ETHIOPIA: Tigray Access Problems

In February 2008 a multidisciplinary study group was established in Germany to improve the treatment of patients with potential vascular access problems. As one of the first results of their work interdisciplinary recommendations for the management of vascular access were provided, from the creation of the initial access to the treatment of complications. As a rule the wrist arteriovenous fistula (AVF) is the access of choice due to its lower complication rate when compared to other types of access. The AVF should be created 3 months prior to the expected start of haemodialysis to allow for sufficient maturation. Second and third choice accesses are arteriovenous grafts (AVG) and central venous catheters (CVC). Ultrasound is a reliable tool for vessel selection before access creation, and also for the diagnosis of complications in AVF and grafts. Access stenosis and thrombosis can be treated surgically and interventionally. The comparison of both methods reveals advantages and disadvantages for each. The therapeutic decision should be based on the individual patients constitution, and also on the availability and experience of the involved specialists.

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Lexical Access Problems Lead to Disfluencies in Speech

Experimental Psychology (formerly Zeitschrift für Experimentelle Psychologie) ◽

10.1027/1618-3169/a000021 ◽

2010 ◽

Vol 57 (3) ◽

pp. 169-177 ◽

Cited By ~ 30

Author(s):

Robert J. Hartsuiker ◽

Lies Notebaert

Keyword(s):

Lexical Access ◽

Picture Naming ◽

Language Production ◽

Line Drawings ◽

Name Agreement ◽

Access Problems ◽

Agreement Condition

A picture naming experiment in Dutch tested whether disfluencies in speech can arise from difficulties in lexical access. Speakers described networks consisting of line drawings and paths connecting these drawings, and we manipulated picture name agreement. Consistent with our hypothesis, there were more pauses and more self-corrections in the low name agreement condition than the high name agreement condition, but there was no effect on repetitions. We also considered determiner frequency. There were more self-corrections and more repetitions when the picture name required the less frequent (neuter-gender) determiner “het” than the more frequent (common-gender) determiner “de”. These data suggest that difficulties in distinct stages of language production result in distinct patterns of disfluencies.

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Therapeutic Plasma Exchange Application in Children Requires Individual Decision

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1714098 ◽

2020 ◽

Author(s):

Gürkan Atay ◽

Demet Demirkol

Keyword(s):

Plasma Exchange ◽

Vascular Access ◽

Pediatric Patients ◽

Demyelinating Disease ◽

Pediatric Intensive Care ◽

Therapeutic Plasma Exchange ◽

Transplantation Rejection ◽

Access Problems ◽

Uremic Syndrome

AbstractTherapeutic plasma exchange (TPE) is a treatment administered with the aim of removing a pathogenic material or compound causing morbidity in a variety of neurologic, hematologic, renal, and autoimmune diseases. In this study, we aimed to assess the indications, efficacy, reliability, complications, and treatment response of pediatric patients for TPE. This retrospective study analyzed data from 39 patients aged from 0 to 18 years who underwent a total of 172 TPE sessions from January 2015 to April 2018 in a tertiary pediatric intensive care unit. Indications for TPE were, in order of frequency, macrophage activation syndrome (28.2%, n = 11), renal transplantation rejection (15.4%, n = 6), liver failure (15.4%, n = 6), Guillain–Barre's syndrome (15%, n = 6), hemolytic uremic syndrome (7.7%, n = 3), acute demyelinating disease (7.7%, n = 3), septic shock (5.1%, n = 2), and intoxication (5.1%, n = 2). No patient had any adverse event related to the TPE during the procedure. The TPE session was ended prematurely in one patient due to insufficient vascular access and lack of blood flow (2.6%). In the long term, thrombosis due to the indwelling central catheter occurred (5.1%, n = 2). TPE appears to be an effective first-stage or supplementary treatment in a variety of diseases, may be safely used in pediatric patients, and there are significant findings that its area of use will increase. In experienced hands and when assessed carefully, it appears that the rate of adverse reactions and vascular access problems may be low enough to be negligible.

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Can Rural Telemedicine Help to Solve the Health Care Access Problems in Turkey?

Clinical Research and Regulatory Affairs ◽

10.1081/crp-120018747 ◽

2003 ◽

Vol 20 (1) ◽

pp. 117-126 ◽

Cited By ~ 1

Author(s):

Cenk Sozen ◽

Adnan Kisa ◽

Sahin Kavuncubasi

Keyword(s):

Health Care ◽

Health Care Access ◽

Care Access ◽

Access Problems

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Discussion of “Survey of Ground-Access Problems at Airports”

Transportation Engineering Journal of ASCE ◽

10.1061/tpejan.0000059 ◽

1969 ◽

Vol 95 (4) ◽

pp. 706-707

Author(s):

Johannes W. Kurz

Keyword(s):

Access Problems

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Data access problems with ESSD-2018-60

10.5194/essd-2018-60-ec1 ◽

2018 ◽

Author(s):

David Carlson

Keyword(s):

Data Access ◽

Access Problems

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Preservation of vascular access.

Journal of the American Society of Nephrology ◽

10.1681/asn.v44997 ◽

1993 ◽

Vol 4 (4) ◽

pp. 997-1003

Author(s):

J L Porile ◽

M Richter

Keyword(s):

Vascular Access ◽

Venous Pressure ◽

Graft Loss ◽

Laboratory Evaluation ◽

Dialysis Access ◽

New Techniques ◽

Lower Complication ◽

Lower Complication Rate ◽

Access Problems

Preservation of vascular access is critical in the long-term successful management of hemodialysis patients. Dialysis access abnormalities are the most common cause of hospitalization in this patient group, and access problems can increase the morbidity and cost involved in the care of these patients. Native fistulas are preferable to synthetic grafts because of longer survival and a lower complication rate. Venous outflow stenosis is the most common site of obstruction in a failing graft. The pathophysiology of access failure is poorly understood, but it seems to be related to intimal hyperplasia in the native vessel downstream from the anastomosis. The stimulation of local growth factors by needle puncture may also play a role. An assessment of access adequacy includes careful physical examination, laboratory evaluation, and ultimately, angiography. Measurements of recirculation and venous pressure are commonly used to screen for access dysfunction, and their appropriate use will lower the incidence of graft loss in dialysis units. Treatment is usually either angioplasty or surgery, with some centers having success with thrombolytic therapy. New techniques such as atherectomy and stent placement may prove to be beneficial, but this requires further study.

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Diseño de Nuevos Materiales para la Formación de Intérpretes en el Ámbito Sanitario (Especialidad: Español - Chino)

FITISPos International Journal ◽

10.37536/fitispos-ij.2016.3.0.109 ◽

2016 ◽

Vol 3 ◽

pp. 195-202

Author(s):

Xi Wang

Keyword(s):

Healthcare System ◽

Chinese Language ◽

Chinese Migrants ◽

Training Materials ◽

Medical Interpreters ◽

Access Problems ◽

Spanish Healthcare System ◽

Training Professional

Resumen: En los últimos años, han llegado abundantes extranjeros a España importando sus lenguas y culturas, de los cuales muchos son de origen chino. Teniendo en cuenta las grandes distancias lingüísticas y culturales que existen entre dicha población y la población mayoritaria en el país de acogida, surgen problemas específicos cuando acuden al servicio sanitario. Ante esta situación actual la formación de intérpretes profesionales en el ámbito sanitario es un tema urgente. Los materiales para la formación en interpretación en el ámbito sanitario se caracterizan, hoy en día, por su escasez en comparación con otros ámbitos profesionales y, más aún, en la combinación lingüística español-chino. El uso de materiales adecuados puede promover el desarrollo de la formación y, en consecuencia, la profesionalización de la interpretación en el ámbito sanitario. Para llevar a cabo el trabajo, se han analizado los materiales existentes y descrito las competencias requeridas por la profesión, con el fin de identificar los aspectos más relevantes de la formación en la interpretación en el ámbito sanitario, en general, como los de la combinación lingüística y cultural, en particular, proponiendo criterios que se pueden aplicar en el diseño de nuevos materiales.Abstract: In recent years, the number of immigrants in Spain has increased considerably, particularly those who come from China. Due to the differences and distance between Spanish and Chinese languages and cultures, serious access problems arise when Chinese migrants want to use the Spanish healthcare system. In this case, the importance of training professional medical interpreters is particularly important. Compared with other professions, materials available to medical interpreters are scarce, even more regarding the Spanish-Chinese language combination. Suitable materials contribute to promote the development of quality training, so as to achieve the purpose of advancing the process of professionalisation. An analysis about the existing materials has been performed and the competences students need to achieve have been described. The ultimate goal of this analysis is to provide criteria for the design of training materials for Spanish-Chinese medical interpreters.

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