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PubMed2006

Optimized and parallelized implementation of the electronegativity equalization method and the atom-bond electronegativity equalization method.

The most common way to calculate charge distribution in a molecule is ab initio quantum mechanics (QM). Some faster alternatives to QM have also been developed, the so-called "equalization methods" EEM and ABEEM, which are based on DFT. We have implemented and optimized the EEM and ABEEM methods and created the EEM SOLVER and ABEEM SOLVER programs. It has been found that the most time-consuming part of equalization methods is the reduction of the matrix belonging to the equation system generated by the method. Therefore, for both methods this part was replaced by the parallel algorithm WIRS and implemented within the PVM environment. The parallelized versions of the programs EEM SOLVER and ABEEM SOLVER showed promising results, especially on a single computer with several processors (compact PVM). The implemented programs are available through the Web page http://ncbr.chemi.muni.cz/~n19n/eem_abeem.

Journal Article↗

PubMed1984

Assessing curriculum implementation: a process for identifying salient variables.

The focus of this study was a process for selecting variables for assessing curriculum implementation. Three sets of variables, program characteristics, curriculum content, and curriculum emphasis, were measured to determine the degree to which program goals were implemented in 18 continuing education pediatric nurse practitioner programs. Program directors (19) responded to a questionnaire on the three sets of variables. Results from one-way analysis of variance (alpha = .05) and omega squared (omega 2) were used to identify variables from each of the three sets most likely to account for differences in curriculum implementation among the programs. Three of 11 program characteristics, 5 of 14 content domains, and 3 of 6 emphasis parameters were identified as salient variables for assessing student achievement and long-term curriculum outcomes.

Achievement↗

PubMed2001

Strategies for the implementation of cervical and breast cancer screening of women by primary care physicians.

OBJECTIVE: While effective screening tests for the prevention and early detection of cervical and breast cancers exist, poor screening rates are evident. The aim of this paper was to determine the most effective strategies for the implementation of breast and cervical cancer screening delivered to women. METHODS: An in-depth search of the literature using Medline and the Cochrane Library was carried out between the years 1966 and 2000. Randomized controlled studies addressing the delivery of both breast and cervical screening were retained for the purposes of this review. Absolute difference (AD) in screening was defined as screening rates in the intervention arm--screening rates in the control arm. Number needed to intervene (NNI) is a new term developed for the purpose of this paper and refers to the number of physicians or physician-patient pairs that must be exposed to the intervention before one screening test is performed. NNI is defined as 1/AD. RESULTS: Strategies for the implementation of screening tests are divided into three categories: physician-only based, physician and patient based, and patient-only based. CONCLUSIONS: Physician-based strategies, especially manual and computer-generated reminders, appear to be the most effective approach in the implementation of breast and cervical cancer delivery to women. Absolute gains in screening rates were as high as 40% with an NNI of 2.5 physicians; therefore, approximately 3 physicians need to be exposed to a reminder notice before 1 physician actually orders the screening tests.

Breast Neoplasms↗

PubMed1999

Quantitative histology using confocal microscopy: implementation of unbiased stereology procedures.

Direct, two-dimensional counting or measuring of cells as they appear in histological sections is subject to a number of artifacts that can lead to erroneous conclusions about changes in cellular populations. Numerous correction procedures devised to compensate for these artifacts are collectively termed model-based stereology due to their reliance on a model of cell geometry for correction formulas. These corrections are valid only to the degree that the geometric model reflects cellular morphology. In addition, there are requirements for population homogeneity that are often not met in biological material. The development of design-based stereology provides a way to directly count or measure cells in three dimensions, avoiding errors (biases) and the need for assumptions regarding cell size, shape, and orientation to be validated. On this basis, these procedures are described as unbiased stereology. The recent commercial availability of semiautomated stereology systems has substantially reduced the effort and experimenter error (bias) associated with the use of design-based stereology. The optical resolution of confocal microscopy and the ability to collect registered series of focal planes is ideally suited for the three-dimensional sampling of design-based stereology. Unfortunately, stereological procedures are not available in any confocal microscope software and it is up to the user to implement these procedures. Strategies and illustrations of approaches to implementing stereological procedures on a confocal microscope are presented. Where possible, particular design issues are discussed and solutions suggested. With user requests, future generations of confocal software may integrate collection of confocal images with the implementation of design-based stereology.

Animals↗

PubMed1999

Factors influencing implementation of the legislated smoking ban on school property in Ontario.

BACKGROUND: Implementation of legislation in Ontario, Canada, that banned smoking on school property gave rise to perceptions of problems in some schools. A telephone survey was conducted to assess these problems. This analysis identifies risk or protective factors in the school environment associated with administrators' reports of problems. METHODS: Survey data were obtained from key informants in 213 high schools. Multiple logistic regression was used to identify school-related characteristics associated with: (1) major problems in implementing the ban and (2) recommendations that schools return to designated smoking areas. RESULTS: A protective factor against both outcomes was having a school no-smoking policy prior to the ban. Also protective against major problems was a perceived decrease in student smoking during the school day. The identification of safety risks to students who leave school property to smoke was a strong risk factor for both outcomes. Beliefs that the ban was not effective and opposition to it from teachers/staff were associated with desires for its repeal. CONCLUSIONS: In implementing legislated school smoking bans, attention should be given to informing teachers and gaining their support. Strategies for dealing with potential safety risks to students who leave school property to smoke should also be devised.

Attitude to Health↗

PubMed1992

A parallel implementation of a multi-state Kalman filtering algorithm to detect ECG arrhythmias.

Detecting arrhythmias from the electrocardiogram (ECG) is of great importance for the continued development of intelligent cardiovascular monitors (ICM). An ICM's main goal is to present to the clinician a 'high-level' analysis of the patient's condition (e.g., the patient is slightly hypovolemic) based upon 'low-level' physiologic signals (e.g., blood pressure, heart rate, etc.). This paper reports on a parallel implementation of a multi-state Kalman filtering algorithm, within a prototype ICM, to help detect ECG arrhythmias. Preliminary test results show that the parallel, multi-state implementation performed exactly as the original sequential version. Several different rhythm disturbances were correctly identified after 3-5 beats. We conclude that our parallel implementation of the multi-state Kalman filter provides a faster and still reliable means of accurately detecting ECG arrhythmias in real-time.

Algorithms↗

PubMed1981

Implementation of the health center concept in a rural community: a case study.

A comprehensive health center integrates inpatient, outpatient, and public health services within the same medical and administrative structure. While health centers have been widely developed in other countries, only limited implementation has occurred in the United States. This case study documents the successful implementation of the health center concept in a sparsely populated area of northwestern New Mexico. This remote geographic setting and the socioeconomic characteristics of the area's tricultural population are described. The evolution of the delivery system with its network of satellite clinics predominantly staffed by mid-level primary care providers is presented. Program development and funding for the provision of a wide range of preventive and curative health services supported by communication, transportation, outreach, education, public health, and administration components are analyzed. Problems purported to hinder the implementation of comprehensive health centers in the United States are discussed from an experimental perspective.

Catchment Area, Health↗

PubMed1998

Implementation of Medicaid Managed Mental Health Care in Iowa: problems and solutions.

Under the terms of a 1915(b) waiver, Iowa implemented a statewide carve-out program in 1995 for the management of mental health services for Medicaid recipients by contracting with a private for-profit corporation. In this commentary, the strategy used to develop the Medicaid managed care contract in Iowa is briefly summarized. Problems that were encountered in program implementation and regulatory attempts to address those issues are described. Suggestions for other states regarding the development, implementation, and oversight of contracts for managed care so that they might be able to deliver comprehensive mental health care services with acceptable standards of care quality are offered. By including appropriate contract specifications, providing mechanisms for oversight, and enforcing standards of care in Medicaid managed care contracts, many problems that occurred in Iowa may have been minimized or avoided. This experience can provide a valuable lesson for similar program initiatives in other states.

Contract Services↗

PubMed1993

Implementation of digital stereo imaging for analysis of metaphyses and joints in skeletal collections.

The surface structure of the growing portion of bones, called the metaphysis, contains clues about the locomotor characteristics of various species. Present methods of capturing this anthropologically interesting surface are time-consuming and subject to human error. The research implements a digital stereo imaging technique for bone metaphyses and joints in skeletal collections. The corresponding points in two images collected from different angles are determined using an area-based correlation matching method. The depths of matched points are computed from the difference in location of the points in the two images. The paper presents a practical implementation of computer vision for anthropology using an 80286-based personal computer, a camera and a video digitiser. The stereo matching algorithm, a practical implementation of classical stereo imaging methods, takes less than 1 min and produces reasonable representations of mammal bones. The accuracy of the depth measurements ranged from 0.7 to 12 per cent for 45-150 cm object-camera distances. False matches occurred in approximately 6 per cent of the total matched points.

Animals↗

PubMed1996

Implementing a system of care: findings from the Fort Bragg evaluation project.

The Implementation Study of the Fort Bragg Evaluation documented how the Demonstration was executed and whether it met the expectations of the continuum of care philosophy upon which it was based. Based on the theory-driven and component approaches to program evaluation, a case study methodology was employed. First, the theories and assumptions about the Demonstration were explicated to derive a program model. Next, the program-as-implemented was compared to the program-as-planned. Barriers responsible for diluting full-scale implementation were documented. This study provides a comprehensive description of how the Demonstration was put into place and the evidence necessary to conclude that the Demonstration was executed with high fidelity, despite barriers, to provide an excellent test of the program theory.

Adolescent↗

PubMed1992

Early implementation of legislative children's mental health reform: the Minnesota/Hennepin County Experience.

The objectives of this study were to identify the strengths and weaknesses of Minnesota's Comprehensive Children's Mental Health Act of 1989 and its early implementation in Hennepin County, Minn. Data were collected from official documents and key informants relative to three implementation criteria: (1) community-based and family-centered values; (2) the range, coordination, and affordability of services; and (3) process, outcome, and consumer accountability. Findings suggest that the state law is a laudable, yet seriously limited, attempt to reform the system of care for children with emotional disorders. While the law is strong in its intent regarding community-based value, range, and coordination of services as well as process accountability, implementation has been hampered by weaker intent with respect to other criteria and by a lack of a comprehensive financing plan. Despite these limitations in the state law, Hennepin County has moved to use the law as leverage to improve the local system of care. Implications for reformers in other states center on the issues of state/county relationships, scope of initial efforts, choice of organizational structure, and the interplay of financing and accountability issues.

Child↗

PubMed1987

A microcomputer implementation of status and alarm algorithms in a cardiac surgical intensive care unit.

Algorithms have been developed for monitoring the cardiovascular status of patients on their return to an intensive care unit after cardiac surgery and also for giving an immediate alarm of a critical deterioration in this status. The two systems for implementing these algorithms were initially developed on Z80 based microprocessor systems and preliminary clinical trials based on the resulting instruments proved encouraging. For further clinical trials of the algorithms the systems have been integrated and implemented on a BBC microcomputer with a 6502 second processor. The development and structure of the programs for implementing the algorithms are described, together with the program input and output facilities and diagnostic techniques used to analyse the information output from the program.

Algorithms↗

PubMed1991

Implementation aspects of image management, archiving, and communication systems in routine clinical use.

Implementation of a digital imaging network in routine clinical use is a difficult task. Not only the high technical requirements, but especially the complexity of the organization of the diagnostic information flow in a hospital makes commitment essential in PACS implementation. The application of project management with a dedicated project team is a good approach to establish this complex endeavor. The different phases of a project for implementation are initiative, definition, design, preparation, realization, and evaluation and are exemplified by what we learned from the Dutch PACS project.

Radiology Information Systems↗

PubMed1997

Picture archiving and communication system implementation: the practical considerations of adapting the technology to the real world of health care operations.

The issues discussed in this article are just some of the real-life considerations a facility's management team should address during the planning process as they make decisions about PACS implementation. We currently are working with the management teams of many facilities on PACS implementation projects that have yet to be completed. In the future, we hope to report on our experiences, including both successes and failures, as construction is completed and the systems actually are implemented.

Computer Communication Networks↗

PubMed2005

[Clinical risk management. Implementation of an anonymous error registration system in the anesthesia department of a university hospital].

BACKGROUND: The main goal of a medical risk management system is reduction of treatment errors and the primary focus is patient safety. MATERIALS AND METHODS: A task force on risk management in anaesthesia was established in the department of Anaesthesiology and Intensive Care at the University Hospital Dresden with the aim to implement a critical incident reporting system (CIRS) followed by a structured analysis. The theoretical basic principles and tools for the incident analysis are presented. RESULTS: The task force developed a machine-readable, structured, anonymous questionnaire, which was implemented in clinical practice after a primary test period. CONCLUSIONS: Prerequisites for the implementation of an effective CIRS are support from the department head, anonymity, independence of the task force from the department head and competence of the task force to initiate changes and improvements. CIRS is a powerful tool to register and analyse critical incidents and may influence the following domains: education and training (human factors), medical equipment (technical factors), quality of working processes and departmental communication (organisational factors).

Anesthesia Department, Hospital↗

PubMed2004

[Survey among local health departments concerning the implementation of the new infectious disease reporting system].

The Infectious Disease Control Act enacted in Germany in January 2001 led to the establishment of a new reporting system for infectious disease. The implementation of this system was evaluated to identify opportunities for further improvement. In a survey of all German local health departments the following criteria were analyzed: resources (staff and technical equipment), information needs (satisfaction with current offers/further training requirements), data analysis (extent of local data analysis/feedback of national data), and acceptability (case definitions/electronic reporting). In local health departments, 11% of the staff were assigned to the infectious disease reporting system. Data were processed mainly by nonmedical staff (78.4%). A computer work-station is available for most staff members. One-third of the local health departments uses the RKI software "SurvNet@rki" for data transmission. All others use commercial software. Experience with the electronic reporting system was rated as very good/good by 47.1% of local health departments, as satisfactory by 44.5%, and as problematic by 8.4%. Most of the local health departments were satisfied with the offers of information provided by RKI (96.4%) and state health departments (83.7%), respectively. However, 49.1% of the local health departments saw a need for further education and training. The implementation of case definitions was supported by 95% of the local health departments, but transmission criteria were criticized. In summary, the new infectious disease reporting system in Germany was successfully implemented. However, the system could be improved through reduction of software problems concerning electronic data processing and transmission, expansion of current offers of in-formation and provision of special staff training programs, and revision of the case definitions concerning clearness and simpler handling.

Communicable Disease Control↗

PubMed2001

[Implementation of a new electronic patient record in surgery].

INTRODUCTION: The increasing amount of clinical data, intensified interest of patients in medical information, medical quality management and the recent cost explosion in health care systems have forced medical institutions to improve their strategy in handling medical data. In the orthopedic department (3,600 surgeries, 75 beds, 14,000 consultations) software application for comprehensive patient data management has been developed. METHOD: When implementing the electronic patient history following criteria were evaluated: 1. software evaluation, 2. implementation, 3. work flow, 4. data security/system stability. RESULTS: In the first phase the functional character was defined. Implementation required 3 months after parametrization. The expense amounted to 130,000 DM (30 clients). The training requirements were one afternoon for the secretaries and a 2-h session for the residents. The access speed on medically relevant data averaged under 3 s. The average saving in working hours was approximately 5 h/week for the secretaries and 4 h/week for the residents. The saving in paper amounted to 36,000 sheets/year. In 3 operational years there were 3 server breakdowns. CONCLUSIONS: Evaluation of the saving on working hours showed that such a system can amortize within a year. The latest improvements in hardware and software technology made the electronic medical record with integrated quality-control practicable without massive expenditure. The system supplies an extensive platform of information for patient treatment and an instrument to evaluate the efficiency of therapy strategies independent of the clinical field.

Database Management Systems↗

PubMed2003

Practical use and implementation of PET in children in a hospital PET centre.

Children are not just small adults-they differ in their psychology, normal physiology and pathophysiology, and various aspects should be considered when planning a positron emission tomography (PET) scan in a child. PET in children is a growing area, and this article describes the practical use and implementation of PET in children in a hospital PET centre. It is intended to be of use to nuclear medicine departments implementing or starting to implement PET scans in children. Topics covered are: dealing with children, dosimetry, organisation within the department and relations with other departments, preparation of the child (provision of information to the child and parents and the fasting procedure), the imaging procedure (resting, tracer injection, positioning, sedation and bladder emptying) and pitfalls in the interpretation of PET scans in children, including experiences with telemedicine.

Adolescent↗