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At least 1,621 records · Page 90Linked to original sources
PubMed2006

Implementing a routine, voluntary HIV testing program in a Massachusetts county prison.

Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon inmate or physician request. Between November 2004 and April 2005, 1,004 inmates met inclusion criteria and were offered routine, voluntary HIV testing. Of these, 734 (73.1%) accepted, 2 (0.3%) were HIV-infected, and 457 (45.5%) had been tested for HIV in the previous year. The testing rate of 73.1% was significantly increased from the rate of 18.0% (318 of 1,723) during the control period (p<0.001). Among the inmates tested for HIV in the prior year, 78.2% had received their last HIV test in the prison setting. Careful attention should be paid to prevent redundancy of testing efforts in the prison population. Implementing a routine HIV testing program among prison inmates greatly increased testing rates compared to on-request testing.

Counseling↗
PubMed1987

Penalizing recidivist drunk drivers in Indiana: impediments to implementation.

In 1983, Indiana enacted a law mandating that anyone convicted a second or subsequent time of Operating While Intoxicated (OWI) receive a minimum of 48 consecutive hours in jail or 10 days of community service. A representative random sample of Indiana counties was used to determine the extent of implementation of this law by the courts in 1984 and 1985. Analysis of the 1984 data concluded that nearly 70% of the cases did comply with the law in its first year of implementation. However, 13.8% of the recidivists received neither jail nor community service. Another 17.6% served some jail time and/or community service, but not of a sufficient length to comply with the law. Overall compliance increased to 75% in 1985, while the proportion who received neither jail nor community service increased to 17%. Several specific causes for noncompliance are identified and recommendations for their correction are offered. It is felt that the Indiana experience described in this paper will prove instructive to other states with newly-strengthened OWI laws.

Alcoholic Intoxication↗
PubMed1992

Implementation of capillary blood glucose monitoring in a teaching hospital and determination of program requirements to maintain quality testing.

PURPOSE: To study the implementation of bedside capillary glucose monitoring using a hospital-wide quality control (QC) program. METHODS: A prospective study of QC performance in 7 outpatient and 39 inpatient treatment units was performed in a large teaching hospital over a 2-year period. Approximately 800 nurses were trained to perform bedside capillary glucose monitoring (Accu-Chek II, Boehringer-Mannheim, Indianapolis, IN). An eight-point QC program was instituted including proficiency testing, instrument maintenance, performance of daily controls, storage of reagent strips and supplies, instrument calibration, and documentation procedures. RESULTS: Comparison of laboratory and bedside test results (split-sample proficiency testing) revealed Y = 1.004X + 7.26, r = 0.95, with a mean percent difference of -4.2% (p < 0.001). Less than 7% of results fell outside +/- 20% of the laboratory results. QC scores (0 = worst to 4 = best), based on adherence to the QC program, improved from 0 on the first inspection to 3.7 +/- 0.17 by the 11th inspection. The most common QC deficiencies were failure to perform split-sample testing (41.4%) and failure to perform instrument maintenance (30.2%). Significant differences were noted in the QC performance of different types of medical services. During the 2-year study period, the total number of glucose assays performed in the clinical laboratories decreased by 22.2% concurrent with initiation of bedside testing. The number of instruments in the hospital increased from 10 to 46. CONCLUSIONS: Bedside capillary glucose assays can be widely implemented in large hospitals with an acceptable degree of accuracy. QC programs with frequent inspections are necessary to identify units that function inadequately, and a formal disciplinary policy is required to ensure compliance with the program.

Blood Glucose↗
PubMed1991

Implementations are not conceptualizations: revising the verb learning model.

In a recent issue of this journal, Pinker and Prince (1988) and Lachter and Bever (1988) presented detailed critiques of Rumelhart and McClelland's (1986) connectionist model of the child's learning of the phonological form of the English past tense. In order to address these criticisms, a new connectionist model was constructed using the back-propagation algorithm, a larger input corpus, a fuller paradigm, and a new phonological representation. This new implementation successfully addressed the criticisms of the phonological representation used by Rumelhart and McClelland. It did a much better job of learning the past tense using a fuller input set with realistic frequencies of occurrence. Ancillary simulations using the same network were able to deal with the homonymy problem and the generation of forms like "ated" from "ate". The one feature not provided by the new model was a way of modeling early correct production of irregular forms. The success of the new model can be used to help clarify the extent to which the published critiques apply to a particular connectionist implementation as opposed to fundamental principles underlying the broader connectionist conceptualization.

Concept Formation↗
PubMed1988

An image filing system for the implementation of image processing algorithms in a research environment.

An image filing system (IFS) has been written to facilitate the implementation and testing of image processing algorithms in a research environment. A programming substrate has been developed to provide applications with routines for acquiring, displaying, and manipulating images without regard for the underlying information format. Images of diverse modalities are cataloged and tracked through a series of image operations with descriptive pointers to all antecedents. This paper presents the design and implementation of the image filing system and describes one of the major image processing applications developed in the IFS environment.

Algorithms↗
PubMed1996

Implementation of an electronic patient data management system (PDMS) on an intensive care unit (ICU).

Implementation of a data management system on an Intensive Care Unit (ICU) needs a good organisation. The expectations and the specifications of the system should be defined and clear before the process is started. Analysis of produced data of communication and information pathways on the ICU is necessary. A complete system should include data acquisition, data base management and archiving of data. In our project, the development of these criteria was performed by participation in a national project. Coupling with a hospital information system and the possibility of data exchange is mandatory. We were able to implement a paperless patient record. Although it takes more time to do the patients administration with a Patient Data Management System (PDMS), medical personal seem to be better informed. Readable information is easy to access at the bedside of the patient.

Attitude to Computers↗
PubMed1993

Implementation and use of gradient predictions for optimization of reversed-phase liquid chromatography of peptides. Practical considerations.

The options in the implementation of gradient theory for optimization work are critically reviewed and evaluated for the case of the reversed-phase liquid chromatography of peptides. Various models are covered together with methods for the determination of model parameters. Approaches for calculating retention times and band widths from experimental data are discussed. Different kinds of extrapolation are compared with interpolation. This study was aimed at finding the best compromise between number of experiments, accuracy of predictions and simplicity of calculations. Implementation and the use of gradient predictions can be simple, and practical recommendations are given.

Amino Acid Sequence↗
PubMed1988

Problems and limitations of ECG baseline estimation and removal using a cubic spline technique during exercise ECG testing: recommendations for proper implementation.

One common variety of exercise-induced artifact is baseline wander resulting from movement, respiration, and poor electrode contact. Although filters can be designed to remove much of this baseline variation, they will distort the low-frequency components of the ECG complex, such as the TP-segment, the PR-segment, and, most problematically, the ST-segment. The ST-segment is the most diagnostically relevant measure of the ECG taken during exercise. While linear baseline interpolation and removal may be adequate at lower heart rates, they also will introduce significant distortions. This is particularly evident when excessive nonlinear wander is present, as seen at higher heart rates and respiration rates. A nonlinear, third-order, polynomial estimator of baseline wander, known as the cubic spline, has been used for nearly 15 years. It is a very robust technique applied to exercise ECG recordings. Since the cubic spline is not a filter and use an a priori knowledge of the shape of the ECG signal, it estimates the true baseline and avoids distortion better. The more common implementations of this technique use relatively short ECG recordings. With the advent of increasing power in computerized ECG systems, the implementation of the cubic spline algorithm for removing baseline wander in continuous, longer-duration ECG records and in real-time processing is being attempted. However, the correct application of the cubic spline to continuous recordings is not straightforward and involves a number of previously unforeseen difficulties. The accuracy and resolution of both floating point and integer operations is critical during long-term application of the cubic spline function.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1993

A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, west Africa. 5. Design and implementation of the trial.

A large-scale malaria intervention programme using insecticide-treated bed nets and chemoprophylaxis administered to children was introduced into a rural area of The Gambia. The operation was carried out using the existing primary health care (PHC) service in the region. Training of the village health workers, sensitization of the communities, and implementation of net impregnation and the drug delivery programme are described. This delivery system resulted in over 90% of nets being treated with insecticide and 80% of children receiving over 90% of their tablets during the rainy season. There was considerable variation in the distribution of permethrin on a bed net and between individual nets, which is likely to facilitate the spread of insecticide resistance in the local mosquito populations. Bed nets made from heavier fabrics tended to absorb more insecticide than those made from lighter materials. Four months after dipping, 89% of the insecticide had been lost from treated nets. This was probably due mainly to women washing their nets, an activity carried out on average once every 2 months during the rainy season. The high number of insecticide-treated bed nets in the study area demonstrated that a malaria control programme operated through a PHC system can be implemented successfully.

Antimalarials↗
PubMed1987

Evaluation and implementation of self-management programs for children with asthma.

We have reviewed the needs and problems associated with the evaluation and implementation of programs designed to assist children with asthma and their parents to manage the illness. To date, there are several programs that have been evaluated and found to be effective in terms of the objectives and dimensions described. Implementation has presented a larger problem because there are few implementors and because of the major barriers to be overcome by those who would make these programs available to the significant numbers of children and families who would benefit. Unless ways can be found to overcome the medical and reimbursement barriers, asthma self-management programs will not thrive. The growing number of individuals enrolled in some form of health maintenance organization, however, suggests a greater market for asthma self-management programs, under circumstances in which the costs of emergency room use and hospital services must be borne by physicians and hospitals, rather than by their patients.

Asthma↗
PubMed1989

The development, implementation, evaluation, and future directions of a chronic disease prevention program for children: the "Know Your Body" studies.

In 1975, the American Health Foundation initiated the development, implementation, and evaluation of a school-based, teacher-delivered program of the primary prevention of heart disease, cancer, and stroke. The aims of this program, entitled "Know Your Body," are to modify favorably the population distributions of risk factors for chronic disease through changes in diet, physical activity, and cigarette smoking. After more than a decade of investigation, this program has been found to be feasible and acceptable to school personnel, students, and parents, and appears to have had favorable effects on prevention-related knowledge, dietary intake, obesity, blood cholesterol levels, and the rate of initiation of cigarette smoking among diverse populations of school children in the New York City area. If these findings can be replicated, the widespread implementation of such programs has the potential to reduce the population risk for the future development of the nation's leading causes of premature mortality.

Child↗
PubMedDate not supplied

Progress and issues in the implementation of the 1984 out-of-home care protection amendment.

The purpose of this paper is to assess the status of implementation of out-of-home protection programs since 1984 in the U.S. Data was obtained from a survey of state child protection services (CPS) liaisons in summer, 1989. A framework for viewing protection after placement is presented and the development of policy regarding maltreatment in out-of-home care is traced from its roots in the deinstitutionalization movement. Changes in state statutes and rules, results in out-of-home abuse and neglect reporting, how states operationalize "properly constituted authority" and "independent investigation," the role of licensing in preventing and remediating out-of-home maltreatment, training initiatives and the extent of the use of background checks are reported. A summary evaluation of the status of the implementation of the federal 1984 out-of-home care protection amendments by state agencies is offered.

Child↗
PubMed1982

Skill acquisition and client movement indices. Implementing cost-effective analysis in rehabilitation programs.

This article outlines the development and implementation of a cost-effective approach to client and program evaluation. The indices presented summarize a client's acquisition of behavioral skills (Skill Acquisition Index) and progression along a continuum of becoming less dependent and more productive (Client Movement Index). Data are presented summarizing how the two non-monetary outcome measures have been used in formative program evaluation. The paper also discusses some of the problems involved in implementing cost-effective analyses in rehabilitation programs and suggests specific strategies to overcome the problems.

Activities of Daily Living↗
PubMed1983

An organization-environment framework for assessing program implementation.

Evaluations of health programs are typically conducted from a rational bureaucratic framework in which client change and client outcome are seen as logical outcomes of program activity. This paper proposes a theoretical framework for examining organizational consequences of program implementation. Factors in the internal environment (e.g., the hospital) and the external environment (e.g., the community) which contribute to the program's success or failure, are considered. Observational and structured interview data are used to compare two state funded perinatal projects, one an organizational "success" and the other a costly failure. Attributes of external environments which may be important to successful implementation include demand for services, provider competition, access to information, social beliefs, and professional commitment. Important features of the internal environment include host organization commitment and conflict, and structural attributes: complexity, formalization, centralization, and coordination. The paper concludes with theoretically-based questions which serve as guidelines for process evaluation.

California↗
PubMed1985

Implementation of a movement paradigm using the Commodore 64 microcomputer.

Implementation of an alternating movement paradigm for monkeys was achieved using an inexpensive but versatile microcomputer, the Commodore 64. During task performance, the computer monitors one of three user selectable input signals (e.g. joint position) and continuously displays this signal as a moving cursor on a video monitor along with a user positioned target box. Other user defined parameters include in-target holding time and reinforcement ratio. The system also provides two sound cues to signal entry of the cursor into the target box and successful completion of a trial. Extensive use is made of the computer's intrinsic hardware features for implementation of movement paradigm functions. Use of external components is limited to digitizing and interface hardware. A two part software package consisting of a BASIC and a machine language program performs all task and hardware related functions. Acquisition and display of analog input signals, display of target positions, and delivery of auditory cues and applesauce rewards are all controlled by the machine language program. All user defined parameters are specified from the BASIC menu program. The specific programs described in this paper should be applicable to the control of tasks requiring alternation of a behavioral parameter between two target zones.

Animals↗
PubMed1989

The district concept for primary health care planning: attempts at implementation in The Netherlands.

Strengthening district-level primary health care systems has high priority in the WHO's 'Health for All' strategy. This article reviews governmental efforts to implement district health care systems in the Netherlands. Up to 1987, these activities corresponded to the WHO objectives, but their impact was limited. In 1987, government policy drifted away from these goals; the regulation of market forces and the increased influence of financing institutions have replaced planning by local government. Attempts to implement the district concept have, in fact, set primary health care planning back without offering the prospect of a leap forward.

Catchment Area, Health↗
PubMed1990

Physiologic trend detection and artifact rejection: a parallel implementation of a multi-state Kalman filtering algorithm.

Using a parallel implementation of the multi-state Kalman filtering algorithm, we have developed an accurate method of reliably detecting and identifying trends, abrupt changes, and artifacts from multiple physiologic data streams in real-time. The Kalman filter algorithm was implemented within an innovative software architecture for parallel computation: a parallel process trellis. Examples, processed in real-time, of both simulated and actual data serve to illustrate the potential value of the Kalman filter as a tool in physiologic monitoring.

Algorithms↗