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PubMed1988

Regen: program for designing gene assembly.

One of the main problems in constructing synthetic genes is the incorrect hybridisation between the oligonucleotides. The problem is resolved if the sequence uniquely defines the position of the oligonucleotide in the assembled gene. This can be accomplished through the wise partition of dsDNA sequence in the fragments. We describe a program for use in designing such gene assembly. For a given DNA sequence and the approximate location of oligonucleotide boundary it generates all sets of protruding ends that share the smallest homology.

Algorithms↗
PubMed1991

Occupational therapy in the Department of Veterans Affairs: focus on health care of the elderly veteran.

The Department of Veteran Affairs (VA) operates the largest integrated health care system in the world (VA, 1989), with designated departments and programs designed to meet the long-term care needs of the aging veteran. Occupational therapy is an important intervention to maximize the quality of life of older persons. Because of the increasing number of aging veterans and the national shortage of occupational therapists, the VA has been devising programs to recruit and retain occupational therapists in VA medical centers. The combination of long-term care programs and the VA's commitment to ongoing research, education, and occupational therapy services points to a promising outlook for care of our aging veterans.

Aged↗
PubMed1993

A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies.

Walking is an ideal physical activity for patients with osteoarthritis because it can help to improve functional status without exacerbating pain or necessitating an increase in the use of medication. Although patient education programs designed to encourage walking have become increasingly important in the management of this condition, there is no single synthesis or other published source of theory and intervention strategies to guide the practitioner in the development of such programs. This paper describes a hospital-based patient education program designed to enhance the functional capacity of who have osteoarthritis of the knee by encouraging the adoption and maintenance of walking. The paper describes the goals, objectives, process, and impact of the program; the principal theoretical model utilized in the design of the program; and how concepts and intervention strategies from the literatures on patient compliance and patient education, exercise compliance, behavioral psychology, and relapse prevention have been operationalized and integrated in a walking program that we have evaluated for safety and efficacy.

Adult↗
PubMed1997

Process surveillance: an epidemiologic challenge for all health care organizations.

Historically, qualitative and quantitative monitoring of patient care practices related to infection control may have been only marginally correlated with findings of nosocomial infection surveillance. More recent developments in health care have included an emphasis on "outcome management," as well as an enthusiasm for applying industrial process improvement methods. Health care organizations may choose to incorporate process surveillance as an adjunct to or a surrogate for outcome measurement. An essential characteristic of a well-designed process surveillance program is a direct relationship with clearly articulated and logically prioritized outcome objectives. To optimize value and efficacy, the program design should be consistent with the organizational strategic plan and sensitive to the needs of members of the health care team to which the data would be reported. Process data must be objectively and consistently measurable, feasible to collect, and, ideally, expressed as rates or ratios to support valid comparative analyses. Infection control professionals should approach development of process surveillance systems with a logical and organized construct.

Documentation↗
PubMed1983

Intervention approaches to conduct disorders in young children.

The scope of the problem in regard to childhood aggression or conduct disorders is large and far exceeds the resources for dealing with them. Moreover, such children are at high risk for developing serious adolescent and adult psychological problems. Nurse practitioners are placed in strategic positions to be able to screen for, identify and treat early signs of conduct disorders in young children. This review describes assessment procedures and the essential components of a parent training program designed to help families reduce childhood aggression. By intervening with families early, nurse practitioners may be able to design effective preventive programs and improve the prognosis for these children.

Adult↗
PubMed1994

An approach to preliminary studies of interlaboratory comparative results for estrogen and progesterone receptors.

Determining estrogen and progesterone (ER/PR) expression has clinical relevance in managing invasive breast carcinoma. Recent studies employing multivariate analyses which control for multiple factors have generally reaffirmed the role of ER and PR as prognostic determinants and management tools. Little information is available regarding the interlaboratory reproducibility of such testing in the clinical setting. Although ER/PR techniques based on cellular extracts have usually been used to make receptor determinations, immunohistological assays are gaining increasingly wider acceptance. The frequent admixture of non-neoplastic mammary parenchyma in tissue selected for ER and PR studies can yield false-positive results when using the cellular extraction assays, but are easily recognized with an immunohistological approach. Furthermore, specimen economy is preserved--particularly when formalin-fixed, paraffin-embedded material is used for the immunohistological assay, an important issue as more small tumors are excised. The College of American Pathologists Cell Markers Resource Committee provides clinical laboratory professionals an opportunity to compare results with peers and to participate in an immunohistology education program. Designing such a program for ER and PR immunohistological assays is presented.

Biomarkers, Tumor↗
PubMed1995

[Prevention of lung cancer through smoking control activities in Japan].

Three kinds of smoking cessation programs have been developed by the Osaka Cancer Prevention and Detection Center. The first program is "Smoking Quit Contest," in which self-help materials are mailed to applicants and prizes are given by lot to those who succeed in quitting. The second program is a "Smokebusters" smoking cessation program designed for outpatients. The third program is designed for people undergoing screening during routine health check-ups, which are widely conducted in communities and workplace in Japan. To reduce lung cancer mortality in Japan, smoking cessation programs such as those described here should be widely implemented and the prevalence of smoking among men in Japan should be reduced at least to the levels in the U.S. and in western Europe.

Female↗
PubMed1996

Organizing Asian Pacific Islanders in an urban community to reduce HIV risk: a case study.

We present a case study of community organization efforts within the Asian Pacific Islander communities of San Diego County to reduce the risk of HIV transmission. We utilized a five-phase process to implement the strategies of locality development, social planning, and social action: community analysis, program design and initiation, program implementation, program maintenance and consolidation, and program reassessment. An evaluation of the process indicates that there were increases over time in the project's activities as well as in the levels of interagency connectedness. This is one of the few reported efforts to organize Asian Pacific Islander groups to address HIV transmission. Key elements that led to the successful organization of the original project into a tax-exempt nonprofit entity (the Asian Pacific Islander Community AIDS Project) were emphasis on community ownership, reliance on group consensus, use of "gatekeepers" to access communities, simultaneous multilevel programming, and service to the community as a "coordinating" entity.

Acquired Immunodeficiency Syndrome↗
PubMed1997

[Contraception in adolescents included in a family planning program].

OBJECTIVE: To describe the motives of consultation, kinds of contraceptive methods and side-effects of oral contraceptives (OCs) in adolescent users of a family planning program. DESIGN: Family planning program at the District Primary Care Unit, Cádiz, Spain. PATIENTS: 283 adolescent females who requested attendance in a family planning program from January 1993 until January 1994. MEASUREMENTS AND MAIN RESULTS: A medical history of every adolescent was carried out and every patient was examined. Those who were recommended the use of OCs passed through 3 controls: at the beginning, after the 6th month and after 1 year. These controls consisted in recording sexual risk behaviours as well as several analytic tests. RESULTS: Most adolescents requested the prescription of contraceptive methods (81.7% of the most prescribed and demanded methods were OCs). We found no serious side-effects after 1 year, so we can conclude that OCs are an usefull contraceptive choice for sexually active adolescents because of its security, acceptance and easy use.

Adolescent↗
PubMed1983

Comprehensive primary care at the neighborhood level: an Israeli experiment that failed.

This paper is an analysis of the first stage of a demonstration program designed to integrate within neighborhood clinics various health and welfare services that were previously provided separately. The program included the active participation of quasi-public, governmental, private, philanthropic, and university institutions. The purpose here is to understand the failure to achieve the original goals and purposes. The analysis takes an organizational perspective, and should contribute to a better understanding of why programs designed to change existing service-delivery systems are inclined to fail. Although this is a case-study of a demonstration program in Israel, the findings should have relevance and interest for academicians and professionals in other countries.

Community Health Centers↗
PubMed1994

DESIGN: a guide to protein crystallization experiments.

Existing guidelines for crystallizing proteins generally require substantial amounts of protein and scarce laboratory resources. To address this problem we have developed the program DESIGN, which, suited to daily laboratory usage, utilizes statistics when screening variables of crystallization. The program DESIGN is described in considerable detail and examples of its outcome and capabilities are shown. In addition, a new scoring scale for crystallization trials is described. It is expected that the use of such an approach may provide additional constraints toward crystallizing the protein, even if the conditions applied are not successful.

Calmodulin↗
PubMed1996

A randomized study of the efficacy of the PROPATH Program for patients with Parkinson disease.

OBJECTIVES: To assess (1) the effects of the PROPATH Program, a health management program designed for patients with Parkinson disease, on perceived general health and psychological well-being and satisfaction with medical care, (2) utilization of health care resources by patients with Parkinson disease, and (3) physician impressions of the PROPATH Program. DESIGN: Patients were randomized to receive either the PROPATH Program in addition to usual care or usual medical care only. All patients and their physicians completed periodic questionnaires designed to assess the study variables. SETTING: Staff model health maintenance organization from June 1992 through June 1993. PATIENTS: Forty-six English-speaking patients diagnosed with Parkinson disease of Hoehn-Yahr stages I through IV. RESULTS: Enrollment in the PROPATH Program resulted in a statistically significant improvement in patient perception of general health and psychological well-being after 1 year. There was no significant difference in patient satisfaction with medical care or utilization of health care resources. The large majority of physicians did not find the PROPATH Program to be helpful for development of a treatment plan, management of the illness, identification of problems sooner than by usual treatment, or identification of drug side effects. CONCLUSIONS: The PROPATH Program may play a useful role in assisting patients to deal with the psychological aspect of Parkinson disease by improving perception of general health and psychological well-being. The program had no significant effect on patient satisfaction with medical care or medical resource utilization.

Aged↗
PubMedDate not supplied

Managed dental care in the HMO setting.

DHMOs are gaining in popularity, and are the fastest-growing dental managed-care product, primarily because of their ability to reduce premium and patient costs. Dentistry, because of the strong correlation between prevention and disease control, is more suited to a managed-care system than medicine. However, there remains a wide gulf between theory and practice, as the DHMO industry continues to evolve. Poorly designed programs will save money but create problems with patient satisfaction and unmet treatment needs. Well-designed programs use the principles of population management to bring large numbers of patients to maintenance oral health levels. In any event, the continuing growth and development of DHMOs will benefit patients, group purchasers, and the dentists who can understand and embrace the concepts of dentistry in the HMO environment.

Capitation Fee↗
PubMed1983

Program development and maternal-child health consultation: a conceptual model for role enactment in developing countries.

Increasingly, nurses are serving as consultants in designing programs to improve the health of individuals in developing countries. In order to be effective, such programs must reflect the socio-cultural context in which identified health problems occur. This can become problematic when nurses work as consultants in cultures with which they are unfamiliar. This paper proposes the use of the World Health Organization's risk strategy approach as a conceptual framework for developing culture specific programs in maternal-infant health. Suggested consultant role behaviors are articulated with this approach and the various phases of program development using an ongoing project in Juarez, Mexico to which the author has provided nursing consultation as a concrete example.

Child Health Services↗
PubMed1986

DIGICALC: a restriction fragment analysis program.

DIGICALC is a program designed to aid in the acquisition, storage, and analysis of nucleic acid restriction fragment data. The chief considerations during program design were (i) ease of use for people with varying degrees of computer experience, (ii) minimal hardware requirements (e.g. an IBM PC), (iii) portability and ease of modification, and (iv) improved functionality in sizing and comparing restriction fragments over manual methods. The program accepts manual or digitizer input of nucleic acid fragment mobility, calculates the fragments' sizes, and provides the means to search the fragment database and to produce charts of fragment sizes.

Base Sequence↗
PubMedDate not supplied

Low back pain: risk evaluation and preplacement screening.

As screening tests in a currently asymptomatic population, all of the available methods for predicting low back pain and disability have serious technical, ethical and legal limitations. From a technical point of view, none of the predictive tests appear to have sufficient sensitivity or specificity to justify routine usage. The most sensitive indicator (a past history of low back pain) lacks reliability and specificity. Muscle strength-testing may be predictive of future musculoskeletal injury as part of a well-designed program that considers specific job demands in relation to specific worker capabilities. Unfortunately, the conditions necessary for a well designed program--a large number of predictable high-risk jobs that have measurable specific demands that can be reproduced reliably in a testing situation--are rarely met. In the future, the use of computer-assisted multivariate models analogous to those used in the prediction of cardiovascular risk may be capable of integrating information about an individual's medical history, physical exam, physical capacity and other tests with specific job requirements to give us a more accurate prediction of the future risk of back pain and disability. If such predictive models are ever developed and verified, it would then be appropriate to examine various interventions and their effectiveness in modifying risks for the population and the individual worker. From a legal point of view, all of the techniques described hold potential for significant discrimination against legally protected groups. Making employment decisions with regard to a past history of low back pain or on the basis of an x-ray will lead to systematic age discrimination and discrimination against the handicapped. The use of muscle strength-testing will systematically discriminate against women and certain ethnic groups. The ethical implications of predictive screening for low back pain clearly depends on what is done with the information that is garnered from such tests. If the information is used only to make a safe job placement for an individual, and this placement does not affect the individual's salary or future job possibilities, then the testing program may have a net social value to the extent that it leads to true prevention of low back pain and disability. If the tests are used merely to reduce employer liability by refusing employment to those who are thought to be at "high risk," the technical, legal and ethical limitations will far outweigh any perceived benefits.

Back Pain↗
PubMed1990

Comparing nutrition programs conducted by public health and Cooperative Extension personnel.

We surveyed 218 county extension agents, 75 state extension specialists, 163 public health nutritionists, and 87 public health administrators in 16 states to compare the nutrition program characteristics of extension personnel with public health personnel. Public health personnel were most strongly influenced by funding regulations--more than 80% of public health nutritionists cited infant/preschool nutrition and nutrition for pregnant/lactating women as program topics. About half of the extension agents listed food preservation and preparation as the dominant topics provided. Public health personnel most frequently designed programs for pregnant and lactating women and low-income clientele; 91% of the nutritionists ranked one-to-one counseling as one of their three most important delivery methods. Extension personnel designed programs more often for homemakers/adults and youth and ranked a combination of group and media delivery methods as most important. Public health personnel use anthropometric measures and food intake records to evaluate their programs; extension personnel use written questionnaires and program records. More than 50% of the nutritionists ranked improving the health of their clients as one of the three most important impacts of their programs; more than 50% of the extension agents ranked increasing knowledge and improving skills as their most important impacts.

Dietary Services↗