[Social aid and need for nursing care: an analysis of fulfilled and failed goals in regulatory health nursing care insurance after 5 years].
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Aged↗
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Results for “Dynamic Programming”
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Dynamic simulation of pharmacokinetic systems using the electrical circuit analysis program SPICE2.
The electrical circuit simulation program SPICE2 is used to perform computer simulations of linear and non-linear pharmacokinetic systems. This is achieved by applying novel network thermodynamic principles which make use of the analogy between the conservation laws of chemical reactions and mass transport and Kirchoff's laws of current and voltage balance for electrical circuits. A simple description of program input for general pharmacokinetic simulation as well as simulation of complex pharmacokinetic and physiologic phenomena such as single and multiple divided daily dosing, Michaelis--Menten kinetics, gastric emptying cycle, drug resorption and linear and non-linear drug protein binding is provided. Drug concentrations or amounts in different compartments are graphically obtained or tabulated as time functions. The economy of time and effort afforded by this program is illustrated by simulating the metabolism and accumulation kinetics of salicylic acid on single and repeated divided dosing. The advantages of SPICE2 over other available simulation packages and its educational value as a teaching and research tool are discussed.
Computers↗
Selective prescribing of third generation oral contraceptives (OCs).
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Contraceptives, Oral↗
Control of Schistosoma mansoni in the Blue Nile Valley of western Ethiopia by mass chemotherapy and focal snail control: a primary health care experience.
A simplified combination of human mass treatment with oxamniquine and focal snail control has been applied in a local Schistosoma mansoni control programme in a primary health care setting in the Dalati and Agallu Metti areas of the Ethiopian Blue Nile Valley. Teams of local health personnel and farmers did the daily work under intermittent supervision. Monthly snail surveys near the major villages disclosed a seasonal pattern with many infected snails during the dry season in upper stagnant sections of tributary rivers (1000-1200 m altitude) with favourable temperatures, and few snails in the rainy season. The highest prevalences and intensities of human infection were found in the 15-19 year age group living in the lower altitudes around 700 m. 5067 individuals (50-80% of the local population) were treated with 20-40 mg oxamniquine per kg body weight during the rainy seasons of 1985 (Dalati) and 1986 (Agallu Metti). In the Dalati area cross sectional surveys in 1985 and 1986, before and after the mass treatment, showed a reduction in prevalence from 42.4% to 11.4%, while in the Agallu Metti area a stratified random sample showed a prevalence reduction from 65.4% in 1986 to 7.8% in 1987 and a reduction in the prevalence of moderate to heavy infection (greater than 100 eggs per gram of stool) from 36.9% to 1.4%. Beginning in 1986 niclosamide was applied focally wherever infected snails were found and the monthly snail surveillance continued until 1989. As a result of this combined approach overall snail infection rates were reduced from 11.2% (Dalati) and 32% (Agallu Metti) to zero and 2% respectively. In 1989 the human prevalence was still only 8.6% in Agallu Metti. This programme has shown that it is feasible to control S. mansoni in these very remote localities through the primary health care system.
Adolescent↗
One year surveillance of HIV-1 infection in Johannesburg, South Africa.
A sero-epidemiological surveillance study to monitor the prevalence of HIV-1 infection in Johannesburg, South Africa, was commenced in February 1988. The population selected for study were attenders at clinics for sexually transmitted diseases (STD) and at family planning (FP) clinics. In the 12 months of the study 6631 sera were tested. Of the STD attenders, 15 of 1224 black females (1.2%) and 21 of 2482 black males (0.8%) were positive. Of the 449 white males tested 49 were homosexual, amongst whom 10 (20.4%) were positive; in the heterosexual white male group 4 of 400 (1.0%) were positive. Of the FP clinic attenders, 4 of 1459 black females (0.3%) were positive. 68 of the 6631 sera tested were indeterminate for infection. No attenders were positive for HIV-2 infection. These data confirmed the entry of HIV infection into the black population in South Africa.
Ambulatory Care Facilities↗
Agglomerative tendencies in the distribution of populations.
"The paper explores the role of accessibility to mutual contacts as an agglomeration force in the spatial distribution of population. The uniqueness conditions for the equilibrium solutions are analyzed in the static case, with the aid of mathematical programming embedding properties. A dynamic version in continuous time is then built, and conditions for instability of a globally stable equilibrium and appearance of multiple locally stable and unstable equilibria are stated. Finally, some implications for the geographical structure are discussed."
Behavior↗
Animation: a useful tool for protein molecular dynamicists, applied to hydrogen bonds in the active site of elastase.
Massive amounts of coordinate data result from molecular dynamics calculations. The animation program MDKINO is a simple but powerful tool for previewing or reviewing the results. In recent simulations of elastase, we have examined hydrogen bonding patterns, conformational changes involving shifts in ring positions and rotations of amino acid side chains, electric fields in interatomic space, and electric forces acting on chosen nuclei. Animation is also useful for checking on the stability of calculations in progress. Simple programming techniques achieve acceptable levels of animation with readily available hardware (PS330 or PS390 display with a serial interface to a laboratory VAX). In about half an hour, it is possible to make and watch a color stereo "movie" of a selected subsystem of a simulation (up to 1,000 frames of about 100 atoms each).
Binding Sites↗
Evolution of tRNA-like sequences and genome variability.
Transfer RNA (tRNA)-like sequences were searched for in the nine basic taxonomic divisions of GenBank-121 (viruses, phages, bacteria, plants, invertebrates, vertebrates, rodents, mammals, and primates) by an original program package implementing a dynamic profile alignment approach for the genetic texts' analysis, in using 22 profiles of tRNAs of different isotypes. In total, 175,901 previously unknown tRNA-like sequences were revealed. The locations of the tRNA-likes were considered over the regions whose functional meaning is described by standard Feature Keys in GenBank. Many regions containing the tRNA-like sequences were recognized as known repeats. A mode of distribution of the tRNA-like sequences in a genome was proposed as expansion in a content of the various transposable elements. An analysis of the integrity of RNA polymerase III inner promoters in the tRNA-like sequences over the GenBank divisions has shown a high possibility of generating new copies of short interspersed nuclear element (SINE) repeats in all divisions, excepting primates. The numerous tRNA-likes found in the regions of RNA polymerase II promoters have suggested an adaptation of RNA polymerase III promoter to a binding of RNA polymerase II.
Algorithms↗
The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time.
This paper examines the determinants of real per capita health expenditures in order to assess the impact of age distribution, income and time using American state-level data for the period 1980-1998 and Canadian province-level data for the period 1975-2000. Ageing population distributions and income explain a relatively small portion of health expenditures when the impact of time effects, which is a partial proxy for technological change, is controlled for. However, the impact of age is of more concern given that cost increases are concentrated in the last few years of life and there may be cohort effects as the "Baby-Boom" generation ages. There is an urgent need to better understand the exact mechanisms driving health expenditure increases given that time accounts for approximately two-thirds of health expenditure increases and that its effect is non-linear.
Age Distribution↗
CFD simulation of aggregation and breakage processes in laminar Taylor-Couette flow.
An experimental and computational investigation of the effects of local fluid shear rate on the aggregation and breakage of approximately 10 microm latex spheres suspended in an aqueous solution undergoing laminar Taylor-Couette flow was carried out according to the following program. First, computational fluid dynamics (CFD) simulations were performed and the flow field predictions were validated with data from particle image velocimetry experiments. Subsequently, the quadrature method of moments (QMOM) was implemented into the CFD code to obtain predictions for mean particle size that account for the effects of local shear rate on the aggregation and breakage. These predictions were then compared with experimental data for latex sphere aggregates (using an in situ optical imaging method) and with predictions using spatial average shear rates. The mean particle size evolution predicted by CFD and QMOM using appropriate kinetic expressions that incorporate information concerning the particle morphology (fractal dimension) and the local fluid viscous effects on aggregation collision efficiency match well with the experimental data.
Biophysics↗
Structural determinants of 14-3-3 binding specificities and regulation of subcellular localization of 14-3-3-ligand complexes: a comparison of the X-ray crystal structures of all human 14-3-3 isoforms.
14-3-3 proteins are a ubiquitous class of regulatory proteins found in all eukaryotic cells and were the first class of molecules to be recognized as discrete phosphoserine/threonine binding modules. 14-3-3 proteins bind a large number of different substrates to regulate a wide array of cellular signaling events including cell cycle progression and DNA damage responses, programmed cell death, cytoskeletal dynamics, transcriptional control of gene expression, as well as processes directly related to cancer progression. In this review, the structural basis of phosphorylation-dependent binding of 14-3-3 to peptide and protein ligands is discussed along with mechanisms that govern how 14-3-3 regulates the function of its bound ligands. The X-ray crystal structures of all human 14-3-3 proteins bound to peptides have now been solved. Here, we use structural comparisons between isoforms as a framework for discussion of ligand binding by 14-3-3 as well as the mechanisms through which post-translational modification of the different isoforms alters their function.
14-3-3 Proteins↗
Head group and chain behavior in biological membranes: a molecular dynamics computer simulation.
A computer-modeled hydrated bilayer model of the lipid 2,3-dimyristoyl-D-glycero-1-phosphorylcholine in the L alpha phase was built. Particular care was taken in building the starting structure with the inclusion of structural detail reported in experiments on the L alpha phase. Molecular dynamics simulations using the molecular dynamics and energy refinement program AMBER 3.1 force field with an optimized parameters for liquid simulation parameter set were run to study the motions and conformations of the lipid molecules and characterize the behavior and structure of the head groups and the hydrocarbon lipid chains. Although the head groups were observed to show great flexibility, certain head-group torsion combinations appeared favored. The observed tilt of the lipid chains is discussed and is consistent with previous experimental findings. Motion of the lipid chains is shown to be correlated with those chains immediately surrounding, but correlation with chains more distant varies with time.
Biophysical Phenomena↗
Pregnancy in adolescents.
The United States must improve its efforts to reduce teen pregnancy. We occupy an alarming position in the developed world from the standpoint of the magnitude of the pregnancy issue. While our society promotes sexuality to sell all sorts of consumer goods, it still refuses for the most part to make contraceptives familiar and available to sexually active teens. The youngest adolescents, 10 to 14 years, are having sex and babies at an increasing rate. Their children will have limited futures. Only by stepping up our efforts to prevent early pregnancy will we make possible a life of opportunity and choice for the young people of our country. Consequences will be costly and tragic if we do not.
Adolescent↗
Alpha L beta 2 integrin/LFA-1 binding to ICAM-1 induced by cytohesin-1, a cytoplasmic regulatory molecule.
The avidity of integrin adhesion receptors for extracellular ligands is subject to dynamic regulation by intracellular programs that have yet to be elucidated. We describe here a protein, cytohesin-1, which specifically interacts with the intracellular portion of the integrin beta 2 chain (CD18). The molecule shows homology to the yeast SEC7 gene product and bears a pleckstrin homology (PH) domain. Overexpression of either the full-length cytohesin-1 or the SEC7 domain induces beta 2 integrin-dependent binding of Jurkat cells to ICAM-1, whereas expression of the isolated cytohesin-1 PH domain inhibits T cell receptor-stimulated adhesion. Similar inhibition is not exhibited by PH domains taken from other proteins, showing that the interaction is specific and that individual PH domains are capable of discriminating between alternative targets.
Amino Acid Sequence↗
Preventing teenage pregnancy.
Teenage pregnancy is still a medical and economic concern. Early anticipatory counseling with an emphasis on abstinence is helpful. Contraception information and sexually transmitted disease prevention should be part of the counseling. This article reviews common contraception methodology.
Adolescent↗
Measles epidemic sweeps through Afghanistan.
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Afghanistan↗
Providing health care for older persons in Singapore.
Health care social policy in Singapore has passed the burden of care to the individual and the family on the rationale that it would enable the state to contain the costs of long-term care by channelling some of its funds to community services and to providing essential health services to all Singaporeans and not just the older group. While a wide array of services has come into existence, there is a lack of integration between the available resources and needs of the individual/family and what has been availed at the community and state levels. Part of the problem lies in the stringent criteria to which the state allows subsidies to be used; the lack of understanding with regard to the profile of users of services; and the case manager approach in offering services. Mapping health care has proven more difficult than anticipated because ageing is a diverse experience, varying by gender, race, income, religion and intergenerational relationships. A social policy does not apply to a 'universal citizen' and services that exist in the public sphere should not exist as merely commodified services which require a great deal of institutional processing.
Aged↗
Complexity theory in the management of communicable diseases.
In nature, apparently complex behavioural patterns are the result of repetitive simple rules. Complexity science studies the application of these rules and looks for applications in society. Complexity management opportunities have developed from this science and are providing a revolutionary approach in the constantly changing workplace. This article discusses how complexity management techniques have already been applied to communicable disease management in Wales and suggests further developments. A similar approach is recommended to others in the field, while complexity management probably has wider applications in the NHS, not least in relation to the developing managed clinical networks.
Communicable Disease Control↗