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101. Screening for disruptive behaviour problems in preschool children in primary health care settings

disabilities . For a significant proportion of preschool children, both clinical and subclinical levels of disruptive behaviours can persist into the early primary school years – , placing children at risk for poorer academic, physical and mental health outcomes into adolescence and adulthood – . Quality of life for children with disruptive disorders—and their families—is lower, while the costs to society for academic, social support, health care and criminal justice services are higher than for typically (...) to communicate or learn new skills? 4. Do you have any concerns about how your child gets along with other children at home or in the community? 5. Do you have any other concerns about your child’s emotions, behaviour or social functioning? STANDARDIZED SCREENING MEASURES Using standardized screening measures can help to assess for and identify problematic disruptive behaviours or the symptoms of mental health problems in preschool children. Most questionnaires can be completed by a parent or other primary

2017 Canadian Paediatric Society

102. Frailty in Older Adults - Early Identification and Management

to the patient and/or family/caregivers/representatives, as appropriate. Consider setting up your medical practice to have access to PharmaNet. To learn more or to register, see . PharmaNet is an online database that captures all outpatient prescriptions for drugs and medical devices dispensed in BC. Community Health Practice Access to PharmaNet is available to all physicians and nurse practitioners licensed to practice in BC. Advance Care Planning Advance care planning involves conversations (...) , Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004 Mar;59(3):255–63. Béland F, Bergman H, Lebel P, Dallaire L, Fletcher J, Contandriopoulos A-P, et al. Integrated services for frail elders (SIPA): a trial of a model for Canada. Can J Aging Rev Can Vieil. 2006;25(1):5–42. Kramer BJ, Auer C. Challenges to providing end-of-life care to low-income elders

2017 Clinical Practice Guidelines and Protocols in British Columbia

104. Diagnosis and Treatment of Peripheral Arterial Diseases

and public awareness about PADs. Indeed, while stroke is acknowledged as a serious condition with significant burden throughout Europe, other PADs can be as lethal and disabling. Major efforts are still necessary to sensitize healthcare providers, decision makers and the general population about the need for earlier and more efficient prevention and management strategies for the 40 million individuals of our continent affected by PADs. , General recommendations on the management of patients

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2017 European Society of Cardiology

105. Palliative Care for the Patient with Incurable Cancer or Advanced Disease: Part 3: Grief and Bereavement

Concerns re: identify, future Partner, parent, or care provider of the deceased Reframe/encourage, refer (hospice, seniors, support services), give homework: explore meaning of loss/what brings purpose to life. Review lifestyle factors. Lack of comprehension or expected reactions Mental illness/disability or depression Mental health/depression protocol Ongoing struggle with activities of daily living, concern about coping History of unhelpful coping strategies (e.g., substance abuse, declines support (...) J (2017) Appendix J: Be Gentle with Y ourself (Patient Handout) Thoughts on Coping with Loss Grief is a process that takes time, patience, and understanding. There are, however, some things you can do to take some control during this painful time. Your physical health is often the easiest place to begin. Start by: • Reducing alcohol, caffeine and sugar intake. • Drinking enough water each day. • Eating a healthy diet. • Getting as much rest as you can. • Learning to say no to things you don’t

2017 Clinical Practice Guidelines and Protocols in British Columbia

107. Stroke in childhood - clinical guideline for diagnosis, management and rehabilitation

, education, and social care professionals throughout the child’s schooling to identify and respond to their specific needs and disabilities. This can include meetings, joint assessments and sharing of relevant knowledge and skills to optimise and personalise the provision of learning support. • Be aware that children and young people with stroke may require a flexible, holistic, integrated approach in supporting them, ranging from targeted therapy or educational interventions for particular difficulties (...) Stroke in childhood - clinical guideline for diagnosis, management and rehabilitation Stroke in childhood Clinical guideline for diagnosis, management and rehabilitation May 2017 i Endorsement Association of Ambulance Chief Executives Association of Paediatric Chartered Physiotherapists British Association for Community Child Health British Academy of Childhood Disability British Association of General Paediatrics British Association of Stroke Physicians British Paediatric Neurology Association

2017 Royal College of Paediatrics and Child Health

108. Cancer Australia Annual Report 2016-17

with the nationally endorsed Optimal Care Pathways (OCPs) for six common and seven complex/high-risk cancers. Cancer Australia held a National Regional Cancer Services Forum in December 2016 to bring together clinical and administrative leaders from regional cancer services across all jurisdictions, state and territory health departments, primary care, consumers and key national stakeholders to share learnings and opportunities to improve outcomes for people with cancer in regional Australia. A key aspect (...) services across all jurisdictions, state and territory health departments, primary care, consumers and key national stakeholders to share learnings and identify opportunities to improve outcomes for people with cancer in regional Australia. The Forum built upon work undertaken by Cancer Australia in reviewing, analysing and synthesising data across 34 regional cancer services on cancer services, treatments and referrals for 6 common and 7 complex cancers.21 Report on Performance B Funding priority

2017 Cancer Australia

111. Mental health care in the perinatal period: Australian clinical practice guideline

, or both, are more likely to develop distress or mental health conditions in the perinatal period (Austin et al 2015). The likelihood is also greater for women who have experienced life stressors (e.g. family problems, family violence or loss, disability) or multiple trauma (Austin et al 2015). Assessment for specific psychosocial risk factors is discussed in Chapter 6. Some groups of women have greater exposure to life stressors, trauma or lack of support. • Aboriginal and Torres Strait Islander

2018 Clinical Practice Guidelines Portal

112. WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections

policies by WHO Member States as well as to help clinicians and other health-care professionals to reduce rates of unnecessary caesarean sections. Effective implementation of this guideline will contribute to achievement of the United Nation’s Sustainable Development Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”) (22) by improving the quality of care during childbirth and reducing complications, disability and death associated with caesarean births, particularly in settings

2018 World Health Organisation Guidelines

114. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment, and Initial Management

-documented need for PC clinicians to learn how to manage this condition, the increasing evidence base that is available to guide clinical practice, the increased selective serotonin reuptake inhibitor–prescribing rates in pediatric PC, , and new evidence that a multifaceted approach with mental health consultation may improve the management of depression in PC settings, , – guidance for the identification and management of depression in adolescents in PC were urgently needed. To address this gap as well (...) strategies for PC clinicians, but more research is needed before a consensus can be reached on how best to optimize training and educational strategies for PC providers. Access to Specialty Consultation In addition to obtaining relevant training, PC providers will benefit from having access to ongoing consultation with mental health specialists. , Consultation after training allows learning to be tailored to the PC provider’s actual practice and can increase provider comfort with diagnosing and treating

2018 American Academy of Pediatrics

116. Employment Considerations During Pregnancy and the Postpartum Period

Americans with “Break Time for Family and Medical None law(s) Discrimination Act Disabilities Act and Nursing Mothers Leave Act (FMLA) Pregnancy Discrimina- Law,” part of tion Act (limited Affordable Care Act circumstances) Benefits Prohibits pregnancy- Requires employers to Employers must provide 12 weeks of unpaid, related discrimination, provide reasonable reasonable break time job-protected leave including in hiring; accommodations for and a private space and continued health right to accommoda (...) Considerations During Pregnancy e117 The Pregnancy Discrimination Act entitles pregnant and lactating workers to the same accommodations offered to other workers with similar limitations aris- ing out of a temporary disability. Yet, even with these protections in place, legal rights to accommodations for pregnancy and lactation remain patchwork and incomplete. By writing appropriate notes to employers, obstetrician–gynecologists and other obstetric care pro- viders can be instrumental in obtaining

2018 American College of Obstetricians and Gynecologists

117. Practice Guideline Recommendations Summary: Disease-modifying Therapies for Adults with Multiple Sclerosis

there is a reasonable chance of benefit compared with the low but serious risk of PML. Starting: Recommendation 17 Rationale Ocrelizumab is the only DMT shown to alter disease progression in individuals with primary progressive multiple sclerosis (PPMS) who are ambulatory. The randomized controlled trial (RCT) of rituximab in PPMS was promising but inconclusive. e10 Although RCTs of fingolimod, glatiramer acetate, and interferon beta-1b failed to demonstrate an effect on disability progression in individuals (...) for the treatment to take full effect and are adherent to their therapy when they experience one or more relapses, two or more unequivocally new MRI-detected lesions, or increased disability on examination, over a one-year period of using a DMT. Switching: Recommendation 2 Rationale None of the available DMTs is completely effective against relapses and MRI activity. When a patient shows breakthrough disease activity (continued relapses, MRI activity), trying a medication with a different mechanism or efficacy

2018 American Academy of Neurology

118. Comprehensive Systematic Review Summary: Disease-modifying Therapies for Adults with Multiple Sclerosis

Academy of Neurology AEs: adverse effects ALT: alanine aminotransferase ARRs: annualized relapse rates AST: aspartate aminotransferase CIS: clinically isolated syndrome CMSC: Consortium of Multiple Sclerosis Centers” COI: conflict of interest CV: curriculum vitae DMTs: disease-modifying therapies EDSS: Expanded Disability Status Scale FDA: US Food and Drug Administration GDDI: Guideline Development, Dissemination, and Implementation Subcommittee IOM: Institute of Medicine mIUs: milli-international (...) . Effective medications share several features: (1) All effective medicines modify measures of disease activity such as relapse rates, the emergence of new or enhancing lesions on MRI, disability, or other parameters. (2) None of these medications is curative. (3) All these medications may have adverse effects (AEs), which may vary from bothersome to life-threatening. Although the disease course is known to vary widely, life expectancy may be shortened by about 6 to 7 years in persons with MS. e15

2018 American Academy of Neurology

119. Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care

of health can help obstetrician–gynecologists and other health care providers better understand patients, effectively communicate about health-related conditions and behavior, and improve health outcomes. The social determinants of health approach also acknowledges intersectionality—the overlapping categories of social identities such as gender, race, class, disability status, and sexual orientation and related structures of oppression and discrimination as they manifest in health care and outcomes (...) , cultural backgrounds. It may be especially helpful, for instance, for a clinician working in a locale with a large population of immigrants from a particular country to learn about cultural specificities of that group, recognize variations within that group, and understand the overlaying general experience of being an immigrant. Instead of “competence,” which mistakenly implies that culture is a skill that one can master, other ways to recognize that culture matters in certain clinical encounters

2018 American College of Obstetricians and Gynecologists

120. Müllerian Agenesis: Diagnosis, Management, and Treatment

dilation. Cognitive issues that affect adherence to dilation may include the following: limited comprehension of the diagnosis and anatomy, young age, underlying learning disability, and inadequate knowledge of the dilation process. Logistical barriers to successful dilation include lack of privacy and limited ability to travel to clinic for close follow-up. In a study of adolescent girls and women in whom müllerian agenesis was diagnosed, respondents reported lack of motivation, uncertainty

2018 American College of Obstetricians and Gynecologists


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