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PubMed1979

Screening and selecting candidates for a hospital pharmacy residency program.

An applicant screening and selection procedure for a hospital pharmacy residency program which (1) efficiently processes a large number of applicants while minimizing the subjective nature of the review process and (2) ranks candidates for submission to the ASHP Residency Matching Program is described. A screening and selection committee consisting of five staff members of the hospital pharmacy department was created. Goals of the residency program and qualities of the optimal resident were defined prior to development of the screening and selection program. Two forms were used by staff in the screening process: a screening worksheet for the preinterview screen, and an evaluation chart for the interview phase. Each form outlined the criteria which serve as indicators of academic, professional and personal development in a format that allows easy extraction of data. By carefully defining program goals and identifying specific human qualities most compatible with those goals, the likelihood of successful applicant selection through use of a systematic screening process is increased.

Education, Pharmacy, Graduate↗

PubMed1993

Stability surveillance testing: an effective and efficient approach.

Stability surveillance programs are run to confirm on a regular basis the registered shelf-life of pharmaceutical products in relation to the relevant climatic zone(s). The "selected date" and the "fixed interval" procedures are compared with respect to their applicability for obtaining a reliable estimate of the true shelf-life. Advantages of the selected date over the fixed interval approach are (1) a more reliable estimate of the true shelf-life, and (2) a more efficient approach in terms of time and costs.

Chemistry, Pharmaceutical↗

PubMedDate not supplied

Project planning, investigator selection, data harmonization.

This paper has presented certain concepts and thoughts regarding the planning process and dealt with two areas where planning and preconsideration of problems will aid in the quality, speed and efficiency of ones programs. The varied examples that have been cited are just that; they are not intended to be a comprehensive evaluation of all the aspects of the planning process or, for that matter, the selection of investigators or harmonization of data. They are intended instead to illustrate the way in which a comprehensive and thorough planning approach to project management can facilitate, ease and improve the quality of the work we do. The important point of this whole paper is not so much the individual benefits to be gained from any one of the systems described, but rather to illustrate as much as possible the value of planning in our process. It is incumbent on us to search for ways to improve the way in which we do or work. Standards have improved considerably over the years, but there is much room for further improvement; good clinical and scientific thought will inevitably continue to contribute to the improvement of those programs. The submission of this author, however, is that if we do these in advance, we will solve them a good deal faster and a good deal more efficiently than if we constantly react to new and developing problems.

Clinical Trials as Topic↗

PubMedDate not supplied

Telephone nursing: evidence of client and organizational benefits.

Telephone nursing (TN) or telephone triage (TT) has been identified as part of a successful cost-reduction demand management strategy. The author examines TN utilization and related client satisfaction, client education, reduction in drop-in clinic visits, and unnecessary ER and urgent care visits associated with an outpatient pediatric clinic population. This study examined 25% of the total of an average of TN 120 phone calls processed by this Southwestern clinic in an average summer month and achieved an 87.3% response rate to followup study questions. "Telephone nursing was performed by specially trained and experienced RNs using approved, written, clinic-specific protocols." The primary goals of the TN program was the "efficient use of health care resources" and provision of the "appropriate level of care at the appropriate time." Over 80% of the callers surveyed reported that if they hadn't been able to speak to the nurse they would have sought medical care elsewhere.

Adult↗

PubMed2002

Pharmacy assistance programs in a community health center setting.

Prescription drug costs represent the fastest growing item in health care and are a driving force in rapidly increasing health care costs. Community health centers serve an indigent population with limited access to pharmaceuticals. Pharmaceutical companies sponsor patient assistance programs. These pharmacy assistance programs can be developed to facilitate the provision of needed pharmaceuticals to this vulnerable population. La Casa de Buena Salud is a rural community health center in eastern New Mexico, which has provided access to a substantial amount of pharmaceuticals to indigent patients through patient assistance programs. Cost savings potential are considerable for a community health center and for patients when a pharmacy assistance program is organized efficiently and employed systematically. Secondary benefits are derived from the entire medical community. While some community health centers currently make effective use of pharmaceutical company-sponsored pharmacy assistance programs, a comprehensive, long-term approach at a national level may be required.

Community Health Centers↗

PubMed2005

Automated electron microscope tomography using robust prediction of specimen movements.

A new method was developed to acquire images automatically at a series of specimen tilts, as required for tomographic reconstruction. The method uses changes in specimen position at previous tilt angles to predict the position at the current tilt angle. Actual measurement of the position or focus is skipped if the statistical error of the prediction is low enough. This method allows a tilt series to be acquired rapidly when conditions are good but falls back toward the traditional approach of taking focusing and tracking images when necessary. The method has been implemented in a program, SerialEM, that provides an efficient environment for data acquisition. This program includes control of an energy filter as well as a low-dose imaging mode, in which tracking and focusing occur away from the area of interest. The program can automatically acquire a montage of overlapping frames, allowing tomography of areas larger than the field of the CCD camera. It also includes tools for navigating between specimen positions and finding regions of interest.

Image Processing, Computer-Assisted↗

PubMed1991

Comprehensive therapeutic interchange program in a community hospital.

The implementation of a comprehensive therapeutic interchange program is described. The need to reduce the number of telephone calls to physicians about nonformulary drug orders, reduce drug costs, and maximize the effectiveness of drug therapy prompted the development of an automatic therapeutic interchange program at a 273-bed nonteaching community hospital. Pharmacists and physicians agreed that a telephone call to discuss every nonformulary drug order was unnecessary. The pharmacy department presented the automatic interchange program to the pharmacy and therapeutics committee. The program was reviewed by the committee, the hospital attorney, and medical staff members and was instituted in 1986 for drug products, such as vitamins and antacids, for which interchanges are noncontroversial. A newsletter describing the program was distributed, and inservice education sessions were held. A reminder was placed on order forms that an interchange for nonformulary drugs would be made unless the nonformulary agent was deemed "medically necessary" by the physician. In such cases, the physician is contacted to discuss the therapeutic alternative. As acceptance of the program and cost efficiencies were demonstrated, more controversial agents were phased in during subsequent years. It was difficult to obtain approval to add some agents, such as third-generation cephalosporins, to the program, but noncompliance and confusion have been minimal. An automatic therapeutic interchange program has worked well at this institution since 1986.

Florida↗

PubMed1984

Administration and service delivery in the SSI program: the first 10 years.

This article provides an overview of the administrative structures and processes through which the Social Security Administration delivers its services to Supplemental Security Income (SSI) claimants and recipients. It documents the improvements and adjustments that have been made in the administration of SSI from 1974, when the program began, through 1983, the 10th year of its operation. The first decade of SSI was marked by significant changes that have led to improvements in fiscal responsibility and administrative efficiency for the program. Among the subjects covered are the legislative history of the program, the claims process, posteligibility procedures, underpayments and overpayments, the administrative complexities that have had to be surmounted, and administrative efforts aimed at quality assurance.

Aged↗

PubMed2003

[EUROVIHTA Project--specific intervention program for HIV infected patients to support the coping process with this chronic illness].

In this European multicenter intervention study 117 persons were examined who took part in group programs to improve coping with the HIV-infection. Psychological measures were taken at four times before, during and after the intervention. These were psychological symptoms (SCL-90-R), Coping (TSK), Locus of Control (KKG), Quality of Life (MOS-HIV), and physical health. Psychopathology (DSM-III-R) and neuropsychological deficits were assessed at baseline. The study is designed to investigate, along with the effectiveness of the intervention, differences between participating homosexual men and drug users as well as to discuss HIV as a chronic disease. The program has proven efficiency to enhance psychological and physical wellbeing and to support participants' coping with HIV. Drug users report less psychopathology and more improvement during the intervention. References for the organization of group programs with these subgroups are made.

Adaptation, Psychological↗

PubMedDate not supplied

Program evaluation in pediatric education.

The goal of this project at the Hospital for Sick Children (HSC), Toronto, Canada, was to evaluate the effectiveness of structure, processes, and outcomes of three pediatric nursing education programs offered by HSC Nursing Education Services. Participatory evaluation was the process used for the project. Results of this project will assist nurse educators to show accountability for the effectiveness and efficiency of their programs, and provide a model for planning and evaluating future programs.

Education, Nursing, Baccalaureate↗

PubMed1995

Programmed stuttering treatment for children: comparison of two establishment programs through transfer, maintenance, and follow-up.

Two different Establishment programs, Delayed Auditory Feedback (DAF) and Gradual increase in Length and Complexity of Utterance (GILCU), for improving the fluency of school-age children who stutter, were compared. The programs were carried out by 12 clinicians under supervision with 24 clients (12 elementary and 12 junior/senior high school) in the schools. Both programs produced important improvement in fluency in 23/24 (96%) of the children in a reasonable time period (7.9 hours). Generally, the two programs were similar in performance. The only difference (between GILCU and DAF) was that the GILCU program provided initially for better generalization of fluency. Transfer and Maintenance programs (10.4 hours) demonstrated that the children from the two Establishment programs performed in a similar manner and that the Transfer and Maintenance Programs were helpful. In a total of 18.3 hours of establishment, transfer, and maintenance treatment, 11 subjects, who completed the programs, reduced their stuttering from 7.9 SW/M to .8 SW/M at a 14-month follow-up showing that the children had maintained their fluency. Clinicians' performances contributed to the effectiveness and efficiency of the programs.

Adolescent↗

PubMed2000

Ballast: blast post-processing based on locally conserved segments.

MOTIVATION: Blast programs are very efficient in finding relatively strong similarities but some very distantly related sequences are given a very high Expect value and are ranked very low in Blast results. We have developed Ballast, a program to predict local maximum segments (LMSs-i.e. sequence segments conserved relatively to their flanking regions) from a single Blast database search and to highlight these divergent homologues. The TBlastN database searches can also be processed with the help of information from a joint BlastP search. RESULTS: We have applied the Ballast algorithm to BlastP searches performed with sequences belonging to well described dispersed families (aminoacyl-tRNA synthetases; helicases) against the SwissProt 38 database. We show that Ballast is able to build an appropriate conservation profile and that LMSs are predicted that are consistent with the signatures and motifs described in the literature. Furthermore, by comparing the Blast, PsiBlast and Ballast results obtained on a well defined database of structurally related sequences, we show that the LMSs provide a scoring scheme that can concentrate on top ranking distant homologues better than Blast. Using the graphical user interface available on the Web, specific LMSs may be selected to detect divergent homologues sharing the corresponding properties with the query sequence without requiring any additional database search.

Algorithms↗

PubMed1984

Microcomputer-based programs for the practicing vascular surgeon.

An inexpensive microcomputer system can be programmed in BASIC to provide convenient data storage, retrieval, and analysis for the practicing vascular surgeon. A personalized registry program permits input of key patient data that can be processed and retrieved in list form or groupings with operator control of variables. A second program, in which lower extremity revascularization procedures can be analyzed by various parameters, is described. Results can be obtained in life-table formats with comparative statistical analysis. For the private practitioner of vascular surgery, the use of various computer programs will allow management of information for self-assessment, record keeping, teaching, and publication with great accuracy and at significant cost savings. In addition, word processing can increase secretarial output and efficiency. Office management programs are available but need to be individually investigated to determine their use for a particular practice. The major advantages of the microcomputer for the practicing vascular surgeon are personal control and ready access to data that are easy to store, analyze, and retrieve.

Computers↗

PubMed1995

Prenatal genetic counseling for hemoglobinopathy carriers: a comparison of primary providers of prenatal care and professional genetic counselors.

Health personnel trained in medical genetics are insufficient to meet the demand for genetic services. Methods must be found to enable primary care providers to offer commonly needed genetic services themselves. In our recently reported community-wide prenatal screening program for hemoglobinopathies, 36% of women detected to have a hemoglobinopathy did not come to a tertiary center for counseling and thus may have not benefited from testing. To determine whether the efficiency of the program could be increased if counseling were provided by the prenatal care provider (obstetrician or family practitioner), we developed a pilot training program on the basis of our experience in offering such services and enlisted 68% of regional prenatal care providers to participate. The proportion of patients detected to have a hemoglobinopathy who received counseling was similar in the primary and tertiary provider groups: 59% versus 50%, respectively, for sickle trait, and 69% versus 66%, respectively, for beta-thalassemia trait. Knowledge after counseling was also similar for the primary and tertiary provider groups: 64% versus 66% (mean % correct), respectively, for sickle trait, and 79% versus 78%, respectively, for beta-thalassemia trait. However, the two provider groups significantly differed with regard to whether or not the patient had her partner tested. For sickle trait, it was 25% for the primary providers but 49% for the tertiary providers (P < .001). For beta-thalassemia trait, it was 47% for the primary providers but 78% for the tertiary providers (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

PubMed2000

Efficiency transfer and coincidence summing corrections for gamma-ray spectrometry

ETNA (Efficiency Transfer for Nuclide Activity measurements) is a new computer program providing both detector efficiency transfer for various types of sources for coaxial source-detector geometries and coincidence summing corrections. This program, available for use on PCs, has a direct link to the computerised database NUCLEIDE in order to automatically import the necessary radionuclide decay data. The specific features and facilities are outlined and examples are given.

Journal Article↗

PubMedDate not supplied

Contraceptive social marketing and community-based distribution systems in Colombia.

Three operations research experiments were carried out in three provinces of Colombia to improve the cost-effectiveness of Profamilia's nonclinic-based programs. The experiments tested: (a) whether a contraceptive social marketing (CSM) strategy can replace a community-based distribution (CBD) program in a high contraceptive use area; (b) if wage incentives for salaried CBD instructors will increase contraceptive sales; and (c) whether a specially equipped information, education, and communication (IEC) team can replace a cadre of rural promoters to expand family planning coverage. All three strategies proved to be effective, but only the CSM system yielded a profit. Despite this, Profamilia discontinued its CSM program soon after the experiment was completed. Unexpected government controls regulating the price and sale of contraceptives in Colombia made the program unprofitable. As a result, family planning agencies are cautioned against replacing CBD programs with CSM. Instead, CBD programs might adopt a more commercial approach to become more efficient.

Colombia↗

PubMed2006

Automatic clustering of orthologs and inparalogs shared by multiple proteomes.

MOTIVATION: The complete sequencing of many genomes has made it possible to identify orthologous genes descending from a common ancestor. However, reconstruction of evolutionary history over long time periods faces many challenges due to gene duplications and losses. Identification of orthologous groups shared by multiple proteomes therefore becomes a clustering problem in which an optimal compromise between conflicting evidences needs to be found. RESULTS: Here we present a new proteome-scale analysis program called MultiParanoid that can automatically find orthology relationships between proteins in multiple proteomes. The software is an extension of the InParanoid program that identifies orthologs and inparalogs in pairwise proteome comparisons. MultiParanoid applies a clustering algorithm to merge multiple pairwise ortholog groups from InParanoid into multi-species ortholog groups. To avoid outparalogs in the same cluster, MultiParanoid only combines species that share the same last ancestor. To validate the clustering technique, we compared the results to a reference set obtained by manual phylogenetic analysis. We further compared the results to ortholog groups in KOGs and OrthoMCL, which revealed that MultiParanoid produces substantially fewer outparalogs than these resources. AVAILABILITY: MultiParanoid is a freely available standalone program that enables efficient orthology analysis much needed in the post-genomic era. A web-based service providing access to the original datasets, the resulting groups of orthologs, and the source code of the program can be found at http://multiparanoid.cgb.ki.se.

Algorithms↗

PubMedDate not supplied

[The organization of instrumental food-procuring movements in rats].

The roles of the lateral hypothalamus, basolateral nucleus of the amygdalar complex, the second field of the frontal cortex, and ventromedial thalamic nucleus in organization of the fast ballistic food-procuring movements were studied in albino rats. Sequences of uni- and bilateral destruction of the brain structures were assessed by photorecording. Movement-related neuronal activity in these structures was recorded in freely moving animals. A specific involvement of each of the above listed structures in organization of food-procuring movements was shown. The lateral hypothalamus seems to participate in initiation of the motor program and its efficient realization, the basolateral amygdala appears to produce activatory, training, and stabilizing effects. The second field of the motor cortex leads in movement acquisition (i.e., in memorizing) and decision making about triggering the program. The idea about the relay role of the thalamic motor nucleus is supplemented by understanding of its more complex integrative function.

Amygdala↗