Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Logistics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMedDate not supplied

Handling an airline disaster: suggestions from psychological and logistical standpoints.

In light of the terrorist attacks on September 11, 2001, which eliminated all crew and passengers of four airliners and produced mass casualties on the ground, OM professionals must re-examine their crisis management programs to ensure that they are in the best possible shape. This article discusses the logistical components of such programs and stresses training, psychological debriefing and defusing, and reintegration of First Responders.

Aviation↗
PubMed2002

[Hearing screening with evoked otoacoustic emission in the neonatal period are logistically and economically feasible].

OBJECTIVE: To design, carry out and assess a protocol for the early diagnosis of hearing loss based on the detection of evoked otoacoustic emissions (EOAE) in the neonatal period. MATERIALS AND METHODS: Five hundred twenty-five infants without risk factors for hearing loss were studied. A hearing screening protocol with EOAE was applied in the first 48 hours of life, with a second test on the fifth day of life, coinciding with phenylketonuria screening if the first test was negative. The diagnostic stage took place when the infants were aged 1 month. RESULTS: A total of 98.8 % of the program was completed. In the initial test, bilateral EOAE were obtained in 458 infants. When the EOAE were performed during the first 24 hours after birth, 72.5 % of newborns achieved a satisfactory result. This percentage rose to 93.6 %, 97.9 % and 94.7 % when the test was delayed until discharge on, respectively, the second, the fifth and subsequent days of age (p < 0.01). All the infants who did not achieve a satisfactory result in the first test underwent a second one. A total of 87.5 % of the newborns who had failed the test within the first 24 hours passed it when it was repeated at 48 hours, at the time of discharge. A third screening was necessary in seven infants (six on the fifth day of life and one, together with auditory brainstem response [ABR], on 30 days of age). One infant showed absence of EOAE in the left ear in the three tests, as well as a threshold above 70 dB to obtain the V wave in the ABR performed at 1 and 3 months of age and was diagnosed with unilateral moderate deafness, representing a prevalence of hearing loss of 1.9 % of live newborns in the general population in our environment. CONCLUSIONS: Universal hearing screening with EOAE is logistically and economically feasible. The use of a second test on the fifth day of age decreases the number of false positives, thus reducing economic cost and family anxiety, and improves recruitment, since it coincides with metabolic screening.

Algorithms↗
PubMed1992

Multinomial logistic models explaining income changes of migrants to high-amenity counties.

"A survey of residents of and migrants to 15 fast-growing wilderness counties [in the United States] showed that only 25 percent of the migrants increased their income, while almost 50 percent accepted income losses upon their moves to high-amenity counties. Concomitantly, amenities and quality of life were more important factors in the migration decision than was employment, for instance. We focused on migrants in the labor force and employed multinomial logistic regression to identify the impact of migrants' characteristics, their satisfaction/dissatisfaction with previous location (push), and the importance of destination features (pull) on income change."

Americas↗
PubMed2002

Comparison of logistic regression and neural net modeling for prediction of prostate cancer pathologic stage.

BACKGROUND: Prostate cancer (PCa) pathologic staging remains a challenge for the physician using individual pretreatment variables. We have previously reported that UroScore, a logistic regression (LR)-derived algorithm, can correctly predict organ-confined (OC) disease state with >90% accuracy. This study compares statistical and neural network (NN) approaches to predict PCa stage. METHODS: A subset (756 of 817) of radical prostatectomy patients was assessed: 434 with OC disease, 173 with capsular penetration (NOC-CP), and 149 with metastases (NOC-AD) in the training sample. Additionally, an OC + NOC-CP (n = 607) vs NOC-AD (n = 149) two-outcome model was prepared. Validation sets included 120 or 397 cases not used for modeling. Input variables included clinical and several quantitative biopsy pathology variables. The classification accuracies achieved with a NN with an error back-propagation architecture were compared with those of LR statistical modeling. RESULTS: We demonstrated >95% detection of OC PCa in three-outcome models, using both computational approaches. For training patient samples that were equally distributed for the three-outcome models, NNs gave a significantly higher overall classification accuracy than the LR approach (40% vs 96%, respectively). In the two-outcome models using either unequal or equal case distribution, the NNs had only a marginal advantage in classification accuracy over LR. CONCLUSIONS: The strength of a mathematics-based disease-outcome model depends on the quality of the input variables, quantity of cases, case sample input distribution, and computational methods of data processing of inputs and outputs. We identified specific advantages for NNs, especially in the prediction of multiple-outcome models, related to the ability to pre- and postprocess inputs and outputs.

Aged↗
PubMedDate not supplied

[Logistic effects in the two-sex model with "harmonic mean" fertility function].

"In the present paper the effects of the presence of logistic terms in [a] two-sex random mating model with 'harmonic mean' fertility function are discussed. The behaviour of the model is studied by means of a phase plane analysis. It [is] possible to show the existence, under quite natural conditions, of one (and only one) meaningful equilibrium point that is globally stable. This equilibrium is the final result of an adjustment process [and includes an]...initial period during which it is possible to observe a preliminary balancing process of the sex composition...." (SUMMARY IN ENG)

Demography↗
PubMed2002

Logistical considerations for emergency response resources.

Resource management is a critical component of disaster preparedness and response. The type and quantity of resources and supplies needed by any particular community will be determined by several factors including the disasters affecting the community, existing resources within the community, resources available from neighboring communities, and the vulnerability assessment of a community. Ideally only needed resources should be requested and delivered. Unsolicited aid can often hamper an emergency response. The needs of a community will change during a disaster. Often the immediate need focuses on the medical sector. Issues such as hygiene, water and shelter will occur later. Disaster planning and logistical management of resources should not only consider the short-term needs of the community but also the long-term consequences of a disaster on the community.

Communication↗
PubMed2003

[Medical logistics: principles applied to diagnostics and therapy in women with symptoms and signs of breast cancer].

BACKGROUND: Using breast cancer as an example, we suggest that medical logistics should be introduced as a method for continuous improvement of quality and cost-effectiveness in the health care system. MATERIALS AND METHODS: Ullevaal University Hospital has approximately 500 newly diagnosed cases of breast cancer per year. The triple diagnostic test supplemented by MRI are the diagnostic tools. We rely on fine needle aspiration cytology as the only morphological test before surgery, which is done as day surgery. 70 % of the patients return home on the same day, the others stay in a patient hotel until the drains can be removed. The sentinel node procedure is routine and has been done on 610 patients. RESULTS: Of 1502 radically operated, 2 had false positive cytology (0.12 per cent). Of 610 sentinel node cases, 91 % were found; of these, 23 % had metastasis. Among the negative cases, two have so far experienced recurrence of the disease in the axilla. The patients are well satisfied. Total yearly savings compared to the era before sentinel node and use of a patient hotel has been calculated to approximately 400 000 euro. INTERPRETATION: We find our results so far acceptable as regards the use of fine needle aspiration cytology as well as the sentinel node. Both techniques are, however, technically demanding and should only be used in centres that have continuous quality monitoring.

Biopsy, Needle↗
PubMed1992

Predicting the probability of malignancy of the neck mass with logistic regression model: a statistical analysis of excisional biopsy of neck masses.

One hundred and fifty-six patients with neck lesions were selected into this retrospective study between January, 1989 and December, 1990. All the patients visited OPD with the chief complaint of neck mass without other apparent symptoms and signs after initial work-up. They can be divided into 5 types according to the pathological reports: type a) metastatic lesion, type b) malignant lymphoma, type c) TB lymphadenitis, type d) miscellaneous benign lesion, and type e) inadequate specimen. They represent 24.4%, 12.8%, 9.6%, 52.6%, and 0.6% of the patients respectively. Type a) and type b) were classified as group of malignancy and the other three types were group of benignancy. Chi-square test and t-test were then used to evaluate the significant level of difference in each semiological factor between both groups. Several parameters were found to reach significant level, including tumor fixation, age of the patients, tenderness, location and size of the tumor, and history of cancer. Stepwise logistic regression was utilized to obtain a regression equation to predict the probability of malignancy in OPD patients with neck masses. The accuracy rate of prediction is 83.3%, if the cutpoint value is 0.5. A clinician can therefore avoid untimely excisional biopsy and delay in treatment planning.

Adolescent↗
PubMed2003

[Sentinel node identification in breast cancer: logistic aspects].

Sentinel node identification has gained its place in early breast cancer surgical management before the results of prospective randomized trials. Published results can be explained by teams configurations and technical aspects can create some confusion in results analysis. Logistic aspects confers a specificity for each team. Sentinel node technique should be reserved to experienced treatment center where it can be utilized routinely.

Breast Neoplasms↗
PubMed2002

Information and logistics for homecare.

TELECOS is a regional project whose ambition is to use new cooperation tools, in the context of homecare, in order to facilitate the coordinated cooperative work of health actors. Homecare can improve the quality of life for the patient and reduce costs but it also induces a lot of difficulties during organisation and care. We aim at knowing more about the activity of cooperation in the homecare context and proposing a cooperation platform which answers to the specific needs generated during homecare and which integrates new applications. In this paper, we present the results of our study of homecare. The activity analysis leads us to determine two specific processes: one concerns the implementation of human and material resources and design of the homecare protocol (the logistics process) and the other concerns the coordination of the healthcare actors during effective homecare (the care process). The first process is composed of five main phases during which an healthcare professional is required as coordinator. We then present the Worklow model used to represent the cooperation activity in homecare. We describe the activity: the tasks and subtasks are represented in a declarative way. We then briefly present our prototype, devoted to homecare management, implementing the different phases of the information process, developed in JAVA.

Home Care Services↗
PubMed2005

Knowledge logistics as an intelligent service for healthcare.

OBJECTIVES: The technology of grid services is developing fast. This paper presents an approach to the implementation of an intelligent grid service that configures a hospital taking advantage of the knowledge logistics idea. METHODS: The presented approach is based on synergistic integration of knowledge acquired from distributed sources in order to obtain new or complement insufficient knowledge. Presented approach uses ontologies and the formalism of object-oriented constraint networks for knowledge representation and applies ILOG to constraint-based problem solving. RESULTS: The application of the approach is illustrated via a decision support system for a fictitious case study of a hospital configuration in the Binni region. The system showed the ability to produce interrelated solutions for subtasks of the hospital configuration task based on the built ontology and input parameters. Besides, such preferences as cost or time minimization are also considered by the implemented fuzzy logic module that finds a feasible solution. CONCLUSIONS: KL would benefit from the grid, and particularly from the concept of a semantic grid. The scalable architecture of the approach enables its extension with regard to knowledge/information sources number and, thereby, with regard to factors taken into account during complex problem solving. Utilizing ontologies allows integration of the approach into existing processes and facilitates knowledge sharing with similar systems. Application of constraint networks allows rapid problem manipulation and usage of such existing efficient technologies as ILOG.

Artificial Intelligence↗
PubMed1992

An empirical assessment of saddlepoint approximations for testing a logistic regression parameter.

Saddlepoint methods provide quick and easy approximations to significance levels for conditional tests of logistic regression parameters. We evaluate the accuracies of saddlepoint approximations for three well-known conditional tests: Bartlett's test for no three-factor interaction in a 2 x 2 x 2 table, the test for trend in a series of probabilities, and the exact test of no association in stratified 2 x 2 tables with a common odds ratio. General recommendations are suggested regarding the use of saddlepoint approximations for exact conditional significance levels.

Mathematics↗
PubMed2005

[Logistics in the pharmaceutical service].

The conception of the field of pharmaceutical service defines pharmaceutical service as the basic part of pharmacy, the principal task of which is to provide pharmaceutical care as an inseparable part of providing health care. It represents a set of professional activities of the pharmacist oriented to securing human and veterinary pharmaceutical products and health care products and to optimising effective, safe and quality pharmacotherapy. Technically, pharmaceutical service is an applied discipline, as it makes use of knowledge gained in other pharmaceutical, medical, psychological, social, and economic sciences. Because of its interdisciplinary character it is necessary to extend the theory of pharmaceutical service in such a way so that it may reflect all aspects of its sphere of activity. One of the possibilities is to define the pharmacy premises as an independent functional unit which operates on the basis of valid legal standards in such a way that on the one hand it secures the provision of health (pharmaceutical) care, and on the other hand it maintains its cost-effectiveness. To keep the quality of care of the patient and the economic aspect in balance, it is necessary to define the term pharmaceutical logistics also under the conditions of Slovak (Czech) pharmacy as early satisfaction of the requirements of the patient (client) in the pharmacy premises, which means that the appropriate pharmaceutical product or health care product and the appropriate information must be at the right time in the required amount and required quality in the right place.

Pharmaceutical Services↗
PubMed2006

[Emergency procedures for taking care of the victims of bomb attacks: logistical and medical aspects].

In The Netherlands the threat of terrorist attacks also exist. Both doctors and hospitals alike should be prepared for such attacks both on the logistical as well as the medical level. Most terrorist attacks are carried out with explosives. This results in many victims and in cases of explosions in closed or semi-closed areas, often results in complex medical problems in many of the victims. An explosion that occurs as the result ofa bomb detonating can result in 4 patterns of injury: the primary explosion injury caused by the pressure of the blast, the secondary injuries caused by flying debris, the tertiary injuries caused by the explosion wind, and the quaternary caused by heat and fire. Common injuries seen following an explosion include: lung damage, neurological damage, abdominal injuries, bone fractures and skeletal damage and crush-syndrome. The triage occurs at the site of the explosion as well as on arrival in hospital. One especially important aspect of this is the sorting and selecting between victims who are likely to develop complex problems and who therefore need to receive aggressive treatment in a specially equipped centre and those patients for whom the nearest emergency department will suffice their needs. The triage should be repeated considering the possibility that initial estimates on these points may have been wrong. Epidemiological research should be carried out for each attack in order to make an inventory of the number of victims, the injuries incurred, the assessment of the effects of the medical help received and an assessment of the effectiveness of the total aid received.

Amputation, Traumatic↗
PubMed2006

[Transplant coordination and logistics of intra and extra-hospital cadaver donor tissue. "The Pamplona Model". Sequence of tasks performed from 1992-2006].

INTRODUCTION: Tissue and organ donations are the only option for many patients. Cerebral death (CD) facilitates this approach. However, hospitals that do not provide CD donors have to adapt in order to obtain donors, referred to as tissue donors (TD), who have died from cardiac arrest. OBJECTIVE: Is this paper it descripte the model for coordination and donation of intra and extra-hospital TD in the Autonomous Community of Navarra. It creats a program for detection, donation and extractions called the Pamplona Model, from 1992-2006. MATERIAL AND METHODS: In 1990, a transplant team was created by an Intensive Medicine Physician of HVC, INML and SOS-Navarra. In 1996, VCH Transplant Coordination is defined as a reference centre for the Tissue Transplant Programme in the Autonomous Community of Navarra. RESULTS: Consensus protocols for "intra and extra-hospital detection" of persons having died from cardiac arrest are developed: - Alerts from NHS-O hospitals, SOS-Navarra; judges and INML forensic pathologists. - Criteria for selection, search and contacts with relatives. - Alert serology, extraction and transport teams. - Logistics and distribution of tissue. - Agreed incentives: Economic, administrative and relevant regulations. CONCLUSIONS: The Pamplona Model, with the Virgen Del Camino hospital has made important contributions and is unique in the world. Intra and extra-hospital coordination of cadaver donor from a referred hospital, it is a scientific and organizational advance to have in it counts for the creation of extraction and transplant tissues teams.

Adolescent↗
PubMed2006

[Comparison of acute physiology and chronic health evaluation II, simplified acute physiology score II and Logistic organ dysfunction system on predicting outcome of critically ill patients in intensive care unit].

OBJECTIVE: To compare and evaluate the prognostic value of three prognostic systems namely acute physiology and chronic health evaluation II(APACHEII), simplified acute physiology score II(SAPSII), and Logistic organ dysfunction system (LODS),to predict mortality rate in intensive care unit (ICU). METHODS: APACHEII, SAPSII and LODS were used to assess probabilities of hospital mortality rate and to compare with actual outcome. The overall goodness-of-fit of three prognostic systems were assessed by using the areas under the receiver operating characteristic (ROC) curves and classification tables. Calibration curves and Lemeshow-Hosmer chi square statistics were used to test accuracy of prediction. RESULTS: Hospital mortality rate was basically equivalent to that predicted by APACHEII but higher than those predicted by SAPSII and LODS. The areas under the ROC curves were 0.881 for APACHEII, 0.904 for SAPSII and 0.875 for LODS, and 95% confidence interval (CI) were 0.858-0.904,0.884-0.924 and 0.851-0.898, respectively.The overall correct classification rates, applying the decision criterion of 50%, were 81.60% for APACHEII, 82.09% for SAPSII and 79.26% for LODS. Calibration of APACHEII(chi (2)=9.69) and SAPSII (chi (2)=13.50) were superior to that of LODS (chi (2)=87.22). CONCLUSION: The prognostic value of discrimination for APACHEII, SAPSII and LODS is good and basically equivalent, but calibration of acuity of APACHEII and SAPSII is much better than that of LODS.

APACHE↗
PubMed1991

Logistic-regression model for assessing portal hypertension by measuring hyaluronic acid (hyaluronan) and laminin in serum.

We earlier observed a positive correlation between portal venous pressure (PVP) and the concentration of laminin in serum. Here we investigated whether the diagnostic efficacy could be improved by considering additional analytes and application of multivariate statistical analysis. In 102 patients with fibrotic liver disease of various etiologies we measured PVP as the gradient of the wedged and free hepatic venous pressures and determined the concentrations of hyaluronic acid and laminin in serum. Regression coefficients established by logistic regression in this group were subsequently used to predict portal hypertension (PVP greater than mmHg) in an independent group of 45 patients. By comparison with the known PVP, we obtained a sensitivity of 0.83 (confidence interval: 0.63-0.93) and a specificity of 0.82 (0.61-0.93) for diagnosis of portal hypertension by means of the concentrations of hyaluronic acid and laminin in serum. Application of the model is suggested as a tool for pre-screening and monitoring patients to be subjected to assessment of portal hypertension.

Adult↗
PubMed1991

[Conditional logistic regression analysis of coronary heart disease].

A case-control study on 215 pairs was carried out in Jinan. Conditional Logistic regression analysis showed that the following five factors were associated with coronary heart disease, i.e., hypertension, hypercholesterolemia and heavy smoking, serum copper and HDL-C/TC. The former three were risk factors, and the latter two were protective factors. There is remarkable dose-response relation between heavy smoking and coronary heart disease. The data analysis show that these five factors are contributory to coronary heart disease with synergism.

Case-Control Studies↗