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PubMed2006

The parallel programming of voluntary and reflexive saccades.

A novel two-step paradigm was used to investigate the parallel programming of consecutive, stimulus-elicited ('reflexive') and endogenous ('voluntary') saccades. The mean latency of voluntary saccades, made following the first reflexive saccades in two-step conditions, was significantly reduced compared to that of voluntary saccades made in the single-step control trials. The latency of the first reflexive saccades was modulated by the requirement to make a second saccade: first saccade latency increased when a second voluntary saccade was required in the opposite direction to the first saccade, and decreased when a second saccade was required in the same direction as the first reflexive saccade. A second experiment confirmed the basic effect and also showed that a second reflexive saccade may be programmed in parallel with a first voluntary saccade. The results support the view that voluntary and reflexive saccades can be programmed in parallel on a common motor map.

Adult↗
PubMedDate not supplied

On the road to the OSHA voluntary protection program.

In 1998, representatives from the Employee Health Services, Safety and Security, Physical Therapy, Human Resources, and Legal Affairs Departments and the Risk Management Program at Robert Packer Hospital (RPH) in Sayre, PA began a project to create a "culture of safety." The journey would ultimately lead to application to the Occupational Safety and Health Administration Voluntary Protection Program (OSHA VPP). Four years later, because of the dedication and collaboration of many individuals, RPH received notification that its application for OSHA VPP participation was approved by the Assistant Secretary of Labor. This article describes that journey and provides other healthcare organizations with the information needed to begin their own journey to successful project implementation.

Education, Continuing↗
PubMed2001

Voluntary screening program for HIV in pregnancy. Cost effectiveness.

OBJECTIVE: To determine the effectiveness of a voluntary human immunodeficiency virus (HIV) screening program in pregnancy. STUDY DESIGN: Using a business decision theory analysis model, we estimated the outcomes and costs of the two possible decisions by our patients (test/no test). Patients with a positive HIV screen would undergo evaluation and possible prophylactic antiviral therapy. The model was utilized to evaluate the Naval Medical Center San Diego Program from 1995-1997. RESULTS: Prevalence of HIV in active duty Navy personnel during the years evaluated were 1995, 0.024%; 1996, 0.028%; and 1997, 0.022%. Patients screened for HIV during these years were 1995, 3,874; 1996, 3,924; and 1997, 4,127 (n = 11,925). Incidence of HIV seroprevalence in patients screened during the study period was zero. The number of patients declining HIV screening was: 1995, 10; 1996, 8; and 1997, 5. During the same period, reported HIV seroprevalence among pregnant patients in the United States was 1.5/1,000. CONCLUSION: HIV seroprevalence in our pregnant population (zero) was lower than expected, considering the national pregnancy prevalence and Navy prevalence. The expected number of cases of positive HIV screens was 17.8. The cost of the program for the study period was $103,748. The cost of care for one positive neonate ranges between $100,000 and $200,000.

California↗
PubMed2001

Assessment of best management practices for improvement of dissolved oxygen in Chesapeake Bay estuary.

Two management scenarios, the base case and the full voluntary program implementation scenarios, are simulated with the three-dimensional Chesapeake Bay estuary model package to study the improvement of dissolved oxygen (DO) over the bay in response to the reduction of nutrient loads. The base case scenario is based on the 1985 nutrient management practices and the associated loads from the watershed and airshed to the bay. The full voluntary program implementation scenario is based on an expanded non-point source and point source program applying current technologies in nutrient and sediment management. The implementation of best management practices is assumed to be by voluntary participation, encouraged by a maximum 75% cost share by the states. The ten-year average (1985-1994) total nitrogen and total phosphorus loads to the bay are reduced 40% and 47%, respectively, from the base case to the full voluntary program implementation scenario. The average annual anoxia and hypoxia volume day is reduced 62% and 42%, respectively, in the whole bay. Daily development of bottom DO in the estuary is observed from an MPEG movie. Graphics of daily DO concentration and depth profile show a significant improvement in DO under improved nutrient control.

Benchmarking↗
PubMedDate not supplied

The impact of mass media advertising on a voluntary sterilization program in Brazil.

The effect of magazine advertising on vasectomy acceptance was tested in São Paulo, Brazil. Four advertisements ran for ten weeks in eight magazines. Clinic performance doubled during the campaign and stabilized at 54 percent higher than baseline. The advertisements selectively attracted the target audience without bringing in large numbers of ineligible candidates, completely avoided negative reactions, and recruited men previously unexposed to vasectomy. The cost of the advertising campaign was offset by additional revenue generated by the increase in vasectomies performed. The results suggest that while interpersonal communications can maintain performance in voluntary sterilization programs, mass media promotion may be necessary for program growth.

Advertising↗
PubMed1987

Maedi-visna control in sheep. III: Results and evaluation of a voluntary control program in The Netherlands over a period of four years.

The results of the first four years of the Dutch national voluntary maedi-visna control program, which was launched on January 1, 1982, are presented. At the end of the observation period, 1711 breeding flocks representing 70% of the registered breeding flocks participated. The program is based on accreditation of flocks that have passed two successive serological tests with an interval of six months between and post-accreditation tests every 12 months. The flocks have to conform to a set of specific regulations. Sheep sold from such flocks receive a certificate stating that their origin was accredited. A total of 1212 flocks gained accreditation. Of these flocks, 29.5% were free from infection from the beginning, 35.6% were created by total replacement of the original stock, 19.6% employed repeated testing and culling of positives, and 15.3% were created by artificial rearing of colostrum-deprived lambs. A total of 22 flocks lost accreditation due to detection of 36 seropositives. These positives and their progeny were culled, and all flocks regained accreditation after passing the two negative flock tests required. In a total of seven flocks, an unusual course of events during the pre-accreditation stage was observed; this was mainly attributed to late seroconversions and uncommon degrees of horizontal transmission. The results indicate that this certification yields a substantial guarantee of freedom from maedi-visna virus and they indirectly show that the basic design of the program has been adequate.

Animals↗
PubMed1991

A program to help staff cope with psychological sequelae of assaults by patients.

Mental hospital staff who are assaulted by patients are at risk of developing symptoms associated with posttraumatic stress disorder. The Assaulted Staff Action Program (ASAP), a voluntary program, offers support to staff victims of patient assaults in a state mental hospital. ASAP team members debrief assault victims, assessing the victim's sense of control, social supports, and ability to make sense of the incident. A short-term support group is offered. During the program's first 90 days, the team responded to 67 assaults. Ten days after the assaults, many of the victims had not regained a sense of control, did not have a support network, and were unable to make sense of the incident. These factors put them at risk for PTSD symptoms. The costs of such a program are discussed.

Adaptation, Psychological↗
PubMed1976

The role of regional quality control programs in the practice of laboratory medicine in the United States.

Since their initiation in 1967, Regional Quality Control Programs have expanded, and they are now accessible to all clinical laboratories in the United States. Based on input from large numbers of laboratories analyzing the same lots of control material for chemistry, hematology, and coagulation, the programs provide computer-generated intralaboratory statistics for day-to-day precision and interlaboratory comparative statistics for relative precision and accuracy. Nearly half the clinical laboratories in the United States currently participate in Regional Quality Control Programs in chemistry. These voluntary programs are coordinated by voluntary professional groups or by the manufacturers of control materials. Professionally directed programs are, for the most part, supervised by committees of state pathology societies.

Chemistry, Clinical↗
PubMed2002

How effectively do managed care organizations influence prescribing and dispensing decisions?

OBJECTIVE: To examine the extent to which managed care organizations (MCOs) use formularies, therapeutic interchange, and prior approval and to determine how effectively these tools influence prescribing and dispensing decisions. RESEARCH DESIGN: Literature review. PATIENTS AND METHODS: Studies relating to effectiveness were identified through a comprehensive literature review using the MEDLINE and International Pharmaceutical Abstracts databases. Only peer-reviewed studies done in outpatient settings were included. Studies measuring extent of use were taken primarily from published and widely available marketing research reports. RESULTS: Closed formularies were found to be effective in decreasing the utilization, but not necessarily the cost, of prescription drugs. Just under half of health maintenance organizations (HMOs) and 10% of employer-sponsored health plans use closed formularies. Prior approval programs have been shown to reduce use of target drugs and drug costs in a small number of drug classes. Nearly all HMOs and most employer-sponsored health plans use prior approval programs. How extensively the programs are used is not reported. About half of HMOs and employer-sponsored health plans use therapeutic interchange. Voluntary programs have been shown to be successful in staff-model HMOs. Mandatory, but not voluntary, programs have been shown to be successful in independent practice association-model HMOs. CONCLUSION: The literature indicates that most MCOs have had limited success using formularies, therapeutic interchange, and prior approval to influence prescribing and dispensing decisions. Although these tools have been effective in some situations, their impact has been limited by their low rate of utilization.

Cost Control↗
PubMed1985

Nosocomial rubella--consequences of an outbreak and efficacy of a mandatory immunization program.

An outbreak of rubella in a large metropolitan hospital is described. Nineteen cases among employees and three secondary cases in family members occurred. Nosocomial cases occurred among the 3,900 employees of an adult medical-surgical unit where a voluntary program of rubella immunization was in effect. No cases occurred among the 1,400 employees of the women's and pediatric units with mandatory policies, despite interfacility and community exposure. Ten pregnant women were among the 377 contacts of the cases. Five were sero-negative to rubella. Two who developed clinical rubella, one asymptomatic sero-conversion and one other, all elected to terminate their pregnancies. The remaining woman, exposed in her third trimester delivered a normal infant. We conclude a policy requiring new employees to be rubella immune is more effective in preventing nosocomial rubella than a voluntary program and is desirable in view of the potential consequences of an outbreak to pregnant employees.

Adult↗