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61. Physical health of people in prison

of injury'). No: record no action needed. Other health conditions 4. Does the person have any of the following: allergies, asthma, diabetes, epilepsy or history of seizures chest pain, heart disease chronic obstructive pulmonary disease tuberculosis, sickle cell disease hepatitis B or C virus, HIV, other sexually transmitted infections learning disabilities neurodevelopmental disorders physical disabilities? Ask about each condition listed. Yes: make short notes on any details of the person's condition (...) and they need immediate support. No: record response. Mental health Physical health of people in prison (NG57) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 10 of 3616. Has the person ever seen a healthcare professional or service about a mental health problem (including a psychiatrist, GP , psychologist, counsellor, community mental health services, alcohol or substance misuse services or learning disability services

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

62. Multimorbidity: clinical assessment and management

or schizophrenia ongoing conditions such as learning disability symptom complexes such as frailty or chronic pain sensory impairment such as sight or hearing loss alcohol and substance misuse. 1.1.2 Be aware that the management of risk factors for future disease can be a major treatment burden for people with multimorbidity and should be carefully considered when optimising care. 1.1.3 Be aware that the evidence for recommendations in NICE guidance on single health conditions is regularly drawn from people (...) for adults with social care needs.] T erms used in this guideline Multimorbidity Multimorbidity Multimorbidity refers to the presence of 2 or more long-term health conditions, which can include: defined physical and mental health conditions such as diabetes or schizophrenia ongoing conditions such as learning disability symptom complexes such as frailty or chronic pain sensory impairment such as sight or hearing loss alcohol and substance misuse. The management of risk factors for future disease can

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

63. Harmful sexual behaviour among children and young people

on transition from child to adult services. 1.1.3 Ensure multi-agency, multidisciplinary teams: have links to clinical and non-clinical services and can make prompt referrals collaborate with specialists when children and young people have difficult or complex needs (for example, those with neurodevelopmental or learning disabilities or conduct disorders) establish relationships with statutory, community and voluntary organisations that work with at-risk children and young people, to provide a broad range (...) and adulthood and distinguishes between 3 levels, using a traffic light system to indicate the level of seriousness. Models that place a child or young person's sexual behaviour on a continuum indicating various levels of seriousness, such as Hackett's model [2] . 1.3.5 T ake account of the child or young person's age, developmental status and gender and, if relevant, any neurodevelopmental or learning disabilities. 1.3.6 Recognise that inappropriate sexualised behaviour is often an expression of a range

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

64. Community engagement: improving health and wellbeing and reducing health inequalities

as possible for people to get involved 10 T erms used in this guideline 11 Implementation: getting started 13 Identifying the resources needed 13 Learning and training 13 Evaluation and feedback 15 Need more help? 16 Context 17 Statutory obligations 17 More information 18 The committee's discussion 19 Background 19 Community engagement activities and approaches 20 Health and social inequalities 21 Evidence 21 Health economics 24 Evidence reviews 26 Gaps in the evidence 28 Recommendations for research 30 (...) and wellbeing initiatives (see sections 1.2 and 1.3). Do this by: Using evidence-based approaches to community engagement (see collaborations and partnerships and peer and lay roles). Being clear about which decisions people in local communities can influence and how this will happen. Recognising, valuing and sharing the knowledge, skills and experiences of all partners, particularly those from the local community (see learning and training). Making each partner's goals for community engagement clear

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

65. Transition from children's to adults' services for young people using health or social care services

] . 1.5.5 Consider establishing local, integrated youth forums for transition to provide feedback on existing service quality and to highlight any gaps. These forums should: meet regularly link with existing structures where these exist involve people with a range of care and support needs, such as: people with physical and mental health needs people with learning disabilities people who use social care services. 1.5.6 Ensure that data from education, health and care plans is used to inform service (...) : support the young person for the time defined in relevant legislation, or a minimum of 6 months before and after transfer (the exact length of time should be negotiated with the young person) hand over their responsibilities as named worker to someone in adults' services, if they are based in children's services. 1.2.10 For disabled young people in education, the named worker should liaise with education practitioners to ensure comprehensive student-focused transition planning is provided. This should

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

66. Sunlight exposure: risks and benefits

days absence because of sunburn or other adverse effects (Sun protection: advice for employers of outdoor workers Health and Safety Executive). Cover the needs of all at-risk groups (see recommendation 1.1.1). T ailor advice according to skin type and age. T ailor advice according to needs and circumstances. This includes people for whom English is not a first language, from lower socioeconomic groups, with specific cultural needs, or with a disability. Encourage people to manage their own risk (...) to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 17 of 40Be clearly displayed in communal locations including pharmacies, airports, schools, travel vaccination clinics and appropriate leisure and sporting events. Be available in a variety of formats, including formats that are suitable for people with a disability. Use skin-type charts. A range of charts are available, such as those produced by Cancer Research UK and the British Association of Dermatologists

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

67. Oral health for adults in care homes

they may be home to around 30,000 younger adults with learning disabilities (Emerson et al. 2013 [2] ). The Alzheimer's Society estimates 80% of residents have dementia or severe memory problems (Low expectations). Research with adults in care homes with moderate to severe dementia has reported poor oral health (Preston 2006 [3] ). A 2012 British Dental Association survey (Dentistry in care homes research – UK) found inconsistent oral health care in care homes. It found many residents had oral health (...) , Hatton C, Robertson J et al. (2013) People with learning disabilities in England 2012. Learning Disabilities Observatory: Lancaster. [3] Preston A (2006) The oral health of individuals with dementia in nursing homes. Gerodontology 23 (2): 99–105 Oral health for adults in care homes (NG48) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 15 of 37The committee The committee's discussion 's discussion Evidence statement

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

68. Transition between inpatient mental health settings and community or care home settings

admission Planning and assessment Planning and assessment 1.2.1 Mental health practitioners supporting transition should respond quickly to requests for assessment of mental health from: people with mental health problems family members carers primary care practitioners (including GPs) specialist community teams (for example, learning disability teams) staff such as hostel, housing and community support workers. Assessments for people in crisis should be prioritised. 1.2.2 If admission is being planned (...) people with dementia, cognitive or sensory impairment people on the autistic spectrum Transition between inpatient mental health settings and community or care home settings (NG53) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 34people with learning disabilities and other additional needs people placed outside the area in which they live. 1.2.5 For planned admissions, offer people an opportunity to visit

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

69. 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

70. Management of Stroke in Neonates and Children

presented as neonates and 44 whose strokes were discovered later. Seventy-six children (68%) exhibited cerebral palsy, and 55 of these individuals had at least 1 additional disability; 45 (59%) experienced cognitive or speech impairment, and 36 (47%) had epilepsy. Detailed neuropsychological testing often documents cognitive dysfunction, especially related to attention and executive function. Such functional deficits are more likely to occur in individuals with a larger infarction, with comorbid (...) that among highly selected adults with AIS and large vessel occlusion, thrombectomy improves 90-day survival without disability over standard medical therapy. A 2016 pooled analysis by Goyal et al of the 1287 adult stroke patients from the 5 endovascular thrombectomy clinical trials published by 2015 demonstrated robust clinical benefits for thrombectomy across a broad spectrum of age and initial stroke severity (moderate or severe, with few minor strokes included) and a number needed to treat of 2.6

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2019 American Heart Association

71. Heart Disease and Stroke Statistics

been cited >20 000 times in the literature. Figure. AHA’s My Life Check – Life’s Simple 7. Seven approaches to staying heart healthy: be active, keep a healthy weight, learn about cholesterol, don’t smoke or use smokeless tobacco, eat a heart-healthy diet, keep blood pressure healthy, and learn about blood sugar and diabetes mellitus. Each annual version of the Statistical Update undergoes revisions to include the newest nationally representative data, add additional relevant published scientific (...) as related deaths and disability-adjusted life-years lost, increased. The majority of global stroke burden is in low-income and middle-income countries. In analyses of 1 165 960 Medicare fee-for-service beneficiaries hospitalized between 2009 and 2013 for ischemic stroke, patients treated at primary stroke centers certified between 2009 and 2013 had lower in-hospital (odds ratio [OR], 0.89; 95% CI, 0.85–0.94), 30-day (hazard ratio, 0.90; 95% CI, 0.89–0.92), and 1-year (hazard ratio, 0.91; 95% CI, 0.90

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2019 American Heart Association

72. United Kingdom National Guideline for the Management of Pelvic Inflammatory Disease (2019 Interim Update)

of mixed race - Irish - White British - Chinese - Other minority groups not listed The highest rates of STI diagnoses at sexual health clinics are found among people of black ethnicity in deprived areas. This is most likely seen as a consequence of a complex interplay of cultural, economic and behavioural factors. Accurate diagnosis and better tolerated treatments should improve the burden of disease in the community Dept of Health Medium Disability - Sensory - Learning disability - Mental health (...) United Kingdom National Guideline for the Management of Pelvic Inflammatory Disease (2019 Interim Update) United Kingdom National Guideline for the Management of Pelvic Inflammatory Disease (2019 Interim Update) Guideline development group: Jonathan Ross (lead author), Michelle Cole, Ceri Evans, Deirdre Lyons, Gillian Dean, Darren Cousins, PPI representative What is new in the 2019 interim update? • the European Medicines Agency has released new guidance highlighting the potential for disabling

2019 British Association for Sexual Health and HIV

73. ESC/ESH Management of Arterial Hypertension

to premature death in 2015, accounting for almost 10 million deaths and over 200 million disability-adjusted life years. Importantly, despite advances in diagnosis and treatment over the past 30 years, the disability-adjusted life years attributable to hypertension have increased by 40% since 1990. SBP ≥140 mmHg accounts for most of the mortality and disability burden (∼70%), and the largest number of SBP-related deaths per year are due to ischaemic heart disease (4.9 million), haemorrhagic stroke (2.0

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2018 European Society of Cardiology

76. Recommendations for the Delivery of Psychosocial Oncology Services in Ontario

with cancer continued on page 1414 | Building the case: why is psychosocial oncology care important? Category Concern Practical • Need for community support (e.g., social work, nursing) • Practical needs (e.g., housing, food, disability aid, transportation, functions of daily living, drug reimbursement, daycare) • Rehabilitation issues (e.g., back-to-work difficulties, changes to home routine and set up) • Employment, school or career concerns, advocacy • Cultural or language issues • Caregiver

2018 Cancer Care Ontario

77. Interpregnancy Care

2014;53:1074–81.e4. Conde-Agudelo A, Rosas-Bermudez A, Norton MH. Birth spacing and risk of autism and other neurodevelopmental disabilities: a systematic review. Pediatrics 2016;137:e20153482. Gunnes N, Suren P, Bresnahan M, Hornig M, Lie KK, Lipkin WI, et al. Interpregnancy interval and risk of autistic disorder. Epidemiology 2013;24:906–12. Ball SJ, Pereira G, Jacoby P, de Klerk N, Stanley FJ. Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort

2019 American College of Obstetricians and Gynecologists

78. Recommendations for the Appropriate Structure, Communication, and Investigation of Tobacco Harm Reduction Claims: An Official ATS Policy Statement

SOCIETY DOCUMENTS e96 American Journal of Respiratory and Critical Care Medicine Volume 198 Number 8 | October 15 2018 especially vulnerable to the negative consequences of nicotine exposure, given the high degree of plasticity during this period. Early exposure potentially alters the normal course of brain growth and development, affecting learning, reasoning, mental health, attention, impulse control, and personality (2, 51–53). Nicotine has a powerful gateway effect on the brain, making (...) the decision-making algorithm. Within-group risk trade-offs are also foreseeable; how do we correctly value avoidance of a known risk if the trade-off involves increasing another? Are disability-adjusted life-years saved an appropriate metric for considering the trade-off? Finally, in a setting of limited resources, investment in one harm reduction strategy may delay or otherwise undermine the development of other, potentially more effective, approaches. Is there an economic metric appropriate

2019 American Thoracic Society

79. Professional Practice Guidelines for the Psychological Practice with Boys and Men

with increasing frequency (Wong & Wester, 2016). GENDER ROLE CONFLICT Gender role conflict (GRC) is defined as problems resulting from adherence to “rigid, sexist, or restrictive gender roles, learned during socialization, that result in personal restriction, devalua- tion, or violation of others or self” (O’Neil, 1990, p. 25). GRC is the most widely studied aspect of masculine gender role strain, and researchers have demonstrated that men experience conflict relat- ed to four domains of the male gender role (...) role strain and gender role conflict (Pleck, 1981, 1995; O’Neil, 2008; O’Neil & Renzulli, 2013), and negatively influence mental health (e.g., O’Neil, 2008, 2013, 2015) and physical health (Courtenay, 2011; Gough & Robertson, 2017). Indeed, boys and men are overrepresented in a variety of psychological and social problems. For example, boys are dispro- portionately represented among schoolchildren with learning dif- ficulties (e.g., lower standardized test scores) and behavior prob- lems (e.g

2019 American Psychological Association

80. Optimal Exercise Programs for Patients With Peripheral Artery Disease: A Scientific Statement From the American Heart Association

the functional independence of patients with PAD. , However, functional impairment and functional decline are present even in people with PAD who are asymptomatic (ie, they have no exertional leg symptoms). , A limited ability to walk represents a disability when people are unable to perform their normal personal, social, and occupational activities. The major goals of treatment in people with claudication and other functional limitations resulting from PAD are to improve walking ability by relieving (...) measures used to assess changes in walking performance in a treadmill exercise test. Of these, PWT or PWD has the greatest reliability. After a treadmill-based SET program, typical changes in PWT, relative to a control group, have been shown to be 3.4 to 4.6 minutes and typical changes in COT have been shown to be 1.65 to 2.2 minutes. , , A limitation of treadmill exercise testing is a learning/placebo effect in which patients with PAD who do not receive an intervention increase their PWD/PWT and COD

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2019 American Gastroenterological Association Institute

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