1000 resultados para manual medicine
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Abstract
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La lateralidad manual se concibe como una dimensión continua (Peters y Durding, 1978) en la que diestros y zurdos consistentes constituyen los extremos opuestos entre los cuales podemos hallar sujetos con diferente “grado” y “dirección” de lateralidad, tales como ambidextros o mixtos de ambas condiciones. De acuerdo con McManus (1996), la distribución de la lateralidad manual evaluada a través de cuestionarios generalmente representa un Modelo Simétrico Bimodal configurado por la integración de dos distribuciones normales situadas simétricamente alrededor de un punto cero, una que contiene aproximadamente el 90% de la población y la otra que contiene el 10% restante. Si representamos gráficamente ambas distribuciones, la tendencia de los valores en torno al punto central reflejan una distribución en forma de J, en la que los extremos corresponden a las puntuaciones máximas de lateralidad manual zurda y diestra, respectivamente. Este modelo de distribución tiene importantes implicaciones para el análisis de la lateralidad manual, sin embargo, la mayoría de cuestionarios (cuya extensión media ronda los 12 ítems) ofrecen una clasificación dicotómica o tricotómica de la lateralidad manual (Manga y González, 1985), cuando lo más óptimo es una clasificación en cuatro categorías (McManus, 1996). Por otra parte, según Coren (1993a), cuando la lateralidad manual es tratada como una dimensión continua, los índices de lateralidad obtenidos con una escala de extensión reducida (4 ítems) se corresponden en gran medida (r=0.95) con los obtenidos con escalas más extensas.
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This manual provides a set of procedural rules and regulations for use in functionally classifying all roads and streets in Iowa according to the character of service they are intended to provide. Functional classification is a requirement of House File 394 (Functional Highway Classification Bill) enacted by the 63rd General Assembly of the Iowa Legislature. Functional classification is defined in this Bill as: "The grouping of roads and streets into systems according to the character of service they will be expected to provide, and the assignment of jurisdiction over each class to the governmental unit having primary interest in each type of service."
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This manual provides a set of procedural rules and regulations for use in functionally classifying all roads and streets in Iowa according to the character of service they are intended to provide. Functional classification is a requirement of the 1973 Code of Iowa (Chapter 306) as amended by Senate File 1062 enacted by the 2nd session of the 65th General Assembly of Iowa. Functional classification is defined as the grouping of roads and streets into systems according to the character of service they will be expected to provide, and the assignment of jurisdiction over each class to the governmental unit having primary interest in each type of service. Stated objectives of the legislation are: "Functional classification will serve the legislator by providing an equitable basis for determination of proper source of tax support and providing for the assignment of financial resources to the governmental unit having responsibility for each class of service. Functional classification promotes the ability of the administrator to effectively prepare and carry out long range programs which reflect the transportation needs of the public." All roads and streets in legal existence will be classified. Instructions are also included in this manual for a continuous reporting to the Highway Commission of changes in classification and/or jurisdiction resulting from new construction, corporation line changes, relocations, and deletions. This continuous updating of records is absolutely essential for modern day transportation planning as it is the only possible way to monitor the status of existing road systems, and consequently determine adequacy and needs with accuracy.
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En este trabajo se exponen las normas y procedimientos para la implantación en el Ayuntamiento de León de un sistema de gestión documental basado en la norma ISO 15489. Se desarrollan los conceptos básicos para la comprensión del manual, los tipos de documentos administrativos, el uso del lenguaje administrativo, los instrumentos, los diagramas, los formularios y la legislación para llevar a la práctica los sistemas de organización de fondos, clasificación, ordenación, valoración y descripción de documentos y los procesos de instalación, transferencias, régimen de acceso al documento, consultas, préstamos y reproducción de documentos en los archivos de gestión de las oficinas. Palabras clave: Sistema de gestión documental, ISO 15489, Ayuntamiento de León (España), organización de fondos, clasificación de documentos, ordenación de documentos, evaluación de documentos, descripción de documentos, archivos de gestión.
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This is a summary of some of the activities the Board was involved with in 2011. More information about the Board’s work is available in the agendas, minutes, reports and press releases on the website, www.medicalboard.iowa.gov, and the Board’s page on Facebook. Much has been accomplished in the past year, but much more remains to be done. The Board looks forward to the many challenges that lie ahead and will continue to strengthen and enhance services to the public and licensees. I am very proud of the staff and Board members and their commitment to excellent service to the citizens of Iowa.
High-altitude medicine: important for trekkers and mountaineers, essential for progress in medicine.
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The purpose of this manual is to provide guidelines for low water stream crossings (LWSC). Rigid criteria for determining the applicability of a LWSC to a given site are not established nor is a 'cookbook" procedure for designing a LWSC presented. Because conditions vary from county to county and from site to site within the county, judgment must be applied to the suggestions contained in this manual. A LWSC is a stream crossing that will be flooded periodically and closed to traffic. Carstens (1981) has defined a LWSC as "a ford, vented ford (one having some number of culvert pipes), low water bridge, or other structure that is designed so that its hydraulic capacity will be insufficient one or more times during a year of normal rainfall." In this manual, LWSC are subdivided into these same three main types: unvented fords, vented fords and low water bridges. Within the channel banks, an unvented ford can have its road profile coincident with the stream bed or can have its profile raised some height above the stream bed.
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Raman spectroscopy combined with chemometrics has recently become a widespread technique for the analysis of pharmaceutical solid forms. The application presented in this paper is the investigation of counterfeit medicines. This increasingly serious issue involves networks that are an integral part of industrialized organized crime. Efficient analytical tools are consequently required to fight against it. Quick and reliable authentication means are needed to allow the deployment of measures from the company and the authorities. For this purpose a method in two steps has been implemented here. The first step enables the identification of pharmaceutical tablets and capsules and the detection of their counterfeits. A nonlinear classification method, the Support Vector Machines (SVM), is computed together with a correlation with the database and the detection of Active Pharmaceutical Ingredient (API) peaks in the suspect product. If a counterfeit is detected, the second step allows its chemical profiling among former counterfeits in a forensic intelligence perspective. For this second step a classification based on Principal Component Analysis (PCA) and correlation distance measurements is applied to the Raman spectra of the counterfeits.
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The health care system faces a difficult challenge as a result of the demographic evolution. The acute hospital is especially challenged by the steady increase of the elderly population. The collaboration between internal medicine and geriatrics in this setting could prove useful to facilitate the adaptation of the acute care setting and greatly enhance education of the health care professionals. Internists and geriatricians can benefit from each other skills and competencies to develop together new models of acute care that would better match the elderly population needs.
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We review some of the most influential papers from 2012 in the different aspects of emergency medicine, such as prehospital medicine, resuscitation, early diagnosis and timely ED discharge and treatment. In particular, intramuscular benzodiazepines have been shown to be efficient in prehospital status epilepticus, epinephrines usefulness in cardiopulmonary resuscitation has been challenged, colloids have been shown to be deleterious in the treatment of severe sepsis and septic shock, the time window for thrombolysis in acute stroke will probably be extended, acute pyelonephritis treatment duration can be decreased, new D-dimers thresholds for older patients may prevent further diagnosis tests, and hs-Troponin may allow earlier discharge of low coronary risk patients.