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 1,351 records · Page 75Linked to original sources
PubMed1998

Does Decentralization Matter in Environmental Management?

/ Questionnaires from 39 state National Pollutant Discharge Elimination System (NPDES) agencies were analyzed using principal component analysis and multiple regression. Decentralized programs scored better in a fundamental indicator of efficiency (lower percentage of expired permits) and in the key effectiveness measure of unit-cost compliance achieved. In no case did centralized states score significantly better than decentralized ones. These results indicated support for the theory that superior local knowledge is the key mechanism. Case studies of five states suggested internal program adjustments may cause outcomes to converge towards efficiency and effectiveness, perhaps explaining the large number of variables showing no difference between centralized programs and decentralized ones.KEY WORDS: NPDES; Compliance; Decentralization; Outcome; Efficiency; Unit-cost analysis

Journal Article↗
PubMed2005

Neonatal screening for congenital adrenal hyperplasia in North-Eastern Italy: a report three years into the program.

AIMS: To evaluate the incidence of congenital adrenal hyperplasia (CAH) in the Northern Italian population and the efficiency of the North-Eastern Italy screening program. To adjust cut-off levels for 17-hydroxyprogesterone (17-OHP) in relation to gestational age and birth weight, comparing the benefits in terms of reduction of recall rates with the two approaches and ultimately choosing the better of the two. SUBJECTS AND METHODS: Since September 2001, blood samples from neonates born in North-Eastern Italy have been screened with a fluoroimmunoassay method for 17-OHP determination (DELFIA). A preliminary cut-off level of > or = 30 nmol/l was set both for term and preterm newborns. The values of 17-OHP were analysed using statistical methods in relation to gestational age and birth weight in order to modify the cut-off on the basis of our data. RESULTS: After 33 months of screening we screened 128,282 newborns and detected 6 affected babies. During the first 8 months of screening among the recalled babies, 89.6 and 78.1% were preterm and low-birth-weight newborns, respectively, with a recall rate of 2.59% for premature neonates and of 4.94% for babies with birth weights < 2,500 g. We chose a new cut-off value of 50 nmol/l for preterm newborns only and, after 4 months, the recall rate was reduced to 0.83% for these infants and to 1.83% for low-birth-weight infants. CONCLUSION: After 33 months of screening for CAH in North-Eastern Italy, we report an incidence of 1:21,380. In 5 out of 6 affected babies, the diagnosis was established only after a positive screening test, which prevented a severe salt-wasting crisis in these babies. The cut-off level related to gestational age led to a significant reduction in the number of false-positives among preterm babies.We therefore intend to continue with the screening program for CAH in North-Eastern Italy, keeping a gestational-age-related cut-off in the hope that our data may encourage a national screening program for CAH.

17-alpha-Hydroxyprogesterone↗
PubMedDate not supplied

Implementation and evaluation of a national external quality control program for cervical cytology in Mexico.

OBJECTIVE: To evaluate cytology laboratories and the performance of cytotechnologists for establishing efficient external quality control for Mexico's National Program for the Prevention and Control of Cervical Cancer. MATERIAL AND METHODS: During January and February 1998, an onsite evaluation of all cytology laboratories of the Ministry of Health found that only 70% of the microscopes were in adequate working conditions, reagents were out of date, and working conditions were sub-optimal. A program for external quality control based on proficiency testing was established for cytotechnologists. Fifty slide sets with 20 Papanicolaou slides and 10 photographic slides were prepared. The sets were given to the cytotechnologists for evaluation and again one year later by courier. RESULTS: Twenty-one percent of microscopes were repaired and 9% replaced; reagents were distributed and laboratory facilities improved. Only 16% of cytotechnologists passed the initial proficiency test. Cytotechnologists received a refresher training course: one year later 67% of them passed the proficiency test. To ascertain that each slide was correctly diagnosed, 41 sets were rescreened by expert cytopathologists or cytologists and their diagnoses compared to the original ones. Thirty-seven sets had 86% to 96% concordance. CONCLUSIONS: This new system for external quality control of cervical cytology allowed the opportune and reliable evaluation of the performance of cytotechnologists.

Diagnostic Errors↗
PubMed1999

Reduction and avoidance of lubricant mist demands an integrated assessment approach.

A case study to identify major factors for lubricant mist exposure covered 15 metal machining sites. The investigation included milling, turning, drilling and grinding applications. Systematic analysis considered all relevant data concerning the machine tool, the lubricant and the suction plant. The efficiency of the implemented maintenance program at the installed filter systems was checked by concentration measurements immediately before and after service. All performed measurements of lubricant aerosol and vapor loads upstream and downstream of the installed filter systems were carried out according to VDI 2066 and BIA 3110, respectively. The selection criteria for the sites to be investigated, the systematic nature of the data acquisition and the procedure of the analysis are demonstrated in detail by performing comparisons between selected applications using emulsions and those employing straight oil for lubrication. The results of the study identify recirculation of ventilated air as the major source of workplace exposure to airborne lubricant emissions. More than 60% of the demisters investigated emit air at total lubricant loads (aerosols and vapor) above the limit of 20 mg m-3 at any time of operation; which also means immediately after service. A common reason for exceeded aerosol loads in recirculated air is e.g. the fact that the type of filter system applied is often not suitable for the separation problem. Loads of lubricant vapor are usually higher at the processes which use water emulsions as lubricant. In a quarter of the cases the limits were exceeded solely due to high vapor loads even immediately after service. The exposure can be reduced by replacing the lubricant, installation of a vapor separation plant or avoiding air recirculation. Maintenance time of the demisting system and aerosol separation efficiency of state-of-the-art demisting systems can be expanded by implementation of enhanced preliminary filter stages. This study confirms that appropriate service measures lower both aerosol emissions and lubricant vapor concentrations due to the reduction of exposed oil-wetted surfaces. The performed measurements show no significant relationship between loads of airborne lubricants and the type of machining process. Therefore, investigations at a much more detailed level have to be performed. However, the individual assessment of any workplace due to the complex situation remains essential.

Aerosols↗
PubMed2003

[Can empowerment of elderly with chronic disease be achieved in Switzerland? First results of the ALLFIT program in Zurich].

Self management courses can efficiently empower elderly with chronic disease. ALLFIT, a Swiss self management and fitness programme for seniors with chronic heart, lung, musculoskeletal or diabetic disease, consists of individual contracting and coaching by a Nurse, a weekly Fitness Training and 8 self management courses for 2 hours a week. Of the first 100 Participants, 99 defined contracts of goals and 80 achieved at least partially, 21% improved their physical fitness in walking and 25% in climbing stairs. Empowerment of elderly with chronic diseases can be achieved in Switzerland by a combination of fitness, self management training and individual coaching.

Activities of Daily Living↗
PubMed1996

Efficient rebuilding of protein structures.

A computer program, called OOPS, is described which facilitates and speeds up the process of rebuilding a protein structure inside its electron density and reduces the chances of local errors persevering throughout the crystallographic protein structure determination process. The program uses a set of criteria to judge how reasonable each protein residue is and it generates macros for the macromolecular crystallographic model-building program O [Jones, Zou, Cowan & Kjeldgaard (1991). Acta Cryst. A47, 110-119] which, when executed, will take the crystallographer on a journey along all suspect residues.

Journal Article↗
PubMed2000

Redasoft Plasmid 1.1: software for easy, efficient cloning and map drawing.

A computer program is described which creates circular and linear genetic maps with or without sequences, performs restriction analysis, and simulates basic molecular cloning operations. Redasoft Plasmid 1.1 is a user-friendly program for Windows 95/98/NT/2000, designed to generate high quality genetic maps for presentation and publication and to aid the molecular biologist in selecting restriction endonucleases for common molecular cloning experiments. The program incorporates an integrated web browser and can automatically generate complete, labeled maps from sequences on the Internet.

Chromosome Mapping↗
PubMed1993

Five-year experience in PBSC collection: results of the Catholic University of Rome.

Several authors have reported a faster immunological and hemopoietic post-transplant reconstitution using autologous peripheral blood stem cell (PBSC) than using autologous bone marrow stem cells. A large number of PBSC can be collected by leukapheresis during the hematological recovery after induction or salvage chemotherapy. In our experience we demonstrated that several separators, even if they have different results in mononuclear cell (MNC) yields, red blood cell and platelet contaminations, are able to collect PBSC for autotransplantation in patients with several malignant diseases and different status of disease. Eighty three patients were submitted to 590 leukapheresis procedures using 4 different blood cell separators: the results showed that all employed protocols are efficient in the collection of peripheral MNC even if after the widespread use of granulocytecolony stimulating factor (G-CSF) in the harvesting phase, the blood cell separator efficiency in terms of MNC is reduced. The use of GCSF in combination with other growth factors, during chemotherapy mobilization could simplify, in the future, this therapeutical program even if improvements in the efficiency of PBSC collection protocols are required.

Adolescent↗
PubMed1986

Medicare program; End Stage Renal Disease Program; redesignation of networks and reorganization of network organizations--HCFA. Final rule.

This final rule revises the requirements in current regulations pertaining to the End-Stage Renal Disease (ESRD) networks and organizations and establishes provisions for new, more efficient network organizations. This rule removes the criteria that define existing networks, removes the requirement that HCFA change designations of ESRD networks through rulemaking, and removes the list of currently-designated networks that now appears in regulations. It is intended that these amendments will increase the efficiency and effectiveness of the ESRD program by instituting a faster process for changing network designations and organizations as program needs arise. These amendments also permit the reduction of the number of existing networks to as few as 14, which is consistent with section 9214 of Pub. L. 99-272, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1997

Application of an expert system in the management of HIV-infected patients.

A rule-based expert system, Customized Treatment Strategies for HIV (CTSHIV), which encodes information from the literature on known drug-resistant mutations was developed. Additional rules include ranking and weighting based on antiviral activities, redundant mechanisms of action, overlapping toxicities, relative levels of drug-resistance, and proportion of drug-resistant clones in the HIV quasispecies. Plasma was obtained from HIV-infected patients and the RNA was extracted. Segments of the HIV pol gene encoding the entire protease, reverse transcriptase, and integrase proteins were amplified by reverse transcriptase-polymerase chain reaction (using a total of three primer pairs) and cloned. Sequencing was performed on five clones from each of two patients. When the patient's RNA sequencing data were entered into the expert program, and the information was downloaded directly into the CTSHIV program, the five most effective two, three, and four drug regimens coupled with an explanation for their choice were displayed for each patient. Thus, the CTSHIV system couples efficient genetic sequencing with an expert program that recommends regimens based on information in the current medical literature. It may serve as a useful tool in the design of clinical trials and in the management of HIV-infected patients.

Anti-HIV Agents↗
PubMedDate not supplied

Compliance hotlines: practical advice for implementing a reporting mechanism.

No element of a corporate compliance program in healthcare facilities generates more controversy than the hotline established for employees who wish to raise a concern. Healthcare organizations are adopting hotlines but with reluctance, mainly because of limited staff available to answer calls and because of limited support from upper management. Those that have committed to the hotline will tell you they can't imagine not having it. Running a good hotline means first answering such questions as whether it will be answered in-house, outsourced or handled through a combination of both means. The best organizations treat the hotline as a resource for employees, managers and physicians. If employees receive advice about policies over the hotline, however, it must be answered in-house. If multiple call answers are used, a secure file-sharing system, either paper or online, must be in use to track caller concerns. Most calls are routine, but one where the caller is reporting a serious infraction can save an organization millions of dollars by forestalling a false claim or allowing for voluntary resolution of a problem. If your company has run a hotline unsuccessfully and earned a poor reputation with employees, outsourcing may be the best option. A hotline that is not supported by management may prove to be an insurmountable problem for anyone who attempts to operate it. Your approach to hotline call intake will set the tone for your compliance program.

Efficiency, Organizational↗
PubMedDate not supplied

The QA program evaluation: a powerful punch.

Even the best quality assurance program requires periodic review in order to attain or regain maximum efficiency and effectiveness. The JCAHO standard for annual QA program evaluation adds impetus to this obligation. Riverside Methodist Hospitals' QA program evaluation is constructed in a three year cycle. Internal evaluation in year one and external expert evaluation in year three are balanced in year two with a combined internal/external program review. The year one internal evaluation discussed in the article outlines a framework for evaluation which includes positioning the evaluation for maximum influence, identifying key QA program components and designing meaningful, comprehensive evaluation inputs. The informed judgments of professionals, as well as traditional documentation review, provide powerful evaluative insights. Evaluation outputs include a program rating, an identification of program strengths and weaknesses, and targeted recommendations for QA program improvements.

Forms and Records Control↗
PubMed2004

Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades: II. Efficiency.

CONTEXT: Although the increasing effectiveness of neonatal programs for extremely low birth weight (ELBW, birth weight <1000 g) infants has been established from cohort studies, there is a paucity of data on the relationship between the costs and the consequences of neonatal intensive care. OBJECTIVE: To determine the changes in the efficiency of neonatal intensive care for ELBW infants in Victoria, Australia over 2 decades. DESIGN: Economic evaluation (cost-effectiveness and cost-utility analyses) in a population-based cohort study of consecutive ELBW infants born during 4 distinct eras (1979-1980, 1985-1987, 1991-1992, and 1997) followed to at least 2 years of age. SETTING: The state of Victoria. PATIENTS: All ELBW live births of birth weight 500 to 999 g in the state in the calendar years indicated (1979-1980: n = 351; 1985-1987: n = 560; 1991-1992: n = 429; 1997: n = 233). MAIN OUTCOME MEASURES: Costs were assessed primarily by the consumption of hospital resources. The consequences included survival and quality-adjusted survival rates at 2 years of age. RESULTS: The cost-effectiveness ratios (expressed in Australian dollars for 1997) were similar between successive eras at 5270 dollars, 3130 dollars, and 4050 dollars per life-year gained, respectively. The cost-utility ratios were similar between successive eras at 5270 dollars, 3690 dollars, and 5850 dollars per quality-adjusted life-year gained, respectively, and were similar to the cost-effectiveness ratios. The cost-effectiveness and cost-utility ratios were generally higher in lower birth-weight subgroups, but there were consistent gains in efficiency over time in infants of lower birth weight. CONCLUSIONS: As there have been large increases in effectiveness from the late 1970s to the late 1990s, the efficiency of neonatal intensive care for ELBW infants in Victoria has remained relatively stable.

Child, Preschool↗
PubMed1995

Psychoeducation and relapse prevention.

This paper reviews the rationale underlying psychoeducational programs designed to prevent or delay relapse in persons with schizophrenia. Since most of these programs have been oriented toward patients and their close relatives, the studies reviewed have tested the effect of these programs when added to maintenance pharmacotherapy. The results of the first generation of studies carried out in the late 1970s and 1980s confirmed the positive effects of a family-based psychoeducational program on delaying the recurrence of a schizophrenic episode. More recent studies, termed the second generation, have built on these findings to test more specific hypotheses concerning the most efficient format for delivery of such programs (relatives-only groups, single family-unit therapy, multiple-family groups). No clear advantage has been found for any one format, suggesting that intensive family involvement in the community care of schizophrenic, and other psychotic patients as well, may be a critical ingredient in successful relapse prevention programs.

Behavior Therapy↗
PubMed1975

Cost of initial development of PLATO instruction in veterinary medicine.

The cost of initial development of PLATO instruction during a 4-year period was $483,266. Of this amount, $220,765 were for equipment or renovation. The cost of lesson development for the entire 4 years averaged about $828 per hour of instruction. If 86 students used the lessons in each class at a maximum rate, over a 5-year period the cost per student-contact hour averages $1.93. With experience this figure should be reduced substantially. The median time required for an individual to program an hour of instruction for the entire 4 years was approximately 77 hours; however, under certain conditions a programmer may require as little as 36 1/2 hours. Programmer efficiency is based on a number of factors such as the quality and complexity of the lessons, experience of the programmer, and his knowledge of the subject matter. The University of Illinois College of Veterinary Medicine PLATO project has been developmental. The expense of continuing the project at this college or of initiating a similar project at another college should be much less as a result of this experience.

Computer-Assisted Instruction↗
PubMed2001

A multithreaded parallel implementation of a dynamic programming algorithm for sequence comparison.

This paper discusses the issues involved in implementing a dynamic programming algorithm for biological sequence comparison on a general-purpose parallel computing platform based on a fine-grain event-driven multithreaded program execution model. Fine-grain multithreading permits efficient parallelism exploitation in this application both by taking advantage of asynchronous point-to-point synchronizations and communication with low overheads and by effectively tolerating latency through the overlapping of computation and communication. We have implemented our scheme on EARTH, a fine-grain event-driven multithreaded execution and architecture model which has been ported to a number of parallel machines with off-the-shelf processors. Our experimental results show that the dynamic programming algorithm can be efficiently implemented on EARTH systems with high performance (e.g., speedup of 90 on 120 nodes), good programmability and reasonable cost.

Algorithms↗
PubMed1994

Attacking the backlog of India's curable blind. The Aravind Eye Hospital model.

The number of individuals in developing nations with preventable blindness from cataract and other disorders is increasing. New programs incorporating local customs and efficiently using available resources must be created to prevent the escalation of blindness and to rehabilitate patients already disabled with cataracts. We describe a system of high-quality, high-volume, cost-effective cataract surgery, using screening eye camps and a resident hospital. This has enabled us to provide efficient low-cost cataract surgery and overcome barriers of adequate eye care in southern India. We have been successful in locating patients with treatable eye problems, educating them about the availability of ophthalmic care, and providing free eye care. Our structure stresses the following: community involvement, identification of individuals most likely to benefit from screening, efficient utilization of both medical and paramedical personnel, and a streamlined approach to screening patients. This system may be capable of modification for use in other developing areas to decrease the backlog of cataract blindness.

Blindness↗