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A multiple sequence alignment algorithm for homologous proteins using secondary structure information and optionally keying alignments to functionally important sites.

The programs described herein function as part of a suite of programs designed for pairwise alignment, multiple alignment, generation of randomized sequences, production of alignment scores and a sorting routine for analysis of the alignments produced. The sequence alignment programs penalize gaps (absences of residues) within regions of protein secondary structure and have the added option of 'fingerprinting' structurally or functionally important protein-residues. The multiple alignment program is based upon the sequence alignment method of Needleman and Wunsch and the multiple alignment extension of Barton and Sternberg. Our application includes the feature of optionally weighting active site, monomer--monomer, ligand contact or other important template residues to bias the alignment toward matching these residues. A sum-score for the alignments is introduced, which is independent of gap penalties. This score more adequately reflects the character of the alignments for a given scoring matrix than the gap-penalty-dependent total score described previously in the literature. In addition, individual amino acid similarity scores at each residue position in the alignments are printed with the alignment output to enable immediate quantitative assessment of homology at key sections of the aligned chains.

Algorithms↗

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↗

The Friendship Club: an after-school program for children with Asperger syndrome.

The Friendship Club is a program designed and implemented by occupational therapy students and faculty to help teach children, ages 8-15, activities related to friendship and skills necessary to maintain friends. The program, a joint effort between university partners, a local parent support group, and a local Rotary Club that provided funding, was deemed successful by participants, parents, and leaders. This article reviews the interdisciplinary development of the club, the program, and its outcomes. Recommendations for the group's continuation are supported by feedback obtained from participants and their parents.

Adolescent↗

Effectiveness of a geriatric medical student scholars program: a qualitative assessment.

In 2003, the University of Cincinnati College of Medicine initiated a 4-year Geriatric Medical Student Scholars (GMSS) program in which a selected group of 14 medical students participated in a variety of extracurricular geriatrics-related activities such as one-on-one mentoring and discussion groups. These students were also required to compose journal entries describing GMSS program-related activities using a semistructured on-line computer program designed specifically for this purpose. The reflective journals, in combination with the American Geriatrics Society (AGS) competencies, were used to evaluate the degree to which the GMSS program achieved its goal of enhancing students' understanding of the complex health and social challenges facing older adults. Using a confirmatory qualitative analysis strategy, the AGS competencies served as an a priori codebook to evaluate the student journal entries. Of the original 53 AGS competencies identified as being relevant for a first- or second-year medical student, 74% were used at least one time, and only 26% were never used. These findings strongly suggest that the GMSS program successfully moved this group of first- and second-year medical students closer to at least understanding the content of many of the AGS competencies by providing them with geriatrics-related experiences and a geriatrics-related framework they could draw on when participating in curricular and extracurricular activities. The findings also point to the potential value of using reflective journaling as a tool for conducting process evaluation of medical education interventions.

Education, Medical↗

The NIMH Depression Awareness, Recognition, and Treatment Program: structure, aims, and scientific basis.

Unrecognized, untreated, and undertreated depressive disorders extract an inordinate human and economic cost, despite the availability of an extensive array of effective clinical interventions. To enhance the availability and quality of care, the National Institute of Mental Health launched the Depression Awareness, Recognition, and Treatment Program, a multiphase information and education program designed to alert health professionals and the general public to the fact that depressive disorders are common, serious, and treatable. The authors review the development of this program, describing the professional education efforts it supports in anticipation of increased demand for services, the public education campaign launched in May 1988, and highlights of the scientific advances that make the program feasible and timely.

Catchment Area, Health↗

An AIDS training program for rural mental health providers.

A total of 194 mental health care providers in Arkansas, primarily from rural areas and small communities, participated in a four-hour training program designed to improve their knowledge about the psychosocial and neuropsychiatric aspects of HIV and AIDS. Participants' responses to questionnaires completed before and after training indicated that the program was successful in achieving its goal. However, only a minimal number of providers reported completing drug, alcohol, and sexual histories and AIDS risk assessments for any of their patients before the training occurred. The authors emphasize the importance of AIDS training for rural providers.

AIDS Dementia Complex↗

Breastfeeding promotion in the Utah WIC program.

The Utah WIC program has implemented a variety of breastfeeding promotion activities and programs designed to encourage more mothers to initiate and continue breastfeeding. These activities include training WIC staff in breastfeeding management and support, updating educational materials, implementing peer counseling programs, meeting to coordinate breastfeeding promotion, purchasing breastfeeding equipment, and coordinating a statewide breastfeeding coalition. Since 1989, the breastfeeding initiation rate in the Utah WIC program has improved 17 percent, and breastfeeding at six months has increased nine percent. Breastfeeding promotion activities will continue to promote breastfeeding among WIC mothers in Utah.

Breast Feeding↗

A review of the 'Statistical Analysis for Genetic Epidemiology' (S.A.G.E.) software package.

The 'Statistical Analysis for Genetic Epidemiology' (S.A.G.E.) software package is an integrated, comprehensive package of computer programs designed to perform many of the different analyses required in the study of genetic epidemiology. It offers a graphical user interface for most platforms and, unlike many programs available in the public domain, is flexible in both receiving many types of input files and in allowing the user to choose among output files. All of the programs accept the same data files and together provide the means to perform familial correlation, segregation, linkage and association analyses, as well as many of the ancillary analyses that help achieve these goals. Many, but not all, of the same or similar analyses can be performed (with more difficulty) using publicly available freeware. The primary limitations of S.A.G.E. at present are the lack of software for estimating haplotypes or for identifying probable double recombinants in linkage analysis. S.A.G.E. is continually being extended and upgraded, however, with automatic downloading of the latest version always available to users.

Databases, Genetic↗

Service-learners at dementia care programs:an intervention for improving contact, comfort, and attitudes.

Service-Learning can be a rewarding and challenging experience for students. One of the rewards for students can be the connection between their course work and real life experience. However, students interacting with populations with which they have limited prior experience face unique challenges. We developed a training program designed to facilitate comfort with older adults who have dementia for service-learners in a gerontology course who were serving at an Adult Day Services (ADS) program. Students in the course completed pre- and post-surveys assessing level of contact with older adults and attitudes on aging. Service-learners serving at the ADS comprised the treatment group (n = 5) while those serving at other S-L sites made up the control group (n = 11). Independent and paired sample t-tests indicated that the training program contributed to intra-individual and group differences in comfort working with older adults and with adults who are cognitively impaired. Differences in attitudes about older adults were also identified. Implications for adult development courses involving S-L at dementia care programs are discussed.

Adult↗

Useful Microsoft Word Macros for molecular biologists and protein chemists.

Biologists today make extensive use of word processing programs for the production of research reports, literature reviews and grant proposals. Frequently, such programs become the default platform for viewing and the later publication of protein and nucleic acid sequence data. Thus, researchers often switch between their word processor and more specialized programs designed to analyze protein and nucleic acid sequences. It would be more convenient to perform these simple sequence analyses using the word processor without switching to another program. The focus here is on the use of the Visual Basic programming language, which is built into all recent versions of Microsoft Word to generate surprisingly complex and useful macros that can conveniently analyze several important features of protein and nucleic acid sequences. The standard Word interface can also be easily modified to display and run these macros from a pull-down menu. Several examples of this approach are provided.

Amino Acid Sequence↗

Improving postpartum marital relationships.

The effects of a traditional prenatal education program focused on maternal and infant physical health education were compared with effects of an innovative prenatal program designed to decrease the potentially negative effects of childbirth on the quality of marital relationships. 53 couples participated in the traditional approach and 63 in the innovative program: all expected a first child. Analysis of variance of their scores on the Sexual Relationship Scale and also on the Abbreviated Marital Adjustment Scale administered two months postpartum (controlled for their scores on the 2 scales before the prenatal education program) showed a significant difference between the two groups of parents only with respect to sexual relationship: the couples graduating from the innovative program were more satisfied with sexual aspects of their marriage postpartum.

Adult↗

A technique for obtaining feedback from students using a computer program in a veterinary anesthesia course.

INTRODUCTION: The College of Veterinary Medicine at Michigan State University has been using computer-aided instructional programs in our pre-clinical veterinary anesthesia course. We describe an embedded feedback collection module (FCM) that facilitates the process of formative evaluation of the program. METHODS: The instructional program was divided into discrete sections. The FCM was accessed easily from all sections of the program. Instructions for use of the FCM were delivered orally to all users of the instructional program and were included in the introduction section of the program. RESULTS: Feedback was obtained from successive classes of veterinary students over four years, using our computer-aided instructional program. Students in each class were required to use the program either in class or for review and to leave at least one comment in the FCM. Of the 653 responses, 293 were positive and expressed appreciation for the program, 209 contained specific comments or suggestions, and 151 were questions relating to the subject material contained within the program. Written survey feedback was also obtained from some students in these classes. CONCLUSION: Our FCM was effective and easy to implement. It proved an easy way to obtain user feedback, which was used in the ongoing process of program design and content improvement.

Anesthesia↗

Mycology at a distance.

GermWare Mycology is an image-rich, CD-ROM-based instruction divided into tutorial and reference programs. The tutorial program, designed for new students, provides only for sequential progress through each of the subject modules, so that each page of information is seen. In contrast, the reference program allows the more experienced learner with random and direct access to each facet of information. The aspergilli, the agents of chromomycosis, the dermatophytes, the dimorphic fungi, the hyaline molds, the dematiaceous molds, the yeasts, and the zygomyces are divided into separate modules. The tutorial program also includes an opening 'isolation procedures' module, in which details of specimen collection, culture media, and microscopic techniques are presented. The random access program includes system maps separating out each of the fungal species, and flow diagrams allowing an algorithm approach to species identifications. A global map is also included through which each fungal species can be directly accessed by the simple click of the mouse. Random access to information on the ecology, clinical presentations, pathology and therapy of the various mycotic diseases is also a feature of the reference program. A series of self-assessment exercises is included at the end of each module, with immediate 'pop-up' feedback to both correct and incorrect answers. The entire program includes over 2500 screens and over 700 color images and diagrams. GermWare Mycology is available through the Colorado Association for Continuing Medical Laboratory Education (CACMLE), who also can provide continuing education credits for individuals who complete a separate examination. For more information contact CACMLE at (303) 321-1734 or info@cacmle.org.

Adult↗

[The hospital perspective: disease management and integrated health care].

Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

Disease Management↗

Development and implementation of a comprehensive faculty development program in PBL core skills.

Large curricular changes associated with changes in teaching and learning methods should be accompanied by faculty development programs linked to the new pedagogy. This article describes a framework for the development and implementation of a program designed to assist faculty with the transition of the dental curriculum to a problem-based learning (PBL) pedagogy. A faculty committee created a PBL core skills program based on experiential, developmentally appropriate approaches that resulted in constructive and social learning opportunities for the faculty participants. Nearly 70 percent of faculty members have participated in the facilitation preparation workshops and contributed to the D.D.S. curriculum as small-group, inquiry-based learning facilitators. Faculty development programs geared toward acquisition of specific teaching skills and based on adult learning principles can be devised locally and result in increased participation in a new curriculum.

Adult↗

Program planning for faculty development in allied health education.

The increased movement of allied health programs from hospitals into colleges and university settings has created a role-transition for the allied health practitioner from a predominately service/secondarily educational role to a predominately educational/secondarily service role. Equally significant is the fact that allied health faculty are employed largely on the basis of specific discipline preparation and work experiences and less on specific preparation for teaching. Thus an acute need exists for faculty development programs designed specifically to address a definite lack of preparation in instructional methodologies. This paper describes a conceptual model readily employable for planning and implementing a faculty development program. The simplicity and flexibility of this model lends well to acquiring a few participant-centered objectives in a one-day workshop or to several over an extended period of time.

Faculty, Medical↗

[Computer assisted codification of diagnosis. Experience in a neurology/neurosurgery service].

The aim of this report is to show a dBase III+based program designed to assign the International Classification of Diseases codes to medical diagnoses. The principal features, advantages and limitations diagnoses. The principal features, advantages and limitations of the program are depicted and its yield with different users in a Neurology and Neurosurgery department is analyzed. It is concluded that this is a user friendly software with minimal hardware requirements that can be used in any clinical setting.

Diagnosis, Computer-Assisted↗