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PubMed1997

Multiple von Neumann computers: an evolutionary approach to functional emergence.

A novel system composed of multiple von Neumann computers and an appropriate problem environment is proposed and simulated. Each computer has a memory to store the machine instruction program, and when a program is executed, a series of machine codes in the memory is sequentially decoded, leading to register operations in the central processing unit (CPU). By means of these operations, the computer not only can handle its generally used registers but also can read and write the environmental database. Simulation is driven by genetic algorithms (GAs) performed on the population of program memories. Mutation and crossover create program diversity in the memory, and selection facilitates the reproduction of appropriate programs. Through these evolutionary operations, advantageous combinations of machine codes are created and fixed in the population one by one, and the higher function, which enables the computer to calculate an appropriate number from the environment, finally emerges in the program memory. In the latter half of the article, the performance of GAs on this system is studied. Under different sets of parameters, the evolutionary speed, which is determined by the time until the domination of the final program, is examined and the conditions for faster evolution are clarified. At an intermediate mutation rate and at an intermediate population size, crossover helps create novel advantageous sets of machine codes and evidently accelerates optimization by GAs.

Algorithms↗
PubMed1998

Improved birth outcomes associated with enhanced Medicaid prenatal care in drug-using women infected with the human immunodeficiency virus.

OBJECTIVE: To evaluate the effectiveness of an intervention designed to enhance Medicaid prenatal care in improving birth outcomes of drug-using women infected with the human immunodeficiency virus (HIV). METHODS: Medicaid and vital statistics records were linked for 353 HIV-infected drug-using women delivering in 1993 and 1994 while enrolled in New York State Medicaid. Of these, 68% were treated by providers participating in the Prenatal Care Assistance Program, designed to provide case management, improved continuity, referral services, and behavioral risk reduction counseling. In a series of logistic models, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of low birth weight (less than 2500 g) and preterm delivery (before 37 weeks), comparing women using and not using the program. RESULTS: Women using the Prenatal Care Assistance Program were significantly less likely, after adjustments were made for maternal characteristics, to have low birth weight infants and preterm deliveries (OR 0.52, 95% CI 0.31, 0.89; and OR 0.57, 95% CI 0.34, 0.97, respectively). Adding measures of greater adequacy and continuity of prenatal care to the models explained just over 20% of the Prenatal Care Assistance Program's protective effect. The addition of maternal high-risk behavior, HIV-focused care, and drug use treatment variables altered program effect estimates less profoundly (together accounting for 4 and 9% of the program's protection against low birth weight and preterm delivery, respectively). CONCLUSION: The Prenatal Care Assistance Program appeared to be successful in reducing the incidence of low birth weight and preterm delivery in this high-risk population. The program's success can be attributed, in part, to increased adequacy and continuity of prenatal care and, to a lesser extent, to more frequent receipt of special services and reduced maternal high-risk behaviors.

Adult↗
PubMed1980

Exposure to a rural population in a rural residency training program.

Previous reports of rural training programs conducted by medical schools have not examined the relationship between the population residing in an area and the population receiving medical services through the clinical training program. In the present study rural household survey data were compared with patient encounter data from a rural ambulatory cliinic engaged in training Family Practice residents from the Texas Tech University School of Medicine. Clinic patients were found to resemble the rural population subgroup that visits a physician at least once a year. Wide variations in individual clinical experiences were observed when health problems and conditions encountered by residents were compared with problems encountered in the clinic as a whole. In light of current national efforts to increase medical care access in unserved and underserved populations, the demographic findings raise questions concerning appropriate patient exposure goals in clinical training programs.

Adolescent↗
PubMed1987

Growth-associated traits in parental and F1 populations of chickens under different feeding programs. 3. Eating behavior and body temperatures.

In two experiments, parental populations of chickens and their F1 crosses were fed ad libitum or on alternate days. Eating and drinking behaviors, ability to compensate for fasting, and surface and cloacal temperatures were measured. Genetic and environmental (due to fasting) differences in feeding and drinking behaviors were found. Chicks from lines selected for larger body weight were better able to compensate for a 24-hr fast than those selected for smaller weight. Crosses were similar to the parental line that was the better compensator. Correlations between surface temperatures and body weights were consistently positive.

Animals↗
PubMed1979

Age effect hearing levels for a white nonindustrial noise exposed population (ninep) and their use in evaluating industrial hearing conservation programs.

A nonindustrial noise exposed population (NINEP) describing age effects for white males and females has been established that can be used as a reference in evaluating an industrial noise exposed population (INEP) data base. In making this comparison, it is desirable to match the two populations properly with respect to sex, race and age characteristics. Since there presently does not exist an equivalent black NINEP, it is necessary to first isolate the data representing the black population from the industrial sample. A definite learning curve exists in industrial audiometric data bases, with the degree of learning dependent upon the effectiveness of the hearing conservation program. Therefore, this variation must be considered when attempting to compare the industrial audiometric test data with the white NINEP data base presented herein.

Adolescent↗
PubMed1982

Physiological observations in essential hypertension.

The various mechanisms that may be involved in essential hypertension are discussed, as well as their therapeutic implications. A step-care treatment program has been shown to be effective not only for the treatment of the individual patient with mild hypertension but also in mass population treatment programs. It is based on a program of sound general medical care, including dietary sodium restriction, reduction of excess body weight, and pharmacologic therapy. With intelligent use of anti-hypertensive drugs for effective control of arterial pressure, a drastic reduction in cardiovascular morbidity and mortality can be expected.

Coronary Disease↗
PubMed2000

The UCSF post-baccalaureate reapplication program: a preliminary report.

The University of California San Francisco School of Dentistry initiated a pilot project in 1998 to assist economically and/or educationally disadvantaged students to gain admission to dental school. Students entering the program have completed the requirements for admission to dental school, have applied, and been denied admission, and have expressed a desire to care for underserved populations. The program features a summer preparation course for the Dental Admission Test (DAT), learning skill workshops, seminars, and assistance in the reapplication process. The students participate in clinical clerkships and during the fall and spring semesters are enrolled in upper-division and graduate-level science courses at a local university. Five students participated in the pilot project in 1998; they were admitted in 1999 and have successfully completed the first year of dental school. The sixteen students enrolled in 1999 have now been admitted to one or more dental schools. Fourteen students are currently enrolled in the 2000/2001 academic year program.

Clinical Clerkship↗
PubMed1989

Strengthening the backbone of primary health care.

This article discusses how to increase the effectiveness of district health systems, with particular reference to the setting of priorities and targets, the realization of various forms of joint action, and the improvement of management and other skills.

Community Health Services↗
PubMed1998

Case management: a team approach.

When establishing a case management program, patient populations were identified; goals and measures defined; and a case manager role developed. A registered nurse and a social worker team manage the patients in the program. After 9 months, a pilot study shows a total savings of $94,159 using case management.

Case Management↗
PubMed1989

The recruitment and retention of minority and disadvantaged allied health students.

Student recruitment and retention has been given high priority over the last several years. The School of Allied Health Sciences at the University of Texas Medical Branch at Galveston has been involved in recruitment and retention programs that have produced minority student enrollment of over 20% over the past seven years. The programs are supported by federal grants that have provided seed money to design, develop, and implement three specific recruitment and retention programs. These programs have assisted in enrolling over 575 minority students with a retention rate above 90%. Graduation, licensure, and certification rates have been at or above the majority population. These programs are adaptable at other allied health professions schools and have been used as models for several programs across the United States.

Data Collection↗
PubMedDate not supplied

[Pilot program of immunization against viral hepatitis B, integrated in the extended immunization program in Abancay (peru)].

INTRODUCTION: Abancay is located at 2,395 m.a.s.l. in the Peruvian Andean Region. It is a hyperendemic area for Hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection, where 7% of the deaths are caused by acute and chronic hepatitis infections. In 1991, a pilot immunization program against HBV infection was started to control the incidence of VHB-VHD, and as a strategy to improve the EPI coverage in general. METHODS: Vaccination population was programmed to include 1,301 children under 1 year old and 3,488 children between 1-4 years old. A total of 3 doses of DNA recombinant vaccine against HBV per child were administered. The vaccination schedule fit within the EPI immunization schedule. For children under one year old, the program includes: Newborn: BCG, Polio 1, HBV1; 2-month old: Polio 2, DPT1, HBV2; 3-month old: DPT2, Polio 3; 4-month old: polio 4, HBV 3 and; 9 month old: Measles. For children aged between 1 and 4 years old, the program includes: HBV1, HBV2 one month after HBV1, and HBV six months after HBV1. RESULTS: One year after the immunization program started, 1,262 (97.0%) children under one year old and 2,529 (72.5%) between 1-4 years old were immunized. No relevant adverse effects have been reported. There were 8 deaths due to acute respiratory infection and acute diarrhea diseases, which are the main causes of death in this area. One of the objectives achieved was an improvement in the EPI vaccination coverage for children younger than 1 year old, with a DPT coverage of 97.0% in 1991 compared to 63.0% in 1988, 26.9% in 1989, and 61.9% in 1990. CONCLUSION: The inclusion of HVB vaccination in the EPI for a HBV and HDV endemic area improves the total EPI coverage and it is safe an effective.

Child, Preschool↗
PubMed1978

Training physicians of developing nations in female surgical contraception.

The majority of developing nations in the Third World (including Thailand) face similar medicosocioeconomic situations arising from uncontrolled population growth which outstrips developmental planning. One of the most effective medical means of combating these problems is surgical contraception. This study describes how the Ramathibodi National Training Program was developed and implemented in Thailand to increase the availability of sterilization services by training local physicians to perform the necessary operations. The success of this program is measured by the increase in the number of service delivery stations (182) and in the number of sterilization procedures performed (24 436 in a 32-month period).

Developing Countries↗
PubMed1984

Effectiveness of a health education program in a lower socioeconomic population. Replication of an ipecac guidance study.

When teaching home safety, we selectively highlight those hazards most likely to injure children at various developmental stages. In one of the few studies evaluating this approach, we successfully taught a middle class population appropriate home use of ipecac syrup. The study reported herein replicated that study in a lower socioeconomic population. Although learning occurred, statistical significance was not quite achieved. While this study does not refute the "targeted" approach, it does demonstrate that characteristics of the population are likely to affect the educational outcome. Impressive statistical improvement may not be demonstrated. Individual realistic goals must be established prior to implementation and evaluation of a program.

Accidents, Home↗
PubMed1980

Plasma high-density lipoprotein cholesterol comparisons in black and white populations. The Lipid Research Clinics Program Prevalence Study.

High-density lipoprotein (HDL) cholesterol distributions were compared among 191 black and 1341 white males and 233 black and 1088 white females, ages 5-44 years, examined in five of the Lipid Research Clinic (LRC) population-based surveys. Mean HDL cholesterol was higher in blacks than whites in each 5-year age group for males and in seven of the eight age groups for females. The black-white mean HDL cholesterol difference was greater for males than females at each age studied. Mean HDL cholesterol was 4.8 mg/dl higher in black than white males ages 5-19 years, after statistical adjustment for age, Quetelet index and plasma total cholesterol differences between blacks and whites (p < 0.001); mean HDL cholesterol was 9.5 mg/dl higher in black than white adult males ages 20-44 years. Adjustment for levels of plasma triglyceride, which were lower in blacks than whites, reduced but did not eliminate the magnitude of the statistical significance in black-white differences: The adjusted means were 2.9 mg/dl higher in black children and 7.9 mg/dl higher in black adults. The finding of higher levels of HDL cholesterol in black males persisted after additional adjustment for alcohol consumption, smoking and educational levels. Adult U.S. black males have lower and black females have higher coronary heart disease mortality rates than their white peers. The magnitude of the black-white difference in HDL cholesterol for males in the LRC studies was within the range associated with coronary heart disease incidence reported in other studies.

Adolescent↗