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At least 937 records · Page 52Linked to original sources
PubMed1990

A program to find regions of similarity between homologous protein sequences using dot-matrix analysis.

MATRIX is a program designed primarily to enable the user to visualize all regions of similarity between two proteins at a glance. The program helps the user to see where they are similar--at what relative positions in the amino acid sequences of the two proteins in question does the similarity exist; how they are similar--what functional characteristics the two similar sequences have in common; and to what extent they are similar--is the similarity significant, if so how significant relative to other similar sequences in the protein. This is achieved by constructing a diagram in which quantitative parameters of amino acids are used to compare every amino acid residue of the first protein with every amino acid residue of the second. Another function of the program is, given two sets of atomic coordinates--either of different proteins or for the same protein (for self-comparison)--to demonstrate which residues of the two proteins, when the two proteins are superimposed upon each other, appear in the same space (or are close to each other).

Amino Acid Sequence↗
PubMedDate not supplied

Patterns of blood utilization by physicians: transfusion of nonoperated anemic patients.

Prior studies have suggested that a high percentage of blood transfusions to hospital patients are unnecessary. If such transfusions can be reduced, more blood would be made available for those patients with legitimate blood requirements. In this study, blood transfusion of 401 nonoperated hospital patients with anemia as the final diagnosis explaining admission and with admission hemoglobin values equal to or greater than 10 gm/dl was analyzed. These patients were drawn from a 300 hospital sample distributed across the United States. Descriptive data showing the extent to which this selected population of patients is transfused with blood must be considered as one measure of unnecessary blood transfusion in this country. Hospital-based programs designed to identify and eliminate unnecessary blood transfusions should be established. The first step in the creation of such programs at the hospital level must be the development of guidelines for blood transfusion derived through the cooperative efforts of hospital physicians who fully understand and accept the rationale for them. Once guidelines for blood transfusion are established in a hospital, transfusion practice need only be measured against them.

Adult↗
PubMed2006

[BeKi--an initiative for nutrition education in children: program description and evaluation].

OBJECTIVES: The State Initiative Be KI is carried out statewide by the Baden-Württemberg Ministry for Nutrition/Food and Rural Area since 1980. Be KI addresses all target groups involved in the upbringing and education of children from age 6 months up to the end of the 6th grade and provides factual, validated, and independent information on child nutrition and nutrition education. Recently a comprehensive evaluation was carried out to assess the public health impact. Program, design and results of the evaluation are presented. METHODS: According to the RE-AIM Model for health promotion programs the evaluation assesses the public health impact in regard of individual and institutional reach, efficacy, adoption, implementation, and maintenance by various methods (e. g. written surveys and interviews with experts of child nutrition, in day care facilities and primary schools supplemented by internal data of the Ministry). RESULTS: Be KI represents the nutrition education program for children in the German language area with the longest uninterrupted operation span. The number of assignments of the child nutrition experts has been increasing ever since Be KI's official inception in 1980. During the school year 2004/2005 the experts carried out 6090 assignments, predominantly in primary schools which accounted for 60% of the assignments. About a third of schools know Be KI. The majority of kindergarten and school teachers who know the experts of child nutrition or the compilation use these offers. Many teachers use Be KI-components without knowing that they belong to Be KI. As a result of Be KI some of the teachers noticed short-time changes: pupils eat healthier break-time snacks and change their attitude towards a more balanced diet. Concerning the frequency of nutrition education and teachers attitude there are hardly any differences between institutions with Be KI and without Be KI. CONCLUSION: Be KI meets the main requirements of effective nutrition education programs for children: it is creative, engaging, inexpensive an widely dissiminated. Contents and methods of the provided materials correspond to the development level of the target groups. But communication and networking with educational institutions as well as public relations should be intensified and teachers in day care facilities and school teachers should be motivated to work with the Be KI-materials on their own (empowerment). Room for improvement exists in regard of a permanent straightforward evaluation system and a more pronounced orientation of the prevention program towards the social environment would be helpful.

Attitude to Health↗
PubMed2006

Hospital-based strategies for combating resistance.

Selective pressures generated by the indiscriminate use of beta-lactam antibiotics have resulted in increased bacterial resistance across all beta-lactams classes. In particular, the use of third-generation cephalosporins has been associated with the emergence of extended-spectrum beta-lactamase-producing and AmpC beta-lactamase-producing Enterobacteriaceae and vancomycin-resistant enterococci. Conversely, beta-lactams (e.g., cefepime, piperacillin-tazobactam, and ampicillin-sulbactam) have not demonstrated such strong selective pressures. Chief among institutional strategies to control outbreaks of multidrug-resistant bacteria are infection-control measures and interventional programs designed to minimize the use of antimicrobial agents that are associated with strong relationships between use and resistance. Successful programs include antimicrobial stewardship programs (prospective audit and feedback), formulary interventions (therapeutic substitutions), formulary restrictions, and vigilant infection control. Fourth-generation cephalosporins, such as cefepime, have proven to be useful substitutes for third-generation cephalosporins, as a part of an overall strategy to minimize the selection and impact of antimicrobial-resistant organisms in hospital settings.

Anti-Bacterial Agents↗
PubMed1997

Effects of family history of heart disease, apolipoprotein E phenotype, and lipoprotein(a) on the response of children's plasma lipids to change in dietary lipids.

We examined the effects of family history of coronary artery disease (CAD), apolipoprotein E (apo E) phenotype, and lipoprotein(a) [Lp(a)] on the response of plasma lipids to change in dietary lipid intake after 3 mo of nutrition education in 125 children aged 4-10 y. The subjects were healthy children with elevated low-density-lipoprotein (LDL)-cholesterol concentrations who participated in the Children's Health Project, a nutrition-education program designed to lower plasma cholesterol by means of dietary modifications in accordance with recommendations of the National Cholesterol Education Program. Dietary and plasma lipids were measured by three 24-h recalls and assessments of two fasting plasma samples collected before and 3 mo after the start of intervention. Family history of CAD was determined by questionnaires administered to parents at baseline. Apo E phenotyping was done with isoelectric focusing followed by immunostaining; Lp(a) was measured with two-site immunoradiometric assays of frozen aliquots of plasma samples collected at baseline and 3 mo. After adjustment for intervention group, age, sex, and body mass index, analysis of covariance showed that baseline plasma lipid concentrations were the strongest independent predictors of change in plasma lipids after 3 mo. Plasma total and LDL-cholesterol concentrations in children with less family history of CAD were significantly more responsive to change in dietary cholesterol than concentrations in children with a stronger family history of CAD. Neither apo E phenotype nor Lp(a) significantly influenced change in plasma lipids independently or interactively with change in dietary lipids.

Apolipoproteins E↗
PubMed2001

Long-term maintenance of gains obtained in postacute rehabilitation by persons with traumatic brain injury.

OBJECTIVE: To investigate maintenance of gains after discharge from a postacute rehabilitation program. DESIGN: Longitudinal cohort study, with inclusion based on availability of subjects at three time points. SETTING: Comprehensive postacute rehabilitation program in the Southern United States. PARTICIPANTS: Thirty-four persons with medically documented complicated mild to severe traumatic brain injury; primarily male Caucasians with some college. MAIN OUTCOME MEASURES: Disability Rating Scale and the Community Integration Questionnaire completed at admission, discharge, and two follow-up time points. RESULTS: Repeated measures analyses, using time from injury to discharge as a covariate, revealed significant improvements on all measures from admission to discharge, with no significant change from discharge to either of the follow-up periods. However, substantial changes were noted in individual cases. CONCLUSIONS: The results indicate that gains made by persons with traumatic brain injury during postacute rehabilitation are generally maintained at long-term follow-up, but changes occur in individual cases. Long-term services may help prevent decline in individual cases.

Adult↗
PubMed2000

Predicting completion of a cognitive-behavioral pain management program by initial measures of a chronic pain patient' s readiness for change.

OBJECTIVE: There is a need to identify pretreatment patient indicators, which are predictive of the successful enrollment and completion of chronic pain treatment programs. Recent evidence suggests the Pain Stages of Change Questionnaire can predict enrollment and completion of a 10-session cognitive-behavioral pain management program. The purpose of this study is to determine whether the pretreatment Stages of Change Questionnaire can predict patients who would complete a cognitive-behavioral pain treatment program. DESIGN: Prospective cohort study using logistic regression analyses. SETTINGS: Patients referred for a 10-session cognitive-behavioral treatment program at a tertiary care multidisciplinary pain clinic or a community-based specialty clinic. SUBJECTS: Three hundred chronic pain patients (151 in the tertiary setting and 149 in the community-based setting) participated, with 147 of the patients (49%) completing and 153 (51%) patients not completing the 10-session program. INTERVENTION: Ten-visit cognitive-behavioral program for chronic pain patients. OUTCOME MEASURE: Completion of program. RESULTS: The Stages of Change Questionnaire scores could predict completion status chi2 (N = 300, 2 df) = 39.7, p <0.001, (goodness-of-fit test chi2 = 5.69, p = 0.68). Those patients completing the program were slightly older and reported higher levels of pain, depression, and disability than did those patients who did not complete. Low "Precontemplation" score remained the best single predictor, as it identified correctly 61% of the cases patients who completed the program and predicted who would drop out in 65% of the cases. CONCLUSION: The Stages of Change Questionnaire is a potentially useful tool; however, the current scoring method is insufficient to recommend its use as an inclusion or exclusion criterion for enrollment in a cognitive-behavioral program.

Adult↗
PubMed1994

Effects of antipsychotic withdrawal in elderly nursing home residents.

OBJECTIVE: To study the effects of antipsychotic withdrawal in elderly nursing home residents. DESIGN: Longitudinal prospective study. SETTING: 12 community nursing homes that participated in a randomized controlled trial of an educational program designed to reduce antipsychotic use. SUBJECTS: 271 residents receiving antipsychotics at baseline and remaining in the home for approximately 6 months thereafter. These were placed into two groups: those with continued use of antipsychotics at follow-up (n = 207) and those with drug discontinued (n = 64). MEASUREMENTS: Change between baseline and follow-up for several standard measurements. These included behavior problems, as reported by both regular care providers (Nursing Home Behavior Problem Scale) or a blinded study rater (items from the Brief Psychiatric Rating Scale), observer-rated psychiatric symptoms (subset of the Brief Psychiatric Rating Scale), and other standard tests of function (Activities of Daily Living, Mini-Mental State Examination, Geriatric Depression Scale, and Abnormal Involuntary Movements Scale). RESULTS: The frequency of behavior problems did not increase in residents with antipsychotics discontinued. For these residents, observer-rated psychiatric symptoms decreased by 21% (P = 0.003), which resulted from a 27% decrease in adverse affective symptoms (P = 0.0002). Residents with drug discontinued had no deterioration in any of the measures of function. CONCLUSION: In this sample, nursing home residents whose antipsychotics were discontinued had significantly improved affect and no discernable adverse effects.

Activities of Daily Living↗
PubMed1999

Energy and nutrient status of amenorrheic athletes participating in a diet and exercise training intervention program.

Chronic energy deficit is one of the strongest factors contributors to exercise-induced menstrual dysfunction. In such cases, macro- and micronutrient intakes may also be low. This study presents the results of a diet and exercise training intervention program. designed to reverse athletic amenorrhea, on improving energy balance and nutritional status in 4 amenorrheic athletes. The 20-week program provided a daily sport nutrition supplement and 1 day of rest/week. The program increased protein intakes for the 3 athletes with a protein deficit to within the recommended levels for active individuals. Micronutrient intakes increased, as did serum concentrations of vitamin B12, folate, zinc, iron, and ferritin. These results indicate that some amenorrheic athletes have poor nutritional status due to restricted EIs and poor food selections. A sport nutrition supplement may improve energy balance and nutritional status in active amenorrheic women.

Adolescent↗
PubMedDate not supplied

Assessment of the integration of the ecological approach in health promotion programs.

PURPOSE: This article proposes a model of the ecological approach in health promotion programs. Based on system theory, the model identifies intervention settings and targets as two independent dimensions for assessing the integration of this approach in programs. Additional objectives are to present and pretest an analytical procedure that allows the assessment of integration of the ecological approach in programs. DESIGN: This was a descriptive study of the integration of the ecological approach in a sample of health promotion programs. SUBJECTS: Subjects were 44 health promotion programs drawn from the population of Canadian federally funded programs. MEASURES: Descriptions of programs were obtained by telephone interviews. A coding scheme was applied to the data to identify intervention settings and targets for each program. Using this information, a summative score of the integration of the ecological approach was estimated for each program. RESULTS: Single-setting programs were the dominant pattern in the sample. Individuals whose health was of concern were very frequently the direct targets of the programs. However, organizational and interpersonal environments were also often directly targeted. Single-setting or single-intervention strategy programs outnumbered ecological programs. CONCLUSION: The proposed model and analytical procedure is a useful framework for the assessment of integration of the ecological approach in health promotion programs. The pilot test having been conducted on a convenience sample, future work should replicate the study in a representative sample of programs.

Canada↗
PubMedDate not supplied

Three-year follow-up of Pawtucket Heart Health's community-based weight loss programs.

PURPOSE: The purpose of the study was to evaluate the effectiveness of a community-based weight loss program. DESIGN: A questionnaire was administered by telephone to subjects one to three years following participation in a weight loss program. SETTING: The study took place in Pawtucket, Rhode Island. The Pawtucket Heart Health Program is part of this setting. SUBJECTS: A stratified sample of 400 subjects was randomly selected from 2,186 people who participated in weight loss programs between 1985 and 1987. A total of 285 subjects completed the questionnaire; 229 subjects provided sufficient information to be included in the study. INTERVENTION: The subjects participated in community-based and worksite-based weight loss programs. MEASURES: Self-reported heights and weights before and after intervention and demographic data were collected. Desirable body weight and Garrow's health risk classifications were calculated. RESULTS: Overall, there was a 3.2% reduction in body weight between time of entrance into weight loss programs and time of interview. Eighty percent of the participants lost weight in the program; mean weight loss was 11 pounds. At time of follow-up interview one to three years later, 65% of subjects weighed less than at entrance into the community programs; on average, subjects weighed six pounds less. Sixty-nine percent of the sample was above 20% desirable body weight at entrance and 26% of this group lost enough weight to lower their health risk category. CONCLUSIONS: Weight loss in this community-based program compares favorably with those reported by more intense and expensive clinic-bound programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1999

Obstetrics anyone? How family medicine residents' interests changed.

OBJECTIVE: To determine family medicine residents' attitudes and plans about practising obstetrics when they enter and when they graduate from their residency programs. DESIGN: Residents in each of 4 consecutive years, starting July 1991, were surveyed by questionnaire when they entered the program and again when they graduated (ending in June 1996). Only paired questionnaires were used for analysis. SETTING: Family medicine residency programs at the University of Toronto in Ontario. PARTICIPANTS: Of 358 family medicine residents who completed the University of Toronto program, 215 (60%) completed questionnaires at entry and exit. MAIN OUTCOME MEASURES: Changes in attitudes and plans during the residency program as ascertained from responses to entry and exit questionnaires. RESULTS: Analysis was based on 215 paired questionnaires. Women residents had more interest in obstetric practice at entry: 58% of women, but only 31% of men were interested. At graduation, fewer women (49%) and men (22%) were interested in practising obstetrics. The intent to undertake rural practice was strongly associated with the intent to practise obstetrics. By graduation, residents perceived lifestyle factors and compensation as very important negative factors in relation to obstetric practice. Initial interest and the eventual decision to practise obstetrics were strongly associated. CONCLUSIONS: Intent to practise obstetrics after graduation was most closely linked to being a woman, intending to practise in a rural area, and having an interest in obstetrics prior to residency. Building on the interest in obstetrics that residents already have could be a better strategy for producing more physicians willing to practise obstetrics than trying to change the minds of those uninterested in such practice.

Adult↗
PubMed1999

Cardiac rehabilitation: the forgotten intervention.

OBJECTIVE: To examine the influence of cardiac patients' demographic and health characteristics on physicians' cardiac rehabilitation (CR) referral practice and patients' attendance at such programs. DESIGN: A retrospective, systematic review of consecutive health records. SETTING: A tertiary care centre and the two associated CR programs in a Western Canadian city. PATIENTS: One thousand, three hundred and twenty-eight adult patients (21 years of age or older) discharged following acute myocardial infarction, percutaneous transluminal coronary angioplasty (PTCA) and/or coronary artery bypass graft surgery between September 1, 1996 and August 31, 1997. MAIN RESULTS: There were 1245 surviving patients. Evidence of attendance at a CR program was 28.4%, while auditable evidence of referral to a CR program was 23.9%. Stepwise logistic regression revealed that ability to speak English (OR 9.56) living in a city (OR 3.97) and current smoking (OR 1.51) were associated with an increased likelihood, whereas having a history of chronic obstructive pulmonary disease or asthma (OR 0.53), being 70 years of age or older (OR 0.42), having a current admission for PTCA (OR 0.32) and having a history of neurological or cognitive impairment (OR 0.26) were associated with a decreased likelihood of CR attendance. Sex, nature of coronary artery disease risk factors, incidence of postevent complications and pre-event cardiac status (including New York Heart Association status and number of previous events) were not associated with patients' CR attendance. CONCLUSIONS: This study suggests that there is an inconsistent and poorly documented approach to referral of patients to CR programs for reasons that remain unclear. These findings provide a foundation for development and testing of enhanced referral mechanisms and of innovative means to provide rehabilitation services to patients who are at risk for not being referred to or attending CR programs.

Adult↗
PubMed1987

Shadowing program to increase student awareness of hospital pharmacy practice.

A shadowing program designed to acquaint second-year pharmacy students with the professional responsibilities of a hospital pharmacist is described. The program developed by the Toledo Area Society of Hospital Pharmacists allowed second-year pharmacy students to "shadow" a staff pharmacist for three to four hours. The program required the cooperation of area hospital pharmacists to develop rotations at each site. Eight hospitals provided shadow rotations for 87 students during the program's first offering. Reactions were positive from both students and pharmacists. Direct pharmacist-student interaction, low cost, and flexibility were important factors in the program's success. The shadowing program has proven to be an effective method of introducing hospital pharmacy career options to prepharmacy students.

Education, Pharmacy↗
PubMedDate not supplied

Osteoporosis prevention in young women.

PURPOSE: To assess whether young women who participate in an osteoporosis prevention program based on the Health Belief (Rosenstock, 1966) and Self-Efficacy Models (Bandura, 1977) demonstrate higher levels of knowledge regarding osteoporosis prevention than young women who do not participate in such a program. DESIGN: A classic experimental design with one treatment group and one control group was used to test the efficacy of the osteoporosis prevention program. Pretest data on knowledge, health belief attitudes (7 subscales), and self-efficacy (2 subscales) were collected in the treatment and control groups. SAMPLE: A convenience sample of 31 young college women were randomly assigned to an experimental group or to a control group to receive an osteoporosis prevention program. METHOD: Subjects in the experimental and control groups completed the Osteoporosis Knowledge Test, the Osteoporosis Health Belief Scale, and the Osteoporosis Self-Efficacy Scale (Kim et al., 1991) at two times. The experimental group received an osteoporosis prevention program. MAIN RESEARCH CLASSIFICATIONS: Osteoporosis, Health Belief, Self-Efficacy, Women's Health. FINDINGS: Subjects in the experimental group had significantly higher knowledge and health belief scores after receiving the intervention than their pretest scores while subjects in the control group had no change in scores. CONCLUSION: The osteoporosis program was effective in increasing awareness of osteoporosis prevention in this group of young women. IMPLICATIONS FOR NURSING RESEARCH: The results may be useful for developing young women's awareness and knowledge of osteoporosis prevention. Future research could include developing osteoporosis prevention programs at an earlier age when girls are in grade school and junior high school. Teaching health promotion strategies for bone health is essential to all women across the life span.

Adolescent↗
PubMed2002

A controlled evaluation of staging dietary patterns to reduce the risk of diabetes in African-American women.

OBJECTIVE: This study evaluated the 3-month follow-up data of the Eat Well, Live Well Nutrition Program, a culturally specific, peer-led dietary change program designed to reduce the risk of type 2 diabetes in low-income African-American women. This peer-led program was delivered in the community and was tailored to the participants' stage of change for individual dietary patterns. We report the results of the 3-month intervention and the extent to which dietary changes and other key outcomes were maintained at a 3-month follow-up assessment. RESEARCH DESIGN AND METHODS: Using an experimental control group design, 294 overweight African-American women (ages 25-55 years), recruited in collaboration with a neighborhood organization, completed pre- and posttest and 3-month follow-up interviews of dietary behaviors, knowledge, attitudes, fat intake, and weight. RESULTS: Significant reductions were found in fat intake among women in the treatment condition when compared with women in the control group; these reductions were maintained at 3-month follow-up assessment. Likewise, significant changes in dietary patterns were reported after the study and were maintained, except for one dietary pattern (replacement). CONCLUSIONS: This model of health promotion, which individually tailors dietary patterns through staging and use of peer educators, has the potential for decreasing fat intake and increasing and maintaining specific low-fat dietary patterns among overweight African-American women at risk for diabetes.

Adult↗
PubMed1993

Genetic algorithms-based design and optimization of statistical quality-control procedures.

In general, one cannot use algebraic or enumerative methods to optimize a quality-control (QC) procedure for detecting the total allowable analytical error with a stated probability with the minimum probability for false rejection. Genetic algorithms (GAs) offer an alternative, as they do not require knowledge of the objective function to be optimized and can search through large parameter spaces quickly. To explore the application of GAs in statistical QC, I developed two interactive computer programs based on the deterministic crowding genetic algorithm. Given an analytical process, the program "Optimize" optimizes a user-defined QC procedure, whereas the program "Design" designs a novel optimized QC procedure. The programs search through the parameter space and find the optimal or near-optimal solution. The possible solutions of the optimization problem are evaluated with computer simulation.

Algorithms↗
PubMed1994

Collaborative evaluation of a volunteer monitoring program to improve group homes for adults with mental retardation.

This report describes an evaluation study of a volunteer monitoring program designed to improve the quality of life in group homes for adults with mental retardation. Special attention is given to the evaluation researchers' efforts to collaborate with the volunteer monitors to develop valid measures and a research design that would minimize the inherent threats to validity (e.g., selection biases). Initial results noted (a) the frequency in which 257 volunteers monitored 248 group homes in Michigan and (b) the homes that were visited three or more times over the course of this study had lower normalization levels than the home visited only once or twice. The impact of the program was tested using a repeated measures design with a subsample of 79 homes that were monitored on at least four occasions. The evaluation results suggested that frequent monitoring was associated with improvements in the homes' decor, the residents' appearance, and the social interaction styles in the homes.

Evaluation Studies as Topic↗