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Assessment of Physical Function

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161. Planning, initiation & withdrawal of Renal Replacement Therapy

knowledge and understanding (5-7), pre-dialysis education confers many additional advantages. These include an improved sense of well-being, enhanced mood, reduced levels of anxiety, and better physical functioning (8). Patients who have received pre-dialysis education also have a lower incidence of unplanned initiation onto dialysis (9-11), even excluding late referrals. Furthermore, fewer patients initiate dialysis with haemodialysis catheters (12). There is also an association between pre-dialysis (...) , functional status, and the physical, psychological and social consequences of starting dialysis in that individual (1B) 5.4 We recommend that once a decision has been made to start dialysis in a patient with established access there should be no delay in starting treatment i.e. no waiting list to start dialysis (1D) - 24 - 5.5 We recommend that urgent dialysis via a haemodialysis catheter should only be initiated where there is a clear clinical indication that the patient would come to harm without

2014 Renal Association

162. Vascular Access for Haemodialysis

as the assessment of vascular access using specialised instrumentation to measure function. It is not uncommon that monitoring and surveillance are used interchangeably in the literature. Access flow measurements, duplex Doppler ultrasound in addition to direct as well as derived static pressure measurements are the commonest techniques in access surveillance. There is considerable variability in the frequency of surveillance in AVF and AVG. Some centres perform flow measurements every 6 months or more (...) practice guideline for vascular access for haemodialysis 1. Preferred type of vascular access (Guideline 1.1) 2. Preservation of sites for native vascular access (Guidelines 2.1-2.2) 3. Pre- operative assessment (Guidelines 3.1-3.2) 4. Timing of creation of vascular access (Guideline 4.1) 5. Selection of Access Types (Guidelines 5.1-5.3) 6. Maintenance of vascular access (Guidelines 6.1-6.5) 7. Prevention of catheter related infections (Guidelines 7.1-7.4) 8. Complications of vascular access

2015 Renal Association

163. WHO recommendations on maternal health

regarding the following: micturition and urinary incontinence, bowel function, healing of any perineal wound, headache, fatigue, back pain, perineal pain and perineal hygiene, breast pain, uterine tenderness and lochia. Breastfeeding progress should be assessed at each postnatal contact. (GDG consensus based on existing WHO guidelines). Source At each postnatal contact, women should be asked about their emotional well-being, what family and social support they have and their usual coping strategies (...) Abbreviations iv Introduction 1 Promote, prevent and protect maternal and perinatal health 3 1. Antenatal care 3 Nutritional supplements 3 Maternal and fetal assessment 4 Preventive measures 6 Interventions for common physiological symptoms 7 Health systems interventions 8 2. Prevention of pre-eclampsia and eclampsia 9 3. Interventions to improve preterm birth outcomes 10 4. Prevention of maternal peripartum infections 12 5. Labour and child birth 13 Induction of labour 13 Delay in the first stage of labour

2017 World Health Organisation Guidelines

164. ABCD position statement on standards of care for management of adults with type 1 diabetes

to hypoglycaemia There is no evidence on which to base guidance for management of type 1 diabetes in older people. The emphasis should be on individualising treatment and targets to meet the needs of the individual. Managing type 1 diabetes in older people ? Acknowledge lower awareness of hypoglycaemia in this group. ? Older adults who are functioning well physically and mentally may wish to aim for the same targets as younger adults. ? Targets may be relaxed and individualised for older adults with either (...) physical or mental frailties but symptomatic hyperglycaemia should be avoided. ? The potential benefits of tight glycaemic targets should be balanced against the risk associated with hypoglycaemia in this age group 28 ? Treatment of cardiovascular risk factors should take life expectancy into account. ? Screening for diabetes complications should pay particular attention to complications that would lead to functional impairment Diabetes UK recommendations for care home residents with diabetes ? Each

2017 Association of British Clinical Diabetologists

165. WHO recommendations on child health

acquired immunodeficiency virus ART antiretroviral therapy ARV antiretroviral AZT zidovudine BCG Bacillus Calmette-Guérin SMC seasonal malaria chemoprevention CSOM chronic supporative otitis media DTP diphtheria-pertussis-tetanus E ethambutol EFZ efavirenz FTC emtricitabine GRADE Grading of Recommendations, Assessment, Development and Evaluation GRC Guidelines Review Committee INH isoniazid HIV human immunodeficiency virus IM intramuscular IPV inactivated polio vaccine MCV measles-containing vaccine (...) The development process includes the synthesis and assessment of the quality of evidence, and is based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. GRADE categorizes the quality (or certainty) of the evidence underpinning a recommendation as high, moderate, low or very low. ¦ High: further research is very unlikely to change our confidence in the estimate of effect; ¦ Moderate: further research is likely to have an impact on our confidence in the effect; ¦ Low

2017 World Health Organisation Guidelines

166. Hypertension management and renin-angiotensin-aldosterone system blockade in patients with diabetes, nephropathy and/or chronic kidney disease

that patients with type 1 diabetes with significant renal function impairment (eGFR <45 ml/min/1.73 m 2 ) should be advised to withhold RAAS-blocking drugs during periods of acute illness (not graded). Audit standards The following are suggested as audit standards for RAAS blockade and hypertension management in patients with type 1 diabetes. 1 The proportion of patients with type 1 diabetes, with micro- or macroalbuminuria who are treated with an ACEI or ARB at the maximum tolerated doses. 2 The proportion (...) patients with type 1 diabetes, microalbuminuria and normal blood pressure reduces end-stage renal disease. There are, however, more short-term studies that focus on a change in AER rather than a change in renal function. A multicentre European study examined 79 patients with microalbuminuria and blood pressure below 155/90 mmHg, and found a significant reduction in AER in the group of patients who were treated with lisinopril compared with the patients who were treated with a placebo (-34.2 mg/min). 28

2017 Association of British Clinical Diabetologists

167. Association of British Clinical Diabetologists - Renal Association (ABCD-RA) Clinical Practice Guidelines for Management of Lipids in Adults with Diabetes Mellitus and Nephropathy and/or Chronic Kidney Disease

to statins. Fibrates were indicated for severe hypertriglyceridaemia (TG >12 mmol/L) to reduce the risk of pancreatitis. The JBS3 consensus recommendations for the prevention of cardiovascular disease suggested a separate approach to lipid lowering in type 1 and type 2 diabetes. The majority of patients aged >40 years (unless short duration type 1 diabetes and otherwise fit) would be considered for statin therapy regardless of renal status, without any need to utilise a CVD risk assessment tool 4 (...) . Persistent proteinuria and/or eGFR 60ml/min. The separate renal section in JBS3 restated the KDIGO guidance of statin alone or statin-ezetimibe combination for all patients with CKD. The NICE Lipid Modification 2014 guidance 23 stated that there was no need to use a CVD risk assessment tool if eGFR was 40years and/or with established nephropathy, but extended recommend inclusion of those with other CVD risk factors or those with >10 years duration of diabetes without any age restriction. NICE still

2017 Association of British Clinical Diabetologists

168. Driving and pain

performance through adverse effects on physical function and cognition. For example, musculoskeletal conditions can cause difficulty with the physical act of driving e.g. people with low back pain may experience difficulties using foot pedals. 4 Tests of ‘on road’ driving performance show that patients with chronic non-malignant pain perform poorly compared to matched healthy controls. 5 When surveyed, 70% of chronic pain patients indicated that pain limited their driving in some way, with 41 (...) and duloxetine are also associated with an increased risk of crashing, although objective tests of driving function often fail to demonstrate a deleterious effect. 7 Antiepileptic drugs Anticonvulsant medications such as carbamazepine and gabapentin can cause sedation, cognitive impairment and visual disturbance and are associated with a significantly increased risk of crashing. 7 Reducing the dose of anti- epileptic medication appears to reduce the risk of an accident. NSAIDS Although not commonly

2017 Faculty of Pain Medicine

169. Clinical Guideline for Administration of Molecular Radiotherapy

Protection Advisor(RPA) Prior risk assessment, compliance with IRR99 (and going forward IRR2018) RPA2000 N Radiation Protection Supervisor* RPA Local rules, radiation safety culture, monitoring (IRR 99 and going forward IRR2018) Local training. Formal appointment Contactable Medical Physics Expert* (MPE) Optimization, dosimetry IRMER2000 and going forward IRMER2018 Eligible for or on (BSSD- IRMER2018) MPE Register Likely to be administered by RPS2000 Contactable for all. Present for research, complex (...) appropriate training for the functions they are going to perform. The training of personnel to administer radiotherapy isotopes should be standardized within the administration centre. The required training package should be agreed with the key duty holders and this should include a competency assessment. All staff should maintain a training record to demonstrate initial training, ongoing competence and CPD. Staff training records should be held within the Trust along with a list of personnel able

2017 British Nuclear Medicine Society

170. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities

EMBASE Excerpta Medica Database EPOC Effective Practice and Organisation of Care (group) ESBL extended-spectrum beta-lactamases GDG Guidelines Development Group GLASS Global Antimicrobial Resistance Surveillance System GRADE Grading of Recommendations Assessment, Development and Evaluation HAI health care-associated infection ICU intensive care unit IHR International Health Regulations IPC infection prevention and control ITS interrupted time series LMICs low- and middle-income countries LTCFs long (...) 8µBREVIATIONS AND ACRONYMSAcute health care facility: A setting used to treat sudden, often unexpected, urgent or emergent episodes of injury and illness that can lead to death or disability without rapid intervention. The term acute care encompasses a range of clinical health care functions, including emergency medicine, trauma care, pre-hospital emergency care, acute care surgery, critical care, urgent care, and short-term inpatient stabilization. Alcohol-based handrub: An alcohol-based preparation

2017 World Health Organisation Guidelines

171. Evidence-based Clinical Practice Guideline for Deprescribing Cholinesterase Inhibitors and Memantine

medication costs, reduced costs of treating adverse drug effects, and an uncertain benefit or cost if there is a change in function that increases or decreases health service utilisation. Further research is required in this area. ? There are numerous clinical considerations when deprescribing ChEIs and/or memantine, including how to assess for ongoing benefit, how to conduct withdrawal and monitoring (plus actions to follow monitoring) and implementation of non- pharmacological management strategies (...) recommendations, labelled ‘Practice Points’ (PP) were also drafted. PPs were not a direct result of the systematic review, and subsequently do not have an assessment of the quality of the evidence or strength of the recommendation. In this guideline, the PPs essentially function to support users to apply and execute the CBRs. After drafting the recommendations, all GDT members were provided with a summary of the systematic review findings and evidence to recommendations tables (Appendix 2: Summary of Findings

2018 Clinical Practice Guidelines Portal

172. Communicating Risk in Public Health Emergencies. A WHO Guideline for Emergency Risk Communication (ERC) policy and practice

, Ombretta Baggio, Claudine Burton-Jeangros, Bishakha Datta, Frode Forland, Natasha Howard, Akram Khayatzadeh-Mahani, Nombulelo Leburu, Sovann L y, Jenny Moberg, Mohamed Nour, Nobuhiko Okabe, Patricia Lima Pereira, Ortwin Renn, Maria-Isabel Rivero, Lisa Robinson, Caroline Rudisill, Matthew Seeger, Luechai Sringernyuang, Karen T an, Chadin T ephaval, Theresa Thompson, Marika Valtier, Sophia Wilkinson and Xie Ruiqian. Jane Noyes, the Grading of Recommendations Assessment, Development and Evaluation (GRADE (...) by the Government of Japan and the Government of the United Kingdom of Great Britain and Northern Ireland.vi a WHO guideline for emergency risk communication (ERC) policy and practice List of key abbreviations CCB WHO Communications Capacity-Building unit COI conflict of interest DOI declaration of interest ERC emergency risk communication ERG External Review Group GDG Guideline Development Group GRADE Grading of Recommendations Assessment, Development and Evaluation GRADE-CERQual GRADE Confidence

2018 World Health Organisation Guidelines

173. Best Practice Guide: Continuous subcutaneous insulin infusion (CSII) A clinical guide for adult diabetes services

, technical issues, safety concerns or user choice (Beato-Vibora et al 2015). 010 CLINICAL GUIDELINE BEST PRACTICE GUIDE CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) Selection for CSII To achieve optimal use of CSII, people with diabetes should be assessed for their suitability via a structured process involving the MDT . The following characteristics should be considered as part of this assessment: 1. Education, understanding and implementation of the principles of intensive insulin therapy (...) such as depression due to disease burden from hypoglycaemia or poor control may actually respond well to CSII and there is evidence that CSII can be safely used in this patient cohort (Rodrigues et al 2005) 6. Cognitive, visual and physical impairments may require a care partner to be co-trained in pump therapy, and should ideally be managed at more experienced centres, but should not be a contraindication to pump therapy. The MDT should continue to support people with diabetes who are unable to proceed

2018 Association of British Clinical Diabetologists

174. Practical Management of Hyperglycaemic Hyperosmolar State (HHS) in children

started, underlying or precipitating causes of HHS (such as infection) must be identified and treated at the same time. Precipitating causes of HHS include infection, undiagnosed diabetes and substance abuse. A full clinical assessment should be carried out, including possible risk factors: ? history from family/patient ? physical examination looking for acanthosis nigricans, obesity, signs of trauma or infection ? mental state ? neurological state ? renal function assessment ? family history etc (...) is probably only needed if plasma potassium concentration is less than 5.5 mmol/l. Give potassium chloride 40mmol in 1000 ml of replacement fluids once renal function has been assessed. ? During insulin treatment and rehydration, serum potassium levels fall rapidly; therefore, it is recommended that potassium replacement should be initiated before insulin is started, with the goal of maintaining a plasma potassium concentration in the range of 4 –5 mmol/L. Higher rates of potassium may be required once

2018 British Society for Paediatric Endocrinology and Diabetes

175. Attention deficit hyperactivity disorder: diagnosis and management

and management (NG87) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 621.1.6 After transition to adult services, adult healthcare professionals should carry out a comprehensive assessment of the person with ADHD that includes personal, educational, occupational and social functioning, and assessment of any coexisting conditions, especially drug misuse, personality disorders, emotional problems and learning difficulties (...) an assessment of the person's needs, Attention deficit hyperactivity disorder: diagnosis and management (NG87) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11 of 62coexisting conditions, social, familial and educational or occupational circumstances and physical health. For children and young people, there should also be an assessment of their parents' or carers' mental health. [2008, amended 2018] [2008, amended 2018

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

176. Management of opioid use disorders: a national clinical practice guideline

. Development of recommendations Recommendations were developed and graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool 11–14 (Box 1) through an iterative consensus process. The node principal investigators developed draft recommenda- tions and assigned initial GRADE scores, which were then revised by the full committee in two consecutive rounds of review, as described below. Following each round of review, two guideline authors (E.W. and J.B.) edited and approved (...) disorders reviewed and provided input on the final draft. Management of competing interests This guideline was entirely funded through the CIHR-funded CRISM network and without pharmaceutical industry support. Competing interests were assessed using the Guidelines International Net- work’s Principles for Disclosure of Interests and Management of Conflicts in Guidelines. 15 No current or ongoing direct competing interests were disclosed by the 43 members of the review commit- tee or the four CRISM

2018 CPG Infobase

177. Management of Anaemia and Iron Deficiency in Patients With Cancer: ESMO Clinical Practice Guidelines

, anaemia is associated with fatigue, impaired physical function and reduced quality of life (QoL) [4–7]. Consequences of anaemia may include impaired response to cancer treatment and reduced overall survival (OS), even though a causal direct relationship has not yet been established [8, 9]. These new ESMO Clinical Practice Guidelines provide tools to evaluate anaemia, also in patients with myelodysplastic syn- dromes (MDS), and include recommendations on how to safely manage chemotherapy-induced (...) /iv96/4866368 by guest on 27 March 2019Iron status assessment ID is re?ected by a low transferrin saturation (TSAT 5%) as markers of both absolute and functional ID [10, 77]. Levels of soluble transferrin receptor (sTfR) and zinc protoporphyrin are increased in patients with absolute ID, but sTfR value is usually within normal limits or low in functional ID except that observed with ESA treatment [10, 78, 79]. Notably, sTfR levels can be decreased after chemotherapy [80], whereas they are increased

2018 European Society for Medical Oncology

178. ABCD position statement on standards of care for management of adults with type 1 diabetes - this has been superseded by the 2017 version - see above

treatment and targets to meet the needs of the individual. Managing type 1 diabetes in older people ? Acknowledge lower awareness of hypoglycaemia in this group. ? Older adults who are functioning well physically and mentally may wish to aim for the same targets as younger adults. ? Targets may be relaxed and individualised for older adults with either physical or mental frailties but symptomatic hyperglycaemia should be avoided. ? The potential benefits of tight glycaemic targets should be balanced (...) against the risk associated with hypoglycaemia in this age group ? Treatment of cardiovascular risk factors should take life expectancy into account. ? Screening for diabetes complications should pay particular attention to complications that would lead to functional impairment Diabetes UK recommendations for care home residents with diabetes ? Each resident should have an individual care plan, based on an annual assessment of functional status (including vision), cognition and nutrition ? The care

2016 Association of British Clinical Diabetologists

179. Guidelines for the Clinical and Operational Management of Drug-Resistant Tuberculosis

of supervised treatment 198 Factors that favour adherence to treatment 200 Infection control in the drug-resistant tuberculosis patient’s home 200 Strategies to improve adherence 201 Indicators used to assess treatment adherence 202 References 202 vi CONTENTS16 Monitoring and evaluation of drug-resistant tuberculosis management 205 Introduction and objectives 206 Indicators 207 De? nitions 207 What records are necessary for multidrug-resistant tuberculosis patient management? 210 How are results reported (...) ? 213 How are data tabulated, assessed and used to facilitate and improve management of multidrug-resistant tuberculosis in the future? 215 References 225 17 Management of second-line medicines for tuberculosis treatment 227 Introduction 227 Selection of medicines to treat drug-resistant tuberculosis patients 227 Quanti? cation 228 Procurement of drug-resistant tuberculosis medicines 229 Quality assurance of drug-resistant tuberculosis medicines purchased 229 Prices of drug-resistant tuberculosis

2013 International Union Against TB and Lung Disease

180. Implementing Collaborative TB-HIV Activities: A Programmatic Guide

-HIV coordinating body? 57 6.9 What are some practical hints to ensure ef? cient functioning of a TB-HIV coordinating body? 58 6.10 What are some of the key TB-HIV messages to be disseminated by TB-HIV coordinating bodies? 60 6.11 What bottlenecks need to be overcome to effectively coordinate and implement collaborative TB-HIV activities? 61 7 Role of collaborative TB-HIV activities in strengthening the general health system 63 7.1 Role of supply management in collaborative TB-HIV services 63 7.2 (...) of quality-assured antiretroviral medicines and use of standardised ART regimens with innovative ways to en- sure long-term treatment adherence • Recording and reporting, including cumulative treatment outcome cohort analysis, enabling assessment of patient survival and pro- gramme performance. 2 CHAPTER 1 The Union’s approach is based on the following core elements: • Provision of a basic package of TB-HIV services • Organisation of TB-HIV care based on: — the concept of the ‘basic management unit

2012 International Union Against TB and Lung Disease

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