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Results for “Program Efficiency”

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At least 145 records · Page 8Linked to original sources
PubMed1984

Decentralization/regionalization in health care: the Quebec experience.

The decentralization policy in Canada was initially aimed at decentralizing the management of services by creating regional bodies within which interested parties would participate in establishing priorities, elaborating programs, allocating resources and assessing program efficiency and effectiveness. A look at the Quebec experience provides insight into the difficulties and implications of decentralization.

Catchment Area, Health↗
PubMed1994

Medicaid reform: an opportunity for the osteopathic medical profession.

Established in 1965 to provide medical care for the impoverished, the Medicaid program has pitted state governments against the federal government, and made adversaries of the providers. The authors examine the legislative history of the program and the rapid growth of expenditures that have led states to cut benefits, tighten eligibility requirements, and slash payments to providers. The call for comprehensive healthcare reform and universal access put Medicaid at the forefront of proposed changes. The osteopathic medical profession, which already provides a quarter of the care in the program, has an opportunity to lead in innovation to promote program efficiencies, and to affirm the profession's commitment to serve vulnerable populations.

Forecasting↗
PubMed1977

Identifying profoundly mentally retarded subtypes as a means of institutional grouping.

While the profoundly mentally retarded social group is behaviorally heterogeneous, this knowledge appears to be of more theoretical than practical interest. The behavioral identification of functional profoundly retarded subtypes derived from ethological analysis may supply the structure necessary to utilize this behavioral variability. Institutional groupings based on dominant and subordinate subtypes may prove to be efficacious in increasing programming efficiency. A study of profoundly retarded persons' territoriality was discussed as it relates to new grouping procedures based on behaviorally identified subtypes. Implications with respect to the control of aggression, stereotypic activity, and behavior modification for functional subtypes were discussed.

Adult↗
PubMedDate not supplied

An overview of the effectiveness and efficiency of HIV prevention programs.

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly when they are delivered with sufficient resources, intensity, and cultural competency and are based on a firm foundation of behavioral and social science theory and past research. Economic evaluations have found that some of these behaviorally based programs yield net economic benefits to society, and others are likely cost-effective (even if not cost-saving) relative to other health programs. Still, specific improvements should be made in certain HIV prevention programs.

Adolescent↗
PubMed2006

Development of novel whole-body exposure setups for rats providing high efficiency, National Toxicology Program (NTP) compatibility and well-characterized exposure.

This paper presents the design, optimization, realization and verification of novel whole-body exposure setups for rats. The setups operating at 902 MHz and 1747 MHz provide highly efficient, National Toxicology Program (NTP) compatible and well-characterized exposures. They are compared to existing concepts of exposure setups with respect to efficiency, induced field uniformity, good laboratory practice (GLP) compatibility and cost. The novel exposure setup consists of a circular cascade of 17 sectorial waveguides excited by a novel loop antenna placed in the centre. The 70% overall efficiency of the exposure setup surpasses comparable values of existing setups. A field uniformity inside the phantom of more than 86% for the 1g cubical averaged specific absorption rate (SAR) within +/-5 dB of the whole-body SAR (WB-SAR) was attained. The uniformity of the exposure inside the setup, defined as the variation of the WB-SAR between animals, was better than +/-24%. Using only stainless steel, gold and polycarbonate in the vicinity of the animals ensured full GLP compatibility. The entire exposure system features fully automated computer controlled exposure and data monitoring, data storing and failure handling. Therefore, the proposed exposure system can be used to run blinded large scale, long-term exposure studies.

Animals↗
PubMed1996

Marker-assisted introgression in backcross breeding programs.

The efficiency of marker-assisted introgression in backcross populations derived from inbred lines was investigated by simulation. Background genotypes were simulated assuming that a genetic model of many genes of small effects in coupling phase explains the observed breed difference and variance in backcross populations. Markers were efficient in introgression backcross programs for simultaneously introgressing an allele and selecting for the desired genomic background. Using a marker spacing of 10-20 cM gave an advantage of one to two backcross generations selection relative to random or phenotypic selection. When the position of the gene to be introgressed is uncertain, for example because its position was estimated from a trait gene mapping experiment, a chromosome segment should be introgressed that is likely to include the allele of interest. Even for relatively precisely mapped quantitative trait loci, flanking markers or marker haplotypes should cover approximately 10-20 cM around the estimated position of the gene, to ensure that the allele frequency does not decline in later backcross generations.

Alleles↗
PubMed1975

Evaluating family planning program effectiveness and efficiency.

This article proposes an integrated in-house evaluation model for family planning programs. The model is designed to meet the need of program management for an operational and internal evaluation system suited to the ongoing character of program activities and focused on the feedback of information for program planning. The ideas presented are applied to the context of the Albany County Family Planning Service, Inc., Wyoming.

Adolescent↗
PubMed2002

State AIDS Drug Assistance Programs: equity and efficiency in an era of rapidly changing treatment standards.

BACKGROUND: The 54 state AIDS Drug Assistance Programs (ADAP) provide medications to HIV-infected persons with limited resources. Eligibility and coverage vary, raising concerns about health inequities. OBJECTIVE: To compare the relative clinical and economic performance of ADAP programs. RESEARCH DESIGN: A state-transition simulation model of HIV disease was used to explore the clinical consequences and lifetime costs associated with selected state policies. Clinical data came from the Multicenter AIDS Cohort Study, AIDS Clinical Trials Group Protocol 320, and other published randomized trials. Cost data came from the national AIDS Cost and Services Utilization Survey, and the 1999 Red Book. ADAP data came from National Association of State and Territorial AIDS Directors reports and interviews. MEASURES: Projected life expectancy, quality-adjusted life expectancy, total lifetime direct medical costs, cost-effectiveness in dollars per quality-adjusted life year (QALY) gained. RESULTS: ADAPs vary considerably in terms of formulary policies, health outcomes, expected costs, and cost-efficiency. Conservative projections, based on a cohort with starting mean CD4 count of 250 cells/microL, yield life expectancies ranging from 5.36 to 6.81 life years (4.69-6.01 quality-adjusted life years [QALYs]). Total per person lifetime direct medical costs range from $81,200 to $112,700; higher costs reflect increased spending on medications. Expected costs per QALY gained range from $7000 to $28,000. Under pessimistic assumptions regarding initial CD4 counts, drug efficacy, and discounting, the most comprehensive policy remains below $33,000/QALY. CONCLUSIONS: Even the most comprehensive ADAPs constitute a cost-effective use of HIV care resources. A uniform, national ADAP formulary warrants consideration.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Two-phased oncology orientation program. A resource efficient teaching strategy.

Orientation is an important component in assuring the assimilation and adequate performance of new employees. In settings that require the integration of high-level technical skills and critical thinking, employees must learn essential information in a short time. In this article, the authors review the process used in a critical care oncology setting to develop a curriculum for a two-phased orientation program. Implementation and evaluation strategies are presented to assist others in the process of developing orientation programs that achieve desired objectives in a resource-efficient environment.

Curriculum↗
PubMedDate not supplied

[Hemoglobin screening: response of a Brazilian community to optional programs].

The efficiency and the viability of three hemoglobin screening programs were investigated. They were offered on a voluntary basis to a Brazilian population and started with the analysis of blood donors, pregnant women and students. The hemoglobin screening was done through optional exams which included electrophoresis of hemoglobin and complementary hematological tests. A total of 13,670 people were tested over a period of 39 months and a total of 644 individuals with hereditary hemoglobin disorders were detected - 4. 7% of the samples examined. The programs showed satisfactory indicators of viability and efficiency, expressed by the significative proportion of exams performed among the probands and their relatives.

Adolescent↗
PubMed2005

A fractional programming approach to efficient DNA melting temperature calculation.

MOTIVATION: In a wide range of experimental techniques in biology, there is a need for an efficient method to calculate the melting temperature of pairings of two single DNA strands. Avoiding cross-hybridization when choosing primers for the polymerase chain reaction or selecting probes for large-scale DNA assays are examples where the exact determination of melting temperatures is important. Beyond being exact, the method has to be efficient, as these techniques often require the simultaneous calculation of melting temperatures of up to millions of possible pairings. The problem is to simultaneously determine the most stable alignment of two sequences, including potential loops and bulges, and calculate the corresponding melting temperature. RESULTS: As the melting temperature can be expressed as a fraction in terms of enthalpy and entropy differences of the corresponding annealing reaction, we propose to use a fractional programming algorithm, the Dinkelbach algorithm, to solve the problem. To calculate the required differences of enthalpy and entropy, the Nearest Neighbor model is applied. Using this model, the substeps of the Dinkelbach algorithm in our problem setting turn out to be calculations of alignments which optimize an additive score function. Thus, the usual dynamic programming techniques can be applied. The result is an efficient algorithm to determine melting temperatures of two DNA strands, suitable for large-scale applications such as primer or probe design. AVAILABILITY: The software is available for academic purposes from the authors. A web interface is provided at http://www.zaik.uni-koeln.de/bioinformatik/fptm.html

Algorithms↗
PubMed1992

Programmed electrical stimulation of the ventricle: an efficient, sensitive, and specific protocol.

A relatively simple and efficient ventricular programmed electrical stimulation (PES) protocol was developed, capable of achieving high degrees of sensitivity and specificity. In a series of 481 subjects, 1, 2, and 3 extrastimuli (ES) were used successively during sinus rhythm and ventricular pacing at two drive cycle lengths, at one or more ventricular sites, together with rapid ventricular pacing, and other maneuvers such as isoproterenol infusion. Three ES were used immediately after two ES at each drive rate, rather than returning after completion of the protocol with two ES. Using the protocol, appropriate arrhythmias could be induced in 88% of all patients with ventricular fibrillation, 84% of all patients with sustained ventricular tachycardia (91% with underlying coronary disease), and 58% of patients with severe nonsustained ventricular tachycardia. There were significant differences in inducibility between patients whose ventricular arrhythmias were due to coronary artery disease and other causes. In contrast, sustained ventricular arrhythmias (all ventricular fibrillation) could be induced in only 5% of a control group of control patients, for a specificity of 95%. The protocol described is simpler and more efficient than those that use exhaustive testing of two ES before going to three ES. Three ES during sinus rhythm proved to be the most productive step, with a higher yield ratio (true: false-positives) than two ES or three ES during pacing, especially at faster rates. Greater efficiency is also achieved by leaving the timing of an extrastimulus just beyond its effective refractory period when an additional extrastimulus is to be added, compared to protocols in which the extrastimulus is moved later in the cycle and then decremented in tandem with the additional extrastimulus. Coupling intervals less than 200 msec produced some false-positives, but fewer overall than intervals greater than or equal to 200 msec, and with yield ratios comparable to other protocol steps. The protocol described meets NASPE standards for ventricular programmed stimulation protocols, and with its demonstrated specificity and relative simplicity and efficiency may be useful as a model for groups not yet committed to an alternative protocol.

Cardiac Pacing, Artificial↗