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PubMed1991

Efficient computation of three-dimensional protein structures in solution from nuclear magnetic resonance data using the program DIANA and the supporting programs CALIBA, HABAS and GLOMSA.

A novel procedure for efficient computation of three-dimensional protein structures from nuclear magnetic resonance (n.m.r.) data in solution is described, which is based on using the program DIANA in combination with the supporting programs CALIBA, HABAS and GLOMSA. The first part of this paper describes the new programs DIANA. CALIBA and GLOMSA. DIANA is a new, fully vectorized implementation of the variable target function algorithm for the computation of protein structures from n.m.r. data. Its main advantages, when compared to previously available programs using the variable target function algorithm, are a significant reduction of the computation time, and a novel treatment of experimental distance constraints involving diastereotopic groups of hydrogen atoms that were not individually assigned. CALIBA converts the measured nuclear Overhauser effects into upper distance limits and thus prepares the input for the previously described program HABAS and for DIANA. GLOMSA is used for obtaining individual assignments for pairs of diastereotopic substituents by comparison of the experimental constraints with preliminary results of the structure calculations. With its general outlay, the presently used combination of the four programs is particularly user-friendly. In the second part of the paper, initial results are presented on the influence of the novel DIANA treatment of diastereotopic protons on the quality of the structures obtained, and a systematic study of the central processing unit times needed for the same protein structure calculation on a range of different, commonly available computers is described.

Algorithms↗
PubMed1990

Assistant programming software: a new tool for an improved programming of pacemakers.

Programming the new DDD pacemakers is becoming increasingly difficult. One must take into account the pacemaker's complexity, the fact that some parameters are linked to others, and the clinical profile of the patient. This difficult problem will lead to the design of software to assist programming, which will help the implanting physicians in choosing adequate programmed settings adapted to the functioning of the device and to the physiology and pathology of the patient. These programming aides should meet certain basic requirements to make them safe, efficient, and easy to use. One such system designed by ELA Médical, "Programming Assistant" is herein described. The preliminary results of an initial study on the acceptance of this programming aide among physicians involved in cardiac pacing are given and discussed.

Adult↗
PubMed1979

The four basic types of evaluation: clinical reviews, clinical trials, program reviews, and program trials.

Four basic types of evaluation, each appropriate in a distinctive situation, are the clinical review and the clinical trial, which are concerned with the care of the individual patient, and the program review and program trial, which deal with programs or services directed at groups or populations. Evaluative reviews are primarily motivated by concern with the welfare of the specific population served, and they appraise specific activities in specific settings as a basis for decisions concerning these activities. Clinical and program trials aim to generate knowledge of more general applicability, especially concerning causal relationships between care and outcomes. The types of evaluation differ in the questions they pose and in the methods used to answer them. Failure to draw a distinction between program reviews and program trials is a frequent cause of wasteful or unhelpful evaluative studies.

Consumer Behavior↗
PubMed1991

Development of an exercise program for older adults: pre-exercise testing, exercise prescription and program maintenance.

Health care practitioners have the technical skills, frequency of contact and credibility with older adults to use exercise as a health-promoting and disease-preventing intervention. This article acquaints the clinician with how to develop an exercise program specifically for older adults. The health-promotion and disease-prevention outcomes of exercise in older adults, including an explanation of the three stages of exercise programming for older adults, are also reviewed. Stage one is labeled pre-exercise testing and discusses assessment protocols for aerobic capacity, body composition, flexibility and strength. Guidelines for who should and should not exercise are also explored. The second stage of exercise programming is exercise prescription. An explanation of how to develop a beginning level of training and guidelines for how to set goals based on the initial pre-exercise testing are presented. Program maintenance is the third stage; this includes suggestions for designing an exercise program that increases program compliance, reduces attrition and prevents relapses to non-exercise behaviors.

Aged↗
PubMed1991

[A study of exercise programs and instructors for a fitness program in a corporate setting].

The objective of the study was to evaluate the importance of diversity in exercise programs and athletic instructors in a corporate physical fitness program. Subjects were 717 Japanese chemical factory employees (male 524, female 193) in Japan who were surveyed using a questionnaire, with a resultant response rate of 84%. Many employees who participated in regular physical activities on a voluntary basis were motivated to exercise for reasons other than health, with a variety of motivating factors suggested. The total number of sports programs in which male and female employees participated voluntarily were 31 and 15, respectively. For employees not yet participating in physical activities but expressing interest in joining a company sponsored sports class, the total number of programs in which interest was shown was 40 for males and 22 for females. Professional athletic instructors from outside fitness clubs appeared to have far more appeal to employees than athletic instructors who were recruited from company employees and given a short athletic instructor course to become health care leaders at the same factory in addition to their regular job. In order to enhance participation in and adherence to a corporate fitness program, it was suggested that the number of exercise programs be increased and that outside professional athletic instructors be employed.

Adult↗
PubMed1992

A program model to enhance adherence in work-site-based fitness programs.

We describe a program model designed to achieve high adherence, a major problem for work-site exercise/fitness programs. Our model is a 6-month program consisting of 15 1-hour program meetings, with participants exercising on their own time four times per week. Procedures employed to enhance adherence are contracting, group competition, monitoring, and social support. This program model has been applied nine times. One hundred fifty-nine university employees took part in the initial test with a dropout rate of 9% (15 persons). The average adherence rate for nondropouts was 98%, which is higher than rates usually reported in the literature. Adherence was defined as exercising four times a week.

Adult↗
PubMed1979

A community program for the control of cardiovascular risk factors: a preliminary evaluation of the effectiveness of the CHAD program in Jerusalem.

A community program for the control of cardiovascular risk factors, the CHAD program, was instituted in a family practice in western Jerusalem in 1971. The effectiveness of the program was evaluated by comparing the findings of community surveys conducted in 1970 and 1975 and by comparing the changes with those observed in an adjacent control neighborhood. This paper reports the findings among men aged 35 years and above. In the community exposed to the program there was a decrease in mean systolic and disatolic pressures, in the prevalence of hypercholesterolemia, and in the prevalence of cigarette smoking. The changes in blood pressures and smoking habits were significantly greater than those observed in the control population. In the control population (only) there was a small increase in mean body weight and a decrease in reported physical activity. The findings suggest that it is possible for a program that operates and through primary health care to have an appreciable influence upon cardiovascular risk factors in the community.

Adult↗
PubMed1976

Relation between programming time and duration of the response being programmed.

When the nature of motor response is varied, holding the number of alternative responses constant, differences in choice reaction time can be attributed to differences in response programming time. The present experiments suggest that although changes in response duration are not necessary to produce small differences in programming time, such response duration changes may be a sufficient condition for the programming time to change and necessary condition for very large changes in programming time. Implications of this conclusion for theories of response programming are discussed.

Feedback↗
PubMedDate not supplied

The effect of an educational program on transfusion practices in a regional blood program.

With the increased complexity of blood component therapy, it is important to be able to modify physician behavior with reliable educational programs. A standardized educational program on the use of red blood cells and whole blood was tested in 22 hospitals in a regional blood program using medical audit and computer monitoring to evaluate effectiveness. Most hospitals were eager to take advantage of the education program but were unwilling to use the audit-education cycle. At the same time, computer monitoring of indivisual hospital ordering and transfusion practices demonstrated an increased utilization of red blood cells in 64 per cent of hospitals with an overall improvement of 8 per cent. The improved use of red blood cells was appreciated within the month of the program and then sustained for six to twelve months at the new level.

Blood Transfusion↗
PubMedDate not supplied

Developing a computer program to assist the nursing process: phase I-from systems analysis to an expandable program.

In a three-stage project, a computer program was devised to assist in the nursing process. As Stage I, a definition of nursing was developed upon which a systems model of the nursing process was constructed. In Stage II, the computer program was written to collect patient data and formulate nursing diagnoses related to functions of the skin, mucous membranes, nails, and hair. The program was designed to serve as a model for the development of a more comprehensive program that would include other functional areas, suggest patient objectives and nurse interventions, and help to evaluate nursing care. In Stage III, initial trials were conducted to obtain feedback from nurses. Nurses found the program took too long but agreed that with modification it could help them give better care.

Computers↗
PubMed1991

Physical training programs and their effects on aerobic capacity and coronary risk profile in sedentary individuals. Design of a long-term exercise training program.

Currently the prevalent perception is that regular exercise training, besides increasing maximal oxygen uptake (VO2max), may have a beneficial effect on blood pressure and plasma lipid fractions. This is the basis for recommending exercise training for health maintenance and as a part of any prevention program for middle aged and older individuals. The purpose of this work was first, to review whether a basis exists for these recommendations and if so, to secondly design an exercise training program adjusted to these groups. Its parameters should be efficient enough to cause improvements in VO2max and risk profile, yet prevent cardial and orthopedic problems. The structure and the results of exercise programs in 27 experimental studies (n = 1153) were reviewed. The findings indicate that significant changes in VO2max, apart from individuals having least favourable values initially, do not necessarily effect simultaneous improvements in either blood pressure or plasma lipid fractions. Results strongly indicate the permanent benefits of participating in a long-term exercise program. This program should therefore provide a very useful and natural addition to the accepted dietary and pharmacological therapies.

Adult↗
PubMed1979

Allied health careers special resources and services program: increasing the probabilities of success for 'high risk' students in allied health career programs.

This article describes a successful developmental program specifically designed for academically "high risk" students entering a two-year community college career program in allied health. The program consisted of providing an intensive three-week instructional program to students before they entered the allied health career program, and subsequently providing an ongoing support system of tutoring, counseling and career development activities. Participants attained higher levels of academic performance and retention than nonparticipants.

Achievement↗
PubMed1978

Patient participation in a hypertension control program. Hypertension Detection and Follow-up Program Cooperative Group.

In the Hypertension Detection and Follow-up Program, the largest standardized hypertension detection, follow-up, and treatment program to date in the United States, participation rates have been high at all stages. More than 75% of those with suspected hypertension at screening attended follow-up rescreening, and more than 80% of the 5,314 hypertensive patients assigned to program treatment remained active at the end of one year. Differences in participation rates were generally small. To accomplish this, intensive efforts were required to maximize attendance, and the program was shaped to reduce known barriers to initial attendance and long-term adherence. Against the background of a high overall program response rate for all sex-race groups, factors that might be associated with variations in response were examined: age, socioeconomic characteristics, health status, and appointment schedule.

Black People↗
PubMed1978

Vocational adjustment of EMR youth in a work-study program and a work program.

Adjustment measures for students who took part in two work programs for EMR graduates of special schools were compared. Fifty students took part in a work program (direct placement in the work) and 50 students, a work-study program. The students, their parents, and their employers were interviewed regarding vocational satisfaction and adjustment. The work-study program graduates were significantly more stable, satisfied, and adjusted than were the work-program graduates (p is less than .001), but their professional opportunities (reflected by the number of different jobs held) were limited.

Adaptation, Psychological↗
PubMedDate not supplied

Alumni perspectives comparing a general internal medicine program and a traditional medicine program.

OBJECTIVE: To evaluate a primary care internal medicine curriculum, the authors surveyed four years (1983-1986) of graduates of the primary care and traditional internal medicine residency programs at their institution concerning the graduates' preparation. DESIGN: Mailed survey of alumni of a residency training program. SETTING: Teaching hospital alumni. SUBJECTS/METHODS: Of 91 alumni of an internal medicine training program for whom addresses had been found, 82 (90%) of the residents (20 primary care and 62 traditional) rated on a five-point Likert scale 82 items for both adequacy of preparation for practice and importance of training. These items were divided into five groups: traditional medical disciplines (e.g., cardiology), allied disciplines (e.g., orthopedics), areas related to medical practice (e.g., patient education), basic skills and knowledge (e.g., history and physical), and technical procedures. MAIN RESULTS: Primary care residents were more likely to see themselves as primary care physicians versus subspecialists (84% versus 45%). The primary care graduates felt significantly better prepared in the allied disciplines and in areas related to medical practice (p less than 0.01). There was no significant difference overall in perceptions of preparation in the traditional medical disciplines, basic skills and knowledge, and procedures. The same results were obtained when the authors looked only at graduates from the two programs who spent more than 50% of their time as primary care physicians versus subspecialists. There was no significant difference between the two groups in the perceived importance of these areas to current practice. CONCLUSIONS: These results suggest that the primary care curriculum has prepared residents in areas particularly relevant to primary care practice. Additionally, these individuals feel as well prepared as do their colleagues in the traditional medical disciplines, basic skills and knowledge, and procedural skills.

Attitude of Health Personnel↗
PubMed1992

Infant Health and Development Program for low birth weight, premature infants: program elements, family participation, and child intelligence.

The Infant Health and Development Program was an eight-site randomized controlled trial testing the efficacy of early intervention to enhance the cognitive, behavioral, and health status of low birth weight, premature infants. The 377 intervention families received for the first 3 years of life: (1) pediatric follow-up, (2) home visits, (3) parent support groups, and (4) a systematic educational program provided in specialized child development centers. The control group (n = 608) received the same pediatric follow-up and referral services only. This paper describes the delivery of the intervention and its outcomes. A Family Participation Index that was the sum of participation frequencies in each of the program modalities unique to the intervention revealed that program implementation was not different across the eight sites. Index scores did not vary systematically with mother's ethnicity, age, or education or with child's birth weight, gender, or neonatal health status; but they were positively related to children's IQ scores at age 3. Only 1.9% of children of families in the highest tercile of participation scored in the mentally retarded range (IQ less than or equal to 70), whereas 3.5% and 13% of children in the middle and lowest participation terciles, respectively, scored in the retarded range. Similar findings were obtained for borderline intellectual functioning. These findings are consistent with previous research linking intensity of intervention services with degree of positive cognitive outcomes for high-risk infants. The determinants of variations in individual family participation remain unknown.

Child Day Care Centers↗
PubMed1992

In vitro fertilization program based on programmed cycles monitored by ultrasound only.

OBJECTIVE: Programmed oocyte retrieval was performed in order to make the in vitro fertilization (IVF) program cheaper and work of the IVF team easier. METHOD: In a group of 77 patients included in the IVF program, the menstrual cycle was modified with estrogen-progesterone contraceptive pills. For this reason, it was possible to start the stimulation protocol in all patients on the same day. The stimulation protocol was a combination of clomiphene (100 mg) for 5 days and HMG (150 IU) every other day. Cycles were monitored by ultrasound only. RESULT: The implantation rate per embryo transfer was 22.4%. The number of embryos per embryo transfer was low (2.6 +/- 1.4) and eliminated the need for cryopreservation. Fertilization rate (82%) and embryo transfer rate (87%) were high. The take home baby rate was 14.3%. CONCLUSION: Seventy percent of all punctures were performed in 3 days in the middle of the week. In our conditions, programmed oocyte retrieval is associated with significant economic benefits.

Clinical Protocols↗
PubMed1991

A technology for program maintenance: programming key researcher behaviors in a student housing cooperative.

Behavioral researchers play critical, but often unanalyzed, roles in the programs they develop. Unless they replace their key activities with standardized procedures, their continued participation may be essential to program success--a situation that is often not only impractical but may be prohibitively expensive and disliked by local staff. This study was conducted in a student housing cooperative that is dependent on close researcher supervision for its continued health and survival. A key activity of the co-op researchers was to provide public recognition for good job performance by co-op members. The purposes of this study were (a) to replace that idiosyncratic recognition with systematic procedures so members, instead of the researchers, would provide public recognition to each other for good job performance; and (b) to evaluate those procedures by comparing job performance when member-delivered recognition was provided and when it was not. When the procedures were in place, job performance increased and fines for poor job performance and complaining at meetings decreased. This study suggests that procedures can be developed to reduce program reliance on the researcher that are effective, inexpensive, sustainable, and acceptable to the participants--a first step toward developing a technology of program maintenance.

Activities of Daily Living↗