George Reynolds - US grants

The research of this program concentrates on the structural aspects of the rod outer segment disk membrane of the bovine eye by means of X-ray diffraction. Knowledge of this structure is necessary for an understanding of how photon absorption leads to neural stimulation. Efforts to date have been subject to uncertainties because of the long time exposures required. Using the image intensification-computer controlled TV data acquisition and analysis techniques we have developed, we can obtain data in much shorter times than previously and analyze to determine the conformational changes upon bleaching, as well as some information about the orientation and extent of the protein in the disk. Our goals for the coming year include 1) Phase the high resolution data already obtained; 2) investigate the later rhodopsin intermediates by means of a synchrotron radiation experiment; 3) Measure the diamagnetic anisotropy of isolated disk membranes; 4) Examine the effects of peripheral disk proteins on the disk profiles; 5) Perform a neutron diffraction experiment to contrast enhanced rhodopsin; 6) Develop time resolved assays for disk peripheral protein attachment.

The Princeton Biophysics group has had an ongoing program over the last 20 years (1) to develop area x-ray detectors based on the principle of image-intensified phosphor screens which are recorded by slow-scan TV cameras and (2) to apply these detectors to research problems in the biological and materials sciences. We propose to develop a new design of detector which would have quantum limited sensitivity, a 75mm wide input area, high resolution, and low signal-induced background. This new design builds on successful earlier detector designs but utilizes newly available fiber-optic and CCD sensor technology to provide unprecedented performance. The detector will be integrated into a small-angle x-ray diffraction system to be applied to the study of the structure and properties of biomembranes and biopolymers. The detector is especially suitable for synchrontron radiation experiments and will be used for time-resolved and Laue synchrotron radiation studies.

DESCRIPTION (provided by applicant): Primary care physicians are in a unique position to impact smoking behaviors;however, efficacy is limited due to competing demands, lack of knowledge, and lack of confidence. During Phase I of this SBIR Silverchair Science &Communications, in partnership with the University of Virginia, developed a prototype point-of-care computer software application to enhance clinician effectiveness in smoking intervention at the primary care level called QuitAdvisorMD. QuitAdvisorMD distills recommended guidelines and evidence based practices into a practical, streamlined, patient tailored, electronic resource that is easy to use, intuitive, and rapidly accessible to busy clinicians at the point of care. The tools content is based on evidence-based practice guidelines;motivational interviewing;and the stage-based behavior change. During Phase II Silverchair will develop QuitAdvisorMD into a robust platform suitable for commercial use. The University of Virginia will conduct a randomized controlled trial to measure QuitAdvisorMD's impact on increasing the number patients who receive appropriate smoking cessation counseling sessions initiated by primary care physicians. PUBLIC HEALTH RELEVANCE: The proposed effort will impact public health by providing point-of-care computer software application that enhances clinician effectiveness in smoking intervention at the primary care level called QuitAdvisorMD. This should lead to an increase in the number patients who receive appropriate smoking cessation counseling sessions initiated by primary care physicians.

DESCRIPTION (provided by applicant): Smoking severely affects dental health, and 80% of dentists consider smoking cessation counseling and advice as one of their medical responsibilities. However, the majority of dental health care workers do not do this. Reasons for this inaction are multifaceted, including lack of training, confidence, time and funding. Silverchair, Inc. has developed QuitAdvisorDDS as a tool for dentists to advise patients on tobacco cessation. This interactive, web-distributable tool assists dentists in providing patient-tailored smoking cessation counseling using proven patient-centered counseling techniques. QuitAdvisorDDS also enables dentists to rapidly determine the patient's stage of readiness for change through four simple prompted questions. Once the dentist has determined the patient's acceptance level, QuitAdvisorDDS will automatically proceed to a scripted motivational interview tailored to the patient's stage of change, while providing relevant health behavior information dentists can use to intervene with during the appointment. Finally, in addition to gathering information prior to the clinical encounter, QuitAdvisorDDS will also be able to track dentist behavior -identifying the clinician using the application, recording a time and date stamp each time the application is opened, recording which sections of the application are accessed and how much time is spent in each - thereby making it possible to evaluate healthcare delivery services, ensure quality treatment, and aid in the conduct of research. In Phase I, Silverchair will develop and evaluate a prototype of the tool with the help of researchers at the University of Kentucky. PUBLIC HEALTH RELEVANCE: This project has the potential to impact public health by improving dentists'knowledge and skills for tobacco and smoking cessation counseling. This will encourage patients to quit smoking/using tobacco, thus increasing overall public health, and reducing mortality and morbidity related to these habits.

DESCRIPTION (provided by applicant): The long-term objective of this project is to provide a smoking-cessation intervention tool for health care providers in prenatal settings. Smoking during pregnancy is a significant public health issue. The prevalence of smoking in women of child-bearing age generally ranges between 17 and 35 percent worldwide, and is heavily influenced by maternal age, ethnicity, education, and socioeconomic level. Smoking while pregnant has been linked to several serious health effects in infants, including impaired lung function, low birth-weight, and preterm birth. Clearly, interventions to prevent smoking during pregnancy have enormous public health importance, but existing interventions have achieved sub-optimal outcomes. This application proposes development of QuitAdvisorOB, an interactive, web-distributable, clinical decision support software application for computers or mobile devices. Based on proven patient-centered counseling techniques such as Motivational Interviewing, the 5 A's (ask, advise, assess, assist, and arrange), and Stages of Change, QuitAdvisorOB will assist prenatal care givers in providing patient-tailored smoking cessation counseling, while facilitating provider adherence to evidence- based practice guidelines. During Phase I, we will develop content and mock-ups of the proposed tool, create a web-based functioning prototype, and subject it to formal usability testing in OB/GYN physicians and nurses, and a pilot study evaluating the prototype's effect on the patients' progression along the stages-of-change continuum. PUBLIC HEALTH RELEVANCE: This research effort will impact public health by developing a health-care provider tool that aids in smoking-cessation counseling in pregnant women. Reducing smoking in pregnant women has significant health benefits for infants and children.

DESCRIPTION (provided by applicant): Evaluation of dental tobacco cessation tool in practice-based research network This Phase II project will finish development and evaluate QuitAdvisorDDS as a tool for dental providers to advise patients on tobacco cessation. The University of Kentucky will evaluate the effectiveness of QuitAdvisorDDS in increasing quit attempts in tobacco using patients. The evaluation will be conducted within the National Institute of Dental and Craniofacial Research's (NIDCR) National Dental Practice- based Research Network (NDPBRN). Tobacco use severely affects dental health, and 80% of dentists consider tobacco cessation counseling and advice as one of their medical responsibilities. However, the majority of dental health care workers do not do this. Reasons for this inaction are multifaceted, including lack of training, confidence, time, and funding. Health Decision Technologies (HDT) is developing QuitAdvisorDDS as a tool for dental providers to advise patients on tobacco cessation. This interactive, web-distributable tool assists dentists and dental hygienists in providing patient-tailored tobacco cessation counseling using proven patient-centered counseling techniques. QuitAdvisorDDS also enables dental providers to rapidly determine the patient's stage of readiness for change through four simple prompted questions. Once the dental provider has determined the patient's acceptance level, QuitAdvisorDDS will automatically proceed to a scripted motivational interview tailored to the patient's stage of change, while providing relevant health behavior information dentists can use to intervene with during the appointment. Finally, in addition to gathering information prior to the clinical encounter, QuitAdvisorDDS is also be able to track dental provider behavior -identifying the clinician using the application, recording a time and date stamp each time the application is opened, recording which sections of the application are accessed and how much time is spent in each - thereby making it possible to evaluate healthcare delivery services, ensure quality treatment, and aid in the conduct of research.