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282. Guidelines for Living Donor Kidney Transplantation

applications for organ donation from living people. This involves an independent assessment process. All donors and recipients see an Independent Assessor (IA) who is trained and accredited by the HTA and acts on behalf of the HTA to ensure that the donor has given valid consent, without duress or coercion, and that reward is not a factor in the donation. If the HTA is satisfied on these matters then approval for the living donation will be given. Clear guidance about the roles and responsibilities (...) of the 2006 Act (2) is to make provision for activities involving human tissue in the context of transplantation, research and education, its removal, retention and use following post-mortem examinations, and for the purposes of the Anatomy Act (1984), which is incorporated into the 2006 Act. Provisions of the Human Tissue (Scotland) Act are based on ‘authorisation’ (24) rather than ‘appropriate consent’ as in the Human Tissue Act 2004 (3), but the principles in each Act are essentially the same. The 2006

2018 Renal Association

283. Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

, generating 166 recommendations. Methods met NHMRC standards and procedures for externally developed guidelines and are outlined in the full guideline and . These involved rigorous systematic review, training, online communication and face-to-face meetings to discuss the evidence and apply the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Evidence quality, feasibility, acceptability, cost, implementation and ultimately recommendation strength were agreed across (...) . The guideline is underpinned by a robust evaluation process which will enable practice benchmarking and feedback data to be collected to guide further alignment with evidence-based care. Downloads of the guideline and its resources will be monitored; focus groups and surveys will measure awareness in consumers and knowledge and practice change by health professionals. This information will then be compared with data that were collected before the guideline release, to measure change. This strategic

2018 MJA Clinical Guidelines

284. Policy on Medically-Necessary Care

outcomes can adversely affect learning, communication, nutrition, and other activities necessary for normal growth and development. 8 Rampant caries is associated with insufficient development in children who have no other medical problems. 9 Children with early childhood caries (ECC) may be severely underweight because of the associated pain and disinclination to eat. Nutritional deficiencies during childhood can impact cognitive development. 10,11 Other oral conditions also can impact general health (...) for respiratory disease, have been linked. The mouth can harbor respiratory pathogens that may be aspirated, resulting in airway infections. 20 Furthermore, dental plaque may serve as a reservoir for respiratory pathogens in patients who are undergoing mechanical ventilation. 21 Problems of esthetics, form, and function can affect the developing psyche of children, with life-long consequences in social, educational, and occupational environments. 22,23 Self-image, self-esteem, and self- confidence

2019 American Academy of Pediatric Dentistry

285. Hydroxychloroquine and Chloroquine Retinopathy Screening

Hydroxychloroquine and Chloroquine Retinopathy Screening Hydroxychloroquine and Chloroquine Retinopathy: Recommendations on Screening Clinical Guidelines February 2018 Review date: February 2021The Royal College of Ophthalmologists (RCOphth) is the professional body for eye doctors, who are medically qualified and have undergone or are undergoing specialist training in the treatment and management of eye disease, including surgery. As an independent charity, we pride ourselves on providing (...) impartial and clinically based evidence, putting patient care and safety at the heart of everything we do. Ophthalmologists are at the forefront of eye health services because of their extensive training and experience. The Royal College of Ophthalmologists received its Royal Charter in 1988 and has a membership of over 4,000 consultants of all grades. We are not a regulatory body, but we work collaboratively with government, health and charity organisations to recommend and support improvements

2018 Royal College of Ophthalmologists

286. Standards and Model for Psychological Care for Children and Young People Living with HIV Infection (Summary)

promote learning, communication, emotional and mental health, independence and on-going life skills. Standard 4: Support for Knowledge, Understanding and Sharing Information about HIV Psychological and developmentally appropriate approaches should be available to all CLWH and their carers aimed at increasing knowledge and understanding of HIV and its effects to enable appropriate participation in decisions about personal health and treatments, enhance awareness of responsibilities around onward (...) and marginalization. This in turn has consequences for emotional wellbeing. Accessing extra services, in social, educational and psychological care can also be limited by concerns about sharing the diagnosis. Being confident in discussions about the diagnosis and having up to date knowledge about HIV is essential for all those involved in the care of CLWH and their families as this helps to destigmatise HIV. It helps too to be clear that confidentiality procedures are in place to protect all who attend a hospital

2018 The Children's HIV Association

287. Human Papillomavirus (HPV), Cervical Screening and Cervical Cancer

if they have completed a recognised training programme and every registrant has a professional duty to inform their employer if they require training. • In October 2017, the NCSP in England launched a refresher e-learning resource. It has been designed to meet the three-yearly updated requirements of registrants and is free to access for sample takers working in the programme. The resource is available at: screening-programmes • In Northern Ireland the Public Health Agency (...) chaotic life events/environments which preclude them from attending a clinic or understanding the importance of regular screening checks. It is equally important to be aware of women who may have learning difficulties or mental health issues, as well as physical disabilities which may require particular consideration. In addition, when caring for women under the age of 25 it is important to convey the rational for not routinely screening, as this is a recurring concern among some young women (DH, 2010

2018 Royal College of Nursing

288. Older people in care homes: Sex, Sexuality and Intimate Relationships

rights and choices in sexuality expression and intimate relationships • offer support and appropriate education for staff in dealing with issues of sexuality, intimate relationships and sex. Care systems and care delivery should: • be person-centred • focus on the perspectives of individuals within the context of their unique lives and experiences • be open to learning about the person’s significant experiences and relationships • promote and support human rights, dignity, privacy, choice and control (...) of sexuality in their day to day practice as a consequence of: • a lack of relevant experience • inadequate training or education in sexuality or sexual health • personal or religious beliefs about sexuality, including when people should or should not be sexually active, on homosexuality or on the appropriateness of various types of relationships, for example an older person with a younger person or between people from different backgrounds • the culture of the home or care environment, its care regimes

2018 Royal College of Nursing

289. Informed Consent

upon expert and/or consensus opinion by experienced researchers and legal practitioners. Background Informed consent is the process by which a health care provider gives relevant information concerning diagnosis and treatment needs to a patient so that the patient can make a voluntary, educated decision to accept or refuse treatment. Minor children are legally unable to give informed consent, and intellectually disabled adults lack capacity to give consent. Parents are authorized to grant (...) with relevant information regarding diagnosis and treatment needs so that an educated decision regarding treatment can be made by the patient. In the case of a minor or intellectually disabled adult, the parent gives informed permission with assent or agreement from the patient whenever possible. The oral discus- sion between provider and patient or parent, not the comple- tion of a form, is the important issue of informed consent. A written consent form serves as documentation of the consent process

2019 American Academy of Pediatric Dentistry

290. Use of Anesthesia Providers in the Administration of Office-based Deep Sedation/General Anesthesia to the Pediatric Dental Patient

techniques have allowed most pediatric dental patients to receive treatment in the dental office with minimal discomfort and without expressed fear. Minimal or moderate sedation has allowed others who are less compliant to receive treatment. Some children and individuals with special care needs who have extensive oral healthcare needs, acute situational anxiety, uncooperative age-appropriate behavior, immature cognitive functioning, disabilities, or medical conditions require deep sedation/general (...) anesthesia to receive dental treatment in a safe and humane fashion. 3 Access to hospital-based anesthesia services may be limited for a variety of reasons, including restriction of coverage of by third-party payors. 3,4 Pediatric dentists and others who treat children can provide for the administration of deep sedation/general anes- thesia by utilizing properly trained and currently licensed anesthesia providers in their offices or other facilities outside of the traditional surgical setting. Office

2019 American Academy of Pediatric Dentistry

291. Management of the Developing Dentition and Occlusion in Pediatric Dentistry

- tically acceptable occlusion and normal subsequent dentofacial development. Early diagnosis and successful treatment of developing malocclusions can have both short-term and long- term benefits while achieving the goals of occlusal harmony and function and dentofacial esthetics. 3-5 Dentists have the responsibility to recognize, diagnose, and manage or refer abnormalities in the developing dentition as dictated by the complexity of the problem and the individual clinician’s training, knowledge (...) dentition. A thorough knowledge of craniofacial growth and develop- ment of the dentition, as well as orthodontic treatment, must be used in diagnosing and reviewing possible interceptive treatment options before recommendations are made to parents. Treatment is beneficial for many children, but may not be indicated for every patient with a developing malocclusion. Treatment considerations: The developing dentition should be monitored throughout eruption. This monitoring at regular clinical examinations

2019 American Academy of Pediatric Dentistry

292. Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

or thera- peutic procedure may be minimized, but not completely eliminated, by a careful preprocedure review of the patient’s underlying medical conditions and consideration of how the sedation process might affect or be affected by these condi- tions: for example, children with developmental disabilities have been shown to have a threefold increased incidence of Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures (...) , appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction, a clear under- standing of the medication’s pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue

2019 American Academy of Pediatric Dentistry

293. Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealan

transition with different levels of comfort around how they wish to describe themselves. • Enquire about and use preferred name and pronouns. • Register the person’s self-identified gender identity on electronic patient records and update the National Health Index (with discussion and consent from the person whose record is being updated). • Provide training for clinicians to enable safe discussions of gender identity if people want to discuss their gender identity with clinicians. • Be knowledgeable (...) , surgeons, and other providers of a trans person’s care and to access regular peer consultation and feedback. These mental health professionals should have the knowledge to provide information to trans people regarding gender affirming care treatment options and community support availability. 4 Finally, an important component of ethical health care provision is for providers to be advocates for the trans people who use their services. This could include educating or working with family members, schools

2018 New Zealand Sexual Health Society

294. Clinical practice guideline for the care of women with decreased fetal movements for women with a singleton pregnancy from 28 weeks’ gestation

perinatal death or disability and maternal anxiety. This guideline is not intended to be prescriptive. It is designed to provide the best available information, enabling integration of the best evidence, clinicians’ judgement and individual choice in arriving at decisions about care. Clinical practice guidelines are considered as generally- recommended practice. Due to the lack of high-quality evidence, recommendations in this guideline are mainly consensus-based, following consideration (...) of the available evidence. E-learning program An eLearning program has been developed to familiarise clinicians with the guidelines as part of the Safer Baby Bundle initiative. Please contact the Centre of Research Excellence in Stillbirth to request access to this eLearning program. ii Update history The first version of the Guideline was developed and disseminated in July 2010, subsequently updated in August 2017. In this update we incorporate the results of the AFFIRM trial and modify the management

2019 Centre of Research Excellence in Stillbirth

295. Care around stillbirth and neonatal death

for the delivery of best practice perinatal bereavement care: ? All clinicians providing maternity and newborn care should attend the IMproving Perinatal Mortality Review and Outcomes Via Education (IMPROVE) Workshops educational program ? All health care professionals in maternity settings should have training in bereavement care that addresses the emotional, physical and practical aspects of perinatal death and relevant local policies ? Formal and peer support should be readily available for health care (...) occurring in that hospitals. The process should be overseen by an interdisciplinary Perinatal Mortality Steering Committee. 2 Staff should be provided with appropriate training on best practice around the time of a perinatal death through the IMPROVE Program and access to support. 3 The review of perinatal deaths should occur as soon as possible after the death aiming to have results in time for the initial follow-up visit with parents. It may be necessary to re-review the death if test results

2019 Centre of Research Excellence in Stillbirth

296. Dysphagia and Aspiration in Older People

are common and important consequences. 3. Older people at risk for aspiration include those with stroke, Parkinson’s disease, dementia, reduced level of consciousness, and any severely ill or disabled persons. 4. Apart from food, aspirate may contain saliva and gastric contents. Clinical symptoms and signs of aspiration may include coughing or choking on food, dyspnoea, oxygen desaturation, fever, pulmonary crepitations and consolidation. 5. Silent aspiration is common in older people. Deterioration (...) be considered. Additionally, dentist and oral hygienist referral may be appropriate. 8. Preventative treatment options for aspiration are limited. The options are nil by mouth, dietary modifications, oral care, positioning, swallowing rehabilitation and education. Evidence for successful drug intervention to prevent aspiration pneumonia is not compelling. 9. Tube feeding may be useful in temporarily providing nutritional support to patients with a non-progressive cause of aspiration such as stroke. However

2018 Australian and New Zealand Society for Geriatric Medicine

297. Pain Assessment - Cognitive Impairment

and inadequately managed in people with dementia, learning disabilities or a stroke– seek specialist advice . Actions If the pain is severe and overwhelming immediate treatment may be required before further assessment . Adjust the dose according to current analgesic use seek specialist advice . Assessment Involve the patient as much as possible in the assessment of their pain. Use a team approach: Is there a carer, friend or staff member who knows the patient and can help with the assessment? How (...) and carers. A trial of analgesics, non-pharmacological treatments or both may be appropriate. If opioids are required, discuss any concerns regarding their use. Agree goals for pain relief and a monitoring plan. If pain has not settled within 24 hours seek specialist advice. Agree arrangements for regular review. Practice Points Consider having a pain chart at the patient’s home. Provide written explanations about opioids. Resources DisDAT tool and information on pain assessment for people with learning

2018 Scottish Palliative Care Guidelines

298. Expert Recommendation Report on Clinical Nurse Specialist and Nurse Practitioner Roles in the Delivery of Adult Cancer Services in Ontario

services in Ontario, providing unpublished emerging practice evidence to fill in the gaps in the published PEBC APN Guideline. Intended Guideline Users APNs, nurses, physicians and other inter-professionals involved in the delivery of cancer care Chief Nurse Executives Directors of Nursing and Inter-professional Practice Educators and researchers Healthcare administrators who plan the delivery of cancer services Healthcare policy makers Professional associations (e.g., Canadian Association of Nurses (...) relationship between Cancer Care Ontario and you. Cancer Care Ontario is a division of CCO and is the Ontario government’s principal cancer advisor. Cancer Care Ontario is committed to ensuring accessible services and communications to individuals with disabilities. To receive any information on this website in an alternate format, please contact Cancer Care Ontario’s Communications Department at: 1-855-460-2647, TTY (416) 217-1815, or .

2018 Cancer Care Ontario

299. Multiple Pregnancy Following Assisted Reproduction (Full text)

and anxiety and parenting stress. Multiple pregnancy is also associated with a six‐fold increase in the risk of preterm birth, which is a leading cause of infant mortality and long‐term mental and physical disabilities, including cerebral palsy, learning difficulties and chronic lung disease. According to the CDC, in the USA 39.7% of ART‐conceived infants in 2013 were born either preterm (less than 37 weeks of gestation) or very preterm (less than 32 weeks of gestation). The cost of care for children born (...) prematurely as a result of multiple births is also considerable. According to one study, the estimated neonatal cost to the UK's National Health Service (NHS) for a twin is 16 times higher than that for a singleton baby. Higher order multiple pregnancies resulting from cross‐border reproductive care or ‘fertility tourism’ are also contributing to the challenges facing NHS maternity and neonatal services. This paper describes current knowledge and progress made since the publication of the previous edition

2018 Royal College of Obstetricians and Gynaecologists PubMed abstract

300. Decision-making capacity of detainees in immigration removal centres (IRCs)

remedies, and for keeping capacity under review. In this context it is noteworthy that NHS England, which is responsible for the provision of healthcare within the IRCs in England, 4 is currently undertaking research into the feasibility of screening for intellectual disability as part of the induction process for new detainees. The College welcomes this initiative. There should be regular training for all Home Office and healthcare staff on the circumstances in which capacity assessments should (...) experience distorted cognitions (due, for example, to high levels of anxiety or delusional beliefs) and these may affect their ability to appropriately weigh and balance information given to them. Such deficits may be difficult to ascertain. Cognitive deficits relating to intellectual disability and dementia are more likely to affect an individual’s ability to understand information and express a consistent opinion. This type of decision-making deficit may be easier to ascertain than the test of weighing

2018 Royal College of Psychiatrists


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