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Delivery Program (delivery + program)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

First Experiences for Pulmonary Vein Isolation with the High-Density Mesh Ablator (HDMA): A Novel Mesh Electrode Catheter for Both Mapping and Radiofrequency Delivery in a Single Unit

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 4 2009
AXEL MEISSNER M.D.
Background: Interventional therapy of atrial fibrillation (AF) is often associated with long examination and fluoroscopy times. The use of mapping catheters in addition to the ablation catheter requires multiple transseptal sheaths for left atrial access. Objectives: The purpose of this prospective study was to evaluate feasibility and safety of pulmonary vein (PV) isolation using the high-density mesh ablator (HDMA), a novel single, expandable electrode catheter for both mapping and radiofrequency (RF) delivery at the left atrium/PV junctions. Methods: Twenty-six patients with highly symptomatic paroxysmal AF (14, 53.8%) and persistent AF (12, 46.2%) were studied. Segmental PV isolation via the HDMA was performed using a customized pulsed RF energy delivery program (target temperature 55,60°C, power 70,100 W, 600,900 seconds RF application time/PV). Results: All 104 PVs in 26 patients could be ablated by the HDMA. Segmental PV isolation was achieved with a mean of 3.25 ± 1.4 RF applications for a mean of 603 ± 185 seconds. Entrance conduction block was obtained in 94.2% of all PV. The mean total procedure and fluoroscopy time was 159.0 ± 32 minutes and 33.5 ± 8.6 minutes, respectively. None of the patients experienced severe acute complications. After 3 months no PV stenosis was observed, and 85.6% and 41.6% of the patients with PAF and persistent AF, respectively, did not report symptomatic AF. Conclusions: In this first study of PV isolation using the HDMA, our findings suggest that this method is safe and yields good primary success rates. The HDMA simplifies AF ablation, favorably impacting procedure and fluoroscopy times. [source]

DEVELOPMENT OF ORAL HEALTH TRAINING FOR RURAL AND REMOTE ABORIGINAL HEALTH WORKERS

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2001
Tom Pacza
Abstract: Research data exists that highlight the discrepancy between the medical/dental status experienced by Aboriginal people compared with that of their non-Aboriginal counterparts. This, coupled with a health system that Aboriginal people often find alienating and difficult to access, further exacerbates the many health problems they face. Poor oral health and hygiene is an issue often overlooked that can significantly impact on a person's quality of life. In areas where Aboriginal people find access to health services difficult, the implementation of culturally acceptable forms of primary health care confers significant benefits. The Aboriginal community has seen that the employment and training of Aboriginal health workers (AHW), particularly in rural and remote regions, is significantly beneficial in improving general health. In the present study, an oral health training program was developed and trialed. This training program was tailored to the needs of rural and remote AHWs. The primary objective was to institute a culturally appropriate basic preventative oral health delivery program at a community level. It is envisaged that through this dental training program, AHWs will be encouraged to implement long-term preventive measures at a local level to improve community dental health. They will also be encouraged to pursue other oral health-care delivery programs. Additionally, it is considered that this project will serve to strengthen a trust-based relationship between Aboriginal people and the health-care profession. [source]

STOCK LEVELS AND DELIVERY RATES IN VENDORMANAGED INVENTORY PROGRAMS

PRODUCTION AND OPERATIONS MANAGEMENT, Issue 1 2001
BEN A. CHAOUCH
Using the latest information technology, powerful retailers like Wal-Mart have taken the lead in forging shorter replenishment-cycles, automated supply systems with suppliers. With the objective to reduce cost, these retailers are directing suppliers to take full responsibility for managing stocks and deliveries. Suppliers' performance is measured according to how often inventory is shipped to the retailer, and how often customers are unable to purchase the product because it is out of stock. This emerging trend also implies that suppliers are absorbing a large part of the inventory and delivery costs and, therefore, must plan delivery programs including delivery frequency to ensure that the inherent costs are minimized. With the idea to incorporate this shift in focus, this paper looks at the problem facing the supplier who wants quicker replenishment at lower cost. In particular, we present a model that seeks the best trade-off among inventory investment, delivery rates, and permitting shortages to occur, given some random demand pattern for the product. The process generating demand consists of two components: one is deterministic and the other is random. The random part is assumed to follow a compound Poisson process. Furthermore, we assume that the supplier may fail to meet uniform shipping schedules, and, therefore, uncertainty is present in delivery times. The solution to this transportationinventory problem requires determining jointly delivery rates and stock levels that will minimize transportation, inventory, and shortage costs. Several numerical results are presented to give a feel of the optimal policy's general behavior. [source]