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PubMedDate not supplied

A program for the numerical integration of enzyme kinetic equations using small computers.

A simple program to integrate differential equations is given. The program is written in BASIC and has been devised to be used on small computers. The program has been used to integrate the differential equations corresponding to a single reaction-single enzyme, a bireaction-single enzyme and a four reaction-four substrate-single enzyme mechanism; it has been used also for studying the interconversions among various molecular forms of a single enzyme, viz. monomer - dimer - trimer - tetramer. The program has proven to be very effective in these models and its time consumption comparable with that of other longer programs. The BASIC version is shown, and the FORTRAN VS version is available upon request to the authors.

Computers↗
PubMed1994

Supplemented low-protein diet and once-weekly hemodialysis.

The aim of this study was to evaluate the feasibility and the nutritional and depurative adequacy of the integrated diet dialysis program. The integrated diet dialysis program consists of a low-protein diet (0.4 g/kg ideal body weight/d), supplemented with essential amino acids or a mixture of essential amino acids and chetoanalogues, and once-weekly hemodialysis, tailored to maintain predialytic blood urea nitrogen levels lower than 90 mg/dL. Sixty-nine of 84 recruited patients with a mean age of 62.9 +/- (SD) 11.1 years and a baseline glomerular filtration rate of 2.54 +/- 0.94 mL/min entered the experimental phase; 15 dropped out, eight because of poor diet compliance. At 12-month follow-up, patient and technique survival were, respectively, 89% and 56%. The laboratory, anthropometric, and instrumental parameters of 28 patients with a follow-up of more than 12 months were also evaluated using repeated measures ANOVA. Mean predialytic blood urea nitrogen values were not significantly different (82 +/- 21 mg/dL v 93 +/- 26 mg/dL at baseline and after 12-month follow-up, respectively); total weekly KT/V from residual renal function plus dialysis (1.64 +/- 0.32 v 1.70 +/- 0.29; P = NS) and dialytic index according to Babb and Scribner (1.35 +/- 0.31 v 1.21 +/- 0.33) were stable. No problems were found as far as acid-base, calcium phosphate, water-electrolyte metabolism and blood pressure control are concerned. Body weight, fat free mass, fat, plasma proteins, albumin, and C3 and C4 complement factors were stable. Creatinine production (sum of metabolized plus excreted creatinine) decreased (14.3 +/- 3.2 mg/kg/d v 13.4 +/- 2.6 mg/kg/d; P < 0.05). Transferrin decreased but not significantly (221 +/- 46 mg/dL v 204 +/- 42 mg/dL; P < 0.09). Distal motor conduction velocity from the posterior tibial nerve did not improve during the study (37.8 +/- 4.9 m/s v 36.4 +/- 4.9 m/s), while distal motor conduction velocity from the median nerve worsened (50.8 +/- 4.3 m/s v 46.3 +/- 6.3 m/s; P < 0.05). In conclusion, even though the integrated diet dialysis program may be very important in the psychologically delicate phase between the conservative and the classical three-times-a-week hemodialysis programs, and may also solve some economic and dialytically related organizational problems, it arouses some concern as far as compliance and long-term nutritional and depurative adequacy are concerned. It should therefore be limited to highly motivated patients in centers with well-trained staff or where dialysis facilities are lacking.

Aged↗
PubMed1997

[Long-term follow-up after participation in an integrated group treatment program for patients with intractable musculoskeletal pain].

METHODS: Long-term outcome in terms of well-being, depression and ability to cope was evaluated by means of a mailed questionnaire up to 5 years after participation in an integrated group treatment program for chronic musculoskeletal pain (mostly back pain). Sixty-one completed questionnaires were available for analysis, representing 69% of all 89 participants. RESULTS: Comparison of responders and non-responders yielded no important differences. On the basis of their further need for treatment, their working ability and global rating of outcome, patients were divided into three groups: In 18 cases the situation had further improved, 33 were unchanged and 10 had worsened. Sociodemographic data and pain history did not differ among the three groups. Patients with a favorable outcome scored significantly lower than the rest of the patients on a symptom check list and showed the greatest decrease from pretreatment values (if available). They rated themselves significantly higher on the two-dimensional health locus of control scale and were aware of significantly more factors influencing their pain than were the unimproved (unchanged or worsened) patients. Cognitive-behavioral strategies had been continued long-term by 83.6% of the patients and were rated most helpful. Physical training and at least one relaxation technique were continued in 80.3% of the patients, with a slightly lower rating of helpfulness. Improved patients gave generally higher ratings for helpfulness and applied these strategies also to problems other than pain (e.g. anxiety). CONCLUSIONS: The majority of patients maintained at least two of the self-help strategies over many years and seem to profit from their use. Positive long-term effects on well-being were visible in 30% of all participants, and these were clearly more orientated towards self-control than the unimproved subgroups.

English Abstract↗
PubMed1989

A computerized log and integrated quality assessment program for the small emergency department.

Emergency department staff at Valley View Medical Center, a 48-bed rural hospital in Utah, implemented a computerized log and integrated a quality assessment program within their small department. A microcomputerized relational data base format is used to keep and cross-reference patient logs and audits. The system stores data for use in emergency department quality assurance (QA) activities, for monitoring trends in patient care, and for recredentialing decisions. The computerized program allows staff to significantly increase the amount of information they can collect for QA activities. It also provides rapid, flexible reporting functions for staff and patient feedback and aids in the collection and dissemination of data to regulatory agencies. The system minimizes physician and nurse time spent in recording and collecting data, while simultaneously increasing their QA involvement.

Emergency Service, Hospital↗
PubMed2004

BOMP: a program to predict integral beta-barrel outer membrane proteins encoded within genomes of Gram-negative bacteria.

This work describes the development of a program that predicts whether or not a polypeptide sequence from a Gram-negative bacterium is an integral beta-barrel outer membrane protein. The program, called the beta-barrel Outer Membrane protein Predictor (BOMP), is based on two separate components to recognize integral beta-barrel proteins. The first component is a C-terminal pattern typical of many integral beta-barrel proteins. The second component calculates an integral beta-barrel score of the sequence based on the extent to which the sequence contains stretches of amino acids typical of transmembrane beta-strands. The precision of the predictions was found to be 80% with a recall of 88% when tested on the proteins with SwissProt annotated subcellular localization in Escherichia coli K 12 (788 sequences) and Salmonella typhimurium (366 sequences). When tested on the predicted proteome of E.coli, BOMP found 103 of a total of 4346 polypeptide sequences to be possible integral beta-barrel proteins. Of these, 36 were found by BLAST to lack similarity (E-value score < 1e-10) to proteins with annotated subcellular localization in SwissProt. BOMP predicted the content of integral beta-barrels per predicted proteome of 10 different bacteria to range from 1.8 to 3%. BOMP is available at http://www.bioinfo.no/tools/bomp.

Bacterial Outer Membrane Proteins↗
PubMed2001

An integrated malaria control program with community participation on the Pacific Coast of Colombia.

The study focuses on integrated malaria control in 23 communities on the Pacific Coast of Colombia, with several elements of an ecosystem approach to human health, including malaria-related sociopolitical, ecological, and economic factors. The program fostered community participation. The program presented here had 2 components: implementation and research. The first was conducted in 23 communities, 21 of which lacked adequate health services in terms of education, community participation, prompt diagnosis and complete treatment, and vector control. Research focused on specific vector control measures and the current national health services decentralization process. The project: 1) created a malaria prevention culture in the community; 2) avoided deaths from malaria (no fatal cases in the 3-year period, compared to 5-8 deaths a year previously); 3) avoided cases of cerebral malaria (no cases, as compared to 90-110 per year previously); 4) reduced malaria incidence by 45.36%; 5) decreased length of sick leave from 7.52 to 3.7 days; 6) established a permanent network of microscope technicians and 2-way radio communications; 7) integrated work by local, regional, and outside institutions; 8) demonstrated efficacy of insecticide-impregnated bednets to reduce malaria transmission.

Ambulatory Care↗
PubMed1998

[Medical auditing: procedures assessment in the women's integral health care program in the Vila Municipal Health Clinic, Pelotas, Rio Grande do Sul, Brazil]

This study is based on a medical audit of the Vila Municipal Health Clinic, Pelotas, Rio Grande do Sul. We collected data from family medical records in 1992,1993, and 1994. The data concerned the Women's Integral Health Care Program. We collected information on age, visits for medical and non-medical reasons, blood pressure, breast examination, coverage of Pap smear testing, and contraceptive methods. On average, women visited the clinic 3.5 to 4 times a year; 53% of the women were between 20 and 39 years of age; 42.5% of the women had had a Pap smear in the previous three years; 19% of the women had had their breasts examined. Blood pressure measurement was the most common procedure recorded in this clinic. We believe quality of medical records is a factor in patient care. We expect a critique of the low-quality medical records found in this audit can serve as the basis for a discussion among the health care team, with a view towards improving medical care, thereby benefiting patients.

Journal Article↗
PubMed1992

[Immunization of hepatitis B vaccine integrated with expanded program on immunization schedule in children].

We studied the immunization of hepatitis B vaccine integrated with of EPI. 180 children (0-9 months of age) from three towns of Shunde County were randomly divided in to three groups (two trial groups and one control group). Which were vaccinated by three different immunization schedule. The serum antibodies to different vaccines were measured before and after immunization. The results show that the seroconversion rate and GMT of each EPI vaccine are conformed with the expected EPI indexes. The seroconversion rate of anti-HBs antibody is found no significantly different among the three groups. The titres of pertussis agglutinating and three types polio neutralizing antibody is higher in trial groups than that in the control group. We conclude that the immunization of hepatitis B vaccine can be integrated into the EPI schedule. And third dose of hepatitis B vaccine can be simultaneously given with measles vaccine.

Child↗
PubMed2004

Evaluation of the potential role of glufosinate-tolerant rice in integrated pest management programs for rice water weevil (Coleoptera: Curculionidae).

The impact of a herbicide-tolerant rice, Oryza sativa L., variety was assessed for its resistance to rice water weevil, Lissorhoptrus oryzophilus Kuschel (Coleoptera: Curculionidae), and its place in current integrated pest management (IPM) programs. Greenhouse experiments were conducted to evaluate the resistance of a glufosinate-tolerant rice variety and its glufosinate-susceptible parent line Bengal to the rice water weevil in the presence and absence of glufosinate applications. The LC50 dose-response and behavioral effects of glufosinate on adult rice water weevils also were studied. Field studies investigated the impacts of glufosinate-tolerant rice on rice water weevil management in the presence and absence of glufosinate under early and delayed flood conditions. Greenhouse studies demonstrated that in the absence of glufosinate, oviposition was 30% higher on the glufosinate-tolerant rice line than on Bengal rice or on glufosinate-tolerant line treated with recommended rates of commercially formulated glufosinate. Applications of glufosinate to glufosinate-tolerant rice resulted in a 20% reduction in rice water weevil larval densities compared with nontreated glufosinate-tolerant rice. The LC50 of glufosinate against adult rice water weevil was nearly 2 times the concentration recommended for application to glufosinate-tolerant rice. There was no difference in the amount of leaf area consumed by adult rice water weevils on glufosinate-treated and nontreated foliage. The absence of direct toxicity of glufosinate to rice water weevil at recommended glufosinate use rates and lack of behavioral effects suggest that the reduction in rice water weevil densities observed after glufosinate applications resulted from herbicide-induced plant resistance. Field experiments showed that neither rice variety nor herbicide use affected larval densities; however, delaying flood and applying insecticide effectively reduced numbers of rice water weevil larvae.

Aminobutyrates↗
PubMed1991

Eating disorders as addictive behavior. Integrating 12-step programs into treatment planning.

To be effective in treating eating-disordered individuals, we must be open to working with an electric model of treatment. Often health care providers have difficulty with the addiction model of treatment, even though many eating-disordered patients will attest to the assistance and support they receive from these programs. It will be useful for both health care professionals and 12-step programs to avoid taking competitive positions. It is far more useful for professionals to have a working knowledge of how these programs work and how they can be of use to the individuals with eating disorders. Knowledge of local resources will also be of great value. Given the assistance that the clients tell us they receive at these programs, it makes more sense to understand and use these programs more, not less. There is evidence that eating disorder behaviors are addictive behavior, both from a psychological and physiologic perspective. Use of a 12-step program will assist with the practical details of helping individuals to stop employing self-destructive behaviors as well as provide support and decrease feelings of isolation and depression. It is important to integrate the 12-step program components into an overall treatment program to make the best use of both programs and decrease the competition usually inherent in both programs.

Behavior Therapy↗
PubMedDate not supplied

[Personality disorders and substance abuse disorders. Psychosocial strategies].

The article begin with a review of the high prevalence of concurrent mental illness and substance abuse disorders among general and clinical populations, highlighting the need for development of appropriate services to treat these persons. Several studies have revealed a significant adverse impact of comorbid personality disorders on treatment tenure and outcome in substance abuse populations and vice versa. We review findings on the longitudinal course of dual disorders in traditional treatment systems, which provide separate mental health and substance abuse programs, and describe new programs that integrate both types of treatment at the clinical level. This is followed by a description of main difficulties to do with outcome and treatment retention. Finally, we review the effectiveness of several specific treatments programs within psychiatric care for patients who have a dual diagnosis of a severe personality disorder and a substance abuse disorder. Such programs include, brief integrated programs based on the disease-and-recovery model or on the cognitive-behavioral model, comprehensive integrated assertive programs and intensive partial hospitalization programs. We conclude, that although several program features appear to be associated with effectiveness, there is no clear evidence supporting an advantage of any type of program when co-occurring substance abuse with severe personality disorder. Implementation of new specialized services for dual disorders should be within the context of simple, well designed controlled studies.

Diagnosis, Dual (Psychiatry)↗
PubMed2003

Boric acid dust as a component of an integrated cockroach management program in confined swine production.

Boric acid dust treatments were evaluated as a tool for the integrated management of the German cockroach, Blattella germanica (L.), in commercial confined swine production. The efficacy of boric acid dust was comparable to that of an organic residual insecticide, cyfluthrin, which is commonly used to control cockroaches in this environment. Fall treatments suppressed the cockroach population for longer durations than treatments in the Spring. Boric acid dust is an effective, inexpensive, and low risk (to animal and human health, and the environment) alternative for the management of cockroaches in livestock production systems.

Animals↗
PubMed2006

Web-based weight management programs in an integrated health care setting: a randomized, controlled trial.

OBJECTIVE: To assess the efficacy of a Web-based tailored behavioral weight management program compared with Web-based information-only weight management materials. RESEARCH METHODS AND PROCEDURES: Participants, 2862 eligible overweight and obese (BMI = 27 to 40 kg/m2) members from four regions of Kaiser Permanente's integrated health care delivery system, were randomized to receive either a tailored expert system or information-only Web-based weight management materials. Weight change and program satisfaction were assessed by self-report through an Internet-based survey at 3- and 6-month follow-up periods. RESULTS: Significantly greater weight loss at follow-up was found among participants assigned to the tailored expert system than among those assigned to the information-only condition. Subjects in the tailored expert system lost a mean of 3 +/- 0.3% of their baseline weight, whereas subjects in the information-only condition lost a mean of 1.2 +/- 0.4% (p < 0.0004). Participants were also more likely to report that the tailored expert system was personally relevant, helpful, and easy to understand. Notably, 36% of enrollees were African-American, with enrollment rates higher than the general proportion of African Americans in any of the study regions. DISCUSSION: The results of this large, randomized control trial show the potential benefit of the Web-based tailored expert system for weight management compared with a Web-based information-only weight management program.

Adult↗
PubMed1999

Consolidation of trauma programs in the era of large health care delivery networks.

OBJECTIVE: To review the development of an integrated trauma program at two separate campuses brought about by the merger of two medical-affiliated hospitals, each with an integrated program and a common trauma administrator, medical director, and educational coordinator. Each campus has an associate trauma medical director for on-site administrative management, a nurse coordinator, and a registrar. The integration resulted in a reduction of 1.5 full-time equivalents and "cost" savings by consolidated use of the helicopter, outreach, prevention, research, and educational programs. Regular "integration meetings," ad hoc committees, and video-linked conferences were used to institute common quality improvement programs, morbidity and mortality discussions, policies, and clinical management protocols. Reaccreditation by an outside agency, elimination of duplicated services, and maintenance of pre-merger clinical volume results. CONCLUSION: This integrated trauma program may serve as a model in this era of individual hospitals merging into large health care delivery networks.

Accreditation↗
PubMed2004

Diffusion of an integrated health education program in an urban school system: planet health.

OBJECTIVE: Assessed the feasibility, acceptability, and sustainability of Planet Health, an interdisciplinary, integrated health education curriculum implemented in six public middle schools. METHODS: Workshops on Planet Health implementation were attended by 129 teachers (language arts, math, science, and social studies) over three school years (1999-2000, 2000-2001, and 2001-2002). Questionnaires were administered post-implementation and in the fall and spring of each year. Outcomes were dose, acceptability, feasibility, and intent to continue use. RESULTS: The average number of lessons taught per teacher per year was 1.7 to 3.1, compared to a goal of 2 to 3. Each year, teachers reported high acceptability and perceived feasibility of the intervention, and the majority indicated they intended to continue using the curriculum. CONCLUSIONS: Planet Health was feasible and acceptable in a participatory research model involving a public school-university partnership, and it was also sustainable independent of the research effort.

Boston↗
PubMed1982

Development of a quality assurance program as an integral part of the physical therapy system.

The purposes of this article are to describe the conditions that must be met and the process that must be carried out to develop, implement, and evaluate a quality assurance program. The conditions to be met are administrative support for the program; knowledge of quality assurance theories and components (including structure, process, and outcome standards); and a commitment of the department members to quality assurance. The participative approach to program development is essential to the acceptance and implementation of the program. The process is cyclical in nature with the actual program design based on the needs of the people to be served. The department's policies and procedures manual provides the appropriate place for the documentation of the program standards so they are easily accessible to all staff and are an integral part of the delivery system. External peer review is used in measuring the potential for success of the program's structure.

Activities of Daily Living↗
PubMed2006

Implementing a Good Catch program in an integrated health system.

In 2004, the Canadian Adverse Events Study (Baker et al. 2004) determined the incidence rate of adverse events (AE) in Canada to be 7.5%. This translates to approximately 185,000 for the almost 2.5 million annual hospital admissions in Canada. The study noted "close to 70,000 of these AEs were potentially preventable". In March 2005, a "Good Catch" program was implemented in Edmonton's Capital Health Region, one of the largest integrated health regions in Canada, as part of the region's comprehensive system of reporting, analyzing and managing incidents, adverse events and near misses.

Alberta↗
PubMed1988

Behavioural and developmental gains made in a therapeutic preschool and an integrated day care program: a pilot study.

The outcomes after 8 months treatment for mildly delayed, behaviorally disordered preschoolers in a therapeutic preschool were compared with outcomes for similar children integrated into daycare centres on measures of development, language and behaviour. The results provide a measure of the gains achievable in a well resourced and specialized program.

Attention Deficit Disorder with Hyperactivity↗