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Results for “Program Efficiency”

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At least 19 recordsLinked to original sources
PubMed1987

Use of manpower data in an integrated database for program efficiency analysis: an example from a statewide community mental health system.

This article describes a method for systematically utilizing manpower data to analyze program efficiency of community mental health services. Examples of how analyses of performance data can be substantially enhanced by integrating manpower staffing data with other key financial, client, and service volume variables are provided.

Community Mental Health Services↗
PubMed2003

The 9-A solution: how mRNA pseudoknots promote efficient programmed -1 ribosomal frameshifting.

There is something special about mRNA pseudoknots that allows them to elicit efficient levels of programmed -1 ribosomal frameshifting. Here, we present a synthesis of recent crystallographic, molecular, biochemical, and genetic studies to explain this property. Movement of 9 A by the anticodon loop of the aminoacyl-tRNA at the accommodation step normally pulls the downstream mRNA a similar distance along with it. We suggest that the downstream mRNA pseudoknot provides resistance to this movement by becoming wedged into the entrance of the ribosomal mRNA tunnel. These two opposing forces result in the creation of a local region of tension in the mRNA between the A-site codon and the mRNA pseudoknot. This can be relieved by one of two mechanisms; unwinding the pseudoknot, allowing the downstream region to move forward, or by slippage of the proximal region of the mRNA backwards by one base. The observed result of the latter mechanism is a net shift of reading frame by one base in the 5' direction, that is, a -1 ribosomal frameshift.

Bacteria↗
PubMed1997

Prospective development of a cost-efficient program for the pubovaginal sling.

OBJECTIVES: We designed and implemented a cost-containment program for patients undergoing a pubovaginal sling procedure. We sought to test the hypothesis that preoperative patient education could reduce the length of hospital stay in these patients. Our goal was to decrease hospital charges while maintaining quality of care. METHODS: A multidisciplinary group of clinic and hospital staff identified factors that contribute to a patient's hospital charges for a pubovaginal sling procedure. A program of preoperative patient education to teach intermittent self-catheterization was combined with the elimination or control of items considered unnecessary to the delivery of safe, efficient care. Patient care was standardized from the preoperative visit to discharge planning. The difference in the mean values of 38 prestudy patients was compared with 15 study patients with a Wilcoxon rank sum test. RESULTS: Length of hospital stay was reduced from a mean of 2.8 to 1.1 days after implementation of the program (P < 0.0001). This decreased length of stay, combined with a reduction in routine laboratory studies (97% decrease; P < 0.0001), operating room charges (11% decrease; P < 0.01), and medications (35% decrease; P < 0.01), led to significantly reduced hospital charges. Total hospital charges decreased by 35%, from a mean of $4862 to a mean of $3153 (P < 0.0001). There was no increase in morbidity. Patient satisfaction with length of hospital stay did not change significantly following implementation of the program. CONCLUSIONS: With a program of preoperative patient education combined with a critical review of the factors contributing to a patient's hospital charges, it is possible to implement a cost-efficient program for a pubovaginal sling, leading to a 35% reduction in mean total hospital charges. This approach directed toward other incontinence procedures could be expected to yield comparative results.

Cost of Illness↗
PubMed1997

Structural probing and mutagenic analysis of the stem-loop required for Escherichia coli dnaX ribosomal frameshifting: programmed efficiency of 50%.

Three elements are crucial for the programmed frameshifting in translation of dnaX mRNA: a Shine-Dalgarno (SD)-like sequence, a double-shift site, and a 3' structure. The conformation of the mRNA containing these three elements was investigated using chemical and enzymatic probes. The probing data show that the structure is a specific stem-loop. The bottom half of the stem is more stable than the top half of the stem. The function of the stem-loop was further investigated by mutagenic analysis. Reducing the stability of the bottom half of the stem strongly effects frameshifting levels, whereas similar changes in the top half are not as effective. Stabilizing the top half of the stem gives increased frameshifting beyond the WT efficiency. The identity of the primary RNA sequence in the stem-loop is unimportant, provided that the overall structure is maintained. The calculated stabilities of the variant stem-loop structures correlate with frameshifting efficiency. The SD-interaction and the stem-loop element act independently to increase frameshifting in dnaX.

Bacterial Proteins↗
PubMed1997

Community mental health program efficiency.

Six urban community mental health centers participated in a capitated payment system designed for persons with severe mental illness who frequently used the state hospital. The centers and their funding agency agreed that a chief outcome measure would be the length of time clients were able to remain enrolled in the outpatient program. Clients of the six agencies were quite similar to one another. During the 18-month study length of enrollment in the outpatient program did not vary among the agencies whereas agency expenditures varied by more than three-fold. Although some of this expenditure variation was due to economies of scale at larger agencies, different practice styles also contributed to variable efficiency.

Adult↗
PubMed1994

Prospective development of a cost-efficient program for radical retropubic prostatectomy.

OBJECTIVES: We designed and implemented a broad-based program to decrease costs while maintaining quality of care in patients undergoing radical retropubic prostatectomy. METHODS: This program initially involved identification of factors that contribute to patient costs after radical prostatectomy and elimination or control of items that were deemed unnecessary. Patient care was standardized with a collaborative care pathway coordinated by a clinical nurse specialist and that served as a goal for each case. RESULTS: Length of total hospital stay was reduced from a mean of 5.7 days to 3.6 days after full implementation of the program (p < 0.0001). A reduction in operating room time, material utilization, antibiotic use, routine laboratory studies, and refinements in postoperative pain management contributed significantly to cost savings. Overall, the average adjusted total hospital charges were reduced from $13,783 to $7741 (p < 0.0001) by the implementation of this program, with no discernible adverse effect on morbidity rates. CONCLUSIONS: Careful analysis of the critical components of medical care and implementation of a standardized pathway with emphasis on a collaborative approach can substantially increase the cost efficiency of medical care.

Aged↗
PubMed2003

Supported employment for persons with traumatic brain injury: a preliminary investigation of long-term follow-up costs and program efficiency.

OBJECTIVE: To investigate the long-term follow-up costs of supported employment as well as the wage and employment characteristics for individuals with moderate to severe traumatic brain injury (TBI) who participated in supported employment services over a 14-year time period. DESIGN: Longitudinal design with prospectively collected data. SETTING: A university-based supported employment program that uses the individual placement model of supported employment. PARTICIPANTS: Fifty-nine individuals with moderate to severe TBI who were consecutively referred for supported employment services. The sample was restricted to individuals who were placed into a least 1 supported employment position during the study period. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Data were collected on clients placed into at least 1 competitive supported employment position from 1985 to 1999. Analyses were performed to examine the costs of supported employment, employment characteristics (eg, wages, length of employment), and benefit-cost ratios of supported employment for individuals with TBI. RESULTS: The average length of employment for the current sample was 42.58 months. Average gross earnings were US dollars 26,129.74 for individuals during their entire duration of employment. Billing charges accrued for employment services averaged US dollars 10,349.37. Individuals with TBI earned an average of US dollars 17,515 more than the costs associated with their supported employment. CONCLUSIONS: Our investigation provides additional support for the conclusion that supported employment is cost effective for individuals with disabilities, including individuals with TBI, and that the costs of supported employment decrease over time.

Adult↗
PubMed1988

Training of personnel in schools to make health education programs efficient.

For health education to become efficient, it is necessary to improve the adult environment in school. This contributes positively to the school health environment. To achieve this goal, the consciousness and knowledge of the needs of children must be improved, broadened and deepened. A school pediatrician must use his knowledge and the advantage of being a part of the school to develop courses for the school personnel to support health services in school. In the municipality of Ostersund, Sweden, we have developed five courses for school personnel concerning children and health. We find this to be one good way of interpreting the aims of school health service: to support the development of the pupils, to preserve and improve their mental and bodily health and to work for healthy life habits.

Adolescent↗
PubMedDate not supplied

FindEM--a fast, efficient program for automatic selection of particles from electron micrographs.

The FindEM particle picking program was tested on the publicly available keyhole limpet hemocyanin (KLH) dataset, and the results were submitted for the "bakeoff" contest at the recent particle picking workshop (Zhu et al., 2003b). Two alternative ways of using the program are demonstrated and the results are compared. The first of these approximates exhaustive projection matching with a full set of expected views, which need to be known. This could correspond to the task of extending a known structure to higher resolution, for which many 1000's of additional images are required. The second procedure illustrates use of multivariate statistical analysis (MSA) to filter a preliminary set of candidate particles containing a high proportion of false particles. This set was generated using the FindEM program to search with one template that crudely represents the expected views. Classification of the resultant set of candidate particles then allows the desired classes to be selected while the rest can be ignored. This approach requires no prior information of the structure and is suitable for the initial investigation of an unknown structure--the class averages indicate the symmetry and oligomeric state of the particles. Potential improvements in speed and accuracy are discussed.

Algorithms↗
PubMed1991

An efficient program for computing conditional maximum likelihood estimates and exact confidence limits for a common odds ratio.

This paper describes a method and associated computer program for calculating exact confidence limits and P values, along with the conditional maximum likelihood estimate of the common odds ratio for a series of 2 x 2 tables. The program can be used to calculate exact estimates for matched data and is considerably faster than others currently available.

Algorithms↗
PubMed2003

EXCAVATOR: a computer program for efficiently mining gene expression data.

Massive amounts of gene expression data are generated using microarrays for functional studies of genes and gene expression data clustering is a useful tool for studying the functional relationship among genes in a biological process. We have developed a computer package EXCAVATOR for clustering gene expression profiles based on our new framework for representing gene expression data as a minimum spanning tree. EXCAVATOR uses a number of rigorous and efficient clustering algorithms. This program has a number of unique features, including capabilities for: (i) data- constrained clustering; (ii) identification of genes with similar expression profiles to pre-specified seed genes; (iii) cluster identification from a noisy background; (iv) computational comparison between different clustering results of the same data set. EXCAVATOR can be run from a Unix/Linux/DOS shell, from a Java interface or from a Web server. The clustering results can be visualized as colored figures and 2-dimensional plots. Moreover, EXCAVATOR provides a wide range of options for data formats, distance measures, objective functions, clustering algorithms, methods to choose number of clusters, etc. The effectiveness of EXCAVATOR has been demonstrated on several experimental data sets. Its performance compares favorably against the popular K-means clustering method in terms of clustering quality and computing time.

Algorithms↗
PubMed1996

Using the telephone interview for evaluation of baccalaureate nursing programs.

Efficient use of the telephone is certainly relevant in the 20th century telecommunication age. A 20- to 30-minute phone call allows for interactive communication between the nurse educators and those who hire their graduates. Important information can be quickly obtained for assessing the outcomes of curriculum related to the perceived quality of nurse graduates practicing in various health care settings. This interview method was found to be efficient, convenient, and facilitated dynamic interchange. Feedback from respondents varied in their familiarity with the graduates and programs.

Clinical Competence↗