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PubMed1994

Predicting protein function: a versatile tool for the Apple Macintosh.

A tool is presented that helps to find biological functions for new protein sequences. Running on any Macintosh computer system, MacPattern provides a unique combination of different algorithms, speed and user-friendliness. It supports searches for protein patterns using the PROSITE database, protein block searches with the BLOCKS database, and the identification of statistically significant protein segments. MacPattern allows batch processing of sequences and automatic translations of nucleotide sequence data. It is particularly suited for genome analysis or cDNA sequencing projects.

Algorithms↗
PubMed1986

Analysis of repeating oligonucleotide sequences in ribonucleic acids using an Apple II microcomputer.

A simple computer program has been developed to locate repeating subsequences of all possible lengths in a given nucleic acid. The observed number of repeats of subsequences was compared with the expected number of such repeats in several RNAs. The analysis showed that, in the case of rRNAs, there are no constraints in the choice of the fourth and the higher order nucleotides, while the selection is maximum at the level of nearest neighbour. This is, however, not true for RNAs coding for proteins, where the constraints are also found at the level of nucleotides containing five or more bases.

Algorithms↗
PubMed1991

Comparing apples and oranges: does cost-effectiveness analysis deal fairly with the old and young?

This paper considers the role patient age plays in the type of outcome analysis most germane for policymakers: cost-effectiveness analysis. The magnitude of age bias is quantified and means to modify it are described. In particular, present value analysis (discounting) is demonstrated to markedly attenuate the effect of patient age on cost-effectiveness analysis. As the discount rate gets larger, the difference in potential "life-years" between old and young gets smaller and the age bias is minimized. However, relegating a decision about the importance of patient age to a decision about the discount rate seems inappropriate. Value judgments cannot be avoided; therefore, it is best that they be explicit.

Adolescent↗
PubMed2003

Assisted living and nursing homes: apples and oranges?

PURPOSE: The goals of this study are to describe the current state of residential care/assisted living (RC/AL) care and residents in comparison with nursing home (NH) care and residents, identify different types of RC/AL care and residents, and consider how variation in RC/AL case-mix reflects differences in care provision and/or consumer preference. DESIGN AND METHODS: Data were derived from the Collaborative Studies of Long-Term Care, a four-state study of 193 RC/AL facilities and 40 NHs. Multivariate analyses examined differences in ten process of care measures between RC/AL facilities with less than 16 beds; traditional RC/AL with 16 or more beds; new-model RC/AL; and NHs. Generalized estimating equation models determined differences in resident case-mix across RC/AL facilities using data for 2,078 residents. RESULTS: NHs report provision of significantly more health services and have significantly more lenient admission policies than RC/AL facilities, but provide less privacy. They do not differ from larger RC/AL facilities in policy clarity or resident control. Differences within RC/AL types are evident, with smaller and for-profit facilities scoring lower than other facilities across multiple process measures, including those related to individual freedom and institutional order. Resident impairment is substantial in both NHs and RC/AL settings, but differs by RC/AL facility characteristics. IMPLICATIONS: Differences in process of care and resident characteristics by facility type highlight the importance of considering: (1) the adequacy of existing process measures for evaluating smaller facilities; (2) resident case-mix when comparing facility types and outcomes; and (3) the complexity of understanding the implication of the process of care, given the importance of person-environment fit. Work is continuing to clarify the role of RC/AL vis-à-vis NHs in our nation's system of residential long-term care.

Aged↗
PubMed2003

Oversight of nursing homes: pruning the tree or just spotting bad apples?

PURPOSE: This study investigated whether higher rates of nursing home quality citations are associated with increased risk of voluntary and involuntary facility terminations from the Medicare/Medicaid certification process. DESIGN AND METHODS: We examined nationwide Online Survey Certification and Reporting (OSCAR) data from 1992 through 2000 and used a multinomial logistic regression model with time-varying covariates to estimate the relationship between nursing home deficiencies and terminations. RESULTS: In the study period, 8.7% of nursing homes voluntarily terminated and 2.4% of facilities were involuntarily terminated. Deficiencies significantly predicted both types of termination, controlling for state and market characteristics. Low occupancy and very high Medicaid mix were strongly related to voluntary and involuntary terminations (p <.05). IMPLICATIONS: Nursing homes that receive a high number of deficiencies exit the Medicare/Medicaid market and have lower occupancy rates before termination, although the relationship varies considerably across states. If competition on the basis of quality is increased because of public reporting efforts, our analyses suggest that terminations, both voluntary and involuntary, will likely increase.

Certification↗

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