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PubMed2004

The Electronic Report on Adolescent Pregnancy (ERAP).

PURPOSE: To create a data management system that: (1) standardizes antecedent, program, and outcome variables relevant to the shared goals of adolescent-oriented maternity programs while allowing users to add variables pertaining to unique aspects of their work; (2) cues providers to physiologic and psychosocial characteristics that predispose teenagers to adverse pregnancy and parenting outcomes, (3) standardizes patient care by guiding providers through adolescent-oriented prenatal, postpartum, and well baby visits, and (4) establishes the infrastructure to collect data from a nationally representative sample of pregnant and parenting teens. METHOD: We adapted a powerful, state-of-the-art relational database framework (Microsoft Access 2000) to create an easy-to-use data management system-The Electronic Report on Adolescent Pregnancy (ERAP)-that requires minimal training to use on a personal computer. RESULTS: ERAP is designed to meet the administrative and analytic needs of adolescent-oriented maternity programs. It consists of six linked core data tables (teen, pregnancy, prenatal visits, child, interconception interval, and interconception interval visits), that allow users to analyze data from these multiple views while preserving the family structure. In addition, the database standardizes methods for collecting and storing the information and automatically computing the variables needed to monitor and evaluate an adolescent-oriented maternity program. Since by adding variables and appending supplementary tables, users can modify the core database to accommodate unique aspects of their programs and/or research, ERAP is also an ideal conduit for translating research findings into clinical practice. Similarly, because ERAP actually structures the care patients receive, the database provides the infrastructure needed to develop and implement best practice guidelines for treating teen-headed families. Finally, the confidentiality of all subject data is assured because ERAP is password-protected and automatically prepares files for batched external analyses by removing personal identifiers. CONCLUSIONS: ERAP provides the infrastructure needed to create a teen-pregnancy databank at the national level and an efficient patient monitoring system at the program level. By standardizing variable definitions and data collection techniques, serving as a repository for data collected at multiple sites, and tracking the multidisciplinary aspects of the care patients receive, ERAP has the potential to facilitate collaboration between adolescent-oriented maternity programs, increase the scientific rigor of teen pregnancy research, and improve the quality of care individual teen-headed families receive by prompting compliance with best practice guidelines.

Adolescent↗
PubMed2005

Cooperative versus dispersion effects: what is more important in an associated liquid such as water?

We implemented the quantum cluster equilibrium theory in our postprocessing program PEACEMAKER. This program may be run in conjunction with the very efficient vibrational frequency analysis code SNF and can therefore provide access to all electronic structure programs combined with this program. We applied the quantum cluster equilibrium theory in order to investigate the influence of a wide range of electronic structure models on the description of the liquid state. This investigation revealed much about the relevance of approximations in modern simulations of associated liquids such as water. While it is often claimed that the use of density-functional theory in condensed matter is leading to gravely erroneous results, we found that, contrary to these assertions, the exact exchange functional B3LYP and the gradient-corrected functional BP perform very well in combination with sizable basis sets as compared to second-order Moller-Plesset perturbation theory employing the same basis set. The use of density-functional theory with smaller basis sets does, in fact, lead to better results in the liquid state than the use of second-order Moller-Plesset perturbation theory in combination with these small basis sets. Most importantly, the neglect of cooperative effects disturbs a good description much more evenly if we apply second-order Moller-Plesset perturbation theory in combination with large basis sets than density-functional theory including cooperativity with smaller basis sets or Hartree-Fock using a very small basis set.

Journal Article↗
PubMed1992

MailMinder: taming DHCP's mailman interface.

While the Department of Veteran's Affairs Decentralized Hospital Computer Program (DHCP) is one of the most widely disseminated and successful hospital information systems in existence, it currently is accessed through a user interface which is not as mature as the rest of the system. This interface is a VT-100 compatible, character oriented interface using menus accessed by typed commands for feature access. This project demonstrated that a mature graphical user interface (MailMinder) can be successfully used as a "front-end" to DHCP. MailMinder is completely compatible with the existing unmodified DHCP electronic mail program, Mailman. MailMinder allows the user to be more efficient than the current interface and offers additional features over the current mail system. The program has undergone evaluation and limited deployment at five separate sites. The feature set of this program and its operation will be shown at this demonstration. The demonstration has implications for all current hospital information systems.

Computer Graphics↗
PubMedDate not supplied

Monitor-based software application programs meet the need for fast, accurate information at the bedside.

This article describes how the availability of applications programs on bedside and central station monitors increases nursing efficiency, enhances patient safety, and reduces hospital costs. Included are descriptions of some specific applications programs that comprise the Space-Labs Clinical Library: continuing education credit programs, drug therapy programs and a pacemaker information retrieval database. The benefits of these monitor-based programs--for both nurses and hospitals--are described.

Drug Therapy↗
PubMedDate not supplied

[Implantation of a program for the early detection of neonatal hearing loss].

Permanent childhood hearing impairment is a serious public health problem. Identification by screening in the first few months of life has the potential to improve affected children development. Neonatal hearing screening programs endorse the WHO requirement for a cost efficient screening. This paper shows the implementation of a medium-size hospital-based universal newborn hearing screening program using transient evoked otoacoustic emissions. Operational procedures and requirements are discussed. Quality control and results are showed.

Algorithms↗
PubMed1995

Using external data and databases: issues and sources.

Third party payers, employers, and accrediting organizations such as the Joint Commission for Accreditation of Healthcare Organization have played an important role in moving health care organizations toward the use of outcomes to measure quality. In addition, other external forces, such as shrinking health care resources and an increasingly competitive health care environment, have pressured organizations to implement continuous quality improvement (CQI) programs. These programs are an important component in effective and efficient organizational operations. Health care organizations must provide the best quality at the lowest cost to survive today. CQI programs incorporate internal and external comparisons to demonstrate improvement. Internal and external comparisons are important to validate the organization's level of quality. The article concentrates on the use of external comparisons, sources of external data or databases, and issues involved in external comparisons or benchmarking.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1985

The effects of three training intensities on VO2 max and VE/VO2 ratio.

This study examined the effects of three training intensities on the maximum oxygen uptake (VO2 max) and ventilatory equivalents for oxygen (VE/VO2 ratio) and carbon dioxide (VE/VCO2 ratio) at submaximal and maximal workloads. Forty males, classified as high or low fit according to their relative VO2 max, were assigned to one of four subgroups: a control group that did not train; a continuous training group that trained at an oxygen uptake that was 10% above that at which the VE/VO2 ratio reached a minimum; another continuous training group that trained at an oxygen uptake that was mid-way between that at which the VE/VO2 ratio reached its minimum and maximum; and an interval training group which trained at 100% VO2 max. The work:rest intervals were one minute each. Initial fitness level and total training power output for the eight week program was equalized in each group in the two fitness categories. The results indicated that both fitness categories responded similarly to the three training intensities. The training groups showed significant but equivalent increases in the VO2 max, but no significant changes in the max VE/VO2 or max VE/VCO2 ratios. The submaximal VE/VO2 and VE/VCO2 ratios were significantly lowered, primarily as a result of a significantly lowered, primarily as a result of a significant decrease in the ventilation volume. It was concluded that continuous and interval training programs wee equally effective in improving VO2 max and submaximal ventilatory efficiency, regardless of initial fitness level, provided the total amount of work completed was equalized. Such training programs, however, were unable to modify the maximal ventilatory efficiency in either fitness category.

Carbon Dioxide↗
PubMed2003

Recommendations for cervical cancer screening programs in developing countries. The need for equity and technological development.

The cervical cancer screening programs (CCSP) have not been very efficient in the developing countries. This explains the need to foster changes on policies, standards, quality control mechanisms, evaluation and integration of new screening alternatives considered as low and high cost, as well as to regulate colposcopy practices and the foundation of HPV laboratories. Cervical cancer (CC) is a disease most frequently found in poverty-stricken communities and reflecting a problem of equity at both levels gender and regional, and this, is not only due to social and economic development inequalities, but to the infrastructure and human resources necessary for primary care. For this reason, the CCSP program must be restructured, a) to primarily address unprivileged rural and urban areas; b) to foster actions aimed at ensuring extensive coverage as well as a similar quality of that coverage in every region; c) to use screening strategies in keeping with the availability of health care services. In countries with a great regional heterogeneity, a variety of screening procedures must be regulated and standardized, including a combination of assisted visual inspection, cervical cytology and HPV detection; d) regional community intervention must be set up to assess the effectiveness of using HPV detection as an strategy in addition to cervical cytology (pap smear); e) the practice of colposcopy must be regulated to prevent the use of it in healthy women at a population level, thus preventing unnecessary diagnosis and treatment which not only are expensive but also causes unnecessary anxiety to women at risk; f) the operation of those clinical laboratories using HPV as a detection strategy must likewise be accredited and regulated and g) the CCSP program for assuring health care quality should meet the expectations of its beneficiaries, and increase the knowledge in cervical cancer related matters. Finally, though a variety of clinical tests on prophylactic and therapeutic vaccines against HPV are recently being developed worldwide; it will take at least from 5 to 10-years time to have them available in the market. For this reason, it will be necessary to intensify the CCSP programs. All these reasons lay emphasis on the need to reinforce actions for CCSP programs. This paper is available too at: http://www.insp.mx/salud/index.html.

Developing Countries↗
PubMed1997

A Comparison of Two References for Using Knowledge of Performance in Learning a Motor Task.

In the present study, the learning of a task in which the goal of the movement was not isomorphic with a specific movement pattern was examined. The subjects' (N = 48) goal in the task was to be both spatially and temporally accurate in reaching 4 targets with a right arm lever movement. After each acquisition trial, the displacement profile of the movement just produced was provided to all subjects as knowledge of performance (KP). The relative effectiveness of 2 possible references, with which subjects could compare the KP, was examined. One of the references examined was knowledge of results (KR), which was provided by reporting the total absolute timing and amplitude errors from the 4 targets. The other reference examined was a criterion template (CT), Which was defined as the most efficient movement pattern for reaching the 4 targets. In the feedback display, CT was superimposed on the displacement profile of the movement just produced. A factorial design, in which 2 levels of KR (KR, no KR) were crossed with 2 levels of CT (CT, no CT), produced 4 feedback conditions. After 120 acquisition trials with feedback, immediate and delayed retention tests without feedback and a reacquisition test with KR (20 trials per test) were conducted. Acquisition results indicated that KR was a better reference than CT for performing the timing aspect of the movement and for producing the generalized motor program (GMP) associated with the most efficient movement pattern. Delayed retention results showed that KR was also a better reference than CT for learning the most efficient GMP. The calibration strategy undertaken by subjects who were provided with KR during acquisition explains the superiority of the KR reference. The calibration strategy is compared with the pattern-matching activity that was probably undertaken by subjects who had received CT as a reference.

criterion template patterns↗
PubMed2002

Efficiencies of master, replica, and multilayer gratings for the soft-x-ray-extreme-ultraviolet range: modeling based on the modified integral method and comparisons with measurements.

The near-normal-incidence efficiencies of a 2400-groove/mm holographic master grating, a replica grating, and a multilayer grating are modeled in the soft-x-ray-extreme-ultraviolet (EUV) regions and are compared with efficiencies that are measured with synchrotron radiation. The efficiencies are calculated by the computer program PCGrate, which is based on a rigorous modified integral method. The theory of our integral method is described both for monolayer and multilayer gratings designated for the soft-x-ray-EUV-wavelength range. The calculations account for the groove profile as determined from atomic force microscopy with a depth scaling in the case of the multilayer grating and an average random microroughness (0.7 nm) for the short wavelengths. The refractive indices of the grating substrate and coatings have been taken from different sources because of the wide range of the wavelengths (4.5-50 nm). The measured peak absolute efficiency of 10.4% in the second diffraction order at a wavelength of 11.4 nm is achieved for the multilayer grating and is in good agreement with a computed value of approximately 11.5%. Rigorous modeling of the efficiencies of three similar gratings is in good overall agreement with the measured efficiency over a wide wavelength region. Additional calculations have indicated that relatively high normal incidence efficiency (of at least several percent) and large angular dispersion in the higher orders can be achieved in the 4.5-10.5-nm range by application of various multilayer coatings.

Journal Article↗
PubMed2003

Original article pilot screening for fragile X carrier in pregnant women of southern Taiwan.

BACKGROUND: Carrier detection before or at early pregnancy through a wide screening program may be a practical approach to prevent the fragile X syndrome. However, prior to implementation of such a program, the carrier prevalence in a population and availability of effective screening tests should be evaluated. METHODS: One thousand and two pregnant women were randomly selected from our obstetric clinic and screened for FMRI mutation. Each woman was examined individually using a simple non-radioactive PCR, as well as in pool with two other women using high-resolution Southern blot hybridization. RESULTS: One third of women could be excluded from carrier status by PCR alone, while the rest had to be screened using Southern-blot hybridization in pool with two other women. This screening strategy was reliable and efficient, and suitable for large-scale screening. Among the 1002 women, no carrier of either premutation or full mutation was found. Allele with intermediate CGG-repeat between 40 and 52 was found in only 22 women (2.2%). CONCLUSIONS: Estimation of female fragile X carrier rate in Taiwan could not be made in the present study, due to insufficient sample size. However, the results indicated clearly that the rate in Taiwan was significantly lower than that of Israel (0/1002 vs. 1/113, p = 0.003), and also lower than those from other western counties (1/186-259, p = 0.020-0.049). We doubt that the cost-efficiency of such a wide screening program in Taiwan is acceptable. However, the effective screening strategy proposed in this study would be very helpful for women with family history of mental deficiency of undetermined etiology.

Female↗
PubMed2003

PCAP: a whole-genome assembly program.

We describe a whole-genome assembly program named PCAP for processing tens of millions of reads. The PCAP program has several features to address efficiency and accuracy issues in assembly. Multiple processors are used to perform most time-consuming computations in assembly. A more sensitive method is used to avoid missing overlaps caused by sequencing errors. Repetitive regions of reads are detected on the basis of many overlaps with other reads, instead of many shorter word matches with other reads. Contaminated end regions of reads are identified and removed. Generation of a consensus sequence for a contig is based on an alignment of reads in the contig, in which both base quality values and coverage information are used to determine every consensus base. The PCAP program was tested on a mouse whole-genome data set of 30 million reads and a human Chromosome 20 data set of 1.7 million reads. The program is freely available for academic use.

Algorithms↗
PubMed2004

Improving children's coping with everyday stress: transporting treatment interventions to the school setting.

Children are continuously confronted with everyday stressors in their daily routine, and their ability to deal with these stressors has been found to be significantly related to their psychological adjustment. In fact, numerous studies have indicated that having a repertoire of coping skills at a young age can be a "buffer" or moderator" of the effects of negative life stress on the development of psychological maladjustment. Because of the importance of developing adequate skills to navigate life's daily challenges, a number of school-based interventions have been designed with the goal of teaching children specific "problem-focused" skills that are presumed to enhance coping, yet fewer programs have taught children "emotion focused" skills such as cognitive restructuring or emotional regulation to deal with more uncontrollable stressors. This paper begins with a review of the theoretical and empirical literature on children's coping with everyday stress and then provides a description of several existing coping skills training programs for children, highlighting those that are school-based interventions. A description is provided of a brief, school based intervention that was recently implemented to determine the differential effects of teaching young children "problem-focused" skills and teaching "emotion-focused" skills on children's subsequent use of specific coping strategies. The study and its outcomes are reviewed. The final section of the paper focuses on issues related to conducting intervention research in the schools, and specific suggestions for researchers are delineated for every stage in the process of school based research, to best assure that the research program can be implemented in the schools efficiently and effectively.

Adaptation, Psychological↗
PubMed1995

Automat and BLAST: comparison of two protein sequence similarity search programs.

Since the early 1980s, protein/DNA sequence similarity search has become of major importance to biologists, and the need for fast and efficient tools grows with the size of databanks. Two programs use the strategy of finite state deterministic automatons to accomplish these searches. One of these two is BLAST, which is now widely used, and the other Automat, which has just been published. The differences and similarities in their basic principles, their use and their performances are analysed in this paper in order to allow optimal use of these important softwares.

Algorithms↗
PubMed1999

Use of a computer software program for qualitative analyses--Part 2: Advantages and disadvantages.

NUD.IST 3.0 was generally effective in managing the qualitative data of dyspnea stimuli. Yet, some disadvantages were found related to format restrictions of transcripts and data volume. In particular, an appropriate format of transcripts for NUD.IST use was critical for efficient data management. Awareness of strengths and limitations of program functions is necessary to use NUD.IST efficiently in qualitative data management.

Abstracting and Indexing↗
PubMed2004

Frequent word section extraction in a presentation speech by an effective dynamic programming algorithm.

Word frequency in a document has often been utilized in text searching and summarization. Similarly, identifying frequent words or phrases in a speech data set for searching and summarization would also be meaningful. However, obtaining word frequency in a speech data set is difficult, because frequent words are often special terms in the speech and cannot be recognized by a general speech recognizer. This paper proposes another approach that is effective for automatic extraction of such frequent word sections in a speech data set. The proposed method is applicable to any domain of monologue speech, because no language models or specific terms are required in advance. The extracted sections can be regarded as speech labels of some kind or a digest of the speech presentation. The frequent word sections are determined by detecting similar sections, which are sections of audio data that represent the same word or phrase. The similar sections are detected by an efficient algorithm, called Shift Continuous Dynamic Programming (Shift CDP), which realizes fast matching between arbitrary sections in the reference speech pattern and those in the input speech, and enables frame-synchronous extraction of similar sections. In experiments, the algorithm is applied to extract the repeated sections in oral presentation speeches recorded in academic conferences in Japan. The results show that Shift CDP successfully detects similar sections and identifies the frequent word sections in individual presentation speeches, without prior domain knowledge, such as language models and terms.

Algorithms↗