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PubMed1997

Multiple von Neumann computers: an evolutionary approach to functional emergence.

A novel system composed of multiple von Neumann computers and an appropriate problem environment is proposed and simulated. Each computer has a memory to store the machine instruction program, and when a program is executed, a series of machine codes in the memory is sequentially decoded, leading to register operations in the central processing unit (CPU). By means of these operations, the computer not only can handle its generally used registers but also can read and write the environmental database. Simulation is driven by genetic algorithms (GAs) performed on the population of program memories. Mutation and crossover create program diversity in the memory, and selection facilitates the reproduction of appropriate programs. Through these evolutionary operations, advantageous combinations of machine codes are created and fixed in the population one by one, and the higher function, which enables the computer to calculate an appropriate number from the environment, finally emerges in the program memory. In the latter half of the article, the performance of GAs on this system is studied. Under different sets of parameters, the evolutionary speed, which is determined by the time until the domination of the final program, is examined and the conditions for faster evolution are clarified. At an intermediate mutation rate and at an intermediate population size, crossover helps create novel advantageous sets of machine codes and evidently accelerates optimization by GAs.

Algorithms↗
PubMed1998

Improved birth outcomes associated with enhanced Medicaid prenatal care in drug-using women infected with the human immunodeficiency virus.

OBJECTIVE: To evaluate the effectiveness of an intervention designed to enhance Medicaid prenatal care in improving birth outcomes of drug-using women infected with the human immunodeficiency virus (HIV). METHODS: Medicaid and vital statistics records were linked for 353 HIV-infected drug-using women delivering in 1993 and 1994 while enrolled in New York State Medicaid. Of these, 68% were treated by providers participating in the Prenatal Care Assistance Program, designed to provide case management, improved continuity, referral services, and behavioral risk reduction counseling. In a series of logistic models, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of low birth weight (less than 2500 g) and preterm delivery (before 37 weeks), comparing women using and not using the program. RESULTS: Women using the Prenatal Care Assistance Program were significantly less likely, after adjustments were made for maternal characteristics, to have low birth weight infants and preterm deliveries (OR 0.52, 95% CI 0.31, 0.89; and OR 0.57, 95% CI 0.34, 0.97, respectively). Adding measures of greater adequacy and continuity of prenatal care to the models explained just over 20% of the Prenatal Care Assistance Program's protective effect. The addition of maternal high-risk behavior, HIV-focused care, and drug use treatment variables altered program effect estimates less profoundly (together accounting for 4 and 9% of the program's protection against low birth weight and preterm delivery, respectively). CONCLUSION: The Prenatal Care Assistance Program appeared to be successful in reducing the incidence of low birth weight and preterm delivery in this high-risk population. The program's success can be attributed, in part, to increased adequacy and continuity of prenatal care and, to a lesser extent, to more frequent receipt of special services and reduced maternal high-risk behaviors.

Adult↗
PubMed2005

The effect of genetic drift in a young genetically isolated population.

The genetic make-up of genetically isolated populations may differ from a general population as a result of genetic drift and founder effects. We assessed the extent of this deviation in a recently isolated population located in the southwest of the Netherlands and studied as part of the Genetic Research in Isolated Population (GRIP) program. A gene-dropping experiment was performed in a large pedigree from this isolate, assuming different initial frequencies in the population founders came from. Allelic frequencies in the last generations of this pedigree were estimated. Simulation analysis showed large fluctuations, as measured by variation coefficient and sufficient loss probability, when initial frequencies were lower than or equal to 1%. For initial frequencies larger than 1% the fluctuations were small. We also analyzed mean heterozygosity and allele diversity of 592 markers in a random sample from the GRIP population. The results were compared with a general population (CEPH sample), old large isolate (Icelandic sample) and the small-sized population of Talana (Sardinia). GRIP mean heterozygosity and mean number of alleles were significantly lower as compared with CEPH and Iceland, but much higher when compared with the Talana population. We also concluded that the findings from the GRIP population for common variants (>1%) are likely to be extendable to other young isolates in Europe as well as to outbred populations.

Cohort Studies↗
PubMed2005

Help on the line: telephone-triage use, outcomes, and satisfaction within an uninsured population.

Telephone triage programs have been shown to be cost-effective and favorably utilized by insured populations. However, there are 45 million Americans who are uninsured and who do not have access to telephone nursing. A telephone triage service was piloted for local uninsured residents. Within the 17-month trial period, 320 calls were received, representing 207 clients. This study reports on the results of the telephone survey with a cross-sectional sample of uninsured triage patrons (N = 80). One half reported they would have sought other medical care if the telephone triage service had not been available. Most callers (98%) believed that their health care concern was understood. Moreover, 98% agreed with the advice given, and 90% reported following up on the advice given. Overall satisfaction by the uninsured population with the telephone-based nurse triage service was positive and appears to be an effective and acceptable tool by those uninsured individuals who utilized its services.

Adult↗
PubMed1980

Exposure to a rural population in a rural residency training program.

Previous reports of rural training programs conducted by medical schools have not examined the relationship between the population residing in an area and the population receiving medical services through the clinical training program. In the present study rural household survey data were compared with patient encounter data from a rural ambulatory cliinic engaged in training Family Practice residents from the Texas Tech University School of Medicine. Clinic patients were found to resemble the rural population subgroup that visits a physician at least once a year. Wide variations in individual clinical experiences were observed when health problems and conditions encountered by residents were compared with problems encountered in the clinic as a whole. In light of current national efforts to increase medical care access in unserved and underserved populations, the demographic findings raise questions concerning appropriate patient exposure goals in clinical training programs.

Adolescent↗
PubMed1987

Growth-associated traits in parental and F1 populations of chickens under different feeding programs. 3. Eating behavior and body temperatures.

In two experiments, parental populations of chickens and their F1 crosses were fed ad libitum or on alternate days. Eating and drinking behaviors, ability to compensate for fasting, and surface and cloacal temperatures were measured. Genetic and environmental (due to fasting) differences in feeding and drinking behaviors were found. Chicks from lines selected for larger body weight were better able to compensate for a 24-hr fast than those selected for smaller weight. Crosses were similar to the parental line that was the better compensator. Correlations between surface temperatures and body weights were consistently positive.

Animals↗
PubMed2004

Assessment of the health status in the Massa Lombarda cohort: a preliminary description of the program evaluating cardio-cerebro-vascular disease risk factors and quality of life in an elderly population.

The Massa Lombarda program (MLP) is the first step of a European multi-center program, promoted and coordinated from Bologna University's Academic Spin off Health Research and Development, which attempts to manage advanced sanitary research in general population. The instant individual definition (IID) study is the first phase of the program concerning the study of risk factors (RF) and early diagnosis of coronary heart disease (CHD), through a new diagnostic technology called myocardial perfusion scoring system (MPS). The study consists of a longitudinal observational epidemiological investigation of adult population (above 25 years of age) resident in Massa Lombarda (Ravenna), with the survey of social and biological parameters. The elderly part of the population (1000 subjects above 75 years) was submitted to a more complex analysis, as part of the study on health status in European aging populations, aimed at revealing the determinants influencing the healthy aging, and at identifying their impact on mortality,cardiovascular and respiratory morbidity, disability and decline of quality of life. Laboratory analyses were aimed at identifying the following factors: (i) Genetic markers related to pro and anti-inflammatory cytokine- codifying genes. (ii) Oxidative stress-involved molecules,and inflammation-involved genes, and more in general genes involved in the brittleness(iii) (ApoE). Appraising the degree of interaction with non-genetic factors, like measurable immunological markers in the peripheral blood, markers of reactions to oxidative stress,evaluation of metabolic parameters. Moreover, old population is expected to answer the questionnaires for evaluation of the dietary habits, physical activity, self-sufficiency,cognitive ability, motor coordination, perceived stress and social relationships.

Aged↗
PubMed2002

Surveillance for unexplained deaths and critical illnesses due to possibly infectious causes, United States, 1995-1998.

Population-based surveillance for unexplained death and critical illness possibly due to infectious causes (UNEX) was conducted in four U.S. Emerging Infections Program sites (population 7.7 million) from May 1, 1995, to December 31, 1998, to define the incidence, epidemiologic features, and etiology of this syndrome. A case was defined as death or critical illness in a hospitalized, previously healthy person, 1 to 49 years of age, with infection hallmarks but no cause identified after routine testing. A total of 137 cases were identified (incidence rate 0.5 per 100,000 per year). Patients' median age was 20 years, 72 (53%) were female, 112 (82%) were white, and 41 (30%) died. The most common clinical presentations were neurologic (29%), respiratory (27%), and cardiac (21%). Infectious causes were identified for 34 cases (28% of the 122 cases with clinical specimens); 23 (68%) were diagnosed by reference serologic tests, and 11 (32%) by polymerase chain reaction-based methods. The UNEX network model would improve U.S. diagnostic capacities and preparedness for emerging infections.

Adolescent↗
PubMed1979

Age effect hearing levels for a white nonindustrial noise exposed population (ninep) and their use in evaluating industrial hearing conservation programs.

A nonindustrial noise exposed population (NINEP) describing age effects for white males and females has been established that can be used as a reference in evaluating an industrial noise exposed population (INEP) data base. In making this comparison, it is desirable to match the two populations properly with respect to sex, race and age characteristics. Since there presently does not exist an equivalent black NINEP, it is necessary to first isolate the data representing the black population from the industrial sample. A definite learning curve exists in industrial audiometric data bases, with the degree of learning dependent upon the effectiveness of the hearing conservation program. Therefore, this variation must be considered when attempting to compare the industrial audiometric test data with the white NINEP data base presented herein.

Adolescent↗
PubMed1982

Physiological observations in essential hypertension.

The various mechanisms that may be involved in essential hypertension are discussed, as well as their therapeutic implications. A step-care treatment program has been shown to be effective not only for the treatment of the individual patient with mild hypertension but also in mass population treatment programs. It is based on a program of sound general medical care, including dietary sodium restriction, reduction of excess body weight, and pharmacologic therapy. With intelligent use of anti-hypertensive drugs for effective control of arterial pressure, a drastic reduction in cardiovascular morbidity and mortality can be expected.

Coronary Disease↗
PubMed2002

Leadership Opportunities with Communities, the Medically Underserved, and Special Populations (LOCUS).

OBJECTIVES: The Leadership Opportunities with Communities, the Underserved, and Special Populations (LOCUS) Program aims to improve medical students' leadership knowledge and skills, to improve self-awareness and motivation for community service, and to provide models for students to integrate community service into their medical careers. DESCRIPTION: The LOCUS program was established as a longitudinal, extracurricular student opportunity at the University of Wisconsin Medical School in the fall of 1998. Up to 15 new students each year are selected for the program through an application and interview process during their first or second year of medical school. Students remain in the program from acceptance until graduation from medical school. Nearly 50 students have enrolled in the program to date. LOCUS fellows are matched with a physician mentor, participate in core curriculum activities, and complete a longitudinal community service project. Mentors are community generalist physicians who have integrated community service into their own careers. Students participate in their mentors' clinical practices one afternoon a month during the first two years, and mentors serve as role models and provide guidance for students' projects and career development. The program administration and staff are supported through federal predoctoral training and Area Health Education Centers (AHEC) grants. The LOCUS core curriculum is delivered through a series of retreats, workshops, and seminars that emphasize active learning methods and include approximately 20 hours of scheduled activities per academic year. The curriculum addresses concepts of leadership in relation to one's self and in relation to others. Students are introduced to methods of self-reflection and develop their own vision and mission statements. Students also discuss the importance of compassion, self-care, striving for balance, avoiding burnout, and being realistic about what they can accomplish. Students practice strategies for working with teams, organizing meetings, working with media, taking political action, and resolving conflicts. They acquire community health skills such as assessing the health needs of a defined population; engaging community members' participation in health program development; and selecting priorities, designing interventions, and measuring the progress of community health care. Working in small teams, LOCUS fellows apply and refine their leadership skills through design and completion of a community health service project. Students can design their own projects or work on projects designed by community partners. The projects have addressed a variety of community health needs, such as parenting support for teen mothers, teaching health education for residents of group homes, and providing free sports physical exams for uninsured youth. DISCUSSION: This pilot program demonstrates that motivated students can develop leadership skills and address unmet community health needs while they progress through medical school. LOCUS students, staff, and physicians provide a social network that includes opportunities, encouragement, reflection, and problem solving. Student and mentor satisfaction with the program has been high. Future challenges include securing long-term funding, refining the core curriculum, assessing the impact of the program on participants, and improving the quality of projects through community partnerships. LOCUS strives to kindle the fires of altruism and community service so they are not extinguished as students progress through medical training.

Community Health Services↗
PubMedDate not supplied

[Evaluation of compliance with dengue fever prevention: the case of Catanduva, São Paulo, Brazil].

This paper presents the results of a qualitative survey on dengue fever prevention in an outlying neighborhood of Catanduva, São Paulo, Brazil. The research aimed to identify factors that interfere with on-going preventive practices by local residents. The authors began with a qualitative approach emphasizing preventive work within local women's daily context, mediated by the relationship they establish with vector control agents. The study indicates that to gain greater collaboration in dengue control requires: personalized consideration by both the programs and vector control agents, yet without excluding technical aspects; review of information content and communications methods: and training vector control agents to establish an on-going communications channel between the program and the population. Such factors can influence the population's interest in the prevention programs and minimize community discredit towards vector control activities.

Adolescent↗