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PubMed2002

MethPrimer: designing primers for methylation PCRs.

MOTIVATION: DNA methylation is an epigenetic mechanism of gene regulation. Bisulfite- conversion-based PCR methods, such as bisulfite sequencing PCR (BSP) and methylation specific PCR (MSP), remain the most commonly used techniques for methylation mapping. Existing primer design programs developed for standard PCR cannot handle primer design for bisulfite-conversion-based PCRs due to changes in DNA sequence context caused by bisulfite treatment and many special constraints both on the primers and the region to be amplified for such experiments. Therefore, the present study was designed to develop a program for such applications. RESULTS: MethPrimer, based on Primer 3, is a program for designing PCR primers for methylation mapping. It first takes a DNA sequence as its input and searches the sequence for potential CpG islands. Primers are then picked around the predicted CpG islands or around regions specified by users. MethPrimer can design primers for BSP and MSP. Results of primer selection are delivered through a web browser in text and in graphic view.

Base Sequence↗
PubMed1989

Developing a unit for mentally retarded-mentally ill patients on the grounds of a state hospital.

For some time patients with the dual diagnosis of mental retardation and mental illness have been recognized as a distinct patient population, but development of programs meeting their special needs is slow. In October 1986 a Massachusetts state psychiatric facility opened a rehabilitative program for such patients in a separate 40-bed unit on the hospital grounds. All patients admitted to the Specialized Habilitative and Rehabilitative Environment (SHARE) program had long histories of institutionalization, and many had been treated with neuroleptic drugs for several years. Most patients now attend day programming, and a few have been able to move on to less restrictive environments. Patients' average neuroleptic dosage has been substantially reduced. This progress has been made in spite of such program-development problems as the need to change staff's long-held perspectives about dual-diagnosis patients, lack of funding, and high staff turnover.

Health Services Needs and Demand↗
PubMed2006

Have the focus and sophistication of research in health education changed?

This study assessed the types of research and the statistical methods used in three representative health education journals from 1994 through 2003. Editorials, commentaries, program/practice notes, and perspectives represent 17.6% of the journals' content. The most common types of articles are cross-sectional studies (27.5%), reviews (23.2%), and analytic studies (i.e., case-control, cohort, and experimental studies) (18.4%). The estimated annual percentage change across the study period in these types of articles was 3.3, -9.3, and 5.5, respectively. A significant increase was observed in use of descriptive statistics (estimated annual percentage change = 2.4), parametric test statistics (4.4), nonparametric test statistics (3.5), epidemiologic statistics (10.3), generalized linear models (6.8), validation statistics (6.7), and other statistics (8.2). Movement toward increasing use of cross-sectional studies, analytic study designs, and statistical methods--representing greater emphasis on needs assessment for health education, health education program development, and program evaluation--indicates the need for better quantitatively trained health educators.

Bibliometrics↗
PubMed2001

Media, audience, and policy perspectives in health broadcasting.

Effective coordination between service delivery systems and communication networks is essential for the success of development programs. This becomes particularly crucial when the number of agencies involved is large and they are not working under 1 authority. Information needs of the community are another major concern. This article attempts to assess the extent of convergence between electronic media, government policy, and the targeted audience on the coverage of health topics. The Indian state of Andhra Pradesh was chosen as the field. The study adopts a mix of both quantitative and qualitative techniques. The findings reveal limited convergence, indicating the need for more effective reflection of the policy guidelines into media programs.

Community Networks↗
PubMed2005

Interdisciplinary service-learning substance abuse projects: processes and outcomes.

The purpose of this paper is to describe the development and implementation of community-based, service-learning field projects by 30 health professional faculty fellows of Project MAINSTREAM, a faculty development program on substance abuse. The fellows worked together for two years in 10 Interdisciplinary Faculty Learning Groups (IFLGs), which consisted of three academics of different disciplines. The ten projects are viewed within the context of service- learning and are based on a balance between the provision of services to the community and furthering the learning objectives of Project MAINSTREAM.

Adolescent↗
PubMedDate not supplied

Developing a rural therapy with big city approaches.

Both rural communities and urban communities experience problems associated with drug use and drug dependence. However, existing treatment interventions are not tailored for rural settings. This article describes a project which will modify an existing social skills behavioral therapy for rural populations, refine the therapy, develop a manual, train and supervise therapists, and pilot test the structured behavioral outpatient rural therapy to treat rural drug users and drug dependents as Stage I Research for NIDA's Behavioral Therapies Development Program.

Behavior Therapy↗
PubMed2003

Development of geriatrics-oriented faculty in general internal medicine.

The need for adequate geriatrics training for the physician workforce has been recognized for decades. However, there are not enough academic geriatricians to provide for the educational needs of trainees, and this situation is not expected to change in the future. General internists are often responsible for teaching medical students and internal medicine residents to care for elderly patients in inpatient and ambulatory settings. These academic general internists could play a pivotal role in providing geriatrics instruction. To characterize what is being done to develop geriatrics-oriented general internal medicine faculty, we identified current practices, "best practices," goals and targets, and barriers to achieving those goals and targets. We reviewed the literature on faculty-development programs for general internal medicine faculty, and we held focus groups and structured interviews with general internal medicine unit chiefs and directors of Geriatric Centers of Excellence at 46 medical schools throughout the United States. We found a need for programs to develop geriatrics-oriented academic general internists. Although general internal medicine faculties seem receptive to further geriatrics training, important obstacles exist. These include inadequate time and resources as well as motivational and attitudinal challenges. We discuss potential solutions for overcoming these barriers and the implications of these solutions for stakeholders.

Faculty, Medical↗
PubMed1993

A system for documentation of pharmacist interventions with incorporation into performance and quality improvement plans.

Budgetary constraints have compelled hospital administrators to take a more discerning look at the role of the pharmacist within the healthcare team. In 1991, financial difficulties and hospital-wide cutbacks at Northern Michigan Hospital resulted in the loss of pharmacy personnel. Consequently, the department has increasingly found it necessary to document the clinical activities of the pharmacists and their potential effect on patient care. To document therapeutic interventions, two forms specific to this activity were developed. These forms allowed evaluation of both the quantity and quality of interventions. The authors realize it is essential for pharmacists to not only maintain, but to continually update their knowledge base to be prepared for the future. A staff development program was developed to help meet the educational needs of the pharmacists. This article describes how therapeutic interventions were integrated into the quality improvement and performance plans to help motivate staff to continually improve their pharmacy practice skills at this institution.

Clinical Pharmacy Information Systems↗
PubMed1995

Perceptions of management development in selected hospitals.

Today health care executives are managing organizations that are complex and require a higher degree of financial management, medical knowledge, and general business skills. The skills and academic background required to manage health care facilities have been debated by practitioners and academicians over the years. This study will examine executives' perceptions of management development activities in their organizations. To assess these perceptions, an eight-item questionnaire was mailed to 587 executives. Forty-two percent were returned. The data showed that a majority of the respondents indicated that the management development programs in their organizations were well received and that the morale of managers had improved. The pressures and challenges facing health care organizations will require managers and executives to make use of a wide range of skills if they are to be successful.

Health Services Research↗
PubMedDate not supplied

Mandatory continuing education for hospital managers.

Because hospital managers and supervisors are more aware of the necessity to regularly upgrade their knowledge and skills, a health care center has created a mandatory management development program that not only fills employee and hospital needs but also provides empirical data for merit reviews. How this highly structured program was developed and organized is presented in this article.

Administrative Personnel↗
PubMedDate not supplied

Creating a center for nursing excellence.

A center for nursing excellence provides a structure for organizing professional nursing within an organization. It gives nursing leadership a method of explaining, demonstrating, and showcasing nursing. A center for nursing excellence provides a method of interpreting the primary and multiple roles of nursing, including patient care delivery, education, research, leadership, and management. A center for nursing excellence can be used as a base for the development of practice models, education and development programs, nurse recruitment strategies and retention, and leadership and management programs.

Academies and Institutes↗
PubMedDate not supplied

Access to colposcopy services for high-risk Canadian women: can we do better?

BACKGROUND: Despite overall decreasing mortality from cervical cancer, selected groups of Canadian women continue to have suboptimal access to diagnostic and treatment interventions for cervical cancer. In this paper, we present an evaluation of a colposcopy program developed to improve attendance for colposcopy in a lower socio-economic and immigrant population. METHODS: All women attending the North Hamilton Community Health Centre (CHC) who required colposcopic assessment and were referred to a newly developed colposcopy program based at the CHC were evaluated. Attendance rates for consultation, follow up and treatment in women referred for colposcopy were compared retrospectively for the CHC-based colposcopy program and concurrently with the regional colposcopy clinic (RCC). RESULTS: Women referred to the CHC colposcopy program had a significant reduction in their no-show rate after the introduction of the locally based colposcopy program (17.2% vs. 1.3%, p<0.01). Comparing the same time periods, there was no significant reduction in the default rate at the RCC (2.5% vs. 3.3%, p=0.21). Despite serving a population of women who were at higher risk for non-attendance, patients at the CHC had a default rate for appointments similar to that of the RCC (1.3% vs. 3.3%, p=0.55) after the introduction of the local colposcopy program. CONCLUSIONS: Lower socio-economic status and immigrant women receiving care from a CHC-based colposcopy program had a significant decrease in their no-show rate for colposcopic evaluation after the introduction of the on-site program. Consideration must be given to locating diagnostic colposcopy programs in settings more accessible to women who require these services the most.

Adolescent↗
PubMed1987

Human apolipoprotein B: analysis of internal repeats and homology with other apolipoproteins.

Apolipoprotein B (apoB) is the major protein component of plasma low density lipoproteins (LDL) and, through its binding to the LDL receptor, it plays a prominent role in lipoprotein metabolism and in the development of atherosclerosis. Specially developed computer programs were applied to detect potential internal repeats in the human apoB sequence and homology of some of these repeats with other apolipoproteins. The simultaneous computer alignment of several (repeated) sequences, carried out in an iterative way to generate consensus sequences, showed the presence of repeated amphipathic helical regions and of repeated hydrophobic proline-rich domains. Extensive Monte-Carlo statistics were used to demonstrate the statistical significance of the internal repeats. Both classes of repeats may contribute to the specific lipid-binding characteristics of apoB. Additional homology, detected between apoB and apoE, the other apolipoprotein-ligand of the LDL receptor, further defined the structural requirements for this receptor-ligand interaction. The computer programs developed in this study should also be useful for detecting internal repeats in other proteins.

Amino Acid Sequence↗
PubMed1982

Managing the implementation of a pharmacy computer system.

The process of managing the implementation of a pharmacy computer system is described. The three major phases of an implementation plan are (1) orientation and testing, (2) training of personnel, and (3) operation and expansion. Testing procedures described include those for entering new medication orders, profile maintenance, printouts for unit dose cart dispensing, label and report generation, i.v. system orders, back-up system, special edit features, charge generation, and admission, discharge, and transfer status. Personnel training components described are orientation, formal and practical sessions, program development, and training manual development. Implementation programs described include parallel operations of manual and computer systems, limited independent operation, and expansion. Successful implementation of a pharmacy computer system depends on careful planning and coordination.

Computers↗
PubMed1995

Home care in the urban setting--a challenge to medical education.

The rapid growth in the use of the home as the site of care delivery necessitates that the home setting be incorporated as a teaching site into the curriculum of medical schools. Urban medical schools have a unique advantage in that they have a large population base readily available to students and preceptors as well as an array of allied health providers. Urban institutions can be in the forefront of developing programs that simultaneously promote: clinically competent care; the maximal function of large numbers of acutely and chronically ill persons; research into issues of cost-effectiveness; and, most importantly, professional humanism. Specific educational objectives are included.

Acute Disease↗
PubMed1998

Asian and Pacific Islander American HIV community-based organizations: a nationwide survey.

A national survey was conducted to (a) ascertain the status of HIV prevention among community-based organizations targeting APIs in the United States, (b) define technical assistance needs among these organizations, and (c) determine their involvement in the HIV community planning process. Of the 80 surveys sent out, 49 (61%) completed responses were received. Filipinos, Chinese, Vietnamese, Cambodians, and multiracials were the subpopulations targeted the most often, and, not surprising, Tagalog, Cantonese, Mandarin, Vietnamese, Cambodian, Korean and Japanese were the Asian languages most widely in use. Gay men, bisexual men, and youth were targeted most frequently by HIV prevention efforts. Of all the largest ethnic subpopulations, Asian Indian is the only group with no community-based organization that exclusively targets them for HIV prevention. More than 95% of respondents reported conducting some type of evaluation; the size of the budget and organization often determined the evaluation strategies used. Program development, staff development, and program evaluation were the most frequently reported areas of technical assistance requested. A majority of the respondents (79%) reported being involved with the HIV prevention community planning process where APIs were represented on state/local community planning groups, they did not rate the performance of the community planning process highly. We recommend providing technical assistance in fund-raising, program evaluation, and participation in the HIV community planning process.

Asian↗
PubMed1999

Who teaches residents about the prevention and treatment of substance use disorders? A national survey.

BACKGROUND: Studies indicate that physicians are poorly prepared to identify and treat tobacco, alcohol, and drug use disorders. Several faculty development programs have been created to increase the number of residency teaching faculty with expertise in this area. There is limited information, however, on those who currently teach residents about these problems and whether there is a need for additional faculty development programs. METHODS: We conducted a 2-stage national survey of faculty who teach residents about substance use problems. First, residency directors from 7 specialties (family medicine, psychiatry, internal medicine, pediatrics, obstetrics and gynecology, emergency medicine, and osteopathy) responded to a mailed questionnaire asking them to identify faculty who teach residents about substance use disorders. Second, those identified were contacted and asked to participate in a telephone interview. RESULTS: Of 1293 faculty identified by the residency directors, 769 participated in a research interview. Most of these teachers were full-time physician faculty, men, white, and based in departments of family medicine or psychiatry. Teaching was primarily conducted in hospitals, general outpatient clinics, and classrooms rather than alcohol and drug treatment programs. Less than 10% of the faculty performed clinical work in alcohol and drug treatment programs, and only 19% were certified addiction specialists. The respondents reported a definite need for additional development programs for themselves and other residency teaching faculty. CONCLUSIONS: We suggest a modest increase in the number of faculty who teach residents about substance abuse disorders, and the creation of additional faculty development programs.

Adult↗
PubMed2005

Medication development for addictive disorders: the state of the science.

In 1989, the National Institute on Drug Abuse (NIDA) established its Medications Development Program. This program has concentrated on developing pharmacotherapies for opiate and cocaine dependence and, more recently, for methamphetamine and cannabis dependence. The major goals of this program are to optimize existing treatments and to expand treatment options for physicians and patients. This review will concentrate on the development of pharmacotherapies for the following substance abuse disorders: opiate, cocaine, methamphetamine, and cannabis dependence. Left untreated, opiate and stimulant dependence are responsible for significant morbidity and mortality. For example, use of illicit opiates is associated with an increased risk of hepatitis C infection, HIV infection, and other medical consequences, e.g., an overdose. The NIDA Medications Development Program has had success in developing, with pharmaceutical partners, levomethadyl acetate, buprenorphine, and buprenorphine/naloxone for opiate dependence. Moreover, several marketed medications have shown promise in reducing cocaine use. Of interest, these medications likely operate through diverse neurochemical mechanisms, suggesting that combination therapy may be a rational next step that could increase treatment gains further in cocaine-dependent patients. The Medications Development Program has also identified multiple neuronal mechanisms that are altered by chronic administration of drugs of abuse. Advances in neuroscience have identified changes in conditioned cueing, drug priming, stress-induced increases in drug intake, and reduced frontal inhibitory mechanisms as all being possible for the development of, maintenance of, and possible relapse to, addiction. Potential medications that modulate these mechanisms are highlighted.

Animals↗