the management of manure is important to crop production environmental quality and maintenance of soil productivity
Economic Effects of Reducing the Fiscal Restraint That Is Scheduled to Occur in 2013 docx
... EFFECTS OF REDUCING THE FISCAL RESTRAINT THAT IS SCHEDULED TO OCCUR IN 2013 expects—with the economy projected to contract at an annual rate of 1.3 percent in the first half of the year and expand ... effect on the level of GDP at the That estimate is smaller than the change in the automatic stabilizers from 2012 to 2013 that is presented in Table C-2 of The Budget and Economic Outlook: Fiscal ... consecutive quarters during the period consisting of the quarter of the report, the quarter before the report, and the four quarters after the report The Budget Control Act of 2011 (P.L 112-25; 125...
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how the use of the diary form narrative is beneficial to the
... group as a whole and the reader can feel as if they are part of the group and read, and think along with the characters Another thing dealing with the diary form is quick referencing The reader, if ... person was talking and acting through the written dialects In the novel Dracula, all the diaries, of all the individuals come together and in the end, become one powerful, combination of descriptions, ... one person was telling the whole story, the reader would see and hear what the person telling the story heard and wrote down So using, the diary, Bram Stoker could make the reader "see" exactly...
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báo cáo khoa học: "Randomised controlled trial of tailored interventions to improve the management of anxiety and depressive disorders in primary care" pdf
... contributed to the design of the study and coauthored the article BT contributed to the design of the study, participated in the training of GPs, and coauthored this article CM contributed to the design ... groups related to the severity of anxiety and depressive symptoms, level of functioning, experience with care, and quality of life Statistical analyses The adequacy of randomisation is assessed ... experiences of GPs in the intervention group, the GP Page of visitors and the experts with the tailoring process, the implemented changes in practice, and the factors influencing the tailoring process To...
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A practical guide to the management of medical emergencies - part 1 ppt
... Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia The right of the Authors to be identified as the ... mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher First published 1990 Second ... prepared by the manufacturers The author and the publishers not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this book Contents...
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A practical guide to the management of medical emergencies - part 2 pot
... patients without a history of anaphylaxis are no more likely to have an allergic reaction to a cephalosporin than patients without a history of penicillin allergy Further reading Sepsis and septic shock ... are pinpoint or there is other reason to suspect opioid poisoning: • Give 0.4–2 mg IV every 2–3 min, to a maximum of 10 mg, until the respiratory rate is around 15/min • If there is a response, ... due to acute coronary syndrome? • Known coronary disease or risk factors for coronary disease? • Previous venous thromboembolism or risk factors for thromboembolism? • Risk factors for aortic dissection...
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A practical guide to the management of medical emergencies - part 4 doc
... stenosis May be due to fibromuscular dysplasia (age 50 with other atherosclerotic arterial disease) Refractory ... limit of normal If the APTT is above this value, recheck it every h Further reading Goodacre S, et al Meta-analysis: the value of clinical assessment in the diagnosis of deep venous thrombosis Ann ... nephritis suspected • Seek an opinion from a maxillofacial surgeon if endocarditis is due to Streptococcus viridans or other oral commensals • Arrange investigation of colon if endocarditis is due to...
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A practical guide to the management of medical emergencies - part 5 docx
... opening, motor response and verbal response • To assess the motor response, ask the patient to move the limb If there is no response, apply firm pressure to the nailbed Test and record for each of the ... Hemoptysis can be distinguished from hematemesis by its color and pH: hemoptysis is bright red and alkaline; hematemesis is brown and acid Bleeding from the nasopharynx may be mistaken for hemoptysis: ... acute pleural disease Lymphocytosis is seen in malignancy, tuberculous pleuritis and in pleural effusions after CABG The yield of cytology is influenced by the histological type of malignancy:...
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A practical guide to the management of medical emergencies - part 6 doc
... thrusting and side to side movements of the head, often intensified by restraint • Gaze aversion, resistance to passive limb movement or eye opening, prevention of the hand falling on to the face ... oral therapy for a total of 7–10 days ALE RT The mortality of variceal bleeding is around 50% Urgent endoscopy is required to define the source of bleeding Therapeutic endoscopy (injection sclerotherapy ... occurs in the left posterolateral wall of the lower third of the esophagus, with leak into the left pleural cavity) • Blunt trauma to the chest • Instrumentation of the esophagus (risk with diagnostic...
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A practical guide to the management of medical emergencies - part 7 pdf
... • Arrange early follow-up with a diabetologist to review therapy Further reading Chiasson J-L, et al Diagnosis and treatment of diabetic ketoacidosis and the hyperglycaemic hyperosmolar state ... tract disorders and acute pancreatitis 64 Biliary tract disorders and acute pancreatitis T A B L E 64 Biliary tract disorders: clinical features and management Disorder Clinical features and blood ... (associated with the hepatorenal syndrome, p 400)? • Is there diabetes, or other multisystem disorder which might involve the kidneys? Do not forget endocarditis (p 203) and myeloma as causes of renal...
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A practical guide to the management of medical emergencies - part 8 ppt
... can be macrocytic if there is marked reticulocytosis MCV usually > 110 fl Other cytopenias Leukocytosis Monocytosis Thrombocytosis Blast cells Hemolysis Primary bone marrow disorder No specific abnormality ... Swab of urethra, cervix and anorectum if gonococcal infection is possible Acute arthritis History • Duration and time course of arthritis and other symptoms (e.g fever, rash, diarrhea, urethritis, ... dermatitis) (NB cellulitis may complicate eczema) Longer history May be bilateral (bilateral cellulitis is rare) No fever or systemic symptoms Itching rather than tenderness of the skin History of...
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A practical guide to the management of medical emergencies - part 9 doc
... X-ray pelvis and hips if history of a fall or clinical signs of fractured neck of femur ALERT Hypothermia is most often seen in the elderly (usually as a consequence of acute illness) and in those ... trypanosomiasis • Brucellosis • Leptospirosis Long (>21 days) • Viral hepatitis • Malaria • Tuberculosis • HIV • Schistosomiasis (Katayama fever) • Amoebic liver abscess • Visceral leishmaniasis • Filariasis ... Thrombocytopenia Diagnosis Microscopy of Giemsa-stained thick and thin blood films The thick film is more sensitive in diagnosing malaria The thin film allows species identification and quantification of the...
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báo cáo khoa học: " A cluster randomised controlled trial in primary dental care based intervention to improve professional performance on routine oral examinations and the management of asymptomatic impacted third molars: study protocol" pptx
... refers to periodic monitoring of the general and oral health status of patients The main purpose of ROEs is to prevent the onset of oral diseases and/ or prevent further progression This allows the ... Timeframe of the study We plan to randomise six of the initially recruited IQual groups that have declared their willingness to participate in this study, and to assign them randomly to one of the ... GDPs on ROEs and the management of MIMs in daily dental practice is more effective and efficient compared to dissemination of CPGs only Methods Study design The study is a cluster-randomised trial...
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Báo cáo y học: "Combined left hepatectomy with fenestration and using a harmonic scalpel, fibrin glue and closed suction drainage to prevent bile leakage and ascites in the management of symptomatic polycystic liver disease: a case report" pps
... continue to grow and appear de novo after treatment [5] Therefore, the therapeutic aim is to significantly reduce the size of the polycystic liver without compromising liver function, and to provide ... relief of symptoms The optimal treatment for symptomatic PLD is uncertain There is no clear consensus regarding the optimum timing of intervention and the surgical approach is based in part on the ... scalpel was the modest trauma that it produced and the controlled dissection of the tissue Especially in the periphery, the UltraCision was an ideal dissection instrument: with the absence of large...
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Báo cáo y học: "The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report" pdf
... local and distant recurrence [9] Care must be taken intraoperatively to avoid rupture of the tumour as the risk of local seeding is high [10,11] The management of the recurrent laryngeal nerve is ... operation It is also important to remember the serious malignant potential of this lesion at the time of resection [6] There are many different modalities for the preoperative localization of the parathyroid ... non-tender and mobile See Figure and Table1 for results of the initial laboratory investigations An ultrasonography of his neck showed a × cm large cyst in the left lobe of his thyroid gland His parathyroid...
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Báo cáo y học: "Pro/con clinical debate: Is high-frequency oscillatory ventilation useful in the management of adult patients with respiratory failure" ppt
... It is unnecessary for a new, large, state of the art, adult intense care unit to use HFOV There is no data to indicate that the survival of adult patients with ARDS is improved with the use of ... with HFOV In one of these studies, HFOV was used during anesthesia and surgery, allowing surgery to proceed in burns patients who may otherwise have been too unstable to go to the operating room ... However, the utility of these animal studies in guiding the practical management of patients with severe hypoxemia is limited by the need for pressure–volume curve measurements [11] and the use of...
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Báo cáo y học: "Pro/con clinical debate: Antibiotics are important in the management of patients with pancreatitis with evidence of pancreatic necrosis" ppt
... supporting the use of prophylactic antibiotics in the setting of severe pancreatitis, there is some evidence suggesting that misuse of antibiotics leads to devastating superinfections Isenmann and Available ... pancreatitis The discussion should focus on the relative benefit in terms of infection, morbidity and mortality against the risk of increased resistance to antimicrobials, based on the current ... decontamination of the digestive tract for prophylaxis deserves special attention It suggests we can achieve the benefits of prophylaxis without the risk of increasing resistance, through the use of systemic...
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Báo cáo y học: "Bench-to-bedside review: Therapeutic options and issues in the management of ventilator-associated bacterial pneumonia" ppt
... predisposing pulmonary conditions that compromise defence mechanisms in their airways Although the respiratory tract is designed to prevent the entry of pathogenic organisms into the lungs and to ... help to guide the choice of antibiotic therapy and confirm the diagnosis of VAP What is clear is that avoiding delay in sampling and initiating therapy quickly are more important than the type of ... antimicrobial therapy for VAP based on assessment of disease severity, the presence or absence of risk factors for specific organisms and time of onset of the pneumonia However, one limitation of these...
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Báo cáo y học: "Bench-to-bedside review: Hyperinsulinaemia/euglycaemia therapy in the management of overdose of calcium-channel blockers" ppt
... Conclusion There is growing experimental and clinical evidence of the value and the safety of HIET in the management of CCB poisoning Although the mechanism of this beneficial action is not fully ... compromises the cardiovascular condition already impaired by the blockade of calcium channels These mechanisms give rise to the hypothesis that high-dose insulin therapy could be beneficial in the management ... treatment and failed to improve the patient’s condition have also been reported [30-32] The effectiveness of HIET is often limited to an improvement of hypotension and acidosis that is observed...
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Báo cáo y học: " How to select a chiropractor for the management of athletic condition" potx
... trying to select or find a chiropractor to refer to, one would ask the questions of the chiropractor based on the characteristics listed in Table to ascertain whether the chiropractor fits these ... contributions to the content of the final manuscript All of the authors participated in the editing and revisions of the multiple drafts that existed between the initial and final draft All authors read and ... (ACSP) Registrars and conceived the idea of the paper At a series of meetings, email and phone conversations WH, HP and PG further developed the discussion of the paper All authors contributed to writing...
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Báo cáo y học: "Chiropractic approach to the management of children" ppt
... brief and take into account the condition, age and size of the child, and it should be clear that intervention is affecting change ahead of the natural resolution history of the disorder The clinician ... chiropractic to distinguish the chiropractic profession from other disciplines Chiropractic is a profession, not a technique and chiropractors are responsible for diagnosis and appropriate management of ... far, is that manual therapy for the paediatric patient, in the hands of a skilled chiropractor, has a very low risk Chiropractors are committed to gathering all data relative to risks In the United...
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