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143. 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

144. 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

146. 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

148. 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

149. 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

150. 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

151. 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

152. 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

153. Hoarseness (Dysphonia)

instructors, clergy, and coaches. Dysphonia can affect a person’s ability to work. An estimated 28 million workers in the United States experience voice problems daily. In the general population, 7.2% of individuals surveyed missed work for ≥1 more days within the preceding year because of a voice problem, and 1 out of 10 individuals with voice disorders file short-term disability claims. In fact, 20% of teachers miss work due to dysphonia, and absenteeism in this occupation alone has associated economic

2018 American Academy of Otolaryngology - Head and Neck Surgery

154. Induced Pluripotent Stem Cells for Cardiovascular Disease Modeling and Precision Medicine: A Scientific Statement From the American Heart Association

, autism, and neurodevelopmental disabilities. The National Heart, Lung, and Blood Institute funded the Next Generation Genetic Association Studies (NextGen) Consortium, which is spread across 8 academic institutions in the United States with the goal of generating iPSC lines from >1500 individuals, including those with various cardiovascular, pulmonary, and blood disorders and their healthy control counterparts. These cell lines are being stored and distributed by WiCell Research Institute (Madison

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2018 American Heart Association

156. AASLD Guidelines for Treatment of Chronic Hepatitis B

disease a Indicates those who should receive hepatitis B vaccine, if seronegative. • Health care and public safety workers at risk for occupational exposure to blood or blood‐contaminated body fluids a Indicates those who should receive hepatitis B vaccine, if seronegative. • Residents and staff of facilities for developmentally disabled persons a Indicates those who should receive hepatitis B vaccine, if seronegative. • Travelers to countries with intermediate or high prevalence of HBV infection

2018 American Association for the Study of Liver Diseases

157. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency

, at 0% to 4% ( ). In regard to morbidity, infants diagnosed through screening have less severe hyponatremia ( ) and tend to have shorter hospitalizations ( , , , ) than infants diagnosed later. Learning disabilities may occur in patients who have had salt-wasting crises ( ). Although salt-wasting males would seem to derive the greatest benefit from screening programs, the delay before correct sex assignment of severely virilized females is also reduced ( , ). Moreover, males with simple virilizing

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2018 The Endocrine Society

158. Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions

and 40% of women in the United States are obese. , Obesity is associated with health problems such as increased risk for coronary heart disease, type 2 diabetes, various types of cancer, gallstones, and disability. , Obesity is also associated with an increased risk for death, particularly among adults younger than 65 years. The leading causes of death among adults with obesity include ischemic heart disease, type 2 diabetes, respiratory diseases, and cancer (eg, liver, kidney, breast, endometrial (...) , intervention components included computer- or web-based intervention modules, web-based self-monitoring, mobile phone–based text messages, smartphone applications, social networking platforms, or DVD learning. Only 1 trial delivered its intervention through print-based tailored materials. Rates of participant adherence were generally high. More than two-thirds of study participants completed interventions. In addition, all study participants completed more than two-thirds of the intervention. Participation

2018 U.S. Preventive Services Task Force

159. Promoting Healthy Relationships in Adolescents

in their state when intimate partner violence, adolescent dating violence, or statutory rape is suspected. Pregnant and parenting adolescents; lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) individuals; and ado- lescents with physical and mental disabilities are at particular risk of disparities in the health care system. The promotion of healthy relationships in these groups requires the obstetrician–gynecologist to be aware of the uniquebarriersandhurdlestosexualandnonsexualexpression (...) and ability to imagine alternative outcomes (7); thus, judgement can lag, and adolescents may not always make wise or healthy decisions. Adoles- cence is a time to prepare for future relationships by learning healthy skills such as compromise, negotiation, conflict resolution, setting healthy boundaries, and other potentially protective behavior. TheRoleoftheObstetrician– Gynecologist The initial reproductive health visit recommended for girls ages 13–15 years provides the opportunity for obstetrician

2018 American College of Obstetricians and Gynecologists

160. WHO recommendations on home-based records for maternal, newborn and child health

, laboratory results, medication information and illness management for children with disabilities (Moore et al., 2000), children with chronic conditions (Byczkowski, Munafo & Britto, 2014) and children living with cancer (Hully & Hyne, 1993; Sharp et al., 2014). Today, ownership of a home-based record is near universal in some countries, but patchy in others. From analysis of 180 demographic and health surveys between 1993 and 2013, home-based vaccination record ownership was estimated at over 80% in 23 (...) , the potential benefits of home-based records include: access to important health data about women, newborns and children; better risk detection and prompt referral of women; improved communications with women and caregivers; and strengthened links among different health workers and services (WHO, 1994). For women, caregivers of children and family members, home-based records can: facilitate learning and awareness of health problems; promote detection of risks and timely action; encourage continuity of care

2018 World Health Organisation Guidelines

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