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Assessment of Physical Function


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181. Management of Tuberculosis: A Guide to the Essentials of Good Clinical Practice

in locations where the National Tuberculosis Programme does not function? 78 6.3 How can the situation be assessed and good results assured? 80 References 85 Appendices 87Tables 4.1 Optimal dosages for essential antituberculosis drugs in adults 31 4.2 For new cases of tuberculosis (never previously treated), number of tablets to be taken daily for adults on treatment according to weight and the content of the tablets 33 4.3 For patients given retreatment for tuberculosis, number of tablets to be taken (...) patient.TUBERCULOSIS 11 Tuberculosis will be detected most ef? ciently where health care pro- viders and community members are highly aware of the symptoms sug- gestive of tuberculosis. 2.2.3. How is a diagnosis of tuberculosis con? rmed? A diagnosis is proposed by the health care worker after considering the history given by the patient (the symptoms) and the evidence resulting from physical examination of the patient (the signs). The process of diag- nosis involves identifying the most likely condition

2010 International Union Against TB and Lung Disease

182. Guideline on the management of premature ovarian insufficiency

assessment and management of women with premature ovarian insufficiency. The initial assessment includes diagnosis, assessment of causation, and basic assessment. The management includes hormonal treatment. Since POI has consequences for health apart from gynaecological issues, these are also described. Consequences of POI and treatment options are included in the following domains: fertility and contraception, bone health, cardiovascular issues, psychosexual function, psychological function (...) involvement. D A cardiologist should be involved in care of pregnant women who have received anthracyclines and/or cardiac irradiation. D How should fitness for pregnancy be assessed in women with POI? Women presenting for oocyte donation who are suspected of having POI should be fully investigated prior to oocyte donation, including thyroid and adrenal function as well as karyotype. C Women previously exposed to anthracyclines, high dose cyclophosphamide or mediastinal irradiation should have

2015 European Society of Human Reproduction and Embryology

183. Routine psychosocial care in infertility and medically assisted reproduction ? A guide for fertility staff

Needs, 2008). Why was this guideline produced? The World Health Organization defines health as a ‘state of complete physical, mental and social well- being and not merely the absence of disease or infirmity’ (World Health Organization, 2007). This definition highlights the many dimensions (anatomical, physiological, and mental) of health and the importance of providing adequate care to address them all and not only to treat the disease. In infertility care, this is especially important for several (...) of psychosocial care for patients. However, the guideline also considers that patients may vary greatly in the types and level of needs they have. To capture this individual variability regarding needs, the guideline informs about risk factors (correlates and predictors) for specific psychosocial needs and about existing infertility-specific and valid tools to detect them. Risk factors point to a patient risk profile and tools are useful for clinical assessment and screening. Fertility staff also have

2015 European Society of Human Reproduction and Embryology

184. Weakness / Fatigue

disease. The severity and impact of fatigue may change in the course of the disease trajectory. It is frequently regarded as more distressing than pain by patients. It is often under-recognised by professionals. Fatigue may be unrelated to level of activity and not fully alleviated by rest or sleep. It is multidimensional affecting physical function, cognitive ability, social, emotional and spiritual wellbeing. Reduced physical function limits participation in preferred activities and activities (...) -rated assessment on a 0 - 10 scale Impact on function and quality of life, eg everyday activities can seem impossible Impact on family or carers Contributing factors: General factors: patient/family roles and responsibilities sleep disturbance nutrition – diet, absorption deconditioning due to reduced activity levels, fitness and/or muscle wasting over-exertion psychological factors, eg anxiety, fear depression. Condition-related factors: metabolic abnormalities – consider checking sodium, potassium

2015 Scottish Palliative Care Guidelines

185. Hiccups

Hiccups Scottish Palliative Care Guidelines - Hiccups Scottish Palliative Care Guidelines search / / / Hiccups Hiccups Introduction Hiccups lasting more than 48 hours are not uncommon in patients with advanced disease and can be very distressing and exhausting. They can affect a patient’s daily living and social functioning. Most studies were uncontrolled, underpowered and lacked comprehensive data and therefore recommendations for any treatments are made cautiously. Treatment of intractable (...) and persistent hiccup is based on patients’ and clinicians’ preferences until more evidence from randomised controlled trials is available. Pharmacological treatment should take into account the potential side effects and risks of medication. Assessment Careful assessment is required to identify the cause. Consider severity, duration and impact on a patient’s quality of life. Causes include: gastric stasis and distension (the most common cause) gastro-oesophageal reflux metabolic disturbances (eg uraemia

2015 Scottish Palliative Care Guidelines

186. Nausea and Vomiting

are distinct entities, principally representing behavioural adaptive mechanisms to avoid the ingestion of toxins. However, there are clearly other physical (eg vestibular upset) and psychological (eg fear, anticipation) triggers that can lead to the experience of nausea, vomiting or both. As there may be several potential contributory factors to consider in any one individual, it may be useful to parallel the approach taken with pain management in palliative care and consider the concept of ‘total nausea (...) , and diuretics which may require to be temporarily discontinued until vomiting is controlled. The effect on family and carers of looking after someone with nausea and / or vomiting can be profound. The patient and their family will therefore usually require emotional and spiritual care as well as physical support. Regurgitation Obstruction of the oesophagus and consequent regurgitation can be reported as vomiting. It is important to differentiate regurgitation from vomiting to avoid delay in seeking

2015 Scottish Palliative Care Guidelines

187. Age-related macular degeneration

. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Age-related macular degeneration (NG82) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 2 of 24Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Classifying age-related macular (...) cover the following: information about AMD and treatment pathways, including likely timescales key contact details – for example, who to contact if appointments need to be altered advice about what to do and where to go if vision deteriorates available support (including transport and parking permits) links to local and national support groups. 1.2.4 Allow enough time to discuss the person's concerns and questions about their diagnosis, treatment and prospects for their vision. Assess the person's

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

188. WHO recommendations: intrapartum care for a positive childbirth experience

Integration of recommendations from published WHO guidelines 13 2.8 Focus and approach 13 2.9 Evidence identification and retrieval 13 2.10 Quality assessment and grading of the evidence 14 2.11 Formulation of the recommendations 15 2.12 Decision-making during the GDG meetings 16 2.13 Declaration of interests by external contributors 17 2.14 Document preparation and peer review 17 2.15 Presentation of guideline content 17 3. Evidence and recommendations 19 3.1 Care throughout labour and birth 19 3.2 First (...) heart rate FIGO International Federation of Gynecology and Obstetrics GBS group B streptococcus GDG Guideline Development Group GRADE Grading of Recommendations Assessment, Development and Evaluation GRC Guidelines Review Committee GREAT Guideline-driven, Research priorities, Evidence synthesis, Application of evidence, and Transfer of knowledge HIC high-income country HIE hypoxic-ischaemic encephalopathy HIV human immunodeficiency virus HRP UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme

2018 World Health Organisation Guidelines

189. Deprescribing benzodiazepine receptor agonists

The overall team comprised 9 clinicians (1 family physician, 1 family physician specializing in long-term care, 1 geriatric psychiatrist, 2 geriatricians, 4 pharmacists) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence was generated from a Cochrane systematic review of antipsychotic deprescribing trials for the behavioural (...) and psychological symptoms of dementia, and a systematic review was conducted to assess the evidence behind the benefits of using antipsychotics for insomnia. A review of reviews of the harms of continued antipsychotic use was performed, as well as narrative syntheses of patient preferences and resource implications. This evidence and GRADE quality-of-evidence ratings were used to generate recommendations. The team refined guideline content and recommendation wording through consensus and synthesized clinical

2018 CPG Infobase

190. Guideline on the management of women with endometriosis

, others have no symptoms at all. The exact prevalence of endometriosis is unknown but estimates range from 2 to 10% within the general female population but up to 50% in infertile women (Eskenazi and Warner, 1997, Meuleman, et al., 2009). Endometriosis diagnosis is based on the women's history, symptoms and signs; the diagnosis is corroborated by physical examination and imaging techniques, and finally proven by histology of either a directly biopsied vaginal lesion, from a scar, or of tissue (...) . References De Graaff AA, D’Hooghe TM, Dunselman GA, Dirksen CD, Hummelshoj L, WERF EndoCost Consortium and Simoens S. The significant effect of endometriosis on physical, mental and social well-being: results from an international cross-sectional survey Hum Reprod 2013 Jul 11. [Epub ahead of print]. Eskenazi B and Warner ML. Epidemiology of endometriosis. Obstet Gynecol Clin North Am 1997; 24:235–258. Kennedy S, Bergqvist A, Chapron C, D'Hooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan

2013 European Society of Human Reproduction and Embryology

191. Pharmacological management of migraine

patient, rather than just focusing on the absolute number of headaches or migraines per month. For example, a few severe incapacitating migraines per month may warrant prophylactic treatment whereas more frequent but milder migraines that have little impact on daily function may not warrant treatment. Overusing acute medication can limit the effectiveness of preventative medication and medication overuse should also be assessed and addressed. 44 Prophylactic treatment should be used for at least three (...) produced using the processes described in SIGN 50: a guideline developer’s handbook, 2015 edition ( index.html). More information on accreditation can be viewed at accreditation Healthcare Improvement Scotland (HIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. SIGN guidelines are produced using

2018 SIGN

192. Ethical considerations arising from the government?s counter-terrorism strategy (supplement to Counter-terrorism and psychiatry)

that specified authorities, including healthcare bodies, ‘must, in the exercise of [their] functions, have due regard to the need to prevent people from being drawn into terrorism’. 1 The strategy is accompanied by a Prevent training programme, which is made available to all professionals working for specified authorities. Although this training is not enforced by the government, many institutions – including some NHS trusts – have chosen to make it mandatory. Further information about this topic can (...) of committing terrorist offences, psychiatrists will focus on treating mental disorder, as they would for any patient. There are other settings in which psychiatrists are asked to assess an individual to determine their risk of engaging in terrorist acts in the future, or to treat a patient with the aim of addressing psychological characteristics associated with terrorism. Psychiatrists can face this situation both when there is a doctor–patient relationship and when there is not (for example, when

2018 Royal College of Psychiatrists

193. Menopause

, in collaboration with the BMS, launched guidance on this. Details of how nurses can become experts in Menopause support and management are contained in the publication Nurse Specialist in Menopause (RCN, 2017) available at: IntroductionROYAL COLLEGE OF NURSING 5 The menopause is defined as a physiological event thus: Ovarian failure due to loss of ovarian follicular function accompanied by oestrogen deficiency resulting in permanent cessation of menstruation and loss of reproductive (...) function. NICE defines menopause as: Menopause is when a woman stops having periods as she reaches the end of her natural reproductive life. This is not usually abrupt, but a gradual process during which women experience peri-menopause before reaching post-menopause (NICE, 2015). The transitional phase known as peri-menopause describes the time leading up to a woman’s final menstruation, and the endocrinological, biological, and clinical features of the approaching menopause. The length

2018 Royal College of Nursing

194. ESMO Consensus Conference on malignant lymphoma: general perspectives and recommendations for the clinical management of the elderly patient with malignant lymphoma

panel and a consensus was reached. This consensus, which was further developed in continuous post-meeting discussions, formed the basis of three manuscripts, each covering one of the three key areas identified. This manuscript presents the consensus recommendations regarding the clinical management of elderly patients diagnosed with malignant lymphoma. Four clinically-relevant topics identified by the panel were: 1) how to define patient fitness, 2) assessing quality of life, 3) diagnostic work-up (...) was compiled by a multidisciplinary panel of 25 experts • It provides guidance on defining patient fitness and assessing quality of life, as well as diagnostic work-up and treatment recommendations in CLL, FL, MCL, PTCL and DLBCL • Recommendations are accompanied by relevant supporting evidence Introduction Western industrial countries, as well as developing countries, are facing dramatic demographic changes in the near future, with an increasing proportion of elderly persons in these societies. In 2015

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2018 European Society for Medical Oncology

195. PET Evidence from Primary Studies and Systematic Reviews and Recommendations from Clinical Practice Guidelines

tomography (PET) in the clinical management of patients with cancer, sarcoidosis, or epilepsy with respect to: ? Diagnosis and staging ? Assessment of treatment response ? Detection and restaging of recurrence ? Evaluation of metastasis Outcomes of interest are survival, quality of life, prognostic indicators, time until recurrence, safety outcomes (e.g., avoidance of unnecessary surgery), and change in clinical management. INTRODUCTION In 2010, the Ontario PET Steering Committee (the Committee (...) ]. In a separate study, the authors concluded that FDG PET/CT (97.1%) was more accurate than CT (91.2%) in assessing therapeutic response of proven omental deposits from ovarian or uterine tumours; however, there was no mention of whether this difference was statistically significant [20]. In high-risk endometrial cancer, the addition of FDG PET/CT to CT increased the sensitivity in both the abdomen (50% versus 65%, p=0.01) and pelvis (48% versus 65%, p=0.004) for detecting lymph node metastasis while

2018 Cancer Care Ontario

196. Mental health care in the perinatal period: Australian clinical practice guideline

is to support health professionals in providing evidence- based care. While the focus of the Guideline is on women, the effects of maternal mental health on infants and families and the emerging evidence on paternal perinatal mental health are acknowledged. The Guideline is relevant to the care of all women in the perinatal period. In addition to screening and psychosocial assessment, the Guideline provides guidance on care for women with depressive and anxiety disorders, severe mental illnesses (...) (schizophrenia, bipolar disorder and postpartum psychosis) and borderline personality disorder at this time. The Guideline includes discussion of: • supporting emotional health and wellbeing of women • screening for symptoms of depression and anxiety and assessment for psychosocial factors that affect mental health • assessing mother-infant interaction and the safety of the woman and infant • referral and care pathways for women who require further assessment or care • care planning for women with diagnosed

2018 Clinical Practice Guidelines Portal

197. BSR guideline Management of Adults with Primary Sjögren's Syndrome

clinical features and the demographics of the individuals with these conditions, clustering of these entities could also be expected to occur on a simple statistical basis. Ageing per se is not a cause of xerostomia. Although there is a broadly linear reduction in the amount of functional acinar tissue within the salivary glands over time, this does not lead to clinically significant salivary gland hypofunction in normal subjects [ ]. Xerostomia in the ageing population is more a function (...) with routine staging being introduced for other eye diseases. In practice rheumatologists and GPs will either rely on patient reported symptoms or simple Schirmer’s testing to assess severity of disease but, by definition the majority of patients with SS will have severe dry eye (Schirmer’s ⩽5 mm in 5 min and tear break-up time ⩽5 s). T able 1 Dry eye management summary Level 1: mild dry eye Level 2: moderate dry eye Level 3/4: severe dry eye (ophthalmology only) Features Features Features Tear film break

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2017 British Society for Rheumatology

198. Surveillance Audiometry

. Surveillance Audiometry requires air-conduction testing only, without masking, and the frequencies tested may vary from those used for other pure-tone audiometric assessments. This procedure should be used to conduct hearing tests for the purpose of meeting the requirements of the Health & Safety Executive for those exposed to noise at work (HSE, 2005). Such tests should only be carried out by those who have received appropriate training in accordance with BSA Minimum Training Guidelines: Surveillance (...) :_____________________________________ Earphone type: ___________________________________________________ Date of last calibration: _____________________________________________ Tester:_______________________________Signature:___________________ Comments:_______________________________________________________ RIGHT LEFT Recommended Procedure Surveillance Audiometry BSA 2017 © BSA 22016 Page14 8. Calibration 8.1 Stage A: routine checking and subjective tests In order to check the audiometer is functioning across the range of frequencies

2017 British Society of Audiology

199. Air pollution: outdoor air quality and health

be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Air pollution: outdoor air quality and health (NG70) © NICE 2019. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 2 of 62Contents Contents Overview 5 Who is it for? 5 (...) processes (such as the core strategy, local transport plan, environment and health and wellbeing strategies) should include zero- and low-emission travel, for example cycling and walking (see section 1.6 and NICE's guideline on physical activity: walking and cycling). Other strategies for zero- and low- emission travel could include: Providing charge points for electric vehicles in workplaces, commercial developments and residential areas. Supporting car sharing schemes or car clubs. 1.1.2 When 'plan

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

200. Guidelines on Monitoring During Anaesthesia Background Paper

cases if a NMB monitor is not available. A comprehensive review of non-depolarising neuromuscular blockade and reversal in 2017 concludes that “Objective measurement (a train-of-four ratio greater than 0.90) is the only Page 3 PS18 BP 2017 method to determine appropriate timing of tracheal extubation and ensure normal muscle function and patient safety” 1 . Therefore, quantitative monitoring is recommended to assess depth of blockade prior to reversal and assessment of adequacy of reversal (...) necessitated the anaesthetist to be in close physical contact to the patient, with constant observation, palpation of peripheral pulses, continual auscultation with precordial stethoscopes, and visualisation of pupils, amongst other things. Increasing sophistication of equipment has allowed the anaesthetist to be removed from direct physical contact and has provided the opportunity for improved quantification of parameters, as well as enabling alarm parameters to be set, and recording of data. This in turn

2017 Australian and New Zealand College of Anaesthetists


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