The effect of provider- and workflow-focused strategies for guideline implementation on provider acceptance

<p>Abstract</p> <p>Background</p> <p>The effective implementation of clinical practice guidelines (CPGs) depends critically on the extent to which the strategies that are deployed for implementing the guidelines promote provider acceptance of CPGs. Such implementation strategies can be classified into two types based on whether they primarily target providers (<it>e.g.</it>, academic detailing, grand rounds presentations) or the work context (<it>e.g.</it>, computer reminders, modifications to forms). This study investigated the independent and joint effects of these two types of implementation strategies on provider acceptance of CPGs.</p> <p>Methods</p> <p>Surveys were mailed to a national sample of providers (primary care physicians, physician assistants, nurses, and nurse practitioners) and quality managers selected from Veterans Affairs Medical Centers (VAMCs). A total of 2,438 providers and 242 quality managers from 123 VAMCs participated. Survey items measured implementation strategies and provider acceptance (<it>e.g.</it>, guideline-related knowledge, attitudes, and adherence) for three sets of CPGs--chronic obstructive pulmonary disease, chronic heart failure, and major depressive disorder. The relationships between implementation strategy types and provider acceptance were tested using multi-level analytic models.</p> <p>Results</p> <p>For all three CPGs, provider acceptance increased with the number of implementation strategies of either type. Moreover, the number of workflow-focused strategies compensated (contributing more strongly to provider acceptance) when few provider-focused strategies were used.</p> <p>Conclusion</p> <p>Provider acceptance of CPGs depends on the type of implementation strategies used. Implementation effectiveness can be improved by using both workflow-focused as well as provider-focused strategies.</p

Boundary Element-Associated Factor 32B Connects Chromatin Domains to the Nuclear Matrix▿

Chromatin domain boundary elements demarcate independently regulated domains of eukaryotic genomes. While a few such boundary sequences have been studied in detail, only a small number of proteins that interact with them have been identified. One such protein is the boundary element-associated factor (BEAF), which binds to the scs′ boundary element of Drosophila melanogaster. It is not clear, however, how boundary elements function. In this report we show that BEAF is associated with the nuclear matrix and map the domain required for matrix association to the middle region of the protein. This region contains a predicted coiled-coil domain with several potential sites for posttranslational modification. We demonstrate that the DNA sequences that bind to BEAF in vivo are also associated with the nuclear matrix and colocalize with BEAF. These results suggest that boundary elements may function by tethering chromatin to nuclear architectural components and thereby provide a structural basis for compartmentalization of the genome into functionally independent domains

Effect of formulation variables on Rifampicin loaded alginate beads

The present work investigated the preparation of biodegradable beads with alginate polymer by ionotropic gelation method to improve the control release properties of the antibiotic rifampicin. Ionotropic gelation method was applied to prepare beads using calcium chloride (CaCl2) as cationic component and alginate as an anionic component. In this method, adding 0.5% w/v polyvinyl alcohol (PVA) to sodium alginate (3.0% w/v) and 2% w/v of polyvinyl pyrrolidone (PVP) to the CaCl2 solution were maintained to study the drug-loading and its released characteristics. The results showed that the addition of PVA and PVP significantly improved drug-loading, encapsulation efficiency and release characteristics. This demonstrates that the ionic gelation of alginate molecules offers a flexible and easily controllable process

Characterization of nuclear matrix proteome of Drosophila melanogaster during embryonic development

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