1000 resultados para administracion regional
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A conductometric micromethod combined with image analysis system has been developed allowing to determine the CO2 production within 'two-dimensional' tissues, i.e., flat and thin cell layers or epithelial sheets. The preparation was mounted into an airtight chamber separated in two compartments by a thin silicone membrane permeable to gases. The lower compartment contained the nutritive medium and the preparation. The upper compartment and a conductivity measuring capillary connected in series were perfused with a solution of Ba(OH)2. The CO2 produced by the tissue precipitated as BaCO3 and the resulting decrease of electrical conductivity was linearly related to the total CO2 production. In addition, the pattern of CO2 production was directly observable as the BaCO3 crystals formed upon the silicone membrane over the regions which produced CO2. The spatial distribution of the crystals was quantified by video image processing and the regional CO2 production evaluated with a spatial resolution of 100 microns. This new microtechnique was originally developed to study the CO2 production in the early chick blastoderm which is a disc 1-5 cells thick. At the stage of young neurula the CO2 production was found to be 235 +/- 37 nmol.h-1 (mean +/- SD; n = 10) per blastoderm and large variations of local CO2 production were detected from one region to another (from 0.6 to 6.5 nmol.h-1.mm-2). These results indicate a high metabolic and functional differentiation of cells within the blastoderm. The possible applications and improvements of such a microtechnique are discussed.
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This thesis examines the local and regional scale determinants of biodiversity patterns using existing species and environmental data. The research focuses on agricultural environments that have experienced rapid declines of biodiversity during past decades. Existing digital databases provide vast opportunities for habitat mapping, predictive mapping of species occurrences and richness and understanding the speciesenvironment relationships. The applicability of these databases depends on the required accuracy and quality of the data needed to answer the landscape ecological and biogeographical questions in hand. Patterns of biodiversity arise from confounded effects of different factors, such as climate, land cover and geographical location. Complementary statistical approaches that can show the relative effects of different factors are needed in biodiversity analyses in addition to classical multivariate models. Better understanding of the key factors underlying the variation in diversity requires the analyses of multiple taxonomic groups from different perspectives, such as richness, occurrence, threat status and population trends. The geographical coincidence of species richness of different taxonomic groups can be rather limited. This implies that multiple geographical regions should be taken into account in order to preserve various groups of species. Boreal agricultural biodiversity and in particular, distribution and richness of threatened species is strongly associated with various grasslands. Further, heterogeneous agricultural landscapes characterized by moderate field size, forest patches and non-crop agricultural habitats enhance the biodiversity of rural environments. From the landscape ecological perspective, the major threats to Finnish agricultural biodiversity are the decline of connected grassland habitat networks, and general homogenization of landscape structure resulting from both intensification and marginalization of agriculture. The maintenance of key habitats, such as meadows and pastures is an essential task in conservation of agricultural biodiversity. Furthermore, a larger landscape context should be incorporated in conservation planning and decision making processes in order to respond to the needs of different species and to maintain heterogeneous rural landscapes and viable agricultural diversity in the future.
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BACKGROUND AND PURPOSE: Knowledge of cerebral blood flow (CBF) alterations in cases of acute stroke could be valuable in the early management of these cases. Among imaging techniques affording evaluation of cerebral perfusion, perfusion CT studies involve sequential acquisition of cerebral CT sections obtained in an axial mode during the IV administration of iodinated contrast material. They are thus very easy to perform in emergency settings. Perfusion CT values of CBF have proved to be accurate in animals, and perfusion CT affords plausible values in humans. The purpose of this study was to validate perfusion CT studies of CBF by comparison with the results provided by stable xenon CT, which have been reported to be accurate, and to evaluate acquisition and processing modalities of CT data, notably the possible deconvolution methods and the selection of the reference artery. METHODS: Twelve stable xenon CT and perfusion CT cerebral examinations were performed within an interval of a few minutes in patients with various cerebrovascular diseases. CBF maps were obtained from perfusion CT data by deconvolution using singular value decomposition and least mean square methods. The CBF were compared with the stable xenon CT results in multiple regions of interest through linear regression analysis and bilateral t tests for matched variables. RESULTS: Linear regression analysis showed good correlation between perfusion CT and stable xenon CT CBF values (singular value decomposition method: R(2) = 0.79, slope = 0.87; least mean square method: R(2) = 0.67, slope = 0.83). Bilateral t tests for matched variables did not identify a significant difference between the two imaging methods (P >.1). Both deconvolution methods were equivalent (P >.1). The choice of the reference artery is a major concern and has a strong influence on the final perfusion CT CBF map. CONCLUSION: Perfusion CT studies of CBF achieved with adequate acquisition parameters and processing lead to accurate and reliable results.
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This paper presents a regional analysis of the effects of educational policies implemented in Spain between 1992 and 2003, focusing specifically on school failure rates. We consider the impact of expenditure per pupil, class size, and pupil-teacher ratio on dropout rates at the end of compulsory education and on the proportion of early school-leavers in the 18-24 year age group. Our results indicate that higher levels of educational expenditure per pupil and lower class sizes and pupil-teacher ratios reduce rates of dropout and early school-leaving (although class-size is not always significant). However, the magnitude of the effects of these variables is small at the average level.
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Valtaosa eurooppalaisista yrityksistä on pk-yrityksiä, mutta tästä huolimatta seudullisen innovaatiopolitiikan vaikutusta juuri pk-yrityksiin on tutkittu melko vähän. Tämän tutkimuksen tarkoituksena on luoda yleiskuva pk-yritysten näkemykseen oman seutunsa innovaatiopolitiikasta viidellä EU:n alueella sijaitsevalla seudulla. Kirjallisuuden perusteella rakennettiin seudullista innovaatiopolitiikkaa kuvaava kysely, johon joukko pk-yrityksiä viideltä seudulta vastasi. Kyselyn tulokset kuvailtiin graafisesti, minkä lisäksi etsittiin vastauksiin vaikuttaneita tekijöitä ja yhteyksiä yritysten vastausten välillä. Tutkimus oli luonteeltaan lähinnä kvantitatiivinen. Tutkimus osoittaa, että seudullisessainnovaatiopolitiikassa on vielä paljon kehitettävää, jotta se tavoittaisi kattavasti pk-yritykset. Pk-yritysten tietoisuutta tulisi lisätä, sillä nämä eivät yleisesti ottaen näytä pitävän seudullista innovaatiopolitiikkaa menetykseen vaikuttavana tekijänä tai siihen liittyviä yhteistyömahdollisuuksia tärkeinä omalle toiminnalleen. Erot innovaatiotoiminnan seudullisessa roolissa tulivat esiin tuloksissa. Yritysten vastauksia selittäviä tekijöitä löydettiin, samoin yhteyksiä vastausten välillä, mutta varsinaisten johtopäätösten tekeminen edellyttänee laajempaa tutkimusta
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Background To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI). Methods Antipsychotic drugs dispensed for people older than 18 and processed by the Catalan Health Service during 2007 were retrospectively reviewed. First and second generation antipsychotic drugs (FGA and SGA) from the Anatomical Therapeutic Chemical classification (ATC) code N05A (except lithium) were included. A patient selection algorithm was designed to identify prescriptions regularly dispensed. Variables included were age, gender, antipsychotic type, route of administration and number of packages dispensed. Results A total of 117,811 patients were given any antipsychotic, of whom 71,004 regularly received such drugs. Among the latter, 9,855 (13.9%) corresponded to an antipsychotic combination, 47,386 (66.7%) to monotherapy and 13,763 (19.4%) to unspecified combinations. Of the patients given antipsychotics in association, 58% were men. Olanzapine (37.1%) and oral risperidone (36.4%) were the most common dispensations. Analysis of the patients dispensed two antipsychotics (57.8%) revealed 198 different combinations, the most frequent being the association of FGA and SGA (62.0%). Clozapine was dispensed to 2.3% of patients. Of those who were receiving antipsychotics in combination, 6.6% were given clozapine, being clozapine plus amisulpride the most frequent association (22.8%). A total of 3.800 patients (5.4%) were given LAI antipsychotics, and 2.662 of these (70.1%) were in combination. Risperidone was the most widely used LAI. Conclusions The scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients, as well as with the limited use of clozapine. Background To analyse the extent and profile of outpatient regular dispensation of antipsychotics, both in combination and monotherapy, in the Barcelona Health Region (Spain), focusing on the use of clozapine and long-acting injections (LAI). Methods Antipsychotic drugs dispensed for people older than 18 and processed by the Catalan Health Service during 2007 were retrospectively reviewed. First and second generation antipsychotic drugs (FGA and SGA) from the Anatomical Therapeutic Chemical classification (ATC) code N05A (except lithium) were included. A patient selection algorithm was designed to identify prescriptions regularly dispensed. Variables included were age, gender, antipsychotic type, route of administration and number of packages dispensed. Results A total of 117,811 patients were given any antipsychotic, of whom 71,004 regularly received such drugs. Among the latter, 9,855 (13.9%) corresponded to an antipsychotic combination, 47,386 (66.7%) to monotherapy and 13,763 (19.4%) to unspecified combinations. Of the patients given antipsychotics in association, 58% were men. Olanzapine (37.1%) and oral risperidone (36.4%) were the most common dispensations. Analysis of the patients dispensed two antipsychotics (57.8%) revealed 198 different combinations, the most frequent being the association of FGA and SGA (62.0%). Clozapine was dispensed to 2.3% of patients. Of those who were receiving antipsychotics in combination, 6.6% were given clozapine, being clozapine plus amisulpride the most frequent association (22.8%). A total of 3.800 patients (5.4%) were given LAI antipsychotics, and 2.662 of these (70.1%) were in combination. Risperidone was the most widely used LAI. Conclusions The scant evidence available regarding the efficacy of combining different antipsychotics contrasts with the high number and variety of combinations prescribed to outpatients, as well as with the limited use of clozapine.
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Background: The 1st Swiss federal Transplant Law was finally enforced in July 2007 with the obligation to promote quality and efficiency in transplant procedures. The LODP was created to develop organ and tissue donation in the Latin area of Switzerland covering seventeen hospitals (29% of the population).Methods: Each of the partner hospitals designated at least one Local Donor Coordinator (LDC), member of the Intensive Care team, trained in the organ donation (OD) process. The principal tasks of the LDC's are the introduction of OD procedures, organisation of educational sessions for hospital staff and execution of the Donor Action programme. The LODP has been operational since July 2009, when training of the LDC's was completed, the web-site and hotline activated and the attendance of Transplant Procurement Coordinators (TPC) during the OD process organised.Results: National and regional guidelines are accessible on the LODP website. The Hospital Attitude Survey obtained a 57% return rate. Many of the staff requested training and sessions are now running in the partner hospitals. The Medical Record Revue revealed an increase in the conversion rate from 3.5% to 4.5%. During the 5 years before creation of LODP the average annual number of utilised donors was 31, an increase of 70%, has since been observed.Conclusion: This clear progression in utilised donors in the past two years can be attributed to the fact that partner hospitals benefit from the various support given (hotline, website and from TPC's). Despite the increase in OD within the LODP the Swiss donation rates remain low, on average 11.9 donors per million population. This successful model should be applied throughout Switzerland, but the crucial point is to obtain financial support.
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The number of patients treated by haemodialysis (HD) is continuously increasing. The complications associated with vascular accesses represent the first cause of hospitalisation in these patients. Since 2001 nephrologists, surgeons, angiologists and radiologists at the CHUV are working to develop a multidisciplinary model that includes planning and monitoring of HD accesses. In this setting the echo-Doppler represents an important tool of investigation. Every patient is discussed and decisions are taken during a weekly multidisciplinary meeting. A network has been created with nephrologists of peripheral centres and other specialists. This model allows to centralize investigational information and coordinate patient care while keeping and even developing some investigational activities and treatment in peripheral centres.
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Valtaosa eurooppalaisista yrityksistä on pk-yrityksiä, mutta tästä huolimatta seudullisen innovaatiopolitiikan vaikutusta juuri pk-yrityksiin on tutkittu melko vähän. Tämän tutkimuksen tarkoituksena on luoda yleiskuva pk-yritysten näkemykseen oman seutunsa innovaatiopolitiikasta viidellä EU:n alueella sijaitsevalla seudulla. Kirjallisuuden perusteella rakennettiin seudullista innovaatiopolitiikkaa kuvaava kysely, johon joukko pk-yrityksiä viideltä seudulta vastasi. Kyselyn tulokset kuvailtiin graafisesti, minkä lisäksi etsittiin vastauksiin vaikuttaneita tekijöitä ja yhteyksiä yritysten vastausten välillä. Tutkimus oli luonteeltaan lähinnä kvantitatiivinen. Tutkimus osoittaa, että seudullisessa innovaatiopolitiikassa on vielä paljon kehitettävää, jotta se tavoittaisi kattavasti pk-yritykset. Pk-yritysten tietoisuutta tulisi lisätä, sillä nämä eivät yleisesti ottaen näytä pitävän seudullista innovaatiopolitiikkaa menetykseen vaikuttavana tekijänä tai siihen liittyviä yhteistyömahdollisuuksia tärkeinä omalle toiminnalleen. Erot innovaatiotoiminnan seudullisessa roolissa tulivat esiin tuloksissa. Yritysten vastauksia selittäviä tekijöitä löydettiin, samoin yhteyksiä vastausten välillä, mutta varsinaisten johtopäätösten tekeminen edellyttänee laajempaa tutkimusta.
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The end of this paper is to offer a Planning Project aimed to the prospective museum of the Rif society. The authors, unaware of the actual purpose of both political and cultural institutions, which eventually will decide about the museum and its location, just want to attract the attention of those responsible for some aspects and the chronological periods that the Planning Project must take into account to assure the success of this new Riffian cultural institution.
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BACKGROUND: Predicting outcome of breast cancer (BC) patients based on sentinel lymph node (SLN) status without axillary lymph node dissection (ALND) is an area of uncertainty. It influences the decision-making for regional nodal irradiation (RNI). The aim of the NORA (NOdal RAdiotherapy) survey was to examine the patterns of RNI. METHODS: A web-questionnaire, including several clinical scenarios, was distributed to 88 EORTC-affiliated centers. Responses were received between July 2013 and January 2014. RESULTS: A total of 84 responses were analyzed. While three-dimensional (3D) radiotherapy (RT) planning is carried out in 81 (96%) centers, nodal areas are delineated in only 51 (61%) centers. Only 14 (17%) centers routinely link internal mammary chain (IMC) and supraclavicular node (SCN) RT indications. In patients undergoing total mastectomy (TM) with ALND, SCN-RT is recommend by 5 (6%), 53 (63%) and 51 (61%) centers for patients with pN0(i+), pN(mi) and pN1, respectively. Extra-capsular extension (ECE) is the main factor influencing decision-making RNI after breast conserving surgery (BCS) and TM. After primary systemic therapy (PST), 49 (58%) centers take into account nodal fibrotic changes in ypN0 patients for RNI indications. In ypN0 patients with inner/central tumors, 23 (27%) centers indicate SCN-RT and IMC-RT. In ypN1 patients, SCN-RT is delivered by less than half of the centers in patients with ypN(i+) and ypN(mi). Twenty-one (25%) of the centers recommend ALN-RT in patients with ypN(mi) or 1-2N+ after ALND. Seventy-five (90%) centers state that age is not considered a limiting factor for RNI. CONCLUSION: The NORA survey is unique in evaluating the impact of SLNB/ALND status on adjuvant RNI decision-making and volumes after BCS/TM with or without PST. ALN-RT is often indicated in pN1 patients, particularly in the case of ECE. Besides the ongoing NSABP-B51/RTOG and ALLIANCE trials, NORA could help to design future specific RNI trials in the SLNB era without ALND in patients receiving or not PST.
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Las revueltas en el Maghreb y Mashrek entre otras consecuencias han promovido la diversificación de actores en el área mediterránea, de manera que la UE ya no es el único vecino con intereses en la región. Turquía, el eterno candidato a la adhesión, ha sido designada por académicos y políticos como un modelo de Estado secular y multipartidista donde la separación entre la religión y la política representa uno de sus pilares constitucionales. Además, el Primer Ministro Recep Tayyip Erdogan se ha erigido como un líder en la región Mediterránea debido al viraje de la política turca de asuntos exteriores. En otros términos, Turquía ya no es un país completamente aliado del mundo occidental para los árabes, sino que ha asumido su responsabilidad en la escena global. Sin embargo, dicha determinación se ha alcanzado a través de actuar como un poder blando asumiendo como propio la máxima aportación europea a las relaciones internacionales.