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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

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

SEQPWR and SEQOPR: computer programs for design of maximum information trials based on group sequential logrank tests.

The maximum information trial paradigm for clinical trials with failure time data was recognized and has been investigated. With the maximum information trial paradigm, a study is concluded when a prespecified maximum number of events of interest, thus maximum information, has been accrued if there was no early stopping due to treatment difference or lack thereof. We present two interactive FORTRAN programs for use in designing maximum information trials based on group sequential logrank tests. The program SEQPWR computes the attainable power of group sequential logrank tests given the combinations of the accrual and follow-up durations. The program SEQOPR allows the users to investigate the operating characteristics of the maximum information trial given the information fractions of interim analyses. A clinical trial from the Eastern Cooperative Oncology Group is provided to illustrate the usage and features of the programs.

Algorithms

Primer design for large scale sequencing.

We have developed PRIDE, a primer design program that automatically designs primers in single contigs or whole sequencing projects to extend the already known sequence and to double strand single-stranded regions. The program is fully integrated into the Staden package (GAP4) and accessible with a graphical user interface. PRIDE uses a fuzzy logic-based system to calculate primer qualities. The computational performance of PRIDE is enhanced by using suffix trees to store the huge amount of data being produced. A test set of 110 sequencing primers and 11 PCR primer pairs has been designed on genomic templates, cDNAs and sequences containing repetitive elements to analyze PRIDE's success rate. The high performance of PRIDE, combined with its minimal requirement of user interaction and its fast algorithm, make this program useful for the large scale design of primers, especially in large sequencing projects.

Algorithms

Dance for health: improving fitness in African American and Hispanic adolescents.

Cardiovascular disease begins early in life but might be prevented or delayed by primary prevention programs designed for children and adolescents. Regular physical activity is an important part of primary prevention programs, and school physical education programs have potential for the promotion of regular physical activity. Cardiovascular disease is the major cause of death among Hispanics and African Americans in the United States. Low levels of fitness and increased body mass index are common in African American and Hispanic adolescents. Increased physical activity and the adoption of healthy eating habits would increase fitness and reduce body mass index among these adolescents. The purpose of the study was to undertake a small-scale controlled trial to determine if Dance for Health, an intervention program designed to provide an enjoyable aerobic program for African American and Hispanic adolescents, has a significant effect on improving aerobic capacity, helping students maintain or decrease weight, and on improving attitudes toward physical activity and physical fitness. In the first year of the program (1990-91), approximately 110 boys and girls ages 10-13 years participated in an aerobic dance pilot program three times per week for 12 weeks. Dance for Health was revised and continued in the 1992-93 school year with seventh grade students and an added culturally sensitive health curriculum. Forty-three students were randomized to Dance for Health and 38 to usual physical activity. Those in the intervention class received a health education curriculum twice a week and a dance oriented physical education class three times a week. The usual physical activity consisted mostly of playground activities. Students in the intervention had a significantly greater lowering in body mass index and resting heart rate than students in regular physical activity.

Adolescent

ICWU cancer control education and evaluation program: research design and needs assessment.

The International Chemical Workers Union is implementing a 3-year nationwide field experiment in cancer prevention education. The educational program includes three stages: generalized cancer control education, education tailored to each local union, and an interactive monitoring system designed to provide ongoing communication and reinforcement for desired cancer control behaviors among local unions and their members. These alternative educational approaches will be systematically evaluated using a randomized factorial study design involving more than 120 local unions. The need for such a program is demonstrated by the results of a needs assessment survey of 690 union members. Respondents expressed strong concern regarding possible carcinogen exposures at the work site, combined with generally low ratings of co-worker knowledge of and adherence to appropriate cancer control behaviors. Engineering controls and personal protective equipment were reported to be inadequate in many work sites.

Attitude to Health

The role of designated driver programs in the prevention of alcohol-impaired driving: a critical reassessment.

We review the "designated driver" concept and the current debate over its role in preventing alcohol-impaired driving. In our view, the focus on this strategy by broadcasters, the alcohol industry, and various public service groups has deflected attention from other alcohol-related problems that account for the vast majority of deaths and injuries associated with alcohol use. This focus has also distracted many public health advocates and policymakers from the bigger and more important jobs of increasing public awareness of the social, environmental, and economic factors that influence alcohol consumption and promoting debate on legislation and other public policy solutions to alcohol-impaired driving. As part of a comprehensive strategy, we strongly encourage a renewed focus on "sobriety checkpoints," strict enforcement of laws against alcohol sales to minors, alcohol advertising reform, increased excise taxes, and other public policy initiatives supported by the Surgeon General. These measures will curb underage and heavy alcohol consumption and will create a legal and social environment in which individuals are motivated to avoid impaired driving through several alternative strategies, including but not limited to the use of designated drivers.

Accidents, Traffic

A model for the improvement of medical faculty lecturing.

The development of a program designed to improve the teaching effectiveness of faculty members of a new Introductory Psychopathology course at the University of Washington School of Medicine is described. Two consultants from the Office of Research in Medical Education worked closely with the faculty in designing the evaluation program during the preparation of the course. The literature on lecture effectiveness is reviewed, as are existing instructional evaluation instruments. The integration of this information and the needs of the involved faculty produced a lecture observation schedule designed to facilitate the observation of a lecture and the immediate feedback which followed each of the 15 lectures evaluated. The process of using this instrument to assist the faculty in self-improvement is discussed. While the specific evaluation method described may not be appropriate for all situations, it may serve as a model for the development of similar programs in other settings.

Evaluation Studies as Topic

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

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

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

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

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

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

[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

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

[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