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ApiDB: integrated resources for the apicomplexan bioinformatics resource center.

ApiDB (http://ApiDB.org) represents a unified entry point for the NIH-funded Apicomplexan Bioinformatics Resource Center (BRC) that integrates numerous database resources and multiple data types. The phylum Apicomplexa comprises numerous veterinary and medically important parasitic protozoa including human pathogenic species of the genera Cryptosporidium, Plasmodium and Toxoplasma. ApiDB serves not only as a database in its own right, but as a single web-based point of entry that unifies access to three major existing individual organism databases (PlasmoDB.org, ToxoDB.org and CryptoDB.org), and integrates these databases with data available from additional sources. Through the ApiDB site, users may pose queries and search all available apicomplexan data and tools, or they may visit individual component organism databases.

Animals↗

The primate embryo gene expression resource: a novel resource to facilitate rapid analysis of gene expression patterns in non-human primate oocytes and preimplantation stage embryos.

Detailed molecular studies of preimplantation stage development in a suitable nonhuman primate model organism have been inhibited due to the cost and scarcity of embryos. To circumvent these limitations, we have created a new resource for the research community, designated as the Primate Embryo Gene Expression Resource (PREGER). The PREGER sample collection currently contains over 160 informative samples of oocytes, obtained from various sized antral follicles, and embryos obtained through a variety of different protocols. The PREGER makes it possible to undertake quantitative gene-expression studies in rhesus monkey oocytes and embryos through simple and cost-effective hybridization-based methods. The PREGER also makes available other molecular tools to facilitate nonhuman primate embryology. We used PREGER here to compare the temporal expression patterns of five housekeeping mRNAs and three transcription factor mRNAs between mouse and rhesus monkey. We observed noticeable differences in temporal expression patterns between species for some mRNAs, but clear similarities for others. Our results also provide new information related to genome activation and the effects of embryo culture conditions on gene expression in primate embryos. These results provide one illustration of how the PREGER can be employed to obtain novel insight into primate embryogenesis.

Animals↗

Resource-based reflective consultation: accessing client resources through interviews and dialogue.

This article presents an interventive, consultative method that is designed to elicit and to promote resource-based language between client families and their therapists. The reflexive interview process that this method entailed is described through case examples. Initially, resource-based language was generated from client interviews and shared in reflective dialogue with their therapists in a way that encouraged participants to consider different views and beliefs about themselves, each other, and their process together. Use of this consultative process in therapy added heightened awareness and respect for competencies possessed not only by the client families but by the therapists as well.

Communication↗

Supplemental Security Income for the aged, blind, and disabled; income, resources and exclusions deeming of income and resources: Medicaid program; financial requirements for categorically needy--HHS. Final rules.

The Social Security Administration (SSA) is adopting as final, interim regulations on deeming of income and resources, which was published on Friday, June 4, 1982. These rules address the problem of certain individuals who require costly medical care and who under the usual Supplemental Security Income (SSI) deeming rules are ineligible for SSI and Medicaid as long as they live with their families. These rules also address the problems of individuals who remain institutionalized because returning home for less costly medical treatment would result in loss of SSI and Medicaid eligibility. The rules provide that the Secretary, in appropriate circumstances, will not apply the usual SSI rules for deeming the income and resources of certain family members to a noninstitutionalized individual. This is a temporary policy that will deal with this concern while States, if they choose, develop appropriate programs of home and community-based services under their Medicaid programs.

Eligibility Determination↗

Report of the Inter-Society Commission for Heart Disease Resources. Optimal resources for vascular surgery--a supplement.

This supplement is an updated and expanded planning and optimal resource guideline for vascular surgery. Activities relating to examination and certification in vascular surgery are reviewed and hospital resource requirements are identified for different categories of vascular operations. There is a detailed summary of results of common vascular operations as reported by leading vascular surgeons. The statement will be of value in planning and organizing vascular surgery programs and in assessing the results of vascular operations locally.

Aorta, Abdominal↗

The use of Healthcare Resource Groups in managing clinical resources.

Healthcare Resource Groups are a way of aggregating together patient treatment episodes that are similar in their resource consumption. They can be derived from existing minimum dataset information. In England, they are being used to provide costs for contract pricing and can also be used to provide comparisons of the efficiency of use of hospital beds. This article describes their development and construction and discusses the potential use and further development.

Bed Occupancy↗

[Studies on theory and models of systemic conservation of animal and poultry genetic resources. I. Theory analysis of systemic conservation of animal and poultry genetic resources].

The concept and fundamentals of Systemic Conservation of Animal and Poultry Genetics Resources (SCAPGR) and mathematical models of genetic structure with conservation population were proposed. The SCAPGR regarded all genes of a given species in definite time and space as conservation object and live animal preservation combining with modern biotechnology as basic method. The SCAPGR might systematically conserve genes controlling the characters of a given species as well as regional varieties. In a no overlapping generation population with selection, mutation migration and random drift under consideration, two mathematical models presented in this paper might describe change of frequencies of multiple alleles at a locus and population mean of metrical characters resp.

Animals↗

Report of the inter-Society Commission for Heart Disease Resources. Optimal resources for ultrasonic examination of the heart.

The echocardiographic examination is described and the current status of ultrasound in cardiac diagnosis is summarized. Planning guidelines are provided for hospital based echocardiography laboratories including resource criteria for professional personnel and training, equipment, space, and support systems. Minimal case loads for maintaining quality performance of the examiner are recommended and various administrative patterns for organizing an echocardiography service are discussed. Approaches for establishing professional fees and emerging applications of diagnostic ultrasound in cardiovascular medicine are briefly reviewed. There is a description of the procedure for conducting an adequate echocardiographic examination in children and adults.

Adult↗

Assessing resources and stress in parents of severely dysfunctional children through the Clarke modification of Holroyd's Questionnaire on Resources and Stress.

The Holroyd (1974) Questionnaire on Resources and Stress (QRS) although clinically useful may be too inclusive and not exclusively relevant to severely dysfunctional individuals. Hitherto, efforts at shortening and psychometrically validating the QRS have met with some success: the shorter forms however still target both mentally and physically handicapped children and are clinically not as useful as the original instrument. The 78-item Clarke modification of the QRS, mainly a subset of the original, was an attempt to remedy these problems. It was validated with mothers and fathers of autistic, mentally retarded, learning-disabled, and asymptomatic children. Good internal consistency, split-half reliability, and coefficient of stability were obtained. Construct and concurrent validities were also acceptable. The questionnaire discriminated best between the two more severely affected groups and the controls. Group differences were found for 8 of its 9 scales and sex of parent differences were found for 3. The Clarke modification of the QRS is recommended for clinical use with parents of children with autism and mental retardation.

Activities of Daily Living↗

Medical Image Resource Center 2002: an update on the RSNA's Medical Image Resource Center.

The Radiological Society of North America has launched a project called the Medical Image Resource Center (MIRC) to establish a community of Web-based libraries of imaging information, including teaching files, other educational materials, and research data. This system would enable radiologic professionals to create and publish such materials more easily and to gain more convenient access to new and existing materials. An overview of the project, a brief summary of the overall requirements and objectives, and a brief description of the progress and ongoing plans for MIRC are presented.

Humans↗

The ecological condition of Gulf of Mexico resources from Perdido Key to Port St. Joe, Florida, USA: part I. coastal beach resources.

Using the approach established by EPA's Environmental Monitoring and Assessment Program (EMAP), a shoreline monitoring survey was conducted in August and September 1999, encompassing the Florida Panhandle from Perdido Key, Florida to Port St. Joe, Florida. The objective of this survey was to demonstrate the use of a probabilistic survey for monitoring and estimating the condition of swimmable beach areas. Thirty stations were sampled using a probabilistic sampling design. Hydrographic data were collected in addition to samples for water chemistry. Bacterial indicators, enterococci and fecal coliforms, were enumerated from the water according to the EPA Beaches Environmental Assessment Closure and Health (BEACH) Program and Florida state guidelines. Additional criteria for site condition included the presence or absence of primary and secondary dunes, anthropogenic debris and vegetation. Based on EMAP evaluation guidelines and Florida state criteria, a baseline assessment of the condition of the Gulf of Mexico beach resources surveyed is presented.

Data Collection↗

Allocating resources to health care: RAWP (Resources Allocaton Working Party) is dead--long live RAWP.

In England, according to the White Paper, "Working for Patients' the RAWP formula (Resources Allocation Working Party) is to be abandoned. Instead, according to the Working Papers, allocations are to be based on populations weighted for their health and age distributions. In the distributions from the centre to the Regions, SMRs (Standardized Mortality Ratios) are to be retained as a proxy for morbidity albeit with a different weight. This is based, partly, on the analysis carried out by Coopers and Lybrand for the RAWP Review which is shown to be inadequate both conceptually and empirically. The criteria to be used for distributing to Districts and General Practitioners are unclear but "allowance will be made for local and social factors' which suggests that some deprivation index will be incorporated into the process. The most likely choice is the Jarman index and this is shown to be equally inappropriate. The criteria used in allocation, as well as being conceptually coherent and empirically practicable, should be clear and comprehensible to all concerned. The proposals in the White Paper fulfil none of these criteria.

Health Services Needs and Demand↗

Evaluation of the pain resource nurse role: a resource for improving pediatric pain management.

Pain resource nurses (PRNs), who act as pain management coaches or mentors for their colleagues, can contribute to effective pain management. The PRN's role has not been well evaluated in the context of pediatric nursing. Therefore, the objective of this study was to examine the PRN's role in a pediatric setting and, more specifically, to describe the role in terms of the activities PRNs engage in, the challenges they face, and the supports that help them fulfill their role. This research was part of an evaluation of the implementation of a comprehensive pain management program in a pediatric hospital. Focus groups were conducted with 18 PRNs six months after implementation of the PRN role. The essence of the role is to provide support for best-practice pain management to nurses and the multidisciplinary team. The PRNs described seven components of their role and specific strategies to operationalize their role. In addition, the PRNs faced challenges, including feeling disappointed when their expectations for better pain management were not met, experiencing difficulty fitting the activities into their busy workdays, facilitating their colleagues' improved pain management without also alienating them, and maintaining their enthusiasm and energy for the role. Pediatric nursing staff can effectively fill the role of the PRN. The role is multifaceted, and maintaining the role required commitment and enthusiasm on the part of the nurses, as well as commitment by their related institutions.

Attitude of Health Personnel↗

Crisis resource management among strangers: principles of organizing a multidisciplinary group for crisis resource management.

Patient safety depends on the skills, vigilance, and judgment of trained individuals working as members of a clinical team that includes anesthesiologists, surgeons, nurses, and technicians. Now, as never before, safe outcome depends both on better knowledge and better management. This requires organization of caregivers, who may be strangers from diverse disciplines, into teams. One can drill an individual to work safely alone. One can rehearse a series of scenarios with small groups (who regularly work together) to improve performance. But what does one do with an unrehearsed group, called together in an emergency from several different disciplines, usually including Anesthesia. These people may not know each other, their roles, their special skills, and may even be hazy about each other's goals. Rapid organization of such an ad hoc team becomes a critical priority where patient safety is at stake. The way by which such an ad hoc team from several disciplines can rapidly be helped to function effectively together is by teaching all the "strangers" the principles of Crisis Resource Management. These principles are not as well-presented in a written text or lecture format, as one cannot introduce the sense of urgency that emotionally charges and changes the impact. We believe the best teacher is experience gained in a realistic simulated environment using a model driven, full human simulator. This simulated environment is safe for both patient and trainee.

Communication↗

Encouraging practitioners to use resources: evaluation of the national implementation of a resource to improve the clinical management of alcohol-related problems in Indigenous primary care settings.

This paper reports on the evaluation of the implementation of the National Recommendations for the Clinical Management of Alcohol-Related Problems in Indigenous Primary Care Settings undertaken in 2001 through 74 standardized workshops, which sought to determine: (1) whether this approach to implementation influenced the likelihood that the National Recommendations would be used; (2) whether it influenced participants' willingness to engage with Indigenous patients regarding alcohol-related issues; and (3) whether the implementation as a whole influenced both practice and clinicians' willingness to engage. Evaluation included pre-/post-workshop and follow-up questionnaires and a focus group. The findings presented indicate that distribution of clinical resources alone is not sufficient to ensure use and that, particularly for medical practitioners, appropriate introduction not only increases use but also positively influences willingness to engage with alcohol-related problems as part of primary clinical care. Further, the enthusiasm for guideline production should be tempered by the need to develop effective implementation strategies.

Alcoholism↗

Protein Information Resource: a community resource for expert annotation of protein data.

The Protein Information Resource, in collaboration with the Munich Information Center for Protein Sequences (MIPS) and the Japan International Protein Information Database (JIPID), produces the most comprehensive and expertly annotated protein sequence database in the public domain, the PIR-International Protein Sequence Database. To provide timely and high quality annotation and promote database interoperability, the PIR-International employs rule-based and classification-driven procedures based on controlled vocabulary and standard nomenclature and includes status tags to distinguish experimentally determined from predicted protein features. The database contains about 200,000 non-redundant protein sequences, which are classified into families and superfamilies and their domains and motifs identified. Entries are extensively cross-referenced to other sequence, classification, genome, structure and activity databases. The PIR web site features search engines that use sequence similarity and database annotation to facilitate the analysis and functional identification of proteins. The PIR-Inter-national databases and search tools are accessible on the PIR web site at http://pir.georgetown.edu/ and at the MIPS web site at http://www.mips.biochem.mpg.de. The PIR-International Protein Sequence Database and other files are also available by FTP.

Computational Biology↗

The cooperative prostate cancer tissue resource: a specimen and data resource for cancer researchers.

PURPOSE: The Cooperative Prostate Cancer Tissue Resource (CPCTR) is a National Cancer Institute-supported tissue bank that provides large numbers of clinically annotated prostate cancer specimens to investigators. This communication describes the CPCTR to investigators interested in obtaining prostate cancer tissue samples. EXPERIMENTAL DESIGN: The CPCTR, through its four participating institutions, has collected specimens and clinical data for prostate cancer cases diagnosed from 1989 onward. These specimens include paraffin blocks and frozen tissue from radical prostatectomy specimens and paraffin blocks from prostate needle biopsies. Standardized histopathological characterization and clinical data extraction are performed for all cases. Information on histopathology, demography (including ethnicity), laboratory data (prostate-specific antigen values), and clinical outcome related to prostate cancer are entered into the CPCTR database for all cases. Materials in the CPCTR are available in multiple tissue formats, including tissue microarray sections, paraffin-embedded tissue sections, serum, and frozen tissue specimens. These are available for research purposes following an application process that is described on the CPCTR web site (www.prostatetissues.org). RESULTS: The CPCTR currently (as of October 2003) contains 5135 prostate cancer cases including 4723 radical prostatectomy cases. Frozen tissues, in some instances including patient serum samples, are available for 1226 cases. Biochemical recurrence data allow identification of cases with residual disease, cases with recurrence, and recurrence-free cases. CONCLUSIONS: The CPCTR offers large numbers of highly characterized prostate cancer tissue specimens, including tissue microarrays, with associated clinical data for biomarker studies. Interested investigators are encouraged to apply for use of this material (www.prostatetissues.org).

Adult↗

Financing long-term care with limited resources: combining the resources of the public and private sectors.

Under Connecticut's recently implemented public/private partnership to finance long-term care, individuals will no longer need to impoverish themselves in order to receive Medicaid assistance. To encourage those people who can afford to buy a private long-term care insurance policy to do so, the state promises to shield one dollar in assets from Medicaid "spend-down" rules for every dollar a private policy pays out for Medicaid-covered services. This article describes the Partnership, shows how dwindling resources and budget constraints affected the development of this model, and then contrasts Connecticut's experience with that of other states and describes what can be learned from this demonstration.

Aged↗