligodeoxyribonucleotides, on the other, showed that(i) the complementary-addressed modification proceeds both in perfect and non-per ect complexes; (ii) 16S rRNA is cleaved by RNase H within both perfect and non-perfect complexes resulted from the alkylation, non-perfect complexes being considerably stabilized by the covalent bond between the reagent and the RNA; (iii) non-perfect complexes of 16S rRNA with the free oligodeoxyribonucleotides are unstable even at the high oligonucleotide concentration, so that no cleavage of 16S rRNA in such duplexes is observed. The approach based on cleavage of RNA within covalent adducts resulted from the complementary-addressed RNA modification may be used for fragmentation of RNA molecule in the addressed reagent's binding site.

Alkylation↗

PubMed1995

In search of effective programs to address students' emotional distress and behavioral problems. Part I: Defining the problem.

This article discusses the prevalence and seriousness of emotional difficulties and behavioral problems in students, with a special focus on high school students and the obstacles they encounter when addressing these problems. The educational, psychological, and medical literature which addressed the problem over the past five years was evaluated, and 22 references were selected. It was determined that the lack of consensus on the terms used to describe the problem prevented accurate assessment of its prevalence. However, one fifth to one third of the students were found to be affected, leading to serious educational, psychosocial, and economic difficulties--and more are likely to be affected in the 1990s. Since the school and mental health systems have not been entirely successful in addressing the problem, adolescents' patterns of seeking help indicate that peer support groups can be part of the solution. It was concluded that the enormity of the problem requires a low-cost gate-keeping mechanism to facilitate early identification and intervention. Thus, school peer-support programs, if proven effective, may complement traditional mental health services in addressing adolescents' emotional distress and behavioral problems.

Adolescent↗

PubMed1996

Solution structure of regioselectively addressable functionalized templates: an NMR and restrained molecular dynamics investigation.

Three cyclic peptides that are Regioselectively Addressable Functionalized Templates (RAFT) for use in protein de novo design have been investigated using a combination of nmr, restrained molecular dynamics, and CD spectroscopy. These peptides contain up to four selectively addressable sites (orthogonally protected lysine side chains) or have selectively addressable faces. The results show a common stable conformation for templates of this kind based on two type II beta-turns and an associated beta-sheet structure. A preferential orientation for the side chains is also demonstrated. The significance of these findings is discussed in the context of applications of RAFT that rely on their conformational rigidity and ability to present functionalities in a defined spatial arrangement.

Amino Acid Sequence↗

PubMed2005

Initial cancer genetic counseling consultation: change in counselees' cognitions and anxiety, and association with addressing their needs and preferences.

The fulfillment of counselees' expectations in cancer genetic counseling and how this affects the outcome of counseling have received little attention so far. This study investigates how the initial consultation influences counselees' cognitions and anxiety, whether counselors address counselees' prior needs and preferences during the visit, and whether addressing needs is associated with a more positive outcome of the visit. One hundred twenty-eight affected and unaffected counselees from families with no known mutation, who were seen by one of fourteen counselors, participated. Pre- and post-visit questionnaires assessed correct knowledge about hereditary breast or colon cancer, perceived personal control (PPC), anxiety (STAI), risk perceptions, and (fulfillment of) needs (QUOTE-gene(ca)). Results demonstrated a pre- to post-visit significant increase in correct knowledge and PPC, and a significant decrease in STAI and risk perceptions. However, marked overestimation of risks persisted. Decrease in STAI and risk perceptions was significantly less pronounced in affected versus unaffected counselees. The majority of counselees were (very) satisfied about the extent to which their needs were addressed, albeit about one-fifth were not regarding emotional matters and explanations about their own cancer risk. Finally, the better counselees perceived their needs to be fulfilled, the significantly higher their PPC and the significantly lower their STAi scores were. Findings suggest that both unaffected and affected counselees should be counseled carefully. Also, a more effective service may be attained if counselors pay more attention to counselees' emotional needs and detail more inheritance and penetrance of mutated genes in relation to counselees' family history.

Adolescent↗

PubMed2006

Nuclear addressing provides a clue for the transforming activity of amino-truncated CCN3 proteins.

CCN3 is a founding member of the CCN (Cyr61, Ctgf, Nov) family of cell growth and differentiation regulators. These secreted proteins are key regulators in embryonic development, and are associated with severe pathologies including fibrotic diseases and cancers. CCN3 was discovered as a MAV integration site in an avian nephroblastoma. Previous work established that the amino-truncated protein expressed in this tumor was inducing morphological transformation of chicken embryo fibroblasts, whereas the full-length secreted CCN3 protein was inhibiting cell growth. Amino-truncated variants were identified in cancer cell lines. Since the lack of signal peptide was expected to alter the fate of the truncated proteins, we hypothesized that modifications of CCN3 subcellular addressing could be responsible for the oncogenic activities of CCN3. The CCN proteins are composed of four structural modules (IGFBP, TSP1, VWC, and CT). We report that amino-truncated variants of CCN3 are addressed to the nucleus and that the carboxyterminal (CT) module of CCN3 is responsible for the nuclear addressing. Furthermore, our data identify nuclear CCN3 variants as potential transcriptional regulators. In this context, the CT module confers on nuclear CCN3 proteins a negative regulatory effect on transcription. We propose that the nuclear localization of amino-truncated CCN3 proteins be correlated to oncogenicity.

Animals↗

PubMed2001

Playing it safe: addressing the emotional and physical health of lesbian and gay pupils in the U.K.

Compared to young people in general, young lesbians and gay men can face specific challenges to their physical and emotional well-being. These include discrimination, victimization, homophobic bullying and an elevated suicide risk. Relative to initiatives which attempt to address bullying in general, little has been done in schools in the U.K. to address physical and verbal homophobic bullying. This paper reports on an exploratory study to examine teachers' perceptions of homophobic bullying, the responses made to this form of bullying, and the factors which impact on the provision of education and support to lesbian and gay pupils. Findings suggested that teachers were aware of homophobic bullying but were confused, unable or unwilling to address the needs of lesbian and gay pupils. Implications for policy, practice and research are discussed. While current U.K. Government policy promoting Healthy Schools and Citizenship education offers hope for the future, much remains to be done to ensure that such initiatives are inclusive of all pupils.

Female↗

PubMed2005

Formative evaluation of home visitors' role in addressing poor mental health, domestic violence, and substance abuse among low-income pregnant and parenting women.

OBJECTIVES: This research assessed home visitor effectiveness in communicating about and responding to poor mental health, domestic violence, and substance abuse among pregnant and parenting women home visited as part of a comprehensive family support strategy in seven urban communities. METHODS: Cross-sectional studies were conducted with mothers (n = 189) actively engaged in home visitation programs and home visitors (n = 45). Maternal interviews assessed need for and receipt of mental health, domestic violence, and substance abuse services, and home visitor discussion of these risk areas. Home visitor surveys assessed perceived adequacy of training and personal effectiveness in addressing these risk areas. RESULTS: Over half of mothers needed mental health, domestic violence, or substance abuse services; however, only 27% of mothers in need of service received services. Most mothers reported having communicated with their home visitor about the three risk areas, but there were no differences in communication frequency based on whether services were needed. Most home visitors perceived themselves as effective in communicating about and responding to these risk factors but rated the training they had received in these areas as less than adequate. CONCLUSIONS: Home visitors could benefit from more intensive training in the formal assessment of risks and the protocols for communication about those risks with their clients. Home visitors could also receive support from and work in collaboration with professionals in addressing client risks. Further research on home visit content is needed to determine which strategies facilitate home visitors' ability to effectively communicate about and address client risks.

Baltimore↗

PubMed1991

Dermenkephalin and deltorphin I reveal similarities within ligand-binding domains of mu- and delta-opioid receptors and an additional address subsite on the delta-receptor.

Dermorphin (Tyr-D-Ala-Phe-Gly-Tyr-Pro-Ser-NH2), dermenkephalin (Tyr-D-Met-Phe-His-Leu-Met-Asp-NH2) and deltorphin I (Tyr-D-Ala-Phe-Asp-Val-Val-Gly-NH2) are the first naturally occurring peptides highly potent for and almost specific to the mu- and delta-opioid receptors, respectively. The amino-terminal domains Tyr-D-X-Phe (where X is either Ala or Met) of these peptides behave as selective and potent mu-receptor ligands. Routing of Tyr-D-X-Phe to the delta- or the mu- receptor is associated with the presence or the absence at the C-terminus of an additional hydrophobic and negatively charged tetrapeptide by-passing the mu-addressing ability of the amino-terminal moiety. A study of 20 Tyr-D-X-Phe-Y-NH2 analogs with substitution of X and Y by neutral, hydrophobic, aromatic amino acids as well as by charged amino acid residues shows that tetrapeptides maintain high binding affinity and selectivity for the mu-opioid receptor. Although residue in position 4 serves a delta-address function, the tripeptide motif at the C-terminus of dermenkephalin and deltorphin I are critical components for high selectivity at delta-opioid receptor. Results demonstrate that mu- and delta-opioid receptors share topologically equivalent ligand-binding domains, or ligand-binding sequences similarities, that recognized Tyr-D-X-Phe as a consensus message-binding sequence. The delta-receptor additionally contains a unique address subsite at or near the conserved binding domain that accommodates the C-terminal tetrapeptide motif of dermenkephalin and deltorphin I.

Amino Acid Sequence↗

PubMed1990

Fate of incorrectly addressed mailed questionnaires.

Mail surveys are a widely used and often inexpensive method for conducting epidemiologic studies, but may suffer from poor response rates. Some of this nonresponse may be due to letters that never reach study subjects rather than nonparticipation. We mailed letters to invalid addresses and to fictitious occupants at valid addresses in order to determine the proportion of letters that were not returned to us by the postal service as undeliverable. All letters mailed to invalid addresses were returned, whereas 13.3% (95% Cl 2.0-24.7%) of letters sent to fictitious occupants were not. Because some undeliverable mail is not returned, investigators may erroneously assume nonresponse for some subjects who never have the opportunity to participate.

Epidemiologic Methods↗

PubMed1998

Obstacles to addressing professional misconduct.

The Ethical Principles exhort psychologists "to encourage ethical behavior by students, supervisees, employees, and colleagues, as appropriate" (American Psychological Association, 1992, p. 1599). In spite of a clear directive to attempt resolution of unethical conduct by colleagues, research indicates that satisfactory resolution or actual reporting of misconduct is infrequent. This paper will address some of the forces that discourage psychologists from dealing responsibly and appropriately with professional misconduct by colleagues. The goals of this paper are to promote understanding of factors that interfere with the effective resolution of ethical misconduct, to identify possible signs of reluctance to address misconduct, and to propose strategies to combat those forces that keep us in silent collusion with colleagues who engage in unethical practices. A flowchart of steps for addressing possible misconduct by a colleague is provided, and educational, organizational, and professional considerations are discussed.

Awareness↗

PubMed2001

Electrical properties of a light-addressable microelectrode chip with high electrode density for extracellular stimulation and recording of excitable cells.

A light-addressable microelectrode chip with 3600 TiN electrodes was fabricated. Amorphous silicon (a-Si:H) serves as a photo conductor. The electrodes on the chip are addressed by a laser spot and electrical properties of the system are determined. DC measurements show a dark to bright dynamic of 10(6)-10(7). The AC impedance dynamic @ 1 kHz/100 mV and thus the signal-to-noise-ratio is determined to 60. This value is quite sufficient for electrophysiological measurements. For the first time, recordings from cardiac myocytes are reported using the principle of light-addressing. Measurements were done with a standard laser scan microscope (Zeiss LSM 410).

Electric Stimulation↗

PubMed2003

Hyperresolving phase-only filters with an optically addressable liquid crystal spatial light modulator.

Hyperresolving (sometimes called 'superresolving' or 'ultraresolving') phase-only filters can be generated using an optically addressable liquid crystal spatial light modulator. This approach avoids the problems of low efficiency, and coupling between amplitude and phase modulation, that arise when using conventional liquid crystal modulators. When addressed by a programmed light intensity distribution, it allows filters to be changed rapidly to modify the response of a system or permit the investigation of different filter designs. In this paper we present experimental hyperresolved images obtained using an optically addressable parallel-aligned nematic LCD with two zone Toraldo type phase-only filters. The images are compared with theoretical predictions.

Diagnostic Imaging↗