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PubMed1981

Infection control as a quality control in an integrated hospital quality assurance program.

I have discussed infection control in the context of a quality control system in a hospital. To date hospital "quality assurance" has been unfocused, retrospective, and CME related-an inappropriate response to such quality problems as inappropriate antibiotic usage, hospital related infection, and professional (malpractice) liability. I have suggested that the control paradigm (a concurrent signal leads to response system) may provide the approach needed to enhance the effectiveness of the whole hospital quality assurance effort.

Cross Infection↗
PubMed1978

An integrated set of computer programs for processing electron micrographs of biological structures.

A set of computer programs is described which has been developed for processing electron micrographs of biological structures. The programs provide facilities for efficient image storage, enhancement and display. Extensive programs are available for analysis of images of structures with translational, rotational and helical symmetry, and for performing 3-dimensional reconstruction. The considerations which went into the design of the system are listed. A description is provided of the means of control of the main program, which performs the majority of the image processing operations, and an example is given to illustrate its use. These programs are compared with other program systems also developed for micrograph image processing.

Computers↗
PubMed2000

Mental health versus substance abuse treatment programs for dually diagnosed patients.

The aim of this study was to assess the similarities and differences of patients with co-existing psychiatric and substance use disorders attending treatment in either a mental health setting or a substance abuse treatment setting. A total of 129 patients were assessed, including 65 individuals from the substance abuse treatment center and 64 individuals from the mental health program. Treatment records were reviewed for diagnoses and sociodemographic data. While the two groups were highly similar with regard to age and ethnicity, there were significant differences in psychiatric profile, with the substance abuse treatment group having less severe diagnoses and no patients with schizophrenia, while the mental health treatment group had a majority of patients with schizophrenia. Other differences in the two groups, such as marital and parental status, disability status, and medical problems appeared to be directly linked with the aforementioned diagnostic profile. These data suggest important differences in characteristics of patients with comorbid disorders that appear to be dependent on the type of treatment program they attend. For the most effective management, integrated treatment programs should be aware of these differences and tailor service provision accordingly.

Adult↗
PubMed2025

Integrated epigenetic and genetic programming of primary human T cells.

Targeted epigenetic engineering of gene expression in cell therapies would allow programming of desirable phenotypes without many of the challenges and safety risks associated with double-strand break-based genetic editing approaches. Here, we develop an all-RNA platform for efficient, durable and multiplexed epigenetic programming in primary human T cells, stably turning endogenous genes off or on using CRISPRoff and CRISPRon epigenetic editors. We achieve epigenetic programming of diverse targeted genomic elements without the need for sustained expression of CRISPR systems. CRISPRoff-mediated gene silencing is maintained through numerous cell divisions, T cell stimulations and in vivo adoptive transfer, avoiding cytotoxicity or chromosomal abnormalities inherent to multiplexed Cas9-mediated genome editing. Lastly, we successfully combined genetic and epigenetic engineering using orthogonal CRISPR Cas12a-dCas9 systems for targeted chimeric antigen receptor (CAR) knock-in and CRISPRoff silencing of therapeutically relevant genes to improve preclinical CAR-T cell-mediated in vivo tumor control and survival.

Humans↗
PubMed2003

Application of intake fraction to population exposure estimates in Hunan Province of China.

This article developed a new method, based on the concept of "intake fraction", to assess population exposure to primary and secondary fine particle matters from site-specific sources. This method was illustrated by a set of 17 power plants (totally 24 stacks) in Hunan Province of China. The CALPUFF long-range atmospheric dispersion model was used to simulate ambient concentrations of fine particles, and the GIS technology was used to generate a population distribution database from county-level population statistical data. An integrated computer program package was developed to carry out numerical integration of dispersion results over the population data, and produce intake fractions. The resulting average intake fractions within 500 km were 9.73 x 10(-6), 2.39 x 10(-6), and 2.47 x 10(-6) for primary fine particles, sulfate and nitrate respectively. Regression analyses were performed to explore the relationships between intake fractions and potential variables. Results showed that the stack height and aggregate populations could be used to predict intake fractions of fine particles. R2 of the regression equations were 0.83, 0.64, and 0.74 for primary fine particles, sulfate and nitrate respectively. Iso-intake fractions presenting geographical distributions of intake fractions in Hunan Province were mapped, showing a factor of about 2 between the highest values in the northeast and the lowest in the southwest of Hunan Province.

Air Pollutants↗
PubMed2005

Field experiences integrating family planning into programs to prevent mother-to-child transmission of HIV.

This article reviews field experiences with provision of family planning services in prevention of mother-to-child transmission (PMTCT) programs in ten countries in Africa, Asia, and Latin America. Family planning is a standard component of most antenatal care and maternal-child health programs within which PMTCT programs are offered. Yet PMTCT sites often miss opportunities to provide HIV-positive clients with family planning counseling. Demand for family planning among HIV-positive women varies depending on the extent of communities' openness about HIV/AIDS, fertility norms, and knowledge of PMTCT programs. In Kenya and Zambia, no differences were observed in use of contraceptives between HIV-positive and HIV-negative women in the study communities, but HIV-positive women have more affirmative attitudes about condoms and use them significantly more frequently than do their HIV-negative counterparts. In the Dominican Republic, India, and Thailand, where HIV prevalence is low and sterilization rates are high, HIV-positive women are offered sterilization, which most women accept. This article draws out the policy implications of these findings and recommends that policies be based on respect for women's right to informed reproductive choice in the context of HIV/AIDS.

Contraception↗
PubMedDate not supplied

The integration of a QA/RM program in a rural healthcare obstetrical service.

Obstetrical services in a rural healthcare setting have special problems because the number of deliveries per month is below 100, with some facilities averaging fewer than 10 to 15 births per month. Medical resources may include obstetricians, pediatricians, or family practitioners, but not necessarily all three. Because it is not cost-effective to staff an obstetrical unit 24 hours a day when a low census is the norm, staffing patterns may be atypical and creative. The development of an effective credentialing system for both nursing and medical staffs is the first component of a QA/RM plan. Nursing staff play a vital role in modifying potential risk. When nurses do not routinely provide care on a unit, an efficient quality assurance plan is vital. Components of the plan must include staffing patterns and ratios, policies and procedures, and documentation. QA indicators should address both volume and outcome-oriented clinical indicators. Medical follow-up when indicated should also be part of the plan. Ongoing communication among team members and utilization of outside resources can assist in promoting an effective program. Although obstetrics is an area where the potential for risk exposure remains great, it is possible to create an efficient, practical risk management system.

Communication↗
PubMed2006

Spatially targeting Culex quinquefasciatus aquatic habitats on modified land cover for implementing an Integrated Vector Management (IVM) program in three villages within the Mwea Rice Scheme, Kenya.

BACKGROUND: Continuous land cover modification is an important part of spatial epidemiology because it can help identify environmental factors and Culex mosquitoes associated with arbovirus transmission and thus guide control intervention. The aim of this study was to determine whether remotely sensed data could be used to identify rice-related Culex quinquefasciatus breeding habitats in three rice-villages within the Mwea Rice Scheme, Kenya. We examined whether a land use land cover (LULC) classification based on two scenes, IKONOS at 4 m and Landsat Thematic Mapper at 30 m could be used to map different land uses and rice planted at different times (cohorts), and to infer which LULC change were correlated to high density Cx. quinquefasciatus aquatic habitats. We performed a maximum likelihood unsupervised classification in Erdas Imagine V8.7 and generated three land cover classifications, rice field, fallow and built environment. Differentially corrected global positioning systems (DGPS) ground coordinates of Cx. quinquefasciatus aquatic habitats were overlaid onto the LULC maps generated in ArcInfo 9.1. Grid cells were stratified by levels of irrigation (well-irrigated and poorly-irrigated) and varied according to size of the paddy. RESULTS: Total LULC change between 1988-2005 was 42.1 % in Kangichiri, 52.8 % in Kiuria and and 50.6 % Rurumi. The most frequent LULC changes was rice field to fallow and fallow to rice field. The proportion of aquatic habitats positive for Culex larvae in LULC change sites was 77.5% in Kangichiri, 72.9% in Kiuria and 73.7% in Rurumi. Poorly - irrigated grid cells displayed 63.3% of aquatic habitats among all LULC change sites. CONCLUSION: We demonstrate that optical remote sensing can identify rice cultivation LULC sites associated with high Culex oviposition. We argue that the regions of higher Culex abundance based on oviposition surveillance sites reflect underlying differences in abundance of larval habitats which is where limited control resources could be concentrated to reduce vector larval abundance.

Animals↗
PubMed1980

Veterans Administration--VA Consumer Affairs Program. VA consumer program.

The Veterans Administration Consumer Affairs Program addresses the ongoing Agency consumer activities and integrates the programs of the Departments of Medicine and Surgery, Veterans Benefits, and Memorial Affairs. The primary goal of this program is to ensure that veterans, their dependents, and their surviving beneficiaries have the opportunity to provide input to the decision making process. The program described complies with the requirements established by Executive Order 12160 on Federal Consumer Programs.

Community Participation↗
PubMed2002

An integrated pattern recognition approach for intrusion detection.

Intrusion detection systems (IDS) attempt to address the vulnerability of computer-based systems for abuse by insiders and to penetration by outsiders. An IDS is required to examine an enormous amount of data generated by computer networks to assist in the abuse detection process. Thus, there is a need to develop automated tools that address these requirements to assist system operators in the detection of violations of existing security policies. In this research, an automated IDS is proposed for insider threats in a distributed system. The proposed IDS functions as an anomaly detector for insider system operations based on the analysis of the system's log files. The approach integrates dynamic programming and adaptive resonance theory (ART1) clustering. The integrated approach aligns sequences of log events with prototypical sequences of events for performing tasks and classifies the aligned sequences for intrusion detection. The system examined for this research is a Boots System for controlling the movement of boots from one place to another under specific security restrictions related to the boot orders. We present the proposed model, the results achieved and the analysis of an implemented prototype.

Algorithms↗