Manual de especificaciones y requisitos de nuevos productos y sistemas

Establiment d'especificacions i requisits tècnics per a l'adaptació i adequació dels diferents productes i sistemes obtinguts en l'informe d'avaluació de productes existents (*ST2.1.1).

Life-threatening versus non-life-threatening manual strangulation: are there appropriate criteria for MR imaging of the neck?

The aim of the study was to determine objective radiological signs of danger to life in survivors of manual strangulation and to establish a radiological scoring system for the differentiation between life-threatening and non-life-threatening strangulation by dividing the cross section of the neck into three zones (superficial, middle and deep zone). Forensic pathologists classified 56 survivors of strangulation into life-threatening and non-life-threatening cases by history and clinical examination alone, and two blinded radiologists evaluated the MRIs of the neck. In 15 cases, strangulation was life-threatening (27%), compared with 41 cases in which strangulation was non-life-threatening (73%). The best radiological signs on MRI to differentiate between the two groups were intramuscular haemorrhage/oedema, swelling of platysma and intracutaneous bleeding (all p = 0.02) followed by subcutaneous bleeding (p = 0.034) and haemorrhagic lymph nodes (p = 0.04), all indicating life-threatening strangulation. The radiological scoring system showed a sensitivity and specificity of approximately 70% for life-threatening strangulation, when at least two neck zones were affected. MRI is not only helpful in assessing the severity of strangulation, but is also an excellent documentation tool that is even admissible in court.

Intraobserver and interobserver variability of ascending aorta diameter as assessed with ECG-gated MDCT: automatic versus manual measurements

Purpose: Recently morphometric measurements of the ascending aorta have been done with ECG-gated MDCT to help the development of future endovascular therapies (TCT) [1]. However, the variability of these measurements remains unknown. It will be interesting to know the impact of CAD (computer aided diagnosis) with automated segmentation of the vessel and automatic measurements of diameter on the management of ascending aorta aneurysms. Methods and Materials: Thirty patients referred for ECG-gated CT thoracic angiography (64-row CT scanner) were evaluated. Measurements of the maximum and minimum ascending aorta diameters were obtained automatically with a commercially available CAD and semi-manually by two observers separately. The CAD algorithms segment the iv-enhanced lumen of the ascending aorta into perpendicular planes along the centreline. The CAD then determines the largest and the smallest diameters. Both observers repeated the automatic measurements and the semimanual measurements during a different session at least one month after the first measurements. The Bland and Altman method was used to study the inter/intraobserver variability. A Wilcoxon signed-rank test was also used to analyse differences between observers. Results: Interobserver variability for semi-manual measurements between the first and second observers was between 1.2 to 1.0 mm for maximal and minimal diameter, respectively. Intraobserver variability of each observer ranged from 0.8 to 1.2 mm, the lowest variability being produced by the more experienced observer. CAD variability could be as low as 0.3 mm, showing that it can perform better than human observers. However, when used in nonoptimal conditions (streak artefacts from contrast in the superior vena cava or weak lumen enhancement), CAD has a variability that can be as high as 0.9 mm, reaching variability of semi-manual measurements. Furthermore, there were significant differences between both observers for maximal and minimal diameter measurements (p<0.001). There was also a significant difference between the first observer and CAD for maximal diameter measurements with the former underestimating the diameter compared to the latter (p<0.001). As for minimal diameters, they were higher when measured by the second observer than when measured by CAD (p<0.001). Neither the difference of mean minimal diameter between the first observer and CAD nor the difference of mean maximal diameter between the second observer and CAD was significant (p=0.20 and 0.06, respectively). Conclusion: CAD algorithms can lessen the variability of diameter measurements in the follow-up of ascending aorta aneurysms. Nevertheless, in non-optimal conditions, it may be necessary to correct manually the measurements. Improvements of the algorithms will help to avoid such a situation.

Data Protection Manual (MS Word 461KB)

Departmental Data Protection manual

Departmental Grants Manual

Guidance on Management and Administration of Grant Making

La força de prensió manual com a factor pronòstic de mortalitat en pacients oncològics terminals a una unitat de cures pal•liatives.

L’objectiu de l’estudi va ser determinar si la força de prensió manual (FPM) era factor pronòstic de mortalitat en malalts amb càncer avançant ingressats a una Unitat de cures pal•liatives (UCP). Es va determinar la força de prensió a l’ingrés i l’evolució de la FPM els primers 12 dies mitjançant un dinamòmetre. Ni la FPM inicial ni a l’evolució va demostrar diferències significatives entre els malalts donats d’alta vius i els que van morir a la UCP. Conclusions: la determinació de FPM no va ser factor pronòstic de supervivència en malalts ingressats per càncer en una UCP.

Manual del aplicador de CO2 en cultivos hortícolas

Este manual se ha solicitado como parte del encargo que Iberdrola realizó al IRTA dentro del proyecto SOST-CO2, financiado por el programa CENIT (Consorcios Estratégicos Nacionales en Investigación Técnica), que forma parte del Programa Ingenio 2010, un proyecto del Gobierno español para incrementar la inversión en I+D, tanto pública como privada, con el objetivo de alcanzar en 2010 el 2% del PIB. El proyecto SOST-CO2 tiene como objetivo abordar el ciclo de vida completo del CO2, desde su captura en las fuentes de emisión pasando por su transporte, su almacenamiento y su valorización a gran escala. Se pretende enlazar la captura del CO2 con su posterior revalorización, buscando así una alternativa sostenible al mero confinamiento geológico de las emisiones. En el contexto del proyecto SOST-CO2, Iberdrola se planteó la utilización directa en horticultura intensiva de gases de combustión procedentes de sus plantas de ciclo combinado que utilizan gas natural como combustible, dado su contenido enriquecido en CO2, y encargó al IRTA su estudio. El objetivo general era, a parte de una importante fijación de carbono por parte de los cultivos, un elevado nivel de sostenibilidad ambiental por reducción de los inputs energéticos empleados en la climatización de los invernaderos y en la depuración de los gases. El trabajo se desarrolló a lo largo de cuatro años (2008-2011) en diversos escenarios experimentales. De las diferentes facetas que abarcó este trabajo, se presentan aquí las más directamente relacionadas con el principal resultado del estudio, es decir, la adecuación de los gases de combustión mencionados para obtener una mejora en la producción y rendimiento por su aplicación en horticultura intensiva.

Manual therapy followed by specific active exercises versus a placebo followed by specific active exercises on the improvement of functional disability in patients with chronic non specific low back pain: a randomized controlled trial.

BACKGROUND: Recent clinical recommendations still propose active exercises (AE) for CNSLBP. However, acceptance of exercises by patients may be limited by pain-related manifestations. Current evidences suggest that manual therapy (MT) induces an immediate analgesic effect through neurophysiologic mechanisms at peripheral, spinal and cortical levels. The aim of this pilot study was first, to assess whether MT has an immediate analgesic effect, and second, to compare the lasting effect on functional disability of MT plus AE to sham therapy (ST) plus AE. METHODS: Forty-two CNSLBP patients without co-morbidities, randomly distributed into 2 treatment groups, received either spinal manipulation/mobilization (first intervention) plus AE (MT group; n = 22), or detuned ultrasound (first intervention) plus AE (ST group; n = 20). Eight therapeutic sessions were delivered over 4 to 8 weeks. Immediate analgesic effect was obtained by measuring pain intensity (Visual Analogue Scale) before and immediately after the first intervention of each therapeutic session. Pain intensity, disability (Oswestry Disability Index), fear-avoidance beliefs (Fear-Avoidance Beliefs Questionnaire), erector spinae and abdominal muscles endurance (Sorensen and Shirado tests) were assessed before treatment, after the 8th therapeutic session, and at 3- and 6-month follow-ups. RESULTS: Thirty-seven subjects completed the study. MT intervention induced a better immediate analgesic effect that was independent from the therapeutic session (VAS mean difference between interventions: -0.8; 95% CI: -1.2 to -0.3). Independently from time after treatment, MT + AE induced lower disability (ODI mean group difference: -7.1; 95% CI: -12.8 to -1.5) and a trend to lower pain (VAS mean group difference: -1.2; 95% CI: -2.4 to -0.30). Six months after treatment, Shirado test was better for the ST group (Shirado mean group difference: -61.6; 95% CI: -117.5 to -5.7). Insufficient evidence for group differences was found in remaining outcomes. CONCLUSIONS: This study confirmed the immediate analgesic effect of MT over ST. Followed by specific active exercises, it reduces significantly functional disability and tends to induce a larger decrease in pain intensity, compared to a control group. These results confirm the clinical relevance of MT as an appropriate treatment for CNSLBP. Its neurophysiologic mechanisms at cortical level should be investigated more thoroughly. TRIAL REGISTRATION: Trial registration number: NCT01496144.

Mental Health First Aid Northern Ireland Manual

The MHFA Manual is the basis of the MHFA Northern Ireland training programme. It has been adapted from the original MHFA programme deveoped in Australia. The manual gives an overview of mental health in Northern Ireland, outlines the MHFA action plan, explores in detail the MHFA approach to major mental health problems, and provides an in-depth resource section with details of related organisations and sources of help.

A manual in quality standards in substance use education.

A Manual in Quality Standards in Substance Use Education is published by The Drug Education Workers Forum (DEWF). The manual looks at different areas of substance use education, such as schools, youth work and community settings, and provides clear information on the best practice for delivering such education.This resource was contributed by The National Documentation Centre on Drug Use.

Diagnostic and statistical manual of mental disorders : DSM-IV-TR.

Since the "DSM-IV(R)" was published in 1994, we've seen many advances in our knowledge of psychiatric illness. This "Text Revision" incorporates information culled from a comprehensive literature review of research about mental disorders published since "DSM-IV(R)" was completed in 1994. Updated information is included about the associated features, culture, age, and gender features, prevalence, course, and familial pattern of mental disorders. The "DSM-IV-TR(R)" brings this essential diagnostic tool up-to-date, to promote effective diagnosis, treatment, and quality of care. Now you can get all the essential diagnostic information you rely on from the "DSM-IV(R)" along with important updates not found in the 1994 edition. Stay current with important updates to the "DSM-IV-TR(R)": Benefit from new research into Schizophrenia, Asperger's Disorder, and other conditions Utilize additional information about the epidemiology and other facets of DSM conditions Update ICD-9-CM codes implemented since 1994 (including Conduct Disorder, Dementia, Somatoform Disorders) DSM-IV-TR(R), the handheld version of the "Diagnostic and Statistical Manual of Mental Disorders, "Fourth Edition, Text Revision, is now available for both Palm OS and PocketPC handhelds. This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders and includes associated features, culture, age, and gender features, prevalence, course, and familial pattern of mental disorders.This resource was contributed by The National Documentation Centre on Drug Use.

Walk Leader training manual

The Walking for Health programme was established in 2001 and continues to be an integral part of Government policy to address the health and wellbeing of the population in Northern Ireland. The programme is delivered through HSC Trusts across Northern Ireland and is supported by the Public Health Agency. Walking for Health aims to encourage inactive people to increase their level of physical activity by participating in local led health walks.