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1601. Unscheduled Care Facilities

, there must be a sufficient range of PGDs to support the treatment of common injuries and ailments, and policies in place to support this • HPs must demonstrate competence in assessment and management of children and young people and vulnerable 4 Healthcare Commission Not just a matter of time. A review of urgent and emergency care services in England Sep 2008 Unscheduled care facilities July 2009 3/4 groups, including mental health, learning disability clients and older people 5 • All HPs must receive (...) agreement, but UCFs should not receive patients who are acutely ill, injured or who require full resuscitation facilities. Where acute patients self-present, staff should be competent in initial management of these patients and have protocols in place to ensure rapid transfer to the Emergency Department. UCFs should not be deemed as a ‘place of safety’ by ambulance services • Training needs analysis should be undertaken to ensure the UCF staff have the requisite skills and competence • Minimum staff

2009 Royal College of Emergency Medicine

1602. Continent Urinary Diversion

material and to facilitate networks that offer support from a patient perspective. Optimal timing for learning and practising skills Learning was defined by Bloom et al (1956) [71] as an acquisition of psychomotor skill, cognitive knowledge or affective attitude achieved through study, experience or teaching. These 3 elements are independent but inter-related. Metcalf (1999) [72] further describes how practical skills can be taught, stating that psychomotor skills are effectively learned (...) Psychological aspects, compliance and cognition 22 6.1.6 Cultural and religious issues 23 6.2 Patient preparation 24 6.2.1 Nutrition and hydration 24 6.2.2 Bowel preparation and bowel function 24 6.2.3 Shaving 25 6.2.4 Patient education 25 page5 Continent Urinary Diversion - April 2010 Pre-operative patient education 25 Patient organisations and brochures 26 Optimal timing for learning and practising skills 26 6.2.5 Procedure before and after surgery and at discharge 26 Pre

2010 European Association of Urology Nurses

1603. Occupational Asthma

their judgement, knowledge and expertise when deciding whether it is appropriate to apply guidelines, taking into account individual circumstances and patients’ wishes. Clinical judgement is necessary when using evidence statements to guide decision-making. Limited recommendations on a particular issue or effect do not necessarily mean that it is untrue or unimportant but may simply reflect insufficient evidence. It is not intended, nor should it be taken to imply, that these guidelines override existing (...) legal obligations. Duties under the UK Health and Safety at Work Act 1974, the Management of Health and Safety at Work Regulations 1999, the Control of Substances Hazardous to Health Regulations 2002, the Disability Discrimination Act 1995 and 2005 and other relevant legislation and guidance must be given due consideration, as should laws relevant to other countries. 4 E X E C U T I V E S U M M A R Y These guidelines are intended to help reduce the incidence of occupational asthma. They aim

2010 British Occupational Health Research Foundation

1604. Shoulder Pain and Mobility Deficits: Adhesive Capsulitis

ROM similar to passive ROM versus Low Irritability Characterized by: • Reports minimal levels of pain (=3/10) • No night or resting pain • Minimal levels of reported disability on standardized self-report outcome tools • Pain occurs with overpressures into end ranges of passive movements • Active ROM same as passive ROM versus High Irritability Modalities: • Heat for pain modulation • Electrical stimulation for pain modulation Self-care/home management training: • Patient education on positions (...) of comfort and activity modi?cations to limit tissue in?ammation and pain Manual therapy: • Low-intensity joint mobilization procedures in the pain-free accessory ranges and glenohumeral positions Mobility exercises: • Pain-free passive ROM exercises • Pain-free active assisted ROM exercises Moderate Irritability Modalities: • Heat for pain modulation as needed • Electrical stimulation for pain modulation as needed Self-care/home management training: • Patient education on progressing activities to gain

2013 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

1605. Ankle Stability and Movement Coordination Impairments

Ankle Stability and Movement Coordination Impairments Clinical Practice Guidelines ROBROY L. MARTIN, PT , PhD • TODD E. DAVENPORT , DPT • STEPHEN PAULSETH, DPT , MS DANE K. WUKICH, MD • JOSEPH J. GODGES, DPT , MA Ankle Stability and Movement Coordination Impairments: Ankle Ligament Sprains Clinical Practice Guidelines Linked to the International Classi?cation of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association J Orthop Sports Phys Ther (...) of Orthopaedic & Sports Physical Therapy ® . The Orthopaedic Section, APT A, Inc, and the Journal of Orthopaedic & Sports Physical Therapy consent to the reproduction and distribution of this guideline for educational purposes. Address correspondence to: Joseph Godges, DPT , ICF Practice Guidelines Coordinator, Orthopaedic Section, APT A, Inc, 2920 East Avenue South, Suite 200, La Crosse, WI 54601. E-mail: RECOMMENDATIONS A2 INTRODUCTION A3 METHODS A4 CLINICAL GUIDELINES: Impairment/Function

2013 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

1606. Low Back Pain

(FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52:157-168. 307 . Waldvogel FA, Papageorgiou PS. Osteomyelitis: the past decade. N Engl J Med. 1980;303:360-370. http:// NEJM198008143030703 308. Wand BM, Bird C, McAuley JH, Dore CJ, MacDowell M, De Souza LH. Early intervention for the management of acute low back pain: a single- blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. Spine (...) Low Back Pain Clinical Guidelines ANTHONY DELITTO, PT , PhD • STEVEN Z. GEORGE, PT , PhD • LINDA VAN DILLEN, PT , PhD • JULIE M. WHITMAN, PT , DSc GWENDOLYN SOWA, MD, PhD • PAUL SHEKELLE, MD, PhD • THOMAS R. DENNINGER, DPT • JOSEPH J. GODGES, DPT , MA Low Back Pain Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association J Orthop Sports Phys Ther. 2012;42(4):A1-A57

2012 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

1607. Occupational therapy for people with Parkinson's disease

a lack of knowledge about condition- specifi c interventions and a tendency to focus on self- care goals. However, Deane et al have summarised four main roles that occupational therapists assumed when treating people with Parkinson’s. These were: problem- solver, educator, networker, and supporter. Currently, there is little higher- level, post- graduate Parkinson’s-specifi c skills training available for health and social care professionals, including occupational therapists, in the UK (...) , and contributes widely to policy consultations throughout the UK. The College sets the professional and educational standards for occupational therapy, providing leadership, guidance and information relating to research and development, education, practice and lifelong learning. In addition, 11 accredited specialist sections support expert clinical practice. 1/10Occupational Therapy for People with Parkinson’s Best practice guidelines Ana Aragon and Jill Kings Specialist Section Neurological Practice

2010 Publication 1554

1608. The treatment of distal radius fractures

. This guideline is intended to be used by all appropriately trained surgeons and all qualified physicians managing the treatment of distal radius fractures. It is also intended to serve as an information resource for professional healthcare practitioners and developers of practice guidelines and recommendations. GOALS AND RATIONALE The purpose of this clinical practice guideline is to help improve treatment based on the current best evidence. Current evidence-based medicine (EBM) standards demand (...) radius fractures. AAOS staff and the physician work group systematically reviewed the available literature and subsequently wrote the following recommendations based on a rigorous, standardized process. Musculoskeletal care is provided in many different settings by many different providers. We created this guideline as an educational tool to guide qualified physicians through a series of treatment decisions in an effort to improve the quality and efficiency of care. This guideline

2009 American Academy of Orthopaedic Surgeons

1609. Reporting Standards for Carotid Artery Angioplasty and Stent Placement

of progressive neurologi- caldysfunction;oramajorsurgicalpro- cedure within the previous 30 days. These patients could be included if the disorder responsible for their ineligibil- ity resolved within 120 days of their qualifying cerebrovascular event. Neu- rological classification was performed 30and90daysaftertheprocedurewith strokes(anynewfocalneurologicaldef- icit lasting 24 hours) categorized as disabling(modifiedRankinscore3)or non-disabling.Ifsufficientfunctionalre- covery occurred within 90 days (...) eventrateof13%)to9%inthesurgical group, thus yielding an absolute risk reduction of 17%. Therefore, for every 100 patients undergoing surgery, 17 nonfatal strokes or deaths were pre- ventedovera2-yearperiod.However, this risk reduction was not equal for all patients. The benefit was twice as greatinpatientswithastenosisof90% to 99% as it was in those with a steno- sisof70%to79%.At8-yearfollow-up, the risk of an ipsilateral disabling stroke was 6.7%; of any ipsilateral stroke was 15.2%; of any stroke

2009 Society of Interventional Radiology

1610. Reporting Standards for Angioplasty and Stent-assisted Angioplasty for Intracranial Atherosclerosis

(in practice and in academic settings); individuals who have per- formed clinical research studying the outcome of neurovascular procedures and stroke; individuals who direct neuroendovascular training and treat- ment programs with a broad cross- section of interventional operators; andindividualswithbroadclinicalex- perience who have had considerable previous involvement with neurovas- cular procedures. No individual was refused participation in the project. Literature Review A computerized search (...) at qualifying event, no. (%) Type and dose of diuretic treatment at time of medical treatment failure, no. (%) Schumacher et al  S453 Volume 20 Number 7Seitherofthesescalesshouldhavebeen trained, tested, and certified in their use to assure their correct application (12–14). Patient Selection According to Under- lyingPathophysiologyofBrainIschemia SecondarytoIntracranialAtherosclerosis Transient ischemic attacks or isch- emic stroke secondary to intracranial cerebral atherosclerosis are caused by 4

2009 Society of Interventional Radiology

1611. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

nutrition, feeding, and positional modifications. In older children and ado- lescents, lifestyle changes include modification of diet and sleeping position, weight reduction, and smoking cessation. Medications foruse inGERD include agents to buffer gastriccontentsorsuppressacidsecretion.Agentsaffect- ing GI motility are discussed. Surgical therapy includes fundoplication and other procedures to eliminate reflux. 5.1. Lifestyle Changes Parental education, guidance, and support are always required (...) irritability. Reflux is an uncommon cause of irritability or unexplained crying in otherwise healthy infants. However, if irrit- abilitypersistswithnoexplanationotherthansuspected GERD, expert opinion suggests the following options. The practitioner may continue anticipatory guidance and training of parents in the management of such infants with the expectation of improvement with time. Additional investigations to ascertain the relation between reflux episodes and symptoms or to diagnose reflux or other

2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

1612. Treatment and recommendations for homeless people with Hypertension, Hyperlipidemia & Heart Failure

). ? Fluids – If fluid restriction needed, specify amount to drink each day (more fluids during hot weather); provide reusable water bottle. ? Health insurance – If uninsured and eligibility likely, urge application/ reapplication for Medicaid, SSI/ SSDI—important for specialty referrals (diabetic educator, cardiologist). ? Harm reduction – Explain risks associated with HTN/ hyperlipidemia (heart attack, stroke, disability). Suggest strategies to minimize damage caused by alcohol, nicotine, other drugs (...) in the field. ? Lifestyle limitations – limited food choice, physical impairments, lack of safe place to exercise, inappropriate footwear. Educate about DASH diet and importance of limiting sodium intake; discuss feasible exercise alternatives. ? Lack of housing and income – Explore availability of low-barrier permanent housing with optional supportive services or convalescent care for patients with severe illness/ impairments. Document medical conditions and functional status with cognizance of disability

2009 National Health Care for the Homeless Council

1613. Management of Pregnancy

fellowship after completing four years of Obstetrics and Gynecology residency training. Fellowship training provides additional education and practical experience to gain special competence in managing various obstetrical, medical, and surgical complications of pregnancy. MFM specialists function in collaboration with Family Medicine physicians, Women’s Health Nurse Practitioners, Certified Nurse-Midwives and Obstetricians. The relationship and referral patterns between Obstetrician-Gynecologists and MFM (...) Factors for Preterm Birth 20 A-5. Routine Visits: Weeks 16-27 23 A-6. Routine Visits: Weeks 28-41 24 A-7. Postpartum Visit 24 Interventions at All Visits 29 I- 1. Screening for Hypertensive Disorders of Pregnancy: Weeks (All) 29 I- 2. Breastfeeding Education: Weeks (All) 30 I- 3. Exercise During Pregnancy: Weeks (All) 31 I- 4. Influenza Vaccine (Season-Related): Weeks (Any Week) 32 First Visit with Nurse (6-8 Weeks) 33 I- 5. Screening for Tobacco Use – Offer Cessation: Weeks 6 - 8 33 I- 6. Screening

2009 VA/DoD Clinical Practice Guidelines

1614. Percutaneous device closure of patent foramen ovale for secondary stroke prevention. A call for completion of randomized clinical trials Full Text available with Trip Pro

in these landmark trials to expedite their completion and help resolve the uncertainty regarding optimal care for this condition. Stroke is the third-leading cause of death among adults in the United States and a major contributor to long-term functional impairment and disability. Despite recent advances in diagnosis and treatment, approximately one fifth of stroke survivors require institutional care 3 months after the index event, and 15% to 30% are permanently disabled. Aggressive measures of primary (...) organizations to increase awareness regarding the need to complete these trials. The importance of patient and provider education was emphasized. Recommendations were issued to facilitate statistically appropriate pooling of data across trials when possible and to curtail the off-label use of closure devices. Table. Current Ongoing Clinical Trials on PFO Closure to Prevent Recurrent Cryptogenic Stroke Trial Name Device Utilized Sponsor Start Date Projected Completion Date Estimated Enrollment For More

2009 American Academy of Neurology

1615. Guidelines for the management of aneurysmal subarachnoid hemorrhage

Guidelines for the management of aneurysmal subarachnoid hemorrhage AHA/ASA Guideline Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Joshua B. Bederson, MD, Chair; E. Sander Connolly, Jr, MD, FAHA, Vice-Chair; H. Hunt Batjer, MD; Ralph G. Dacey (...) , individual find- ings occur inconsistently, and because the type of headache from SAH is sufficiently variable, misdiagnosis or delayed diagnosis is common. Misdiagnosis of SAH occurred in as many as 64% of cases before 1985, with more recent data suggesting an SAH misdiagnosis rate of 12%. 4,21,192–195 Misdiagnosis was associated with a nearly 4-fold higher likelihood of death or disability at 1 year in patients with minimal or no neurological deficit at the initial visit. 21 The most common diagnostic

2009 American Academy of Neurology

1616. Evaluation of the child with microcephaly

, physicians may consider educating caregivers of children with microcephaly on how to recognize clinical seizures (Level C). There are insufficient data to support or refute obtaining a routine EEG in a child with microcephaly (Level U). Cerebral palsy. Data from a Class II study of children with developmental disabilities found cerebral palsy (CP) in 21.4% of the 216 children with microcephaly compared to 8.8% of the 1,159 normocephalic children ( p < 0.001). Two Class I (n = 2,445) studies and one Class (...) SD), mental retardation was found in 11%. Mental retardation was diagnosed in 50% of the 99 subjects with severe microcephaly (<−3 SD) and in all of those with an HC less than −7 SD. e7 A number of Class III studies of children with microcephaly have examined other clinical factors. There are conflicting data as to whether proportionate microcephaly (i.e., similar weight, height, and head size percentiles) is predictive of developmental and learning disabilities. ,e2 Other Class III studies have

2009 American Academy of Neurology

1617. Evaluation of distal symmetric polyneuropathy: role of autonomic testing, nerve biopsy, and skin biopsy

and estimates that 40% of his clinical effort is spent on EMG/NCS, 10% on autonomic testing, and 10% on botulinum toxin injections. L.J.K. has received speaker honoraria from American Medical Seminars, Cross Country Education, Therapath Laboratories, and CME, LLC, and holds equity in Passnet Air Ambulance. He estimates 25% of his clinical effort is spent on NCS/EMG, 4% on skin biopsy for nerve fiber counting, and 8% on autonomic studies, and has received payment for expert testimony in legal proceedings (...) . The particular kinds of tests utilized by a physician in the evaluation of polyneuropathy depend upon the specific clinical situation and the informed medical judgment of the treating physician. This statement is provided as an educational service of the AAN, AANEM, and AAPM&R. It is based upon an assessment of current scientific and clinical information. It is not intended to include all possible proper methods of care for a particular neurologic problem or all legitimate criteria for choosing to use

2009 American Academy of Neurology

1618. A review of the evidence for the use of telemedicine within stroke systems of care Full Text available with Trip Pro

neurologists and nurses, and to retrospective medical record NIHSS abstraction. Although the NIHSS is a reliable stroke deficit scale, it includes items with redundancy and items with less-than-excellent reliability. This reliability can be improved with training. To ensure the adequacy of stroke evaluation by HQ-VTC, the feasibility and reliability of performing the NIHSS were demonstrated first in the nonacute and subsequently in the acute stroke environment. In these validation study paradigms (...) training in either the NIHSS or telestroke administration, but this variable of physician-extender experience during telestroke consultation has not been the subject of any of the reports. Table 3. NIHSS Reliability Studies Feasibility and Reliability of Performing Neurological Assessment Over Telestroke Systems Nonacute Setting There are data on the feasibility and reliability of conducting a general neurological evaluation over telemedicine compared with face-to-face consultation. One small study

2009 American Academy of Neurology

1619. Evaluation and Management of Adult Hypoglycemic Disorders Full Text available with Trip Pro

that the prevention of hypoglycemia in diabetes involve addressing the issue in each patient contact and, if hypoglycemia is a problem, making adjustments in the regimen based on review and application of the principles of intensive glycemic therapy—diabetes self-management (supported by education and empowerment), frequent self-monitoring of blood glucose, flexible and appropriate insulin or insulin secretagogue regimens, individualized glycemic goals, and ongoing professional guidance and support (...) in people with knowledge of, and access to, glucose-lowering medications. Malicious hypoglycemia ( , , ) can be accomplished by administration of insulin or an insulin secretagogue. Clinically, insulinoma is characterized by spells of neuroglycopenia due to endogenous hyperinsulinemic hypoglycemia occurring primarily in the fasting state but occasionally only in the postprandial period ( , , ). The incidence is approximately 1 in 250,000 patient-years ( ). It may occur in all ethnic groups and at any

2009 The Endocrine Society

1620. Definition and evaluation of transient ischemic attack Full Text available with Trip Pro

for Healthcare Professionals From the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease: The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. , MD, FAHA, Chair , MD, FAHA, Vice-Chair , MD , MD, FAHA , MD, FAHA, FAAN , MD, FAHA (...) diagnosis of a TIA. Definition Often, health professionals and the public consider TIAs benign but regard strokes as serious. These views are incorrect. Stroke and TIA are on a spectrum of serious conditions involving brain ischemia. Both are markers of reduced cerebral blood flow and an increased risk of disability and death. However, TIAs offer an opportunity to initiate treatment that can forestall the onset of permanently disabling injury. The traditional definition of a TIA was a sudden, focal

2009 American Academy of Neurology


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