625 resultados para Providence


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Dans cet article, nous analysons les changements de l' Etat-providence suédois a l' exemple des services municipaux de soins pour personnes agées. On montre qu'il est possible de tracer des processus de transformation à trois niveaux. Analysées comme phénomènes complèmentaires cela montre à quelle envergure les pratiques administratives sont devenues le lieu primordial de la mise en forme de l' Etat-providence. L'incorporation du managérialisme, comme mode prévalent de gouvernance et d'organisation de services et des politiques sociales mène a la conclusion qu'on devient temoin d'une transformation d' un regime (d Etat-providence) moral et politique à un regime administratif. Dans le dernier paragraphe, nous argumentons que cette transformation affaiblit la citoyenneté sociale et transfère les valeurs et principes de la politique sociale a la sphère administrative. Nous argumentons dès lors que cette perspective analytique a des implications plus larges pour la charactérization des “Welfare regimes” et pour l'analyse des différences transnationales.

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OBJECTIVES We sought to evaluate the strategy success and short term clinical outcomes of direct stenting via 5 French (F) diagnostic catheters using a novel bare metal stent with integrated delivery system (IDS) (Svelte Medical Systems, New Providence, NJ) and compare the results to a conventionally treated matched group. METHODS Fifteen consecutive patients with lesions deemed suitable for direct stenting using a bare metal stent were included. The primary endpoint was the strategy success defined as the ability to successfully treat a target lesion via a 5 F diagnostic catheter with a good angiographic result (TIMI III flow, residual stenosis ≤20%). Procedure and fluoroscopy times, contrast agent use, cost, and short-term clinical outcomes were compared to a matched group treated via conventional stenting. RESULTS The primary endpoint was reached in 14/15 patients (93%). There were no significant differences in procedural (58.6 min ± 12.7 vs. 57.4 min ± 14.2) or fluoroscopy times (10.0 min ± 4.3 vs.10.1 min ± 3.9) or contrast agent use (193.7 ml ± 54.8 vs. 181.4 ml ± 35.6). However, there were significant reductions in materials used in the study group compared to the control group equating to cost savings of almost US $600 per case (US $212.44 ± 258.09 vs. US $804.69 ± 468.11; P = 0.001). CONCLUSIONS Direct stenting using a novel bare metal stent with an IDS via 5 F diagnostic catheters is a viable alternative to conventional stenting in selected patients and is associated with significant cost savings.

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Catches of leptocephali of shelf and slope marine eels of the Chlopsidae, Congridae, Moringuidae, Muraenidae, and Ophichthidae collected during a survey in the southwestern Sargasso Sea in late September and early October 1984 were analyzed to learn about their reproductive ecology and larval transport. Sampling along a transect from the Florida Current (FC) out across the southwestern Sargasso Sea and in the Northwest Providence Channel (NWPC) of the Northern Bahamas enabled the evaluation of the larval distributions, abundances and size ranges, regional assemblage structure, and the apparent spawning areas of these marine eels. Distinctly different assemblages observed in the FC and NWPC included the congrid genera Heteroconger, Paraconger, Uroconger, and many ophichthid species, which were rare or absent offshore. Other taxa of congrids, chlopsids, muraenids and moringuids were present in all areas, but the smallest specimens of most taxa were only caught at the NWPC or FC stations. Multivariate analyses reflected higher richness and abundance in the FC and NWPC and also similar species compositions in offshore areas. The patterns of distribution of these leptocephali differed from those of anguillid, nettastomatid, and mesopelagic eel leptocephali collected in the same survey. These findings support the hypothesis that most taxa of marine eels spawn close to their adult habitats, and indicate that despite high biodiversity of marine eels in the Northern Bahamas, only some species of leptocephali appear to get transported far offshore by ocean currents.

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Petrographic descriptions and stable oxygen and carbon isotope compositions of microsamples of Campanian-age sediment gravity-flow deposits from Northeast Providence Channel, Bahamas, indicate deep-marine cementation of shallow-marine skeletal grains that were transported to the channel during the Late Cretaceous. Shallow-marine components are represented by mollusks, especially rudists, and shallow-water benthic foraminifers as well as sparse echinoderm and algal grains. The sole evidence of diagenesis in shallow-marine environments consists of micrite envelopes around skeletal grains. Shallow-marine skeletal grains have mean stable isotope values of -3.1 per mil d18O and +2.6 per mil d13C. The d18O values are consistent with precipitation in equilibrium with warm (20°-30°C), shallow-marine water. Deep-marine components are represented by equant calcite spar cements and rip-up clasts of slope sediments. Spar cements, exhibiting hexagonal morphology with scalenohedral terminations, most commonly occur as thin isopachous linings in the abundant porosity. Deep-marine cements have mean stable isotope values of - 1.1 per mil d18O and +2.7 per mil d13C. Deep-marine cements are 18O-enriched relative to shallow-marine skeletal grains, consistent with precipitation in equilibrium with colder (10°-20°C), deep-marine waters. The cement .source during lithification appears to have been dissolution of aragonite and high-magnesium calcite skeletal grains, which made up part of the transported sediment. Interbedded periplatform ooze remains uncemented, or poorly cemented, probably because of lower permeability. Equant spar cements that occur in gravity-flow deposits recovered from Hole 634A have stable isotope compositions similar to spars in Lower and mid-Cretaceous shallow-water limestones exposed on the Bahama Escarpment, to Campanian-Paleocene deep-marine hardgrounds recovered during DSDP Leg 15 in the Caribbean, and to spars in Aptian-Albian talus deposits at the base of the Campeche Escarpment recovered during DSDP Leg 77.