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PubMed2006

Molecular network and chromosomal clustering of genes involved in synaptic plasticity in the hippocampus.

Gene transcription is required for establishing and maintaining the enduring form of long term potentiation (LTP). However, the transcriptome and its associated molecular programs that support LTP are not well understood. The purpose of this study was to identify activity-regulated genes (ARGs) and their molecular pathways that are modulated by LTP induction and to investigate the genomic mechanism for coordinating the transcription of ARGs. We performed time course DNA microarray analyses on the mouse dentate gyrus to determine the temporal genomic expression profiles of ARGs in response to LTP-inducing tetanic stimulation. Our studies uncovered ARGs that regulate various cellular processes, including the structure and function of the synapse, and offered an overview of the dynamic molecular programs that are probably important for LTP. Surprisingly, we found that ARGs are clustered on chromosomes, and ARG clusters are conserved during evolution. Although ARGs in the same cluster have apparently different molecular properties, they are functionally correlated by regulating LTP. In addition, ARGs in specific clusters are co-regulated by the cAMP-response element-binding protein. We propose that chromosomal clustering provides a genomic mechanism for coordinating the transcription of ARGs involved in LTP.

Animals↗
PubMed1984

Women's program impact on village women's contraceptive and reproductive behavior in rural Bangladesh.

The author examines the impact on contraceptive and reproductive behavior of a social program designed to teach trade skills and family planning to women in rural Bangladesh. The focus is on "whether a social program that is designed to use a particular group as catalysts brings about any change in [the] contraceptive and reproductive behaviour of the community that is indirectly exposed to the program." A sample of 625 women indirectly exposed to the program and 312 women from non-program, control villages were interviewed; baseline data are from the 1976 Bangladesh Fertility Survey. It is found that "the indirectly exposed and unexposed women are very similar in their contraceptive and reproductive behaviour. The impact of the directly exposed women (trained women) in family planning was trivial even after three years of program operation. Socio-economic and demographic characteristics of both the groups are also similar....The current use among the indirectly exposed women was only 12% as compared to 10% for the unexposed women."

Asia↗
PubMed1998

Saving mothers' lives: things can go wrong.

One of the goals of Sierra Leone's primary care programme, established in the 1980s, was to reduce maternal mortality by 30% by the end of the twentieth century, but no significant progress has been made in this direction. The reasons are examined below in the light of a study conducted in one of the country's Chiefdoms.

Culture↗
PubMed2002

China's family planning policy: an overview of its past and future.

This article provides a broad overview of China's family planning policy during the last three decades, highlighting key trends and goals of the program at national and provincial levels. It focuses on the administrative, economic, cultural, and other factors that have helped or hindered the family planning effort and reviews the impact of the program on the provincial population. A key question is whether the policy of strict fertility control will remain relevant and enforceable as population growth slows, as controlling private life becomes increasingly problematic for the government, and as new demographic problems (for example, aging) emerge.

Adult↗
PubMed1991

Improving the cost-effectiveness of AIDS health care in San Juan, Puerto Rico.

In an era of decreasing availability of funds and increasing demand, the AIDS epidemic threatens to overwhelm health-care services in some countries. We describe a comprehensive model for the treatment of AIDS in San Juan, Puerto Rico, and compare it with traditional hospital-based services. Given the existing allocation of funds, the comprehensive model emphasised prevention, education, surveillance, early detection, and outpatient care to reduce hospital care. In 1987, the last year of the traditional system, there were 95 admissions of AIDS patients to hospital, and in 1988, the first year of the comprehensive model, there were 100 admissions. The mean length of stay of AIDS inpatients was reduced from 22.3 days in 1987 to 11.3 days in 1988, a 46.8% reduction (p = 0.001). The annual mean (SE) cost of inpatient care per AIDS patient fell from $15,118 (1699) in 1987 to $3869 (659) in 1988. Savings were used to improve non-hospital services, including outreach, education, emergency and outpatient care, laboratory and epidemiological services, and research, and to introduce an employee incentive scheme. Management strategies that reduce the length of inpatient care and provide less costly treatment alternatives can improve AIDS health care in developing nations.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Short-term impact of safer choices: a multicomponent, school-based HIV, other STD, and pregnancy prevention program.

This study evaluated the effectiveness of the first year of Safer Choices, a theoretically based, multicomponent HIV, STD, and pregnancy prevention program for high school youth. The study featured a randomized trial involving 20 schools in California and Texas, with a cohort of 3,869 ninth-grade students. Students who completed both the baseline and the first follow-up survey approximately seven months later were included in the analysis (n = 3,677). Safer Choices enhanced 9 of 13 psychosocial variables including knowledge, self efficacy for condom use, normative beliefs and attitudes regarding condom use, perceived barriers to condom use, risk perceptions, and parent-child communication. Safer Choices also reduced selected risk behaviors. Specifically, Safer Choices reduced the frequency of intercourse without a condom in the three months prior to the survey, increased use of condoms at last intercourse, and increased use of selected contraceptives at last intercourse.

Adolescent↗
PubMed1993

Adolescent mothers and repeated childbearing: effects of a school-based intervention program.

This study examined the effectiveness of a public school program for pregnant teenagers in preventing rapid repeated childbearing. Students permitted to attend longer than seven weeks postpartum were much more likely to avoid having another child in the next five years than were students required to return to their regular schools. The results indicate the potential of school-based programs to improve life outcomes for adolescent mothers and their children.

Adolescent↗
PubMed2004

Educating social workers to meet the challenge of an aging urban population: a promising model.

As Americans live longer, they will require more health and social services to address the onset of acute and chronic conditions. The persistent changes in health care delivery and the increasingly diverse older adult population in urban settings, coupled with the high expectation for families to be responsible for home care needs, challenge social workers, who work alongside physicians, nurses, and other health care professionals, to provide services effectively. Because social workers are becoming more essential, social work education must increase the numbers of social workers with the knowledge and skills necessary for practice in the current U.S. health, mental health, and social service systems, particularly in caring for the aging populations in urban settings. A New York Academy of Medicine study identified the need for increased synergy between the two components of graduate social work education: the field experience and classroom instruction. One educational model, the Practicum Partnership Program, which is designed to better integrate field and classroom, is being tested at six sites. Early results from over 300 graduates are encouraging, with evidence that students' knowledge and skills regarding aging adults have increased, their satisfaction with the experience was very high, and those who were trained reflect the diversity of the population of older adults. The early success of this program suggests that innovative educational models that expose graduate social work students to diverse populations across the continuum of care are possible. Such models will be essential for the nation to be successful in producing a social work labor force qualified to meet the challenge of an aging urban population.

Aged↗
PubMedDate not supplied

Using randomized designs to evaluate client-centered programs to prevent adolescent pregnancy.

CONTEXT: Interventions to prevent adolescent pregnancy (primarily curriculum-based programs) have not produced convincing evidence as to their success. Moreover, many evaluation approaches have been inadequate to assess program effectiveness. Therefore, rigorous evaluation of different kinds of interventions may help identify potentially effective strategies to prevent adolescent pregnancy. METHODS: An experimental design, in which clients were randomized to treatment and control groups, was used to evaluate the effects of a "client-centered" approach to reducing pregnancy among high-risk young people in seven communities in Washington State. Four projects served 1,042 youth (clients aged 9-13), and three served 690 teenagers (primarily clients aged 14-17). Projects offered a wide variety of services tailored to individual clients' needs, including counseling, mentoring and advocacy. RESULTS: On average, clients in the treatment group at youth sites received 14 hours of service, and their teenage counterparts received 27 hours; controls received only 2-5 hours of service. At one youth site, clients were less likely to intend to have intercourse after the intervention than before; at another, they became less likely to intend to use substances. Clients at one teenage project reported reduced sexual behavior and improved contraceptive use after receiving services; teenagers at another site reported reduced sexual intentions and drug use, and a greater intention to use contraceptives. The programs showed no other effects on factors that place young people at risk of becoming pregnant, including their sexual values and educational aspirations, communication with their parents (measured at youth sites only), and sexual and contraceptive behavior (assessed for teenagers only). CONCLUSIONS: High-risk clients likely need considerably more intervention time and more intensive services than programs normally provide. Rigorous evaluation designs allow continued assessment that can guide program modifications to maximize effects.

Adolescent↗
PubMed1989

School-based clinic use and other factors affecting adolescent contraceptive behavior.

Adolescent risk taking, preventive behavior, and contraceptive use were investigated using a self-administered questionnaire in a sample of 260 inner-city high school students targeted by a school-based health clinic. Multivariate models consisting of individual and environmental variables significantly predicted sexual activity and contraceptive use. Older age at first intercourse, higher number of welfare benefits received by the household (including Medicaid, food stamps, and free or reduced price lunch), and use of the school-based clinic were significant positive predictors of more frequent contraceptive use by adolescents. Results of our study suggest that programs may be having some success in encouraging and enabling sexually active adolescents to use contraception and to use it more consistently. Rigorous program evaluations should help program planners and policy makers design and refine adolescent pregnancy-prevention efforts.

Adolescent↗
PubMed2002

[Are new data collection systems needed to achieve public health and research goals for the prevention of suicide?].

Evaluation of suicide prevention programs, both on the local and national level, is a methodological challenge. In September 2000, France initiated a nation program for suicide prevention. But, as was noted in the Prémutan report and more recently the FNORS report, very few of the hundreds of preventive measures taken annually are evaluated. In addition to this assessment challenge, new data, particularly concerning the different phases of the suicide process, are needed to design new programs, define their objectives with precision, and assure their implementation. For example, if the objective is to improve prevention in men aged 25-54 years who suffer from a state of depression, alcohol abuse, impulsive personality disorders, and life events implicating loss, the necessary information is currently unavailable or sparse. The lack of data and research in this domain can be grouped into several categories: lack of proper definition and quantification of the objectives; insufficient study of the mechanisms by which prevention measures are effective: lack of monitoring tools providing information on the rate of implementation of planned actions. These arguments demonstrate the need for collecting new information to develop a dynamic prevention program. Such data collection should be synchronized, conducted by a wide range of actors, and concern multiple actions. Without a coherent information system, it is doubtful the current impetus for the prevention of suicide can be sustained.

Adult↗
PubMedDate not supplied

Small-area analysis: targeting high-risk areas for adolescent pregnancy prevention programs.

CONTEXT: Traditional methods of identifying areas in need of adolescent pregnancy prevention programs may miss small localities with high levels of adolescent childbearing. METHODS: Birthrates for 15-17-year-olds were computed for all California zip codes, and the zip codes with birthrates in the 75th percentile were identified. Panels of local experts in adolescent pregnancy reviewed these "hot spots" for accuracy and grouped them into potential project areas, based on their demographics, geography and political infrastructure. RESULTS: In all, 415 zip codes exceeded the 75th-percentile cut-off point of 62.8 births per 1,000, and 210 of them differed significantly from the state average of 44.5 per 1,000 for 15-17-year-olds. While all had high adolescent birthrates, they varied greatly in racial and ethnic mix, poverty and educational attainment, and certain perinatal measures such as inadequate prenatal care and repeat pregnancy. CONCLUSIONS: The use of zip code-level data holds promise for more effective program planning and intervention.

Adolescent↗
PubMed1981

Adaptation to peripheral muscle training.

Ten healthy subjects underwent a 6-week dynamic exercise program designed to put a high relative load on individual muscle groups while maintaining low central circulatory stress levels. This was done to test the hypothesis that such "peripheral" training could produce skeletal muscle adaptation at low levels of myocardial work. Such a program may be useful in rehabilitating patients whose myocardial disease prevents adequate levels of participation in the traditional types of large muscle training. Strength testing, muscle biopsies and both submaximal and maximal bicycle ergometry were done to assess the effects of "peripheral" training. Heart rate during the training sessions decreased progressively over the 6 weeks (p less than 0.001). Quadriceps strength increased (p less than 0.02) with training as did both quadriceps (p less than 0.03) and gastrocnemius (p less than 0.008) fiber areas. Fiber composition was unchanged. Succinic dehydrogenase concentrations were unchanged while phosphorylase activity decreased in both muscle groups (p less than 0.03). Submaximum and maximum bicycle ergometry results were unchanged with training. The data show that dynamic training of small groups of muscles sequentially can produce significant skeletal muscle adaptation with little central circulatory stress. The effects of "peripheral" training in cardiac patients remain to be determined.

Adaptation, Physiological↗
PubMed1989

The transmigration programme in Indonesian national development strategy: current status and future requirements.

The author reviews the Indonesian transmigration program. He notes that over four million people moved in the period from the program's 1904 inception through mid-1986. "Despite considerable success the programme has been plagued by numerous problems. These include inadequate income levels, improper site selection, poor matching of settlement models to the specific sites, environmental deterioration, migrant adjustment, land conflicts and financing." Current efforts to improve existing settlements, encourage spontaneous migraton, and involve the private sector are also described.

Asia↗
PubMed1988

A focus group study of sexually active black male teenagers.

This is a report of a focus group study conducted by the National Institute for Adolescent Pregnancy and Family Services at Temple University. It presents in detail how the study was carried out and relevant findings from the transcripts of sessions held with a group of sexually active teenage males, including excerpts from the transcripts. Also included are the characteristics of the participants and a summary of the services they requested from a model adolescent pregnancy prevention and care program.

Adolescent↗
PubMed2000

Detection of linear and nonlinear dependencies in time series using the method of surrogate data in S-PLUS.

A general implementation of the method of surrogate data in the S programming language for use with the S-PLUS statistical package is presented. We illustrate the application of the S functions to testing hypotheses about a human heart rate time series and demonstrate that there is evidence for both linear and nonlinear dependencies. We expect these S functions will be useful for the application of the method of surrogate data to the analysis of biomedical time series using the S-PLUS statistical software package.

Data Interpretation, Statistical↗