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181. Contraception - assessment: Scenario: Issues to discuss and consider

thromboembolism (VTE). Concurrent medication — liver enzyme-inducing drugs (such as medicines used to treat epilepsy, anti-retrovirals and St John’s Wort) can affect some forms of contraception. Avoid less effective methods of contraception (such as fertility awareness-based methods) if the woman is taking teratogenic drugs (for example lithium or warfarin). Age of the woman — approaching the menopause or under 18 years. Consider any relevant ethical and legal issues if the woman has a learning disability (...) on what CKS considers to be good clinical practice. What ethical and legal issues do I need to consider when arranging contraception for someone with a learning disability? Support women with learning and/or physical disabilities to make their own decisions about contraception. Assess a woman's competence to consent to treatment by her ability to: Understand the information provided, and Weigh up the risks and benefits, and Express her own wishes. When a woman with a learning disability cannot

2020 NICE Clinical Knowledge Summaries

182. Contraception - assessment: Scenario: Assessment for specific contraceptive methods

for the person . Assess the person's: M ental capacity to make the decision. If there is any doubt about their mental capacity, seek advice from appropriately experienced colleagues (such as a specialist in learning disabilities). Level of understanding of the advantages, disadvantages, procedures involved, and relative failure rates of a vasectomy or tubal occlusion. Offer alternative long-term reversible methods of contraception such as hormonal methods (combined hormonal contraceptives, progestogen-only

2020 NICE Clinical Knowledge Summaries

183. Autism in adults: Scenario: Managing confirmed autism

: A structured and predictable training programme based on behavioural principles. For adults with ASD without a learning disability or with a mild to moderate learning disability, who are socially isolated or have restricted social contact: A group-based structured leisure activity programme, or An individually delivered structured leisure activity programme for people who find group-based activities difficult. For adults with ASD without a learning disability or with a mild to moderate learning disability (...) are coping well with the current support they are receiving and are well informed on how to access additional support if needed. Ensure that the person with ASD has access to appropriate psychosocial interventions, such as social learning programmes to improve social interaction, anger management interventions, and an individual supported employment programme for those with ASD without a learning disability or with a mild learning disability, who are having difficulty obtaining or maintaining employment

2020 NICE Clinical Knowledge Summaries

184. Autism in children

and communication, combined with restricted interests and rigid and repetitive behaviours. ASD is strongly associated with a number of coexisting conditions that may significantly impact on the wellbeing of the child or young person and their family and/or carers. Mental health or behavioural disorders associated with ASD include anxiety, attention deficit hyperactivity disorder, oppositional defiant disorder, behaviour that challenges, and learning (intellectual) disability. Functional problems associated (...) . The prognosis of ASD can be improved by early diagnosis and assessment because this aids understanding of why the child or young person is different from their peers. Early diagnosis also ensures that the child or young person and their family and/or carers have prompt access to support and services in education, health services, and social care; a route into voluntary organizations; and contact with other children and families with similar experiences. All of these can improve the lives of the child

2020 NICE Clinical Knowledge Summaries

185. Autism in adults: Scenario: Managing suspected autism

learning disability: Consider a brief assessment to ascertain whether the following behaviours are present (if necessary using information from a family member, partner, or carer): Difficulties in reciprocal social interaction, including limited interaction with others (for example, being aloof, indifferent, or unusual); interaction to fulfil needs only; and interaction that is naive or one-sided. Lack of responsiveness to others. Little or no change in behaviour in response to different social (...) to make these recommendations, see the . Adults with possible autism spectrum disorder (ASD) who do not have a moderate or severe learning disability The NICE guideline development group (GDG) considered the sensitivity and specificity of the five versions of the Autism-Spectrum Quotient (AQ) questionnaire: the 50-item (AQ-50), the 21-item (AQ-21), the 20-item (AQ-20), and two versions of a 10-item questionnaire (AQ-10 [British] and AQ-10 [Japanese]). The GDG judged that there were no important

2020 NICE Clinical Knowledge Summaries

186. Self-harm: Scenario: Acute management following an act of self-harm

be assessed by mental health professionals experienced in the assessment of older people who self-harm. People with a moderate or severe learning disability should be referred to a specialist learning disabilities service. Examine any physical injuries. Assess the person's emotional and mental state, and for the presence of features that may increase the person's risk, such as : Features of depression. For further information, see the CKS topic on . Features that suggest suicidal intent. Consider history (...) for children about self-harm. Support for adults and young people affected by self-harm. Harmless ( ) — provides support and information to people who self-harm, their friends, and families; and training for healthcare professionals. Mind ( ) — provides information and support, helplines, local support groups, and publications aimed at anyone who self-harms, and their friends and family. National Self Harm Network ( ) — aims to support, empower, and educate people who self-harm and their families

2020 NICE Clinical Knowledge Summaries

187. Restless legs syndrome: How do I assess a person with restless legs syndrome?

mildly annoying to disabling. The IRLSSG therefore stated that, for clinical significance, the symptoms of RLS should cause significant distress or impairment in social, occupational, educational or other important areas of functioning by their impact on sleep, energy, daily activities, behaviour, cognition or mood. Consider using the validated symptom rating scale of the IRLSSG (which can be obtained from ). This is completed by the person with RLS, and then graded by the healthcare professional

2020 NICE Clinical Knowledge Summaries

188. Covid-19: Neurocritical Care

Scientific Corner December 19, 2019 COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education October 1, 2018 Continuing medical education July 24, 2018 (...) Resident and Research Fellows May 13, 2020 Resident and Research Fellows May 5, 2020 Resident and Research Fellows April 27, 2020 Resident and Research Fellows April 27, 2020 Fellowship reports May 5, 2020 Fellowship reports April 27, 2020 Fellowship reports April 5, 2020 Fellowship reports March 2, 2020 Education corner May 5, 2020 Education corner April 27, 2020 Education corner January 24, 2020 Education corner January 17, 2020 EAN Congress news May 5, 2020 General interest May 5, 2020 COVID-19 May

2020 European Academy of Neurology

189. Covid-19: Stroke

COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education October 1, 2018 Continuing medical education July 24, 2018 Resident and Research Fellows May (...) 13, 2020 Resident and Research Fellows May 5, 2020 Resident and Research Fellows April 27, 2020 Resident and Research Fellows April 27, 2020 Fellowship reports May 5, 2020 Fellowship reports April 27, 2020 Fellowship reports April 5, 2020 Fellowship reports March 2, 2020 Education corner May 5, 2020 Education corner April 27, 2020 Education corner January 24, 2020 Education corner January 17, 2020 EAN Congress news May 5, 2020 General interest May 5, 2020 COVID-19 May 5, 2020 COVID-19 May 2, 2020

2020 European Academy of Neurology

190. Covid-19: Child Neurology Full Text available with Trip Pro

December 19, 2019 COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education October 1, 2018 Continuing medical education July 24, 2018 Resident (...) and Research Fellows May 13, 2020 Resident and Research Fellows May 5, 2020 Resident and Research Fellows April 27, 2020 Resident and Research Fellows April 27, 2020 Fellowship reports May 5, 2020 Fellowship reports April 27, 2020 Fellowship reports April 5, 2020 Fellowship reports March 2, 2020 Education corner May 5, 2020 Education corner April 27, 2020 Education corner January 24, 2020 Education corner January 17, 2020 EAN Congress news May 5, 2020 General interest May 5, 2020 COVID-19 May 5, 2020 COVID

2020 European Academy of Neurology

191. Covid-19: Neurorehabilitation

December 19, 2019 COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education October 1, 2018 Continuing medical education July 24, 2018 Resident (...) and Research Fellows May 13, 2020 Resident and Research Fellows May 5, 2020 Resident and Research Fellows April 27, 2020 Resident and Research Fellows April 27, 2020 Fellowship reports May 5, 2020 Fellowship reports April 27, 2020 Fellowship reports April 5, 2020 Fellowship reports March 2, 2020 Education corner May 5, 2020 Education corner April 27, 2020 Education corner January 24, 2020 Education corner January 17, 2020 EAN Congress news May 5, 2020 General interest May 5, 2020 COVID-19 May 5, 2020 COVID

2020 European Academy of Neurology

192. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain from a Multispecialty, International Working Group Full Text available with Trip Pro

no correlation between any historical or provocative examination sign and immediate or prolonged response to injections. A prospective study by Lilius et al assessed work and disability in 109 patients with LBP who had no signs of radicular pain following an IA injection with either cortisone and LA; a pericapsular injection of the same mixture; or an IA saline injection. They found that psychosocial factors significantly influenced outcome. Schwarzer et al conducted a prospective study attempting (...) -group response rate to MBBs was statistically significant (p<0.05). In a third study, an observational, open-label design was used to compare the outcomes of MBB in patients with chronic LBP (n=30) with and without facet joint-positive SPECT scans. The primary outcome measure was >50% pain reduction on the visual analog scale (VAS) at weeks 2 and 4 following the MBB. A secondary outcome measure was the Oswestry Disability Index (ODI) score. All MBB were performed using ultrasound guidance

2020 American Society of Regional Anesthesia and Pain Medicine

193. WHO recommendation on Calcium supplementation before pregnancy for the prevention of pre-eclampsia and its complications

and the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a cosponsored program executed by the WHO. WHO emphasizes that donors do not participate in any decision related to the guideline development process, including the composition of research questions, membership of the guideline development groups, conducting and interpretation of systematic reviews, or formulation of the recommendation. The views of the funding bodies have (...) of Recommendations, Assessment, Development and Evaluation GREAT Guideline development, Research priorities, Evidence synthesis, Applicability of evidence, Transfer of knowledge (a WHO project) GSG Executive Guideline Steering Group HELLP Haemolysis, elevated liver enzymes, low platelets ICM International Confederation of Midwives ICU Intensive care unit LMIC Low and middle-income country MAP Mean arterial pressure MCA [WHO Department of] Maternal, Newborn, Child and Adolescent Health and Ageing MCSP Maternal

2020 World Health Organisation Guidelines

194. Covid-19: Coma and Chronic Disorders of Consciousness

is generally available only in post-acute rehabilitation wards. These wards have the necessary expertise in the management of tracheal tubes and enteral nutrition, oxygenation monitoring, tracheo-bronchial secretion management, respiratory and swallowing training, neuromotor and cognitive-behavioral rehabilitation and caregivers education and psychological support (Formisano, unpublished data). Of note, the Italian Society of Neurorehabilitation has recently proposed recommendations on urgent measures (...) January 17, 2020 Scientific Corner January 17, 2020 Scientific Corner December 19, 2019 COVID-19 May 13, 2020 COVID-19 May 5, 2020 COVID-19 May 5, 2020 Educational May 5, 2020 E-Brain May 1, 2020 E-Brain February 28, 2020 E-Brain April 1, 2019 E-Brain November 1, 2018 Grand Rounds October 2, 2017 Grand Rounds July 1, 2016 Grand Rounds July 1, 2016 Grand Rounds February 1, 2016 Continuing medical education June 3, 2019 Continuing medical education February 21, 2019 Continuing medical education October

2020 European Academy of Neurology

195. Obstetric Management of Patients with Spinal Cord Injuries

with disabilities. Matern Child Health J 2006;10(suppl 5):S175-6. Article Locations: Le Liepvre H, Dinh A, Idiard-Chamois B, Chartier-Kastler E, Phe V, Even A, et al. Pregnancy in spinal cord-injured women, a cohort study of 37 pregnancies in 25 women. Spinal Cord 2017;55:167–71. Article Locations: McLain AB, Massengill T, Klebine P. Information/education page. Pregnancy and women with spinal cord injury. Arch Phys Med Rehabil 2016;97:497–8. Article Locations: Hocaloski S, Elliott S, Hodge K, McBride K (...) Obstetric Management of Patients with Spinal Cord Injuries Obstetric Management of Patients with Spinal Cord Injuries | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Obstetric Management of Patients with Spinal Cord Injuries Committee Opinion Number 808 May 2020 Jump to Resources Share By reading this page you agree to ACOG's Terms and Conditions. . Nearly half (47.6%) occur in persons between

2020 American College of Obstetricians and Gynecologists

196. Gynecologic Management of Adolescents and Young Women With Seizure Disorders

are on antiepileptic drugs do not have adequate knowledge of antiepileptic drugs’ interactions with hormonal contraception and feel they receive insufficient counseling from their health care providers . Early discussion including family involvement may lay the foundation for improved knowledge, contraception use, and pregnancy planning as adolescents with seizure disorders transition to adult care. Education about the reproductive cycle, contraception, and pregnancy should begin early and be readdressed at each (...) Gynecologic Management of Adolescents and Young Women With Seizure Disorders Gynecologic Management of Adolescents and Young Women With Seizure Disorders | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Gynecologic Management of Adolescents and Young Women With Seizure Disorders Committee Opinion Number 806 May 2020 Jump to Resources Share By reading this page you agree to ACOG's Terms

2020 American College of Obstetricians and Gynecologists

197. AIM Clinical Appropriateness Guidelines for Whole Exome and Whole Genome Sequencing

for testing and proficiency in genetic variant interpretation, in order to maximize the genetic testing experience for patients and their healthcare providers. The genetic counseling informed consent process also educates and empowers patients to consider the psychological, financial, employment, disability, and insurance implications of genetic testing and results (Al-Khatib et al. 2018). Patients who receive genetic counseling report increased knowledge, understanding, and satisfaction regarding (...) encephalopathy (onset before three years of age) for which likely non-genetic causes of epilepsy (e.g. environmental exposures; brain injury secondary to complications of extreme prematurity, infection, trauma) have been excluded Or two of the following four criteria: - Abnormality affecting a single organ system - Significant intellectual disability or severe psychological/psychiatric disturbance (e.g. self-injurious behavior, reversed sleep-wake cycles) - Family history strongly implicating a genetic

2020 AIM Specialty Health

199. Responding to the Needs of Youth Involved With the Justice System During the COVID-19 Pandemic Full Text available with Trip Pro

statement, “ ,” 5 youth involved in the justice system are more likely to have unmet medical, mental health, and social needs; more likely to be youth of color; and more likely to have been exposed to adverse childhood experiences (ACEs). Lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth, youth with current or past involvement with the child welfare system, and youth with developmental disabilities are a few of the many marginalized populations that are overrepresented in the justice (...) limited contact with family, and may have poor access to education and developmentally appropriate programs. Recognizing that under normal circumstances, incarcerated and detained youth often experience poor conditions of confinement, juvenile justice advocates have raised concerns that many juvenile detention facilities are not equipped to adequately respond to COVID-19 pandemic. These concerns have been validated by media reports highlighting the experiences of confined youth during the COVID-19

2020 American Academy of Pediatrics

200. AACE Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

(LSC) (Grade B; BEL 1, down- graded due to limited evidence). R29. Follow-up of patients should ideally be conducted in the same facility with the same dual-energy X-ray absorp- tiometry (DXA) system, provided the acquisition, analy- sis, and interpretation adhere to International Society for Clinical Densitometry DXA best practices (Grade C; BEL 2, downgraded due to limited evidence). R30. Consider using bone turnover markers (BTMs) for assessment of patient compliance and efficacy of therapy (...) be diagnosed in patients with or without fragility fractures. Vertebral fractures, however, may occur during routine daily activi- ties, without a specific fall or injury. In clinical practice, it may be difficult or impossible to reconstruct the mechani - cal force applied to bone in a fall. Osteoporosis-related fractures often lead to pain, disability, and deformity and reduce quality and quantity of life. Hip fractures are the most serious consequences of osteoporosis. Women have an increased mortality

2020 American Association of Clinical Endocrinologists

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