837 resultados para Access peritoneal


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Transparency is now seen as a key tool of democratic governance. The European Union's commitment to transparency is now at the centre of a crucial debate between the Commission and the Parliament on the future of citizen's right of access to information. This article presents the main characteristics of the current regime and questions the pertinence of the proposed changes in light of the international drive at modernising access to information laws and the attempt at identifying the ̳proper limits of transparency'. The questions raised range from the identification of what can be accessed to the definition of exemption and the protection of competing interests.

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OBJECTIVES: To assess the performance of 45F vs. 36F smartcanula in CPB with gravity drainage alone. METHODS: Twenty patients were randomly assigned to two groups receiving for venous drainage a smartcanula which is collapsed over a mandrel for trans-atrial insertion into the inferior vena cava and expanded in situ to either 45F or 36F. RESULTS: Valve replacement/repair was realized in 7/10 and/or CABG in 6/10 for 36F (69+/-13 years) vs. 5/10 and 5/10, respectively, for 45F (63+/-11 years: NS). Body weight and surface area (BSA) were 83+/-9 kg (1.9+/-0.2 m2, max 2.2 m2) for 36F vs. 79+/-6 kg: NS (1.9+/-0.1 m2 (NS), max 2.1 m2) for 45F. Insertion and access orifice diameter (area) was 6 mm and 10 mm (78.5 mm2) for the 36F vs. 6 mm and 13 mm (132 mm2) for the 45F (+69%). Calculated target pump flow (2.4 l/min/m2) was 4.7+/-0.4 l/min for 36F vs. 4.5+/-0.3 l/min for 45F. Achieved pump flow accounted for 5.0+/-0.3 l/min for 36F (8% above target) vs. 4.8+/-0.3 l/min for 45F (8% above target): NS. The water balance during the pump run (clear volume added minus hemofilter and urine output) was 2.2+/-0.3 l for 36F vs. 2.0 l for 45F: NS. CONCLUSION: Due to its 'open' wall (the vena cava provides the seal), its reduced wall thickness (range: 0.0-0.4 mm), and its self-expanding design, the 36F smartcanula requiring a 30F access orifice has sufficient drainage capacity by gravity alone for full CPB in adults with a BSA up to 2.2 mm2.

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According to Iowa crash records, almost 10% of all crashes in Iowa occur at commercial driveways. Most of these crashes occur on arterials within municipalities. In recent years, nearly a quarter of these crashes have occurred in the Des Moines metropolitan area. This makes the Des Moines metropolitan area a prime candidate for improved access management. Case study research in Iowa has shown that access management is an extremely effective highway safety tool—well-managed routes are, on average, 40% safer than poorly managed routes. The Des Moines metropolitan area has many miles of four-lane, undivided arterials constructed when less was known about the importance of managing access to adjacent land development. This project involved a cooperative effort of the Des Moines Area Metropolitan Planning Organization (Des Moines Area MPO) and the Center for Transportation Research and Education (CTRE) at Iowa State University to develop a comprehensive access management study and program for the Des Moines metropolitan area. The goal of the study is to use the knowledge developed to make improvements that will reduce access-related crashes. It is also anticipated that this project will help local officials make better decisions about access management so that future safety and operational problems can be avoided.

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This research project was intended to produce a strategy for addressing current and future access management problems on state highway routes located just outside urban areas that serve as major routes for commuting into and out of major employment centers in Iowa. There were two basic goals: (1) to develop a ranking system for identifying high-priority segments for access management treatments on primary highways outside metro and urban areas and (2) to focus efforts on routes that are major commuting routes at present and in the future. The project focused on four-lane expressways and two-lane arterials most likely to serve extensive commuter traffic. Available spatial and statistical data were used to identify existing and possible future problem corridors with respect to access management. The research team developed a scheme for ranking commuter routes based on their need for attention to access management. This project was able to produce rankings for corridors based on a variety of factors, including proportion of crashes that appear to be access-related, severity of those crashes, and potential for improvement along corridors. Frequency and loss were found to be highly rank correlated; because of this, these indicators were not used together in developing final priority rankings. Most of the highest ranked routes are on two-lane rural cross sections, but a few are four-lane expressways with at-grade private driveways and public road intersections. The most important conclusion of the ranking system is that many of the poor-performing corridors are located in a single Iowa Department of Transportation district near two urban areas--Des Moines and Ames. A comprehensive approach to managing access along commuting corridors should be developed first in this district since the potential benefits would be highest in that region.

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Cocaine-induced neuroadaptation of stress-related circuitry and increased access to cocaine each putatively contribute to the transition from cocaine use to cocaine dependence. The present study tested the hypothesis that rats receiving extended versus brief daily access to cocaine would exhibit regional differences in levels of the stress-regulatory neuropeptide corticotropin-releasing factor (CRF). A secondary goal was to explore how CRF levels change in relation to the time since cocaine self-administration. Male Wistar rats acquired operant self-administration of cocaine and were assigned to receive daily long access (6 hours/day, LgA, n = 20) or short access (1 hour/day, ShA, n = 18) to intravenous cocaine self-administration (fixed ratio 1, ∼0.50 mg/kg/infusion). After at least 3 weeks, tissue CRF immunoreactivity was measured at one of three timepoints: pre-session, post-session or 3 hours post-session. LgA, but not ShA, rats showed increased total session and first-hour cocaine intake. CRF immunoreactivity increased within the dorsal raphe (DR) and basolateral, but not central, nucleus of the amygdala (BLA, CeA) of ShA rats from pre-session to 3 hours post-session. In LgA rats, CRF immunoreactivity increased from pre-session to 3 hours post-session within the CeA and DR but tended to decrease in the BLA. LgA rats showed higher CRF levels than ShA rats in the DR and, pre-session, in the BLA. Thus, voluntary cocaine intake engages stress-regulatory CRF systems of the DR and amygdala. Increased availability of cocaine promotes greater tissue CRF levels in these extrahypothalamic brain regions, changes associated here with a model of cocaine dependence.

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The Iowa Department of Transportation's Access Management Task Force was established as part of the Iowa Department of Transportation's overall Safety Management System (SMS) effort. The goal of the Access Management Task Force is to develop a program designed to educate and market the concept and benefits of access management to landowners and developers, professional planners and engineers, planning and zoning staff members, appointed and elected officials, and motorists. Access management is pursued through the design and control of driveways, curb cuts, turning movements, interior circulation of parking lots, and public street connections and intersections. Usually, state highways or major urban and suburban arterial streets are the targets of access management projects. Access management is also a concern on main county roads when there is a transition from a rural environment to a town or city.

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The Department on Human Services (DHS) carefully considered how to transition Medicaid services to managed care while creating stability for both members and providers.

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Access management involves balancing the dual roles that roadways must play - through travel and access to property and economic activity. When these roles are not in proper balance, the result is a roadway system that functions sub-optimally. Arterial routes that have a too high driveway density and provide overly extensive access to property have high crash rates and begin to suffer in terms of traffic operations. Such routes become congested, delays increase, and mean travel speeds decline. The Iowa access management research and awareness project has had four distinct phases. Phase I involved a detailed review of the extensive national access management literature so lessons learned elsewhere could be applied in Iowa. In Phase II original case study research was conducted in Iowa. Phase III of the project concentrated on outreach and education about access management. Phase IV of the Iowa access management project extended the work conducted during Phases II and III. The main work products for Phase IV were as follows: 1) three additional before and after case studies, illustrating the impacts of various access management treatments on traffic safety, traffic operations, and business vitality; 2) an access management handbook aimed primarily at local governments in Iowa; 3) a modular access management toolkit with brief descriptions of various access management treatments and considerations; and 4) an extensive outreach plan aimed at getting the results of Phases I through IV of the project out to diverse audiences in Iowa and elsewhere.

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Access to Recovery - Iowa (ATR) is a three year grant awarded to the Iowa Department of Public Health (IDPH) by the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA) in October 2014. ATR provides funding to individuals to purchase services and supports linked to their recovery from substance abuse. ATR emphasizes client choice and increases the array of available community-based services, supports, and providers.

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Les travailleuses du sexe constituent un groupe hétérogène qui cumule les facteurs de vulnérabilité, comme l'instabilité géographique, la migration forcée, les addictions et la précarité du permis de séjour. Leur accès aux soins dépend notamment des lois régissant le "marché du sexe" et de la politique migratoire du pays d'accueil. Dans cet article, nous passons en revue diverses stratégies sanitaires européennes destinées à ce groupe vulnérable et présentons les résultats préliminaires d'une étude pilote réalisée auprès de 50 travailleuses du sexe pratiquant dans les rues de Lausanne. Les résultats sont préoccupants : 56% n'ont pas d'assurance maladie, 96% sont migrantes et 66% sans permis de séjour. Ces résultats préliminaires devraient sensibiliser les décideurs politiques à améliorer l'accès aux soins des travailleuses du sexe. [Abstract] Sex workers constitute a heterogeneous group possessing a combination of vulnerability factors such as geographical instability, forced migration, substance addiction and lack of legal residence permit. Access to healthcare for sex workers depends on the laws governing the sex market and on migration policies in force in the host country. In this article, we review different European health strategies established for sex workers, and present preliminary results of a pilot study conducted among 50 sex workers working on the streets in Lausanne. The results are worrying: 56% have no health insurance, 96% are migrants and 66% hold no legal residence permit. These data should motivate public health departments towards improving access to healthcare for this vulnerable population.

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Tríptic informatiu sobre la publicació de documents amb accés obert en el repositori institucional de la UOC, O2 (La Oberta en obert). Aquest informa sobre quins documents hi poden publicar els membres de la comunitat UOC, com fer-ho i els serveis de valor afegit per a tots els usuaris (web 2.0, subscripció per RSS o correu electrònic, exportació al gestor bibliogràfic Refworks, etc.) i per a la recerca (lligam amb l'aplicació d'avaluació de la recerca GIR i informació del factor d'impacte de la revista a SCOPUS, IN-RECS/IN-RECJ i MIAR).