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81. Contraceptive Choices for Young People

factors: individual factors (knowledge, attitude, personal aspirations, previous use, perceived risk); familial (family structure, parent–child relationship, socioeconomic status); relationship (partner characteristics) and social (social norms, peer influences, access to services). 12,26–30 In the UK, the contraceptive pill and condom remain the two most commonly used methods. Office of National Statistics survey data (2008/2009) 31 indicate that among women aged 16–29 years who were at risk (...) that use of EC may be influenced by factors such as perceived pregnancy risk, personal and perceived attitudes towards EC and confidence in asking for it. 50–52 Data from the Office of National Statistics indicates that whilst 86% of individuals aged 16–19 years had heard of emergency hormonal contraception, only 35% had heard of the emergency intrauterine device (IUD). 48 There are now three methods of EC available in the UK: POEC, the copper-bearing intrauterine device (Cu-IUD), and the progesterone

2019 Faculty of Sexual & Reproductive Healthcare

82. What is the evidence on the role of the arts in improving health and well-being? A scoping review

capital and reduce discrimination, the latter being linked with mental illness and a range of other health conditions including CVD, respiratory conditions and indicators of illness such as pain and headaches (31). Physical activity through participating in the arts can reduce sedentary behaviours, which are associated with conditions such as chronic pain, depression and dementia (32). Engagement with discussions of health or with health-care settings through arts activities can also help to encourage (...) that people who engage with the arts are more likely to lead healthier lives, including eating healthily and staying physically active, irrespective of their socioeconomic status and social capital (189). Engagement with community activities such as WHAT IS THE EVIDENCE ON THE ROLE OF THE ARTS IN IMPROVING HEALTH AND WELL-BEING? A SCOPING REVIEW HEALTH EVIDENCE NETWORK SYNTHESIS REPORT 16 arts and crafts has been shown to improve general self-perceived health and aspects of mental health and well-being

2019 WHO Health Evidence Network

83. Treatment for Acute Pain: An Evidence Map

KIs mentioned an observational study showing a statistically significant relationship between the number of opioid pills taken on the day before discharge (if discharge is not on the first postoperative day) and self-report of opioid pills taken during recovery at home. 32 Data from this study contributed new guidance regarding discharge medication, and resulted in a 40 percent decrease in opioid prescriptions. 32 • Our discussions also highlighted nonsurgical acute pain conditions (...) pain condition. Acute pain conditions that may need a comprehensive systematic review or overview of systematic reviews include postoperative postdischarge pain, acute back pain, acute neck pain, renal colic, and acute migraine. • Certain acute pain conditions have many published systematic reviews: postoperative pain, pain associated with dental procedures and oral surgery, low back pain, acute migraine. Several acute pain conditions have sufficient new data to warrant a new systematic review

2019 Effective Health Care Program (AHRQ)

84. Supporting Adults Who Anticipate or Live with an Ostomy

: Implementation of Best Practice Guidelines, Second Edition (2012). Tables 3, 4, and 5 provide potential structure, process and outcome measures to assess Guideline success. It is important to evaluate evidence-based practice changes when implementing a Guideline. Select the measures most relevant to the practice setting. There are few data repositories/indicator libraries available for ostomy support in Ontario and Canada. The following measures will support quality improvement and evaluation. Table 3 (...) provides potential structure measures associated with all recommendation statements, to assess attributes related to human resources. Table 3: Structure Measures for Overall Guideline Success STRUCTURE MEASURES MEASURES IN DATA REPOSITORIES/ INSTRUMENTS Ratio of nurses specialized in wound, ostomy, and continence care (NSWOC) to persons who anticipate or live with an ostomy Numerator: Number of nurses specialized in wound, ostomy and continence care (NSWOC) Denominator: Total number of persons who

2019 Registered Nurses' Association of Ontario

85. Guidance on the clinical management of anxiety disorders, specifically focusing on diagnosis and treatment strategies

always produces distress, anxiety disorders can be disabling. Data from the Australian National Survey of Mental Health and Wellbeing (Slade et al., 2009b) dem- onstrate significant disruption to everyday life among peo- ple who met criteria for current panic disorder, SAD or GAD as their principal complaint; the number of days unable to work or do normal tasks due to anxiety during the previous month was reported as less than 1 day by approximately half, 1–7 days by one-third, and more than 7 days (...) be experienced as normal when they are consistent with the demands of the situation. Anxiety disorders, like all mental disorders, lie on dimen- sions that extend from transient symptoms, to symptoms that are severe, disabling and persist for years. The threshold on this dimension at which a disorder is defined is specified in the diagnostic criteria listed by International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10; World Health Organization, 1993, 2016

2018 Royal Australian and New Zealand College of Psychiatrists

86. Long-Term Drug Therapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review

osteoporosis drug treatment (ODT) and ODT discontinuation and holidays on fractures and harms. Data sources. MEDLINE ® , Embase ® , and Cochrane databases from 1995 to October 2018;; bibliographies of relevant systematic reviews. Review methods. We defined long-term ODT as >3 years and ODT holidays as discontinuation for =1 year after =1 year of use. Trials were used for incident fractures and harms, and controlled observational studies were included for additional harms. Two (...) investigators rated risk of bias. For studies with low or medium risk of bias, one investigator extracted data and a second verified accuracy. Two investigators graded strength of evidence (SOE). Results. Sixty-one English-language studies were included. In women with osteoporosis, 4 years of alendronate reduced clinical fractures (hazard ratio [HR] 0.64 [95% confidence interval (CI) 0.50, 0.82]) (moderate SOE) and radiographic vertebral fractures (HR 0.50 [95% CI 0.31, 0.82]) (moderate SOE), while 4 years

2019 Effective Health Care Program (AHRQ)

87. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD

about the effectiveness and harms of pharmacologic and nonpharmacologic treatments for exacerbations of chronic obstructive pulmonary disease (ECOPD). Data sources. Embase ® , Epub Ahead of Print, In-Process & Other Non-Indexed Citations, MEDLINE ® Daily, MEDLINE, Cochrane Central Registrar of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus from database inception to January 2, 2019. Review methods. We included randomized controlled trials (RCTs) that evaluated (...) pharmacologic intervention or nonpharmacologic interventions for ECOPD. The strength of evidence (SOE) was graded for critical final health outcomes. Results. We included 98 RCTs (13,401 patients, mean treatment duration 9.9 days, mean followup 3.7 months). Final health outcomes, including mortality, resolution of exacerbation, hospital readmissions, repeat exacerbations, and need for intubation, were infrequently evaluated and often showed no statistically significant differences between groups. Antibiotic

2019 Effective Health Care Program (AHRQ)

88. Integrated care for older people (?ICOPE)?: guidance for person-centred assessment and pathways in primary care

in intrinsic capacity can be done with the help of the integrated care for older people (ICOPE) screening tool. • Those identi?ed with these conditions are re- ferred to a primary health-care clinic for in-depth assessment, which informs the development of a personalied care plan • The care plan may include multiple interventions to manage declines in intrinsic capacity and to optimie functional ability, such as by physical exercises, oral supplemental nutrition, cognitive stimulation and home adaptations (...) . Most care plans will include interventions to improve nutrition and encourage physical exercise; • the management and treatment of underlying diseases, multimorbidities and geriatric syndromes. WHO has developed clinical guidelines to address most of the relevant chronic diseases that may contribute to declines in intrinsic capacity (2). Every health-care provider should have access to these guidelines; • support for self-care and self-management; • the management of any advanced chronic conditions

2019 World Health Organisation Guidelines

89. Reducing Acute Care Length of Stay in Newfoundland & Labrador

); ? the combination of these trends results in an exponential increase in the total number of ALOS days among increasing age groups of acute care patients (Figure 3). The ALOS profiles for different types of acute care patients tend to follow a similar pattern in which most patients have shorter stays and fewer patients have longer stays (see Figure 4 which shows data for all of Canada). Medical patients are the largest group in terms of numbers of acute care patients. Mental health patients have the longest ALOS (...) or implied, nor assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information, data, product, or process disclosed in this report. Conclusions drawn from, or actions undertaken on the basis of, information included in this report are the sole responsibility of the user. This report is the property of the Newfoundland & Labrador Centre for Applied Health Research (NLCAHR). Reproduction of this document for non-commercial purposes is permitted provided proper

2018 Newfoundland and Labrador Centre for Health Information

90. Cardiac rehabilitation

and therapeutic effects on many chronic conditions including CHD. 38 The term ‘physical activity’ is defined as bodily movement which requires energy expenditure. 39 Exercise is a subcategory of physical activity that is planned, structured, repetitive, and aims to improve or maintain one or more components of physical fitness. 39 All individuals should be advised to minimise the amount of time they spend sedentary, especially over extended periods and should aim to be active daily. 8 This should be in line (...) with UK guidance (see Annex 2). 38 Over one week, activity should add up to 150 minutes (2½ hours) of moderate-intensity activity in bouts of 10 minutes or more, or 75 minutes of vigorous-intensity activity. This can include occupational and leisure time activity and may be accumulated in bouts of activities such as brisk walking. 8 In addition it is recommended that all adults should undertake physical activity to improve muscle strength on at least two days a week. 38 Those who are moderately active

2017 SIGN

91. Risk estimation and the prevention of cardiovascular disease

of this guideline for the purpose of implementation in NHSScotland. Risk estimation and the prevention of cardiovascular diseaseContents 1 Introduction 1 1.1 The need for a guideline 1 1.2 Remit of the guideline 2 1.3 Risk estimation 4 1.4 Statement of intent 5 2 Key recommendations 7 2.1 Estimating cardiovascular risk 7 2.2 Diet 7 2.3 Physical activity 7 2.4 Smoking 7 2.5 Antiplatelet therapy 7 2.6 Lipid lowering 7 3 Cardiovascular risk 8 3.1 Risk factors 8 3.2 The concept of risk and why it matters 8 3.3 Risk (...) syndrome 21 6 Physical activity 22 6.1 Definitions 22 6.2 Physical activity and cardiovascular risk 22 7 Smoking 26 7.1 Tobacco exposure and cardiovascular risk 26 7.2 Smoking cessation interventions 27 8 Alcohol 32 8.1 Alcohol and cardiovascular risk 32 9 Antiplatelet therapy 35 9.1 Antiplatelet agents for people with established cardiovascular disease 35 9.2 Antiplatelet agents for people without cardiovascular disease 36 9.3 Antiplatelet agents for people with diabetes 38 Risk estimation

2017 SIGN

92. Risk factors for breast cancer: A review of the evidence 2018

4.7.12 Diet—foods high in carotenoids 108 4.7.13 Diet—Mediterranean diet 110 4.7.14 Diet—phytoestrogens 112 Breast cancer risk factors: A review of the evidence iv 4.7.15 Diet—glycaemic index 114 4.7.16 Diet—total energy 115 4.7.17 Diet—sugar 117 4.7.18 Diet—fat 118 4.7.19 Diet—processed meat 119 4.7.20 Diet—red meat 121 4.7.21 Environmental tobacco smoke 123 4.7.22 Tobacco smoking 125 4.7.23 Physical activity 127 4.7.24 Shift work disrupting circadian rhythm 130 4.8 Medical factors 133 4.8.1 Aspirin (...) and risk of breast cancer 393 Table D.53 Diet—processed meat and risk of breast cancer 395 Table D.54 Diet—red meat and risk of breast cancer 398 Table D.55 Environmental tobacco smoke and risk of breast cancer 401 Table D.56 Tobacco smoking and risk of breast cancer 405 Table D.57 Physical activity and risk of breast cancer 409 Table D.58 Shift work disrupting circadian rhythm and risk of breast cancer 415 Table D.59 Aspirin and risk of breast cancer 420 Table D.60 Cardiac glycosides and risk

2018 Cancer Australia

93. GCPH response - a healthier future

. Increasing active travel, like increasing physical activity more generally, cannot be achieved through behavioural focused interventions alone and requires changes in our approaches to planning, transportation and sport and recreation. A recent Sustrans research report highlighted that the main barrier to active travel to school is parental concerns over safety 51 . This is consistent with GCPH research into the influences on adult travel choices 52 . Bike training and road safety education is important (...) of estimates of physical activity based on the SHS needs to be reviewed, particularly in relation to children's physical activity for which other surveys provide quite different results. It would be timely, at the outset of this strategy, to have a more robust and accurate means of measuring physical activity. In addition, we recognise the inherent challenges in getting accurate dietary intake data and we wonder whether a similar approach could be adopted to food data as was used for alcohol data – to use

2018 Glasgow Centre for Population Health

94. Improving the health of the public by 2040

by lifestyle factors, including smoking, diet and physical activity, alongside nascent concerns with social inequalities of health. The recent concept of a ‘fifth wave’ is one defined by a ‘culture of health’, in which the value of health and incentives for healthy behaviour are maximised, healthy choices are promoted by default, and factors that create a culture and environment which promote unhealthy behaviour are minimised. 23 Ecological public health The concept of ‘ecological public health’ focuses (...) recent UK initiatives in public health research 111 Annex IV. Previous reviews of UK public health research 113 Annex V. Some recent UK initiatives for the strategic coordination of research 114 Annex VI. Examples of the impact of population data 115 Glossary 116 Improving the health of the public by 20404 Executive summary Executive summary Over the coming decades, the UK population will face a wide range of complex health challenges and opportunities, many of which can only be fully addressed

2017 Academy of Medical Sciences

95. Wellbeing indicators across the life cycle

“individuals have the psychological, social and physical resources they need to meet a particular psychological, social and/or physical challenge.” It is usually multidimensional, capturing all important aspects in life, including mental health, physical health, economic wellbeing, social wellbeing and liveability. Wellbeing can be measured objectively and subjectively. WELLBEING INDICATORS ACROSS THE LIFE CYCLE | SAX INSTITUTE 5 Indicators and measurement Data availability The availability (...) in the academic and grey literature. We assessed the quality of evidence for each indicator using three criteria: • Frequency of inclusion in key frameworks (rated as high, medium or low), for the whole population, children, youth and older adults • Reliability — the consistency of the statistical association of the indicator with wellbeing outcomes in multiple reputable journal articles or reports (high, medium or low) • Availability of data for NSW (including administrative data, if known) (measured as high

2017 Sax Institute Evidence Check

96. Community-based approaches to adolescent obesity

as discretionary foods. 21 These foods are typically energy dense and nutrient poor, and are not considered as part of a recommended diet — except occasionally by the physically active. 21 COMMUNITY BASED APPROACHES TO ADOLESCENT OBESITY | SAX INSTITUTE 11 Physical activity has a vital role in adolescent health, and contributes to short and long-term physical, social and psychological development. 22-24 Improved academic performance, improved social and mental health, and decreased anxiety and depression have (...) been associated with physical activity in adolescents. 25, 26 However, epidemiological studies have identified an increasing prevalence of inactivity in those aged 11–15 years old, with nine out of ten young people not meeting national physical activity guidelines. 24 In Australia, adolescents aged 15–17 years old average one hour of physical activity per day and three hours of screen- based leisure activities per day 27 , well outside the Australian national physical activity and sedentary

2017 Sax Institute Evidence Check

97. Addressing the global challenge of multimorbidity: Lessons from the BRICS countries

Obesity, for instance, increases the risk of a host of conditions, and any factors that affect the risk of obesity – such as poor diet or lack of physical activity – will therefore influence the risk of multiple conditions. Diseases may also share underlying pathology – chronic inflammation, for example, increases the risk of multiple conditions. Developing one condition may also predispose to another, through physiological or behavioural mechanisms (or both). An example is the increased risk (...) , such as changes in cytokine levels, and behavioural pathways, such as reduced physical exercise or impacts on other aspects of personal care or health-seeking behaviour. In some cases, conditions are likely to share underlying causes. Prevention and treatment addressing these shared factors may therefore deliver benefits across conditions. However, some common comorbidities may be quite dissimilar. For example, people with psychiatric disorders also experience extremely high rates of cardiovascular and other

2017 Academy of Medical Sciences

98. Enhancing Equitable Access to Assistive Technologies in Canada

brief summarizes research evidence drawn from systematic reviews of the research literature and occasionally from single research studies. A systematic review is a summary of studies addressing a clearly formulated question that uses systematic and explicit methods to identify, select and appraise research studies, and to synthesize data from the included studies. The evidence brief does not contain recommendations, which would have required the authors of the brief to make judgments based (...) Canadians, but (where possible) it also gives particular attention to two groups: • people living with a disability (includes cognitive impairments, intellectual disabilities, mental health or substance abuse problems, and vision and hearing impairment); and • people living in rural/remote communities. Many other groups warrant serious consideration as well, and a similar approach could be adopted for any of them. † The PROGRESS framework was developed by Tim Evans and Hilary Brown (Evans T, Brown H

2017 McMaster Health Forum

99. Later school start times for supporting the education, health and well-being of high school students

BACKGROUND 12 Description of the condition 13 Description of the intervention 15 How the intervention might work 15 Why it is important to do this review 16 Objectives 17 Methods 17 Search methods for identification of studies 20 Data collection and analysis 22 Assessment of risk of bias in included studies 23 Data synthesis 26 RESULTS 29 Description of studies 29 Narrative synthesis 38 Mental health indicators 40 Student truancy or attendance 40 Student alertness 41 Missing outcome data 42 Adverse (...) of 11 interventions in six countries. What studies are included? Included studies were randomized controlled trials, controlled before-and-after studies, and interrupted time series studies with data for students aged 13 to 19 years and that compared 8 The Campbell Collaboration | different school start times. Studies had to report either primary outcomes of interest (academic outcomes, amount or quality of sleep, mental health indicators, attendance, or alertness

2017 Campbell Collaboration

100. Developing a National Pain Strategy for Canada

. Whenever possible, the evidence brief summarizes research evidence drawn from systematic reviews of the research literature and occasionally from single research studies. A systematic review is a summary of studies addressing a clearly formulated question that uses systematic and explicit methods to identify, select and appraise research studies and to synthesize data from the included studies. The evidence brief does not contain recommendations, which would have required the authors of the brief (...) ; • exploring new and innovative treatment options and alternative public-health policies; • sharing data and best practices; and • reducing the stigma of problematic substance use.(6) The media has also given significant attention to the opioid crisis and many of the same potential solutions. A recent media analysis by a patient advocate also identified the media coverage being given to the importance of awareness-raising and education, and to a number of cross-cutting themes, including: • learning from

2017 McMaster Health Forum

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