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The de novo molecular design program SPROUT has been applied to the X-ray crystal structures of Plasmodium and human dihydroorotate dehydrogenase, respectively. The resulting design templates were used to prepare a series of molecules which, in keeping with predictions, showed useful levels of species-selective enzyme inhibition.
OBJECTIVE: To evaluate the utility of psychological screening for couples entering a donor insemination program. DESIGN: Each spouse completed questionnaires. A psychologist reviewed them and rated the psychological fitness of the couple for participation in the program. Follow-up questionnaires were sent to each couple at a mean of 11 months after entry into the program. SETTING: Applicants for donor insemination were studied in an infertility program in a large, tertiary referral center. PATIENTS, PARTICIPANTS: Consecutive applicants to enter the donor insemination program were required to participate in the initial evaluation. INTERVENTIONS: Couples judged by the psychologist to be at risk for a poor psychological outcome had an assessment and counseling interview with the psychologist before proceeding with insemination. MAIN OUTCOME MEASURES: Initially, the Stress and Infertility Questionnaire measured specific anxieties related to donor insemination, marital and sexual impact, and attitudes about confidentiality; the Brief Symptom Inventory measured psychological distress; and the Dyadic Adjustment Inventory assessed marital satisfaction. At follow-up, 48% of couples returned a modified version of the Stress and Infertility Questionnaire and the other two questionnaires. RESULTS: The psychologist's rating was predictive of pregnancy rates (59% for excellent candidates, 41% for acceptable couples, and 14% for couples psychologically at risk). At-risk couples were more likely to drop out of the program (50% versus only 20% of other couples). Sexual problems were reported by 59% of women and 53% of men. Couples believed that a child should not be told of the donor insemination (74% of wives and 80% of husbands). Initially, 64% of wives and 70% of husbands chose total secrecy with families or friends, and these attitudes shifted little over time. CONCLUSION: This screening procedure is cost-effective and suggests that psychological intervention should be attempted with at-risk couples.
This bulletin describes state-of-the-art universal and selective prevention programs designed to promote parent and teacher competencies and to prevent conduct problems. In addition, it describes indicated interventions designed for children who already have been diagnosed with oppositional defiant disorder and/or conduct disorder. Emphasis is placed on empirically supported programs that have identified key malleable risk factors in children, families, and schools, which have been shown in longitudinal research to be related to later development of substance abuse, delinquency, and violence. We have targeted preschool and primary grade children, ages 0-8 years, in this review because research suggests that the most effective interventions can nip in the bud risk behaviors in the early years, before antisocial behaviors become crystallized. Guidelines for selecting effective interventions are provided.
OBJECTIVES: To evaluate the impact of directed physical exercise in patients with spinal cord injury (SCI) and to measure functional independence before and after an exercise program. DESIGN: Case series. SETTING: Tertiary care center. PARTICIPANTS: Thirteen volunteers with thoracic SCI. INTERVENTION: Patients participated in a 16-week exercise program, consisting of 3 weekly 120-minute sessions. They performed mobility, strength, coordination, aerobic resistance, and relaxation activities. MAIN OUTCOME MEASURES: The FIM instrument, arm crank exercise test, wheelchair skills, maximum strength, anthropometry (body composition measurements), and lipid levels. The results were processed by using nonparametric statistical tests. RESULTS: After comparing the values at the beginning and end of the program, patients showed a significant increase in the following parameters: average FIM score (p < .001) 113 +/- 7.1; weight lifted in the bench press exercise (46%, p < .0001), military press (14%, p < .0002), and butterfly press exercise (23%, p < .0001), and number of repetitions for biceps (10%, p <.0001), triceps (18%, p < .0001), shoulder abductors (61%, p < .0001), abdominals (33%, p <.009), and curl back neck exercise (19%, p < .0001). The maximum resistance achieved during the arm crank exercise test increased (p < .001), and heart rate 6 minutes after the exercise test decreased (p <.05). The time required for the wheelchair skill tests significantly decreased in all the tasks. No statistically significant changes occurred in body weight (p < .154), percentage of body fat (p < .156), lean body weight (p < .158), cholesterol/high-density lipoprotein cholesterol ratio (p < .076), or maximum heart rate (p < .20). The only complication arose in a patient who developed transient sinus bradycardia and hypotension after the arm crank exercise test. CONCLUSION: The directed exercise program had a positive impact for most of the variables of the study.
Participants in a variety of health plans, clinics and employer groups were invited to participate in the Asthma Self-Management Program (ASMP), an education program designed to improve self-management skills and daily functioning in individuals with asthma. The ASMP is an 8-week classroom program that provides information on the respiratory system, trigger avoidance, use of monitoring techniques and asthma medications. After program completion, graduates were contacted at scheduled intervals to reinforce performance of behaviors that are important to asthma self-management and to collect outcomes data. This paper reports the results of 2 years of follow-up with these individuals.
Monochromatic x-ray beams are desirable in various fields of diagnostic radiology; in fact a reduction of the dose and an enhancement of the contrast could be achieved. In this work two different methods to monochromatize x-ray beams produced by conventional tubes have been compared. In the first one the beam is obtained via Bragg diffraction on mosaic crystal and in the second one by attenuating the polychromatic beam with aluminium filters. We have simulated quasi-monochromatic x-ray spectra by setting suitable values of Bragg's angle to obtain beams tuned to 20, 30, 40 and 50 keV with the SHADOW code, an x-ray tracing program designed to study the propagation and the interaction of a photon beam through an optical system. We have validated such a program by comparing some calculated data with measurements carried out on an experimental apparatus. Attenuated polychromatic x-ray spectra have been simulated by setting appropriate values of aluminium filters and potential with the SPECTRUM PROCESSOR, the software version of the Catalogue of Spectral Data for Diagnostic X-Rays, which provides radiographic x-ray spectra that can be attenuated with several material filters. The relation between the energy resolution and the flux as a function of the mean energy has been investigated and results have been compared. Results show that quasi-monochromatic x-ray beams produced via Bragg diffraction exhibit, for a given mean energy and energy resolution, a higher total flux compared to attenuated spectra.
In 1951 the Centers for Disease Control and Prevention created the Epidemic Intelligence Service to provide training and epidemiologic service on the model of a clinical residency program. By January 2001, an additional 28 applied epidemiology and training programs (AETPs) had been implemented around the globe (with over 945 graduates and 420 persons currently in training). Field Epidemiology Training Programs and Public Health Schools Without Walls are the most common models. Applied epidemiologists, or field epidemiologists, use science as the basis for intervention programs designed to improve public health. AETPs train people by providing them with health competencies through providing service to public health intervention programs and strengthening health systems. AETPs are relatively expensive to create and maintain, but they are highly sustainable and can produce immediate benefits. Of the 19 programs that began before 1997, 18 (95%) continue to produce graduates. The Training Programs in Epidemiology for Public Health Interventions Network was organized in 1997 to provide support, peer review, and quality assurance for AETPs. In 2001, new programs are planned or in development in India, Argentina, China, and Russia.
A pharmacy residency on-call program designed to contribute to residents' competence in patient care and to extend the functions of the pharmacy department is described. The program, which was begun at the University of Kentucky Chandler Medical Center in 1984, offers a supportive environment in which the resident is held accountable for pursuing optimal outcomes of drug therapy. The program provides opportunities for the resident to engage in independent decision-making, care for a wide variety of patients, and manage acute illness. On-call services are provided in single 24-hour shifts beginning at 0800 each day. Residents assess and respond to supratherapeutic serum drug concentrations, perform pharmacokinetic monitoring, provide drug information, evaluate patients for specific drug therapy, obtain medication histories for HIV-seropositive patients, and participate in emergency patient management. Residents provide services in the absence of the primary pharmacist on nights, weekends, and holidays and devote a four-hour period to drug distribution. Each pharmacy resident participates in the on-call program, regardless of the chief focus of his or her residency. Residents' activities are documented electronically, and preceptors give feedback via e-mail. The program and its activities have evolved over the years to reflect changes in pharmacy practice. An on-call program for pharmacy residents provides a valuable learning experience while enhancing patient care.
UNLABELLED: Paloverde is a new program designed to help visualize the phylogenetic structure of moderately large trees--trees on the scale of 100-2500 leaf nodes. The program embeds the user in an interactive virtual 3D world in which a large tree presented in various layouts can be manipulated through a mouse interface. The program implements radial 2D layouts, and true 3D spiral, conical and hemispherical (i.e. truly 'tree'-like) layouts. Subclades can be defined in the input file (using standard node-based definitions) and displayed collapsed as new leaf nodes, or left intact but annotated with names around the periphery of the tree. A search tool lets the user zoom to any selected leaf node. Paloverde is an open source project written in ANSI C using the OpenGL library for 3D visualization. AVAILABILITY: Source code, makefiles for Mac OS X and Linux and a compiled binary for Mac OS X are available at http://ginger.ucdavis.edu/paloverde/paloverde.html, along with a sample dataset.
We evaluated the effectiveness of an 11-lesson psychoeducational program designed to enhance the ability of deaf children to understand the emotional experience of themselves and other people. The "Funny Faces Program" was provided to 14 children, aged 9 to 13, with moderate to profound hearing impairments. All children were enrolled in an "oral" education program at a school for the deaf. Alternate forms of the Emotion Recognition Scales (Dyck, Ferguson, & Shochet, 2001) were administered at pretest and posttest. Results indicate significant increases in emotion vocabulary and emotion comprehension but not in the speed or accuracy of emotion recognition (ER), from pretest to posttest. At posttest, children whose hearing loss was moderate to severe did not differ from hearing children in ER abilities but children with profound hearing loss continued to show substantial ability deficits.
The purpose of this study was to investigate the effect of increased abdominal muscle strength on forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Twenty-five healthy volunteers were assigned randomly to either an experimental group (n = 16) or a control group (n = 9). Peak isokinetic torque of the abdominal muscles during the performance of a trunk curl-up, FVC, and FEV1 were measured before and after a 12-session training program designed to increase abdominal muscle strength. The control group did not train. Although abdominal muscle strength increased significantly after the training program, FVC and FEV1 did not increase significantly. The correlations between abdominal muscle strength and FVC, and between abdominal muscle strength and FEV1 were low. Based on these results, abdominal muscle strengthening does not appear to be an effective means of improving FVC and FEV1 in healthy subjects.
OBJECTIVES: To describe the development, implementation, and preliminary outcome of the Pain-Disability Prevention (PDP) Program. The PDP Program is a 10-week cognitive-behavioral intervention program that aims to increase daily involvement in goal-directed activity and minimize psychological barriers to activity involvement after occupational injury. Workers' Compensation Board claimants with soft tissue injuries to the back, who were still off work 6 weeks after injury and showed evidence of at least one "yellow flag," were offered participation in the PDP Program. DESIGN: A single-group, prospective treatment outcome analysis. PARTICIPANTS: Data from the first 104 claimants who participated in the PDP Program are summarized. RESULTS: Participation in the PDP Program was associated with a 60% success rate, where success was defined as return to work (45%) or readiness to return to work (15%). Initial scores on measures of catastrophizing, fear of movement/reinjury, and depression afforded 92% correct classification of treatment outcome. Early treatment changes in catastrophizing and fear of movement/reinjury were also predictive of treatment outcome. CONCLUSIONS: The findings suggest that a psychologically based activity mobilization program can be an effective means of yielding reductions in psychological risk factors for occupational disability. Challenges to program implementation, fidelity to protocol, and issues related to cost efficacy are discussed.
This study compared the effects of preoperative physical therapy of general cardiovascular conditioning exercises with the routine procedure of no preoperative physical therapy on patients undergoing primary total knee replacement. Thirty patients were randomly assigned to 1 of 3 groups. Group 1 was the control group. Group 2 participated in a physical therapy program designed to strengthen the upper and lower limbs and improve knee range of motion. Group 3 participated in a cardiovascular conditioning program, consisting of arm ergometry, cycle ergometry, aquatic exercises, and aerobic activity. All patients were evaluated preoperatively and postoperatively using the Hospital for Special Surgery Knee Rating, the Arthritis Impact Measurement Scale, and the Quality of Well Being instrument. Both experimental groups tolerated their respective exercise protocols extremely well. All 3 groups showed significant improvement postoperatively as measured by the Hospital for Special Surgery Knee Rating, the Arthritis Impact Measurement Scale and the Quality of Well Being measurement scales. However, neither type of preoperative exercise added to the degree of improvement after surgery at any of the postoperative evaluations.
LSFitXAFS is a computer program designed to calculate fractions of individual components (i.e. individual species, minerals, compounds or chemical environments) making up bulk XAFS spectra. The program performs Gaussian elimination and multiple linear regression techniques to simultaneously solve mass balance equations. In addition, the program contains a number of data reduction and analysis routines including the determination of random and systematic noise in Fourier-transformed spectra and calculation of the goodness-of-fit parameters for different combinations of shells.
OBJECTIVE: To create a program to identify preventive needs for community-dwelling older persons and incorporate intervention strategies to improve implementation of these services. DESIGN: Program development and case-series. SETTING: Community-based meal sites, academically administered program. PARTICIPANTS: Persons 60 years of age or older attending meal sites and their primary care physicians. MEASUREMENTS: Demographic characteristics, self reported preventive health behaviors and services, blood pressure measurement. RESULTS: During the first 2 years of the program, 927 persons 60 years of age or older were screened. The most common physician-initiated preventive recommendations were: tetanus booster (72%), aspirin prophylaxis (68%), pneumonia vaccination (61%), and colorectal cancer screening (51%). The most common self-care recommendations have been: calcium supplementation (54% of women) and breast self examinations (51% of women). As part of the adherence intervention, we were able to complete health educator calls for 600 (65%) subjects. In addition, the physicians of 599 (65%) subjects were contacted either by telephone (n = 496) or by letter only (n = 97). CONCLUSION: A community based preventive services program can identify large numbers of unmet preventive services needs, and a dual intervention strategy aimed at meeting these needs can be delivered successfully to the majority of participants. Implementation rates of specific recommendations and impacts on health outcomes remain to be determined.
PURPOSE: To identify learning experiences of Native American graduate nursing students in a university-based nurse practitioner program. DESIGN: The phenomenological approach of Heideggerian hermeneutics. METHOD: A purposive sample of 11 Native American graduate students in a nurse practitioner program were given the choice of participating in a focus group or completing an individual interview to elicit common meanings and shared experiences. FINDINGS: Four themes and two constitutive patterns: (a) Native American students' worldviews reflected unwritten knowledge that served as a background of common understanding, (b) academic environment as a rigid environment with only one way to learn and constant evaluation, (c) faculty-student relationship barriers to establishing a supportive learning environment, and (d) strategies to survive, including a commitment to succeed, conforming to unwritten rules, helping each other, and ultimately changing themselves. Constitutive patterns were: (a) value conflicts when students' values conflicted with academic behavioral values, and (b) on the fringe, when students felt isolation from the main student body, and open to attack (evaluation). Students struggled to be successful in their commitment to complete the degree, but often questioned the applicability of the program in their cultural setting. CONCLUSIONS: A more flexible supportive environment is needed to support students' goals to attain degrees, as well as to encourage dialogue on differing cultural values. Faculty who teach culturally diverse students may need to examine rigid behavioral standards that mandate an assertive practitioner persona and may be a barrier to attainment of goals.
The recruitment and retention of students from culturally diverse backgrounds remains a critical issue in nursing education. This article describes one program that was very successful in helping Native Canadian and other disenfranchised students succeed academically in nursing. The program design and operation as well as issues related to recruitment and retention of these students are presented. Many aspects of this program are now incorporated into the baccalaureate nursing program in the college.
BACKGROUND: Primer design is a critical step in all types of RT-PCR methods to ensure specificity and efficiency of a target amplicon. However, most traditional primer design programs suggest primers on a single template of limited genetic complexity. To provide researchers with a sufficient number of pre-designed specific RT-PCR primer pairs for whole genes in Arabidopsis, we aimed to construct a genome-wide primer-pair database. DESCRIPTION: We considered the homogeneous physical and chemical properties of each primer (homogeneity) of a gene, non-specific binding against all other known genes (specificity), and other possible amplicons from its corresponding genomic DNA or similar cDNAs (additional information). Then, we evaluated the reliability of our database with selected primer pairs from 15 genes using conventional and real time RT-PCR. CONCLUSION: Approximately 97% of 28,952 genes investigated were finally registered in AtRTPrimer. Unlike other freely available primer databases for Arabidopsis thaliana, AtRTPrimer provides a large number of reliable primer pairs for each gene so that researchers can perform various types of RT-PCR experiments for their specific needs. Furthermore, by experimentally evaluating our database, we made sure that our database provides good starting primer pairs for Arabidopsis researchers to perform various types of RT-PCR experiments.