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41. Sexually transmitted infections: condom distribution schemes

into a pre-designed scheme and potentially benefit from economies of scale [ES10, EA, EP1, EP2]. Inequalities Inequalities The committee recognised that targeting schemes at different population groups or geographical areas could lead to inequalities (for example, people living outside cities may not have access to city-based services). It also noted the lack of evidence of effectiveness for some groups, for example, people with learning disabilities. For this reason, the committee kept its (...) to single component schemes. The committee was aware that young people under 16 might also use single component schemes. It agreed that there was no way to prevent this. But it was clear that multicomponent schemes are the best option for them and for anyone over 16 for whom there is a duty of care (for example, if they have special educational needs or disabilities). It agreed that providing condoms freely to people most at risk of STIs is important, although it is better if this takes place

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

42. Drug misuse prevention: targeted interventions

. This may include people: in multiple groups at risk whose personal circumstances put them at increased risk who may already be using drugs on an occasional basis who may already be regularly excessively consuming another substance, such as alcohol. Y Y oung people oung people People aged 10 to 18. This term also includes people aged up to 25 who have special educational needs or a disability (consistent with the Children and Families Act 2014). Drug misuse prevention: targeted interventions (NG64) ©

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

43. Spondyloarthritis in over 16s: diagnosis and management

#notice-of-rights). Page 14 of 321.4.8 When using BASDAI and spinal pain VAS scores, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect the responses to the questionnaires, and make any adjustments they consider appropriate. [This recommendation is from NICE's technology appraisal guidance on TNF- alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis.] Biological DMARDs (...) technology appraisal guidance on secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors.] 1.4.11 When using BASDAI and spinal pain VAS scores, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect the responses to the questionnaires, and make any adjustments they consider appropriate. [This recommendation is from NICE's technology appraisal

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

44. Antimicrobial stewardship: changing risk-related behaviours in the general population

to provide a coordinated system of information. 1.3.2 Ensure information is available in a variety of formats to meet people's literacy and language needs and the needs of people with sensory disabilities. 1.3.3 Consider distributing information and advice through facilities and services operated by local authorities, such as leisure centres and libraries. 1.3.4 When deciding where to distribute information, prioritise settings in which people are more vulnerable to infection or where there is a high (...) be helpful). 1.4.12 Consider giving children information to take home about when and how to wash their hands. 1.4.13 Share information with parents and carers that can support their children's learning. This could include teaching their children how and when to wash their hands. 1.4.14 Give parents and carers advice on other ways to help prevent infections. This should include advice on being up to date with vaccinations (see NICE's guideline on immunisations: reducing differences in uptake in under 19s

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

45. Cerebral palsy in under 25s: assessment and management

palsy communication difficulties do not necessarily correlate with learning disability (intellectual disability). Assessment and referr Assessment and referral al 1.9.2 Regularly assess children and young people with cerebral palsy during routine reviews to identify concerns about speech, language and communication, including speech intelligibility. 1.9.3 Refer children and young people with cerebral palsy for specialist assessment if there are concerns about speech, language and communication (...) and degree of pain can be challenging, especially if: there are communication difficulties or learning disability (intellectual disability) there are difficulties with registering or processing sensory information (see section 1.16) ask about signs of pain, discomfort, distress and sleep disturbances (see section 1.14) at every contact recognise that pain-related behaviour can present differently compared with that in the wider population. 1.13.6 Assess for other possible causes of distress

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

46. Menstrual Suppression in Special Circumstances

Library using appropriate controlled vocabulary and key words (heavy menstrual bleeding, menstrual suppression, chemotherapy/radiation, cognitive disability, physical disability, learning disability). Results were restricted to systematic reviews, randomized controlled trials, observation studies, and pilot studies. There were no language or date restrictions. Searches were updated on a regular basis and new material was incorporated into the guideline until September 2013. Grey (unpublished (...) specific indications, contraindications, and side effects, both immediate and long-term, and the investigations and monitoring necessary throughout suppression. Outcomes Clinicians will be better informed about the options and indications for menstrual suppression in patients with cognitive and/or physical disabilities and patients undergoing chemotherapy, radiation, or other treatments for cancer. Evidence Published literature was retrieved through searches of Medline, EMBASE, OVID, and the Cochrane

2019 Society of Obstetricians and Gynaecologists of Canada

47. Monitoring Progress of Neurological and Functional Outcomes in the Paediatric HIV Cohort in the UK

educational or social care support, should be referred to a local Learning Disability (LD) and/or child development services at the earliest opportunity. On-going liaison with LD health and social care organisations is crucial to support the young person’s health, education and transition through education and to adult health services in the future. The health team should support young people to gain age appropriate levels of understanding and independence in their health care, through joint working (...) care is to enhance wellbeing and quality of life outcomes as well as improve the management of the condition and treatment demands. To achieve these, careful attention needs to be given to monitoring all aspects of progress (physical, cognitive, behavioural, learning, social and emotional) and address the changing demands of daily life as a child moves through childhood and adolescence. Background The developing brain is known to be particularly vulnerable to the effects of early biological

2019 The Children's HIV Association

48. Valproate Use In Women and Girls Of Childbearing Years

approach, considering issues through life stages. 1. Girls with epilepsy Our consensus is that the current guidance requires clarity with regard to the age and developmental stage of girls/young people as it is not appropriate for all children/young people in the paediatric population. In order to provide a framework for clinical management, the prescribing needs of children/young people should be considered by age and learning ability (13). The prescribing needs of girls with intellectual disability (...) 14 5.4 Emergency contraception 14 5.5 Adverse effects of contraception 15 5.6 Discontinuation or exchanging of valproate 15 5.7 Women choosing to remain on valproate, but without a PPP 15 5.8 Intellectual Disability (ID) 16 5.8.1 With lack of mental capacity 17 5.8.2 With mental capacity 17 5.9 Women who fail to attend their specialist appointment 17 5.10 Prescribing responsibility: consider shared care 18 5.11 Particular situations that may arise 18 5.11.1 Status epilepticus 18 5.11.2 Women

2019 Royal College of Obstetricians and Gynaecologists

49. Respiratory tract infections (self-limiting) – reducing antibiotic prescribing

may be supported by evidence-based written information tailored to the patient’s needs. Treatment and care, and the information patients are given about it, should be culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. Families and carers should also be given the information and support they need. 1. American Academy of Pediatrics Subcommittee on Management of Acute (...) ) and an examination to identify relevant clinical signs. 1.2 Patients’ or parents’/carers’ concerns and expectations should be determined as per the Code of Health and Disability Services Consumers’ Rights, and addressed when agreeing the use of the three antibiotic prescribing strategies (no prescribing, delayed prescribing and immediate prescribing). 1.3 A no antibiotic prescribing strategy or a delayed antibiotic prescribing strategy should be recommended for most patients with the following conditions

2019 Best Practice Advocacy Centre New Zealand

50. Haemodialysis

, Royal Free London NHS Foundation Trust Prof Ken Farrington Consultant Nephrologist, Lister Hospital, East & North Hertfordshire NHS Trust Dr Katey Flowers Nephrology Registrar, Wessex Kidney Centre, Portsmouth NHS Trust Dr James Fotheringham Consultant Nephrologist, Sheffield Teaching Hospitals NHS Foundation Trust Andrea Fox RN Deputy Director of Learning and Teaching, School of Nursing and Midwifery, University of Sheffield Gail Franklin Lead Clinical Specialist Dietitian, East & North (...) opportunity and encouragement to learn aspects of their dialysis treatment, and take an active role in their care. [2D] Guideline 8.3 - Intradialytic exercise We recommend that intradialytic exercise should be available in all units, as a treatment for enhancing physical functioning, in patients without contraindications. [1B] We suggest that intradialytic exercise be considered as a method of enhancing quality of life. [2C] We suggest that exercise regimes be devised by appropriately trained staff. [2C

2019 Renal Association

51. Management of Dyslipidaemias

in men (490 000 vs. 193 000). Prevention is defined as a co-ordinated set of actions, either at the population or individual level, aimed at eliminating or minimizing the impact of CV diseases and their related disabilities. More patients are surviving their first CVD event and are at high-risk of recurrences. In addition, the prevalence of some risk factors, notably diabetes (DM) and obesity, is increasing. The importance of ASCVD prevention remains undisputed and should be delivered at the general

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2019 European Society of Cardiology

52. Follow-Up Model of Care for Cancer Survivors: Recommendations for the Delivery of Follow-up Care for Cancer Survivors in Ontario

to employment and work re-entry, finances, and disability). These consequences may be temporary or chronic, or they may appear long after treatment was completed. Supportive care is needed to address social, psychological, emotional, spiritual, quality-of-life, and functional aspects of cancer to ensure high quality follow-up care. 7 Primary care providers have reported willingness to provide supportive care for cancer survivors, if clinical guidance, education/training, support from and communication (...) and confidence in managing their health and well-being. Self-management support is underpinned by effective communication skills of health care providers and is augmented by patient education resources and tools that reinforce learning and behaviours. 42,43,44 Survivorship Phase of the cancer continuum following diagnosis and treatment, prior to recurrence of subsequent cancers or death. 7 Follow-Up Model of Care for Cancer Survivors 14 Term Definition Telehealth The delivery of services by healthcare

2019 Cancer Care Ontario

53. Simplified guideline for prescribing medical cannabinoids in primary care

(such as anxiety), sleep disorders, and spasticity in MS. 3 Surveys of medical marijuana users find 70% or more believe medical mari- juana use results in moderate or better improvement in their symptoms. 3 A Canadian study found that functional status among medical marijuana users was worse than among the general population, reporting scores of 28 versus 7 on functional assessment, respectively (using the World Health Organization Disability Assessment Schedule for which possible scores range from 0 to 100 (...) recommend long-term monitoring of medical cannabinoids to further assess potential individual and societal benefits and harms. Dr Allan is Professor of Evidence-Based Medicine in the Department of Family Medicine at the University of Alberta in Edmonton. Mr Ramji, Ms Perry, and Dr Ton are Knowledge Translation Experts in the Physician Learning Program with the Alberta Medical Association and in Lifelong Learning and the Department of Family Medicine at the University of Alberta. Dr Beahm is Research

2018 CPG Infobase

54. Pharmacological management of migraine

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 (...) headache with a global prevalence of around one in seven people. 8 The Global Burden of Disease study ranks migraine as the seventh most common cause of disability worldwide, rising to the third most common cause in the under 50s. 9 It is estimated that migraine costs the UK around £3 billion a year in direct and indirect costs, taking into consideration the costs of healthcare, lost productivity and disability. 10 Twice as many women as men are affected. 11 This is considered to be due to changes

2018 SIGN

55. Practice guideline: joint CCMG-SOGC recommendations for the use of chromosomal microarray analysis for prenatal diagnosis and assessment of fetal loss in Canada

of specialty genetics centres across Canada, please refer to the Canadian Association of Genetic Counsellors website at www. cagc- accg. ca. Discussion around approaches to incidental findings follows later in this document, but centres that choose to report such findings should ensure that patients receive counselling by quali- fied health professionals, focusing on both the risks and benefits of learning about this type of result. Counselling must include recognition of and discussion of possible adverse (...) outcomes, including parents’ learning about secondary findings that they did not wish to know, such as identification of an adult onset disorder. r ecommendation 4 Given the varied contexts in which prenatal chromosomal microarray analysis may be offered, it is essential that pretest counselling be undertaken by a professional with expertise in the utilisation of CMA in the prenatal setting. The counsel- ling content should be documented in the medical record. This pretest counselling should include

2018 CPG Infobase

56. Diagnosis and management of epilepsy in adults

epilepticus 23 4.11 Patients with recurrent prolonged or serial seizures in the community 26 4.12 Drugs which exacerbate epileptic seizures 27 4.13 Management of patients with epilepsy in the perioperative period 27 4.14 Management of older people with epilepsy 27 4.15 Management of people with learning disability and epilepsy 29 5 Epilepsy and women’s health 31 5.1 Contraception 31 5.2 Preconceptual counselling 35 5.3 Risks of inheriting epilepsy 36 5.4 Pregnancy 38 5.5 Labour and birth 40 (...) after a seizure, and by recordings during sleep or following sleep deprivation. 16, 37, 38 Incidental epileptiform abnormalities are found in 0.5% of healthy young adults, but are more likely in people with learning disability and psychiatric disorders, patients with previous neurological insult (for example head injury, meningitis, stroke, cerebral palsy), and patients who have undergone neurosurgery. 39-41 Diagnosis and management of epilepsy in adults 3 • Diagnosis 2 +10 | In a patient in whom

2018 SIGN

57. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU

Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL/Certifications Exam Prep Research Research Funding AUA Funding Research Education & Events Online Research Education Courses Research Resources Biorepositories and Other Resources Research Publications Research Career Opportunities Advocacy Scholar & Fellowship Programs Comment Letters & Resources International International Opportunities Annual Meeting Membership Collaborations Academic Exchanges Giving Back

2019 Canadian Urological Association

58. 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 (...) developmental level and comprehension skills, affect the practitioner’s behavior guidance approaches. The success of restorations may be influenced by the child’s response to the chosen behavior guidance technique. To perform treatment safely, effectively, and efficiently, the practitioner caring for a pediatric patient may employ advanced behavior guidance techniques such as protective stabilization and/or sedation or general anesthesia. 59,60 The patient’s age, dental needs, disabilities, medical

2019 American Academy of Pediatric Dentistry

59. End of life care for infants, children and young people with life-limiting conditions: planning and management

, coping, and building resilience. 1.2.24 Be aware that children and young people may experience rapid changes in their condition and so might need emergency interventions and urgent access to psychological services. 1.2.25 Be aware of the specific emotional and psychological difficulties that may affect children and young people who have learning difficulties or problems with communication. 1.2.26 Provide information to children and young people and their parents or carers about the emotional (...) of 44bone pain (for example associated with metabolic diseases) pressure ulcers headache (for example caused by raised intracranial pressure) musculoskeletal pain (particularly if they have neurological disabilities) dental pain. 1.3.23 Be aware that pain, discomfort and distress may be caused by a combination of factors, which will need an individualised management approach. 1.3.24 For children and young people who have pain or have had it before, regularly reassess for its presence and severity even

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

60. Coexisting severe mental illness and substance misuse: community health and social care services

and employment services. 1.3.2 Ensure the care plan includes an assessment of the person's physical health, social care and other support needs, and make provision to meet those needs. This could include: personal care and hygiene family and personal relationships housing learning new skills for future employment or while in employment (including those administering social security benefits) education Coexisting severe mental illness and substance misuse: community health and social care services (NG58) © (...) that can help to improve wellbeing and create a sense of belonging or purpose. For example, encourage sport or recreation activities, or attendance at community groups that support their physical health or social needs. Ensure activities take account of a range of different abilities. Consider, for example: the gym education opportunities volunteering use of personal budgets (if applicable) for learning new skills, such as those that might support a return to employment. 1.3.6 Consider the following

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines


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