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141. Child abuse and neglect

Working with children and y orking with children and young people oung people 1.1.1 T ake a child-centred approach to all work with children and young people. Involve them in decision-making to the fullest extent possible depending on their age and developmental stage. 1.1.2 Use a range of methods (for example, drawing, books or activities if appropriate) for communicating with children and young people. T ailor communication to: their age and developmental stage any disabilities, for example learning (...) solutions avoiding blame, even if they may be responsible for the child abuse or neglect inviting, recognising and discussing any worries they have about specific interventions they will be offered identifying what they are currently doing well, and building on this making adjustments for any factors which may make it harder for them to get support, such as refugee status, long-term illness, neurodevelopmental disorders, mental health problems, disability or learning disability being sensitive

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

142. 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

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

health team carried out a rapid review of systematic reviews (review 3) that: evaluated the effectiveness of educational interventions on the public's knowledge and behaviour in relation to antimicrobial use or antimicrobial resistance Antimicrobial stewardship: changing risk-related behaviours in the general population (NG63) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 26 of 44targeted both the public (...) to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 44Contents Contents Overview 5 Who is it for? 5 Recommendations 6 1.1 Overarching principles 6 1.2 Local system-wide approaches to reducing inappropriate antimicrobial demand and use 6 1.3 Local system-wide approaches to preventing and limiting the spread of infection 9 1.4 Childcare and education providers 10 1.5 Prescribers, primary care and community pharmacy teams 13 T erms used in this guideline 15

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

144. Eating disorders: recognition and treatment

nervosa, binge eating disorder and bulimia nervosa. Who is it for? Healthcare professionals Commissioners and providers Other professionals who provide public services to people with eating disorders (including in education and criminal justice settings) People with suspected or diagnosed eating disorders and their families and carers Eating disorders: recognition and treatment (NG69) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice (...) /terms-and- conditions#notice-of-rights). Page 5 of 40any physical or other mental health problems or disabilities. 1.1.3 Healthcare professionals assessing people with an eating disorder (especially children and young people) should be alert throughout assessment and treatment to signs of bullying, teasing, abuse (emotional, physical and sexual) and neglect. For guidance on when to suspect child maltreatment, see the NICE guideline on child maltreatment. Communication and information Communication

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

145. 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

146. Drug misuse prevention: targeted interventions

of self-worth, but it did not report data, p values or an effect size. One study reported that the intervention may have affected intention to use drugs, but the data were not reported. Another study reported a statistically significant improvement in knowledge of drugs and their risks after the intervention with peer educators but not with adult educators. Personal and social skills training for only carers and families of children and young people at risk of drug misuse was not recommended (...) of drug misuse, including: people who have mental health problems people who are being sexually exploited or sexually assaulted people involved in commercial sex work people who are lesbian, gay, bisexual or transgender people not in employment, education or training (including children and young people who are excluded from school or who truant regularly) Drug misuse prevention: targeted interventions (NG64) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

147. 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 (...) (both in terms of education and hands-on training or demonstration) so 'condom naive' young people can take responsibility for using them effectively. But it was unclear from the evidence exactly what mix of components made multicomponent schemes more or less effective, so the committee was unable to make firm recommendations about their exact content [ES1, ES2, ES3]. No evidence of effectiveness was identified for the C-Card scheme, the most common multicomponent scheme in the UK. The committee

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

148. Mental health of adults in contact with the criminal justice system

this guideline with the NICE guidelines on service user experience in adult mental health and patient experience in adult NHS services to improve the experience of care for people with mental health problems including those with neurodevelopmental disorders. 1.1.2 Use this guideline with any NICE guidelines on specific mental health problems [1] . T ake into account: the nature and severity of any mental health problem the presence of a learning disability or any acquired cognitive impairment other (...) learning disabilities), cognitive impairments, or physical health problems or disabilities. Seek advice or involve specialists if needed. 1.3 Identification and assessment throughout the care pathway 1.3.1 Be vigilant for the possibility of unidentified or emerging mental health problems in people in contact with the criminal justice system, and review available records for any indications of a mental health problem. 1.3.2 Ensure all staff working in criminal justice settings are aware of the potential

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

149. 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 (...) for Health and Care Excellence 2015. All rights reserved. NICE copyright material can be downloaded for private research and study, and may be reproduced for educational and not-for- profit purposes. No reproduction by or for commercial organisations, or for commercial purposes, is allowed without the written permission of NICE. This guideline is an adaptation of Respiratory Tract Infections – Antibiotic Prescribing (CG69). NICE guidance is prepared for the National Health Service in England. © National

2019 Best Practice Advocacy Centre New Zealand

150. Guidelines on Chronic Coronary Syndromes Full Text available with Trip Pro

revisions the Guidelines are approved by all the experts involved in the Task Force. The finalized document is approved by the CPG for publication in the European Heart Journal. The Guidelines were developed after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The task of developing ESC Guidelines also includes the creation of educational tools and implementation programmes for the recommendations including condensed pocket guideline (...) educational material addressing the cultural and professional needs for cardiologists and allied professionals. Collecting high-quality observational data, at appropriate time interval following the release of ESC Guidelines, will help evaluate the level of implementation of the Guidelines, checking in priority the key end points defined with the ESC Guidelines and Education Committees and Task Force members in charge. The Members of this Task Force were selected by the ESC, including representation from

2019 European Society of Cardiology

151. The management of urinary incontinence in women

professionals and patients make decisions about the most appropriate treatment and care for specific clinical circumstances. • Can be used to develop standards to assess the clinical practice of individual health professionals. • Can support the education and training of health professionals and others. • Can improve communication between patients and health professionals. The Best Practice Advocacy Centre New Zealand (bpac nz ) has an agreement with NICE to contextualise recently published NICE clinical (...) in the management of UI and associated disorders or who work within an MDT with this training, and who regularly carry out surgery for UI in women. 1.11.2 Training should be sufficient to develop the knowledge and generic skills documented below. Knowledge should include the: • specific indications for surgery • required preparation for surgery including preoperative investigations • outcomes and complications of proposed procedure • anatomy relevant to procedure • steps involved in procedure • alternative

2019 Best Practice Advocacy Centre New Zealand

152. Management of Dyslipidaemias Full Text available with Trip Pro

the experts involved in the Task Force. The finalized document is approved by the CPG and EAS for publication in the European Heart Journal and Atherosclerosis Journal. The Guidelines were developed after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The task of developing ESC/EAS Guidelines also includes the creation of educational tools and implementation programmes for the recommendations including condensed pocket guideline (...) and are regularly updated. The ESC carries out a number of registries which are essential to assess diagnostic/therapeutic processes, use of resources and adherence to Guidelines. These registries aim at providing a better understanding of medical practice in Europe and around the world, based on data collected during routine clinical practice. The guidelines are developed together with derivative educational material addressing the cultural and professional needs for cardiologists and allied professionals

2019 European Society of Cardiology

153. Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD Full Text available with Trip Pro

by the CPG for publication in the European Heart Journal. The Guidelines were developed after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The task of developing ESC Guidelines also includes the creation of educational tools and implementation programmes for the recommendations including condensed pocket guideline versions, summary slides, booklets with essential messages, summary cards for non-specialists and an electronic version (...) are essential to assess, diagnostic/therapeutic processes, use of resources and adherence to Guidelines. These registries aim at providing a better understanding of medical practice in Europe and around the world, based on data collected during routine clinical practice. The guidelines are developed together with derivative educational material addressing the cultural and professional needs for cardiologists and allied professionals. Collecting high-quality observational data, at appropriate time interval

2019 European Society of Cardiology

154. 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 (...) . Some impairment may not be evident until later years and affect learning, independence and the ability to realise their full potential in education, social relationships or employment. Such weaknesses may also make coping with HIV, including adherence to treatments, more challenging. UK Cohort There is a paucity of available neurological and developmental data for children with HIV in the UK, particularly comparison data with uninfected children. The UK’s largest neurocognitive research study

2019 The Children's HIV Association

155. 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 (...) Promotion 10 IMPLEMENTATION CONSIDERATIONS 10 Information Systems 10 Access to Services 11 Training and Education 11 Communication 11 Funding 12 NEXT STEPS 12 GLOSSARY 13 APPENDIX A: LIST OF RECOMMENDED DATA ELEMENTS FOR POST- TREATMENT FOLLOW-UP CARE PLANS 18 Follow-Up Model of Care for Cancer Survivors 4 OVERVIEW Background With advances in early detection and treatment, the survival rate from all cancers combined rose from 53% (1992-1994) to 60% (2006-2008). 1 The continuing improvement in survival

2019 Cancer Care Ontario

156. 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

157. Heart Failure - Systolic Dysfunction

Heart Failure - Systolic Dysfunction 1 Quality Department Guidelines for Clinical Care Ambulatory Heart Failure Guideline Team Team Leader William E Chavey, MD Family Medicine Team Members Barry E Bleske, PharmD Pharmacy R Van Harrison, PhD Medical Education Robert V Hogikyan, MD, MPH Geriatric Medicine Yeong Kwok, MD General Medicine John M Nicklas, MD Cardiology Consultant Todd M Koelling, MD Cardiology Initial Release August, 1999 Most Recent Major Update August, 2013 Interim/Minor Revision (...) . Cardiopulmonary exercise testing can quantitate a patient’s functional capacity. Testing may be indicated to document disability for insurance. Patients with poor ventilatory efficiency (VE/VCO2 slopes > 35) or very low peak oxygen consumptions (VO2 1 year. These patients should be referred to an electrophysiologist or cardiologist for evaluation. Part of the evaluation for ICD should be an ECG. This will define the QRS duration and help determine whether the device should also provide Cardiac

2020 University of Michigan Health System

158. Management of Type 2 Diabetes Mellitus

that clinicians should address at each visit and annually. DSME has evolved from didactic programs based on information-transfer and compliance or adherence as outcomes, to more patient-centered, empowerment based approaches. Recent findings related to DSME include: • Diabetes self-management education is effective for improving psychosocial and health outcomes (including HbA1c) and for reducing costs. • Traditional knowledge based DSME is essential but not sufficient for sustained behavior change. People (...) Management of Type 2 Diabetes Mellitus Quality Department Guidelines for Clinical Care Ambulatory Diabetes Mellitus Guideline Team Team Leaders Connie J Standiford, MD General Internal Medicine Sandeep Vijan, MD General Internal Medicine Team Members Hae Mi Choe, PharmD College of Pharmacy R Van Harrison, PhD Medical Education Caroline R Richardson, MD Family Medicine Jennifer A Wyckoff, MD Metabolism, Endocrinology & Diabetes Consultants Martha M Funnell, MS, RN, CDE Diabetes Research

2020 University of Michigan Health System

159. 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

160. Palliative care - dyspnoea: Scenario: Symptomatic treatment

and breathing techniques. Controlled breathing techniques include positioning, pursed-lip breathing, breathing exercises, and coordinated breathing training. In pursed-lip breathing, people inhale through their nose for several seconds with their mouth closed, then exhale slowly through pursed lips for 4–6 seconds. This can help to relieve perception of dyspnoea during exercise or whenever dyspnoea is triggered. Relaxing and dropping the shoulders reduces the 'hunched' posture that comes with anxiety (...) benefit. Long-term oxygen therapy (15 hours or more a day) should be initiated by a respiratory specialist for people with severe disabling breathlessness due to cancer or other progressive, life-threatening diseases. Oxygen therapy may also be appropriate in people with cancer who have dyspnoea of non-malignant causes. For more information, see . For more information see the section on in . Basis for recommendation Appropriate use of oxygen therapy is recommended for some people with dyspnoea

2020 NICE Clinical Knowledge Summaries

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