Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Program Efficiency”

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 1,279 records · Page 71Linked to original sources
PubMed2003

Introducing BF++: AC++ framework for cognitive bio-feedback systems design.

OBJECTIVE: This paper addressed the issue of building-up a framework for the realization of several cognitive bio-feedback (CBF) systems. It minimizes the programming effort and maximizes the efficiency and the cross-platform portability so that it can be used with many platforms (either software or hardware). METHODS: A generic CBF system was decomposed into six modules: acquisition, kernel, feedback rule, patient feedback, operator user interface and persistent storage. The way in which these modules interact was defined by immutable software interfaces in a way that allows to completely substitute a module without the need to modify the others. RESULTS: Three Brain Computer Interface engines were developed with less than 40 lines of C++ code each. They can also be used under virtually any platform that supports an ANSI C++ compiler. CONCLUSION: A framework for the implementation of a wide range of CBF systems was developed. Compared to the other approaches that are described in the literature, the proposed one is the most efficient, the most protable across different platforms, the most generic and the one that allows the realization of the cheapest final systems.

Cognition↗
PubMedDate not supplied

A medical reasoning program that improves with experience.

A physician's problem-solving performance improves with experience. The performance of most medical expert systems does not. The author has developed a diagnosis program for coronary disease that improves its performance by remembering and learning from cases that it has already solved. The program diagnoses commonly-seen problems efficiently by recalling similar, previous cases and adapting their solutions through simple modifications. When it lacks experience in solving a particular type of problem, the program resorts to reasoning from a physiological model, then remembers the solution for future use. The program can produce solutions identical to those derived by a model-based expert system for the same domain, but with an increase of two orders of magnitude in efficiency. The method described is independent of the particular domain and should be generally applicable.

Artificial Intelligence↗
PubMed1994

Cleveland Health Quality Choice (CHQC)--an ongoing collaborative, community-based outcomes assessment program.

Cleveland Health Quality Choice (CHQC) is a unique community-based program designed to provide more efficient delivery of healthcare services through routine collection and dissemination of selected patient interventions and outcomes. This effort, coordinated by a consortium of business, hospital, and medical leaders, provides comparative public data on hospital performance. In the ICU, this effort involves collection of Acute Physiology and Chronic Health Evaluation (APACHE) III, as well as severity and prognostic data. To date, results suggest that a higher percentage of patients admitted to the ICU are at low risk of death or adverse outcome when compared with a national benchmark using APACHE III. Risk-adjusted mortality rates are lower and length of stay is shorter than predicted. CHQC demonstrates that cooperative public efforts, undertaken by groups with often divergent interests and using objective risk estimates, can provide useful data for hospital quality improvement activities and market-based health reform efforts.

Data Collection↗
PubMed1988

Increased muscle efficiency and sustained benefits in an outpatient community hospital-based pulmonary rehabilitation program.

Previous reports of pulmonary rehabilitation programs have demonstrated improvement in exercise capacity in subjects with disabling pulmonary disease. However, the cost-effectiveness, benefits to outpatients in a community setting, durability of these improvements, and mechanism of improved exercise capacity remain unclear. Forty-four patients with an average FEV1 of 33 +/- 4 percent of predicted completed a six-week long period of supervised treadmill exercise, as well as a continuing home program. Twenty percent had previously unsuspected cardiac disease discovered through the program, while 36 percent had previously unsuspected exercise desaturation. Cardiopulmonary stress testing before and after the program revealed a 73 +/- 16 percent improvement in aerobic capacity (METs peak [power]) and a 250 +/- 78 percent improvement in endurance (MET-min [work]). No significant change was seen in VE max, HR max, FEV1, or the degree of exercise desaturation. Only a small improvement was noted in VO2 max (15 +/- 8 percent) and O2 pulse (16 +/- 8 percent), suggesting that most of the improvement was due to improved muscle efficiency. Follow-up testing at 12 +/- 3 months in 24 subjects revealed that 89 +/- 7 percent of the peak exercise performance was maintained. The cost of the basic program was +800. The results demonstrated that an outpatient community hospital pulmonary rehabilitation program can accomplish substantial exercise capacity improvement with sustained benefits in a cost-effective manner.

Arrhythmias, Cardiac↗
PubMed1986

[Clinico-biochemical aspects of the polychemotherapy of disseminated lymphogranulomatosis resistant to the COPP protocol].

With a purpose of providing efficient treatment of extended lymphogranulomatosis resistant to the routine COPP program, new programs of polychemotherapy including the use of an antibiotic, plant alkaloid, alkylating agent and glucocorticoid were developed and studied. The optimal rhythm and regimen of the drug administration were developed. The study was based on the treatment of 65 patients. The clinical trials showed that the ALVP program including the use of adriablastin, lofenal, vinblastin and prednisolone was the most efficient. Its use provided a significant therapeutic effect in 77 per cent of the patients. The BrLVP program including the use of bruneomycin, lofenal, vinblastin and prednisolone, the RLVP program including the use of rubomycin, lofenal, vinblastin and prednisolone, the DLVP program including the use of dactinomycin, lofenal, vinblastin and prednisolone and the BlLVP program including the use of bleomycin, lofenal, vinblastin and prednisolone were less efficient and provided the therapeutic effect in 66, 63, 60 and 60 per cent of the patients respectively. The direction of shifts in the spectrum of the blood serum enzymes mainly corresponded to the results of clinical trials. This first of all referred to the ALVP and BrLVP programs. The use of these programs provided normalization of the hexokinase and lactate dehydrogenase activity of the serum and positive shifts in the isoenzyme spectrum.

Adult↗
PubMed2004

Sustained low-efficiency daily diafiltration (SLEDD-f) for critically ill patients requiring renal replacement therapy: towards an adequate therapy.

BACKGROUND: Sustained low-efficiency daily dialysis (SLEDD) is an increasingly popular renal replacement therapy for intensive care unit (ICU) patients. SLEDD has been previously reported to provide good solute control and haemodynamic stability. However, continuous renal replacement therapy (CRRT) is considered superior by many ICU practitioners, due first to the large amounts of convective clearance achieved and second to the ability to deliver treatment independently of nephrology services. We report on a program of sustained low-efficiency daily diafiltration (SLEDD-f) delivered autonomously by ICU nursing personnel, and benchmark solute clearance data with recently published reports that have provided dose-outcome relationships for renal replacement therapy in this population. METHODS: SLEDD-f treatments were delivered using countercurrent dialysate flow at 200 ml/min and on-line haemofiltration at 100 ml/min for 8 h on a daily or at least alternate day basis. All aspects of SLEDD-f were managed by ICU nursing personnel. Clinical parameters, patient outcomes and solute levels were monitored. Kt/V, corrected equivalent renal urea clearance (EKRc) and theoretical Kt/V(B12) were calculated. RESULTS: Fifty-six SLEDD-f treatments in 24 critically ill acute renal failure patients were studied. There were no episodes of intradialytic hypotension or other complications. Observed hospital mortality was 46%, not significantly different from the expected mortality as determined from the APACHE II illness severity scoring system. Electrolyte control was excellent. Kt/V per completed treatment was 1.43+/-0.28 (0.96-2.0). Kt/V(B12) per completed treatment was 1.02+/-0.21 (0.6-1.38). EKRc for patients was 35.7+/-6.4 ml/min (25.0-48.2). CONCLUSION: SLEDD-f provides stable renal replacement therapy and good clinical outcomes. Logistic elements of SLEDD-f delivery by ICU nursing personnel are satisfactory. Small solute clearance is adequate by available standards for CRRT and intermittent haemodialysis, and larger solute clearance considerable. SLEDD-f is a viable alternative to CRRT in this setting.

Acute Kidney Injury↗
PubMed1995

Universal screening for infant hearing impairment: simple, beneficial, and presently justified.

In a recent article, Bess and Paradise (Pediatrics 93 (1994) 330-334) rejected the recommendation of the National Institutes of Health that all infants be screened for hearing loss on being released from their birthing hospital. This article responds to their objections with data from the literature and operational newborn hearing screening programs. These data show that universal newborn hearing screening is practicable, effective, cost-efficient, and safe, and concludes that such programs should be implemented without further delay.

Audiometry, Evoked Response↗
PubMed1995

Effects of an individual intensive educational control program for insulin-dependent diabetic subjects with poor metabolic control.

The aim of our study was to evaluate the efficiency of an individual intensive educational control program on improving the metabolic control of insulin-dependent diabetic patients at short- and long-term follow-up. Fifteen insulin-dependent diabetic subjects with poor metabolic control (hemoglobin A1c > 9%) were included. At entry, their knowledge of diabetes (DKQ2 test), total energy intake and its distribution, insulin schedule, technical skill for insulin administration and self monitoring of blood glucose were evaluated. According to the initial evaluation, individual goals were stipulated and monitored in weekly visits. Individual life-style was particularly kept in mind. Thereafter, patients were switched to our ambulatory clinic for outpatients. At 1, 6, 12 and 24 months of follow-up, the items analyzed at the beginning were reevaluated. After 1 month, the program produced a significant decrease in hemoglobin A1c and an increase in knowledge of diabetes. The same beneficial effects were present at 6, 12 and 24 months evaluation compared to those values recorded at entry. There were neither major changes in dietary intake nor insulin schedule nor any increase in the frequency of hypoglycemic episodes. In conclusion, our program (5.2 +/- 0.8 weekly visits) significantly reduced and sustained hemoglobin A1c values close to those levels recommended by multicenter controlled trials. We consider that our program produced two major changes: a long-lasting improvement in knowledge of diabetes and an increase in self-monitoring blood glucose which provided the key for optimal self-regulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Fetal surveillance and timing of delivery in pregnancy complicated by diabetes mellitus.

Protocols for antepartum fetal assessment in pregnancies complicated by diabetes mellitus are an important part of a care program that allows most of these pregnancies to reach term, ensuring fetal maturation. Maternal assessment of fetal activity serves as an efficient screening test in most surveillance programs. These programs have used primarily biophysical testing consisting of the nonstress test, cardiac stress test, or biophysical profile. Doppler studies have been investigated as an adjunct for identifying fetal compromise. These studies may prove most valuable in cases of maternal vascular disease. The success of these protocols continues to be predicated on careful regulation of maternal glycemia through aggressive therapy with insulin and diet. Reassuring tests of fetal condition are present in most diabetic women and, therefore, permit fetal maturation to occur prior to delivery.

Blood Glucose↗
PubMed1990

Resource productivity and returns to scale in school-based mouthrinsing programs.

The viability of community dental programs is influenced by various factors, including costs and effectiveness. Costs, in turn, are influenced by the prices and productivity of resources, and variations in these will influence not only comparisons among programs providing a homogeneous service but also any conclusions that can be drawn about cost-effectiveness. This paper eliminates wage effects and examines resource productivity and returns to scale in relationship to the size of a group of school-based mouthrinsing programs. The research questions were to determine: 1) whether the programs exhibit increasing, decreasing, or constant returns to scale, and 2) the productivity of labor and capital. Data from 14 programs in the US were pooled for 2 yr to yield 28 observations. The production relationship between output (numbers of participants) and inputs (labor and capital) was specified in a Cobb-Douglas model. Findings were that 1) the programs exhibited decreasing returns to scale (P less than 0.01); and 2) the average and marginal productivities of labor and capital declined (P less than 0.001). The implications of these findings are that, with equal wages and homogeneous labor, the average cost of mouthrinsing per participant would have increased as a function of the size of these programs. To the extent that the economics of community dental programs are influenced not only by the costs and productivity of the resources they use but also by their size, there may be some value in research on the economics of optimum program size and the role of management in program organization.

Adolescent↗
PubMed1979

Relative efficiency of anticodons in reading the valine codons during protein synthesis in vitro.

Using a protein synthesizing in vitro system programmed with MS 2-RNA, the relative efficiency (in the presence of each other) of valine tRNAs with the anticodons U*AC (U* represents 5-oxyacetic acid uridine monophosphate), GAC, and IAC to read the valine codons was investigated. An anticodon which can read all three positions of the codon according to the rules of Watson-Crick base-pairing and the wobble hypothesis is an order of magnitude more efficient than an anticodon which misreads the codon by reading only the first two positions and presumably disregards the third nucleotide of the codon. There are two seeming exceptions to this behavior: the anticodon U*AC reads the codon GUU quite efficiently and IAC is as effective as U*AC in reading the codon GUG. The significance of these exceptions is evaluated with respect to the organization and evolution of the genetic code.

Anticodon↗
PubMed1998

Model-based evaluation of HIV prevention interventions.

The ultimate goal of HIV prevention interventions is to reduce the spread of HIV; however, the effectiveness of these programs is seldom assessed directly. Although direct measurement of an intervention's impact via HIV seroincidence monitoring is usually unfeasible, mathematical models can be used to estimate the number of infections averted by the intervention. This article describes three model-based summary measures of sexually transmitted HIV risk and discusses their relevance to HIV program evaluation in general economic efficiency analyses in particular. The calculation of these measures is demonstrated with an illustrative application to previously published data from an HIV prevention intervention for gay men.

Female↗
PubMed1994

Safeguarding the confidentiality of automated medical information.

BACKGROUND: Information about encounters between patients and physicians, nurses, and other caregivers is recorded on paper and in computer databases. Caregivers are expected to respect the confidential nature of patient information. Yet quality management programs, for example, entail systematic, efficient collection of information extracted from patient case files. Compiling "report cards" on managed care networks necessitates access to aggregated information on episodes of care and their outcomes. Regional provider networks; the development of comprehensive computerized patient records; and the dependence of health care reform on large-scale, highly distributed databases make the patient record even more vulnerable. Each organization must assess whether its protection of patients' privacy is sufficient. AN INFORMATION SECURITY PROGRAM: A logical first step in devising such a program is to establish the necessary policies, which are prerequisites to the proper development of computer systems. A policy should address such issues as the authorized access needs to sensitive information and limitations concerning secondary use; the application of technical, procedural, physical, and personnel safeguards; and the dissemination of information. Information managers should seek opportunities to install commercially secure products that meet their security requirements. CONCLUSIONS: Top management, information systems planners, and quality improvement leaders must jointly determine policies that satisfy the duty to preserve patients' confidentiality, foster the most effective use of information in the patient record, and avoid overly restrictive policies that would impede total quality management.

Computer Security↗
PubMed2000

Cost analysis as a vitamin A program design and evaluation tool: a case study of the Philippines.

Vitamin A deficiency (VAD) is a serious and widespread public health problem in the Philippines. Initiated in 1993, the Philippines National Vitamin A Supplementation Program (NVASP) is one of the oldest, most mature and comprehensive of its kind. This paper presents a cost-effectiveness and efficiency analysis of the NVASP and of a hypothetical program of vitamin A fortification of wheat flour that was conducted to inform policymakers as to how to modify the program. Employing a proxy effectiveness indicator of VAD--the intake of < 70% of the recommended daily allowance of vitamin A--in a series of simulations using individual child consumption data, the analysis finds that fortification is more efficient in reducing inadequate vitamin A intake (IVAI) compared to the NVASP. Due to the nature of food consumption patterns, however, fortification alone, is not enough. At what is regarded as the maximum politically acceptable fortification level, there will still be 2.2 million (29%) Filipino children aged 12-59 months who will have IVAI. An investigation of the cost and efficiency of geographically targeted supplementation programs reveals that maintaining a universal supplementation program in urban areas and, in rural areas, introducing a targeted program to only the poorest municipalities (where the prevalence of VAD is the highest) will provide a more acceptable public health policy response than fortification alone. Such a policy will reduce incremental direct Government expenditures on vitamin A programs by nearly 20% and will reduce the number of children with IVAI to 900,000 (12%) Filipino children. The paper describes the fortification and supplementation programs, and how their costs were estimated. Lessons for program designers and policymakers in other countries in which vitamin A deficiency constitutes a public health problem are also discussed.

Child, Preschool↗
PubMed1989

Universal prenatal screening for hepatitis B, Alberta, 1985-1988.

A cooperative effort to identify all newborn infants at risk of acquiring hepatitis B infection involving the Canadian Red Cross BTS, Health Units, hospitals, and private doctors has been in place in Alberta since 1985. Routine universal screening of all prenatal patients identifies just under 200 infected mothers per year and about 90% of their infants receive HBIG and HB vaccine in a timely manner and are protected against infection and becoming hepatitis B carriers. At least half of these infants would not be identified if a selective testing program was in place and the cost for this much less efficient policy would be at least 4 times higher. The cost per infant protected through the universal screening program is estimated to be less than $1275. Routine screening of prenatal patients for HBsAg in a public health-coordinated program is highly cost effective and efficient. It is recommended that all jurisdictions consider such a program as recommended by the ACIP unless the hepatitis B carrier state is known to be extremely rare.

Alberta↗
PubMed2003

International standardization of water analysis: basis for comparative assessment of water quality.

The efficiency of a water treatment program or a water monitoring program can be checked only if it is accompanied by water analysis procedures allowing meaningful statements on water quality. Meaningful statements do not only include high accuracy, but high precision as well. With high precision values, good repeatability and reproducibility is aimed for. Repeatability and reproducibility may either be monitored by regular inter-laboratory trials, without prescribing a distinct analytical method, or by applying a standardized method which has undergone thorough checks concerning its reliability and efficiency. The article presents the structure of the ISO, CEN and DIN standardization work in water analysis.

Environmental Monitoring↗
PubMed1998

A NOESY-HSQC simulation program, SPIRIT.

A program SPIRIT (Simulation Program considering Incomplete Recovery of z magnetization and INEPT Transfer efficiency) has been developed to simulate three-dimensional NOESY-HSQC spectra. This program takes into account (1) different transfer efficiency during INEPT and reverse INEPT durations due to differential relaxation rates and 1J coupling constants; (2) the different effect of the sensitivity-enhancement scheme on CH, CH2 and CH3 systems; and (3) incomplete recovery of longitudinal magnetization between scans. The simulation program incorporates anisotropic tumbling mode for symmetric tops, and allows for differential external relaxation rates for protons. Some well-defined internal motions, such as the fast rotation of methyl groups, are taken into account. The simulation program also allows for input of multiple conformations and their relative populations to calculate the average relaxation matrix to account for slow internal motions. With the SPIRIT program, the sensitivity-enhanced NOESY-HSQC experiment can be used directly in the evaluation of the accuracy of structures, which can potentially be improved by direct refinement against the primary data.

Computer Simulation↗
PubMedDate not supplied

Postsurgical knee rehabilitation. A five year study of four methods and 5,381 patients.

This study was an investigation into the influences of rehabilitation procedures on the long-term success of postsurgical knee patients. In a blind retrospective paradigm, the cases of 5,381 patients (2,417 females, 2,964 males; mean age, 32.7 years; age range, 13 to 61 years) were reviewed to correlate rehabilitation methods with postsurgical success. Postsurgical success was defined as patient resumption of required activities without symptom recurrence, over a period of 5 years after surgery. The four rehabilitation methods studied were programs of no exercise, home exercise, isotonic exercise, and isokinetic exercise. Statistical analysis revealed significant differences at the P = 0.05 level for comparison of the isokinetic exercise to the other methods on the basis of rehabilitation interval (isokinetic, 8.9 +/- 3.7 weeks; isotonic, 12.3 +/- 6.1 weeks; home, 10.0 +/- 4.5 weeks) and correlation to success (isokinetic, r = 0.92, isotonic, r = 0.48, home, r = 0.09, no exercise, r = 0.00). It was concluded that rehabilitation methods that incorporate isokinetic exercise are more efficient and effective than nonisokinetic programs in the long-term successful management of postsurgical knee patients.

Adolescent↗