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At least 1,567 records · Page 87Linked to original sources
PubMed1990

Computerization of plateletpheresis quality control records with a commercially available spreadsheet program.

Many apheresis units lack the resources to acquire customized computer software for record keeping. We have adapted a commercially available "spreadsheet" program (Lotus 1-2-3) to aid in quality control activities for plateletpheresis. Data are entered in a grid pattern wherein each donation occupies one row and successive columns contain numerical data derived from the donation. The last two columns contain formulas that calculate yield and collection efficiency from values entered in preceding columns. The program runs on an IBM PC or equivalent with 512 K RAM; the combined cost of a computer and software is currently under $2,000.00. Data entry requires fewer keystrokes per record than computation of yield and efficiency with a calculator, and creates an inclusive permanent record for future analysis. Data sorting and statistical functions allow rapid identification of incomplete records, and derivation of average platelet yield and/or collection efficiency for any time period of interest. The program also facilitates determining the proportion of donations that fall below any chosen cutoff. Performance characteristics of a particular instrument or operator can be assessed easily by isolating the pertinent records and analyzing them separately. The system will thus accomplish a variety of quality control activities, including those mandated by licensing agencies. It can be implemented by apheresis personnel with limited "computer literacy" and is superior to manual tabulation of quality control data in both ease of data entry and facility of analysis.

Data Interpretation, Statistical↗
PubMed2005

Local-MP2 electron correlation method for nonconducting crystals.

Rigorous methods for the post-HF (HF-Hartree-Fock) determination of correlation corrections for crystalline solids are currently being developed following different strategies. The CRYSTAL program developed in Torino and Daresbury provides accurate HF solutions for periodic systems in a basis set of Gaussian type functions; for insulators, the occupied HF manifold can be represented as an antisymmetrized product of well localized Wannier functions. This makes possible the extension to nonconducting crystals of local correlation linear scaling On techniques as successfully and efficiently implemented in Stuttgart's MOLPRO program. These methods exploit the fact that dynamic electron correlation effects between remote parts of a molecule (manifesting as dispersive interactions in intermolecular perturbation theory) decay as an inverse sixth power of the distance R between these fragments, that is, much more quickly than the Coulomb interactions that are treated already at the HF level. Translational symmetry then permits the crystalline problem to be reduced to one concerning a cluster around the reference zero cell. A periodic local correlation program (CRYSCOR) has been prepared along these lines, limited for the moment to the solution of second-order Moller-Plesset equations. Exploitation of point group symmetry is shown to be more important and useful than in the molecular case. The computational strategy adopted and preliminary results concerning five semiconductors with tetrahedral structure (C, Si, SiC, BN, and BeS) are presented and discussed.

Journal Article↗
PubMed1985

Economic specification of cost estimates in dental programs.

This paper compares two approaches to the estimation of costs in dental care programs: a conventional approach and an approach based on theoretical expectations. The conventional approach typically uses a linear extrapolation of an average figure - e.g., cost per visit - over various program sizes and thus predicts constant costs. Constant costs are, however, theoretically implausible, and it should be anticipated that their use in program planning or analysis would generate biased estimates. This hypothesis is examined using annual costs and visits from a group of uniform clinics over a five-year period. Results show that costs calculated by the conventional method are underestimated at low volumes and increasingly over-estimated at higher volumes. The findings, which illustrate how in-efficiency can inadvertently be incorporated into program design, have implications for cost-effectiveness of dental care delivery in the public sector.

Child↗
PubMedDate not supplied

Choosing among alternative programs for poor children.

Many public programs serve poor children. By setting budgets, benefit levels, and program rules, policymakers decide how many children will receive benefits and which benefits they will receive. Making these choices in a rational way is difficult, given the noncomparability of different types of program benefits and the limited information available about the effects these programs have on poor children. This article suggests four criteria (efficiency, return on investment, incentives, and equity) for evaluating and comparing public programs for poor children, and provides an overview of the patchwork of information that is currently available about the effects of eight large federal programs using these criteria. Some broad themes emerge. First, several programs that target specific benefits directly to children have been shown to have positive effects on a range of outcomes. Second, even before the current round of welfare reform, the mix of federal support available to poor children had changed in a way that put more emphasis on providing benefits in kind. Finally, more must be learned about the effects of programs for poor children before sweeping policy recommendations can be made. This article concludes with policy recommendations that can be supported by the available evidence.

Child↗
PubMed2004

Comparison of two mononuclear cell program settings on two apheresis devices intended to collect high yields of CD14+ and CD3+ cells.

BACKGROUND: In cancer and transplantation therapy apheresis devices and software of optimum standards are required for the collection of high cell yields with high purity of the desired cell fraction. STUDY DESIGN AND METHODS: In a paired study, 15 healthy blood donors underwent four 10-L leukapheresis procedures (197 +/- 33 min) with an inlet blood flow rate of 60 mL per minute by use of two different MNC program settings of the COBE Spectra (Gambro BCT) and the AS.TEC 204 (Fresenius Hemocare) cell separators. RESULTS: Use of the standard MNC program of both apheresis devices resulted in significantly higher (p < 0.01) collection efficiencies of CD14+ monocytes, CD3+ cells, CD4+ cells, CD8+ T cells, CD16+ CD56+ natural killer (NK) cells, and residual PLTs (p < 0.001), owing to higher centrifuge speed. The mean MNC purity of all components was more than 90 percent. By use of standard programs of either device, significant correlations (p < 0.01) between donor monocytes and preleukapheresis NK cell counts and the corresponding component cell yields were found. CONCLUSION: Compared to the program modifications with lower centrifuge velocities the standard MNC programs were significantly more efficient regarding CD14+, CD3+, and CD16+ CD56+ cells. Enhanced centrifuge speed and inlet blood flow rate in MNC programs resulted in higher, similar composed MNC concentrations of the products.

Adult↗
PubMed2003

The role of DNA breaks in genomic instability and tumorigenesis.

DNA double-strand breaks (DSBs) represent dangerous chromosomal lesions that can lead to mutation, neoplastic transformation, or cell death. DSBs can occur by extrinsic insult from environmental sources or may occur intrinsically as a result of cellular metabolism or a genetic program. Mammalian cells possess potent and efficient mechanisms to repair DSBs, and thus complete normal development as well as mitigate oncogenic potential and prevent cell death. When DSB repair (DSBR) fails, chromosomal instability results and can be associated with tumor formation or progression. Studies of mice deficient in various components of the non-homologous end joining pathway of DSBR have revealed key roles in both the developmental program of B and T lymphocytes as well as in the maintenance of general genome stability. Here, we review the current thinking about DSBs and DSBR in chromosomal instability and tumorigenesis, and we highlight the implications for understanding the karyotypic features associated with human tumors.

Animals↗
PubMedDate not supplied

Tooth decay in our poorest children: what can we do?

Dental programs for the poor have failed to deliver improved oral health for children to the same degree as their more well-off counterparts. Community health workers continue to identify dental problems as the greatest unmet need in their communities. Yet, many do not see this as a problem. Practitioners need to act in concert through their dental societies to establish and efficiently manage community-based outreach programs. Child dental health can also be improved by increasing access through public and non-profit community clinics and integrating child dental services with medical care.

Child↗
PubMed2006

A focused approach to assessing program fidelity.

The primary goals of the present study were 1) to explore the types and frequencies of adaptation reported by facilitators; 2) to document their reasons for making those adaptations; and 3) to propose an efficient approach to the study of prevention program fidelity based on interview data. We interviewed 42 program facilitators involved in a large-scale dissemination about their implementation of a community-based prevention program. Interview questions addressed facilitators' attitudes about program fidelity and the various types of changes, deletions, and additions they made. Although nearly all facilitators reported that fidelity to program curriculum was important, most also reported adapting the program. The most frequent reason facilitators gave for adaptation was deleting or changing material because they ran out of time. We employed a method used in business and health care settings (the Pareto principle, or the "law of the vital few") to identify the minority (30%) of types of adaptation that accounted for a majority (70%) of all adaptations reported. Similarly, we identified the minority of reasons (25%) for adaptation that accounted for a majority (75%) of reasons reported. This approach helps to focus the assessment of fidelity on those adaptations that occur with high frequency, since low-frequency events are unlikely to have a significant impact on large-scale outcomes. High-frequency adaptations can then be targeted to determine their effect on outcomes; to address in training; and to assess on an ongoing basis for continuous quality improvement.

Administrative Personnel↗
PubMed1985

Medicaid program; Medicaid Management Information System requirements for physician and supplier services--HCFA. Final notice.

In this notice, we are informing Medicaid state agencies of two new system requirements for Medicaid Management Information Systems. These systems will be required to accept and use exclusively: (a) A common claim form for physicians, durable medical equipment suppliers, laboratories, chiropractors, and podiatrists (the current version of the Health Insurance Claim Form, HCFA-1500); and (b) A uniform procedure coding system (HCFA Common Procedure Coding System). The purpose of these requirements is to improve the efficiency and effectiveness of the Medicaid program and to reduce the paperwork burden by implementing a single claim form for providers to bill multiple third party payers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Optimal positioning of markers to control genetic background in marker-assisted backcrossing.

Molecular markers are commonly used in backcross breeding programs in plants. As genetic maps contain more and more markers, it is of interest to determine which markers are to be used for selection. Here we describe how one can compute an optimal positioning of markers resulting in a maximization of the expected proportion of recipient genome. This criterion allows us to take selection into account and to produce relevant results regarding the final efficiency of background selection in backcross programs.

Crosses, Genetic↗
PubMed2003

Regulation of translation initiation in mussels (Mytilus galloprovincialis, lam.) following contamination stress.

The use of mussels (Mytilus sp.) as bioindicators of the aquatic environment is a valuable approach to monitor environmental contamination. Applying batteries of biomarkers is an essential prerequisite, since the complexity of environmental contaminants can induce in mussels a variety of structural and functional responses, which are not necessarily correlated. In an attempt to correlate translation responses to contamination stress, the sedimentation profiles of runoff ribosomes isolated from digestive gland cells of control or contaminated Mediterranean mussels (Mytilus galloprovincialis, Lam.) were examined and the efficiency of these ribosomes to accomplish protein synthesis was determined. While the major species of ribosomal material was 80S monomers, native 60S and 40S ribosomal subunits were also detected independently of the contamination level in the surrounding waters. However, concomitant with the increase of contamination stress, the level of 80S ribosomes was reduced in favor of free ribosomal subunits. In addition, ribosomes isolated from contaminated mussels and programmed with poly(U) were less efficient to enzymatically bind AcPhe-tRNA, compared with ribosomes from control samples. These results suggest that the contamination stress causes stoichiometric aberrations in the ribosomal particle pool and reduction of translation machinery capability to initate protein synthesis. Data support the notion that downregulation of translation is an important component of the cellular stress response and may be exploited as a biomarker of environmental contamination.

Animals↗
PubMed2004

BlueWorks aims to improve performance throughout Blues' system.

Last October, the Chicago-based Blue Cross and Blue Shield System, in collaboration with researchers at Harvard Medical School in Boston, embarked on a unique collaboration to identify and promote the most promising programs developed by Blues companies to maintain health care affordability while encouraging the adoption of effective clinical practices. Those efforts are beginning to bear fruit, with the first six winning initiatives revealed in the first BlueWorks Quarterly Report.

Blue Cross Blue Shield Insurance Plans↗
PubMed1985

Medicaid program; Medicaid Management Information System; system requirements--HCFA. Final rule.

In this notice, we are informing State Medicaid agencies of three new system requirements for Medicaid Management Information Systems. These systems will be required to accept: (a) and use exclusively a uniform diagnostic coding system (the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM)), wherever diagnostic coding is used; (b) And use exclusively a common claim form for inpatient and outpatient hospital billing (HCFA-1450); and (c) A uniform electronic billing format for institutional billing. The purpose of these requirements is to improve the efficiency and effectiveness of the Medicaid program; the second and third requirements will reduce the paperwork burden by implementing a single claim form and a single electronic billing format for providers to bill multiple third party payers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1988

When the patient requires observation not hospitalization.

Developing alternative health care delivery systems that successfully meet the needs of multiple consumers in a cost-efficient manner is essential. Minor revisions of long-standing programs are frequently inadequate in the face of escalating demands for a more efficient health care system. The SSU Observation Area has met the primary objectives by providing a quality, cost-efficient alternative to the use of existing inpatient and emergency department services. Alternatives, such as the SSU, require three major components to succeed: A risk-taking environment. Innovative nursing leaders, especially at the department head level. Staff nurses who demonstrate flexibility, enthusiasm, and pride in expanding their professional roles. The SSU was not developed without difficulty or some conflict. As the program was developing, full-time night coverage was not warranted so an on-call system was used. Increased use of the SSU resulted in the on-call person frequently being called in rather than just occasionally being called. Staff discontent grew as this continued. Additional night staff were added and use continued to increase, which ensured financial viability. Nursing leaders are developing alternatives in every setting. As we learn from each other, the opportunities for change grows.

Child↗
PubMedDate not supplied

Clinical laboratory technician to clinical laboratory scientist articulation and distance learning.

Laboratory workers and educators alike are challenged to support access to education that is current and provides opportunities for career advancement in the work place. The clinical laboratory science (CLS) program at the Medical College of Georgia in Augusta developed a clinical laboratory technician (CLT) to CLS articulation option, expanded it through distance learning, and integrated computer based learning technology into the educational process over a four year period to address technician needs for access to education. Both positive and negative outcomes were realized through these efforts. Twenty-seven students entered the pilot articulation program, graduated, and took a CLS certification examination. Measured in terms of CLS certification, promotions, pay raises, and career advancement, the program described was a success. However, major problems were encountered related to the use of unfamiliar communication technology; administration of the program at distance sites; communication between educational institutions, students, and employers; and competition with CLT programs for internship sites. These problems must be addressed in future efforts to provide a successful distance learning program. Effective methods for meeting educational needs and career ladder expectations of CLTs and their employers are important to the overall quality and appeal of the profession. Educational technology that includes computer-aided instruction, multimedia, and telecommunications can provide powerful tools for education in general and CLT articulation in particular. Careful preparation and vigilant attention to reliable delivery methods as well as students' progress and outcomes is critical for an efficient, economically feasible, and educationally sound program.

Computer-Assisted Instruction↗
PubMed1995

[Evaluation of the school-lunch program in Campinas, Brazil].

The objective of this study was to investigate the calorie and protein adequacies, to establishoffe operation model and the operational difficulties of the School-Lunch Program in Campinas, Brazil. Six schools randomly selected (1,237 children) were investigated. Calorie and protein consumption were estimated by weighed records. A model food project was developed in order to analyse the city food-service operation. The adequacy values were very low: 48.6 +/- 17.3% for energy and 52.7 +/- 17.2% for protein. The Tukey test indicated that schools did not differ regarding adequacies (alpha = 0.005). The results suggested that the efficiency and/or the impact of Campinas program may be limited by both, lack of resources and several operation failures such as: preparation of large amount of food which is not served to the children; the type of the food served; the ineffective administrative controls; the low supervision frequency, low school garden production and inefficient staff training; as well as the lack of food quality control, evaluations, community participation, nutritional education had integration with health programs.

Brazil↗
PubMedDate not supplied

Comparison of consensus scoring strategies for evaluating computational models of protein-ligand complexes.

Here, the comparisons of performance of nine consensus scoring strategies, in which multiple scoring functions were used simultaneously to evaluate candidate structures for a protein-ligand complex, in combination with nine scoring functions (FlexX score, GOLD score, PMF score, DOCK score, ChemScore, DrugScore, PLP, ScreenScore, and X-Score), were carried out. The systematic naming of consensus scoring strategies was also proposed. Our results demonstrate that choosing the most appropriate type of consensus score is essential for model selection in computational docking; although the vote-by-number strategy was an effective selection method, the number-by-number and rank-by-number strategies were more appropriate when computational tractability was taken into account. By incorporating these consensus scores into the FlexX program, reasonable complex models can be obtained more efficiently than those selected by independent FlexX scores. These strategies might also improve the scoring of other docking programs, and more-effective structure-based drug design should result from these improvements.

Computer Simulation↗
PubMed2005

Is the future for clinical trials internet-based? A cluster randomized clinical trial.

OBJECTIVE: To compare the efficiency and ease of use of internet data capture compared with conventional paper based data recording in the conduct of a clinical trial. DESIGN: Multicentre, cluster randomized clinical trial. SETTING: General practice in the UK. MAIN OUTCOME MEASURES: Timings for study landmarks, queries, data entry and monitoring time; Investigator Questionnaire Results. RESULTS: The internet-derived database was ready for release 33 days after the last patient visit compared with 48 days for the paper-derived database, despite much higher numbers of patients in the internet group. The mean times from visit to data entry were 10.2 (SD 18.9) days and 95.4 (SD 44.6) days respectively (P < 0.01). The mean times from a visit to a query being resolved were 121.4 (SD 58.3) days and 182.1 (SD 58.9) days respectively (P < 0.01). The post-study responses from investigators were positive. Seventy-one percent of centres said they would prefer to use the internet rather than paper CRFs for future studies. CONCLUSIONS: There were efficiency gains seen with the use of an internet-based system when compared with a paper-based system in terms data entry, query resolution and the time to the release of the database. The investigators' response to the internet system was generally favourable although on average investigators reported increased time spent on the study. Further efficiency might be gained with improved programming, increased investigator familiarity with the internet system, and with newly adapted working practices for sponsors' monitors and database personnel.

Clinical Trials as Topic↗