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121. Sex Effects in High-impact Conditions for Women Veterans - Depression, Diabetes, and Chronic Pain

the potential to be adequately powered to detect interaction effects (intervention * sex). 31 For depressive disorders, we looked at quality improvement interventions or psychotherapy, whereas for diabetes, we focused on diet, physical activity, and culturally tailored psychoeducation. For CLBP, we selected behavioral interventions, and for chronic knee OA, exercise interventions. Mapping the Evidence: Sex Effects in High-Impact Evidence-based Synthesis Program Conditions for Women Veterans 5 DATA (...) -based Synthesis Program. These organizations are known for their expertise and high-quality systematic reviews. Further, to help readers interpret estimates of treatment effect, we included review authors’ comments on study quality or the overall quality of the evidence, when this was available. DATA SYNTHESIS We used descriptive statistics for the amount and types of evidence for included interventions per condition of interest (Table 2). We generated heat maps and barplots to graphically portray

2016 Veterans Affairs Evidence-based Synthesis Program Reports

122. Cystic fibrosis: diagnosis and management.

clearance, nebuliser use, musculoskeletal disorders, exercise, physical activity and urinary incontinence. Specialist dietitians should assess and advise people with cystic fibrosis about all aspects of nutrition at outpatient clinic visits, during inpatient admissions and at their annual review (see "Nutritional Interventions," below). Specialist pharmacists should advise people with cystic fibrosis on medicines optimisation at outpatient clinic visits, during inpatient admissions, on discharge from (...) parties, and has expanded into a large amount of related projects for saving online and digital history. History is littered with hundreds of conflicts over the future of a community, group, location or business that were "resolved" when one of the parties stepped ahead and destroyed what was there. With the original point of contention destroyed, the debates would fall to the wayside. Archive Team believes that by duplicated condemned data, the conversation and debate can continue, as well

2017 National Guideline Clearinghouse (partial archive)

123. Practice Parameters for the Clinical Evaluation and Treatment of Circadian Rhythm Sleep Disorders

, melatonin administration prior to daytime sleep after night work shift improved daytime sleep quality and duration, caused a shift in circadian phase in some but not all subjects, but failed to en- hance alertness at night. Melatonin doses in these studies ranged from 0.5 to 10 mg. From these data, effectiveness did not appear to correlate with dosage strength or form. However, both level 1 simulation studies showed a positive effect on sleep quality and used dosages ranging from 1.8 to 3 mg. 3.2.1.5 (...) relevant published evidence retrieved 2084 articles, and is described in detail in the review paper. 1 Abstracts of these articles were reviewed by task force members to determine if they met inclusion criteria. Initial data extraction, preliminary evidence grading in accordance with the standards in Table 1, and initial data entry into evidence tables were performed by professionals con- tracted by the SPC to expedite the review process. All evidence table entries were reviewed by at least one other

2017 American Academy of Sleep Medicine

124. Clinical Practice Guidelines for Enhanced Recovery

can be reduced with physical activity. 275 Within enhanced recovery programs (ERPs) for colorectal surgery, definitions of early mobilization vary, from any mobilization at all within 24 hours 10 to 8 hours per day by postoperative day (POD) 2. 276 Patients in ERPs meet mobilization targets sooner compared with con- ventional care. 8,277,278 In observational studies, adherence with various mobilization targets, if reported, ranged from 28% 279 to 69% 276 and was a significant predictor of earlier (...) in terms of complications, a meta-analysis of seven RCTs (1769 patients) comparing MBP with OBP versus MBP alone showed a reduction in total surgical site infection and incisional site infection, with no difference in the rate of organ/space infection after elective colorectal sur- gery. 80 These trial findings are consistent with population- level data. In a retrospective analysis of a large nationwide database in the United States, MBP plus OBP in left colonic resection was associated with decreased

2017 American Society of Colon and Rectal Surgeons

125. Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

disease (FALD). Retro- spective reviews of liver histopathology in patients with Fontan physiology consistently show near-universal fi- brosis both early and late after Fontan completion. 92–95 On noninvasive imaging, 57% to 67% of patients with Fontan physiology have ultrasound abnormalities of the liver, and 72% to 100% have abnormalities on CT or magnetic resonance (MR) imaging. 96–99 Epidemiologic data are limited in other CHD populations in which rou- tine surveillance is uncommon and recognition (...) - kinesia is often associated with heterotaxy syndrome, which may further increase the susceptibility of patients with CHD to respiratory infections. 180 Examples of en- capsulated bacteria are Haemophilus influenzae type B, Streptococcus pneumoniae, N meningitidis, group B streptococcus, Klebsiella pneumoniae, Salmonella ty- phi, and Escherichia coli. K pneumoniae and E coli are the principal pathogens in patients 6 months of age, although successful H influenza vaccination is altering this picture

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2017 American Heart Association

126. Childhood and Adolescent Adversity and Cardiometabolic Outcomes: A Scientific Statement From the American Heart Association

of mental health problems on cardiometabolic outcomes, there are also indirect effects that further exacerbate cardiometabolic risk factors. For example, youth with mood disorders are less likely to achieve recommended levels of physical activity and sleep and more likely to have suboptimal dietary habits, all of which impart cardiometabolic disease risk. In addition, several pharmacological treatments used to treat mental health problems could contribute to cardiometabolic risk factor accumulation (...) of early smoking initiation. Furthermore, the home environment is central to children’s daily experiences, particularly with regard to meal and activity patterns. The home environment may affect practices such as meal preparation, use of television (and other digital media), consumption of food outside the home, and participation in physical activity. , , , Parental psychological distress is associated with lower consumption of fruits, vegetables, and high-calcium foods among children, plus fewer

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2017 American Heart Association

127. Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association

statistically significant changes but few clinically significant improvements in BP. In systematic reviews 42,96 and meta-analyses, 31,33,42,96 both diastolic and systolic BP readings were statistically improved when SMBP was used; however, BP improvements were not clinically significant. Improve- ments in BP were often associated with reported increases in hypertensive medication use and other recommended lifestyle behaviors (eg, diet modification, physical activity). 33,42 Out- comes from an RCT using (...) studies focused on CAD risk- reduction interventions for PCI patients, which included use of self-efficacy mechanisms 49 and a culturally tailored behav- ioral intervention to increase positive affect/self-affirmation to promote increased physical activity. 50 Atrial Fibrillation A majority of the self-management TPE interventions for patients with AF were characterized by improving patients’ knowledge related to AF and medication use of oral antico- agulants (OACs), such as warfarin (Table 3). 51–59

2017 American Heart Association

128. Atrial Fibrillation

diagnosis, treatment, prevention and rehabilitation) of a given condition according to ESC Committee for Practice Guidelines (CPG) policy and approved by the EACTS and ESO. A critical evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger populations were included, where data exist. The level of evidence and the strength of the recommendation of particular management options were weighed

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2016 European Society of Cardiology

129. An update to the Greig Health Record: Preventive health care visits for children and adolescents aged 6 to 17 years ? Technical report

for promoting helmet use, condom use to prevent sexually transmitted infections (STIs), more physical activity, responsible television viewing, and parental smoking cessation. Office counselling may also be effective in increasing seat belt use. Visit frequency and structure The frequency of preventive visits in this age group is recommended to be every one to two years (consensus). However, 31% of adolescents in a 2011 Ontario survey reported no visits to a physician in the preceding year, including visits (...) . Obesity in children and adolescents is associated with both physical health problems (mainly cardiovascular and metabolic) and psychosocial morbidity as well as increased mortality rates in adulthood. Populations at particular risk include low socio-economic groups, those living in rural or remote areas and certain ethnic groups, such as First Nations people living off reserve. Adolescence is a critical period in the development of obesity, as a time when diet changes, physical activity declines

2016 Canadian Paediatric Society

130. The 2017 hormone therapy position statement of The North American Menopause Society

balance through decreases in resting energy expenditure and physical activity. 137 Reviewsofpreclinicalstudiesandlimitedclinicalstudiesof HTinpostmenopausalwomensuggestabenefitonmaintaining or increasing muscle mass and related connective tissue, improving strength and improving posttraumatic or postatro- phy muscle recovery when combined with exercise. 138-140 Key points Development of frailty with aging is a health risk. Sarcopenia and osteoporosis are related to aging, estrogen depletion (...) Women’s Association, American Society for Reproductive Medicine, Asociacio ´n Mexicana para el Estudio del Climaterio, Association of Reproductive Health Professionals, Australasian Menopause Society, Chinese Menopause Society, Colegio Mexicano de Especialistas en Ginecologia y Obstetricia, Czech Menopause and Andropause Society, Dominican Menopause Society, European Menopause and Andropause Society, German Menopause Society, Groupe d’e ´tudes de la me ´nopause et du vieillissement Hormonal

2017 The North American Menopause Society

131. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline

) competence in using the Diagnostic and Statistical Manual of Mental Disorders (DSM) and/or the International Statistical Classification of Diseases and Related Health Problems (ICD) for diagnostic purposes, (2) the ability to diagnose GD/gender incongruence and make a distinction between GD/gender incongruence and conditions that have similar features ( e.g. , body dysmorphic disorder), (3) training in diagnosing psychiatric conditions, (4) the ability to undertake or refer for appropriate treatment, (5 (...) persons. Those clinicians who recommend gender-affirming endocrine treatments—appropriately trained diagnosing clinicians (required), a mental health provider for adolescents (required) and mental health professional for adults (recommended)—should be knowledgeable about the diagnostic criteria and criteria for gender-affirming treatment, have sufficient training and experience in assessing psychopathology, and be willing to participate in the ongoing care throughout the endocrine transition. We

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2017 Pediatric Endocrine Society

132. Dementia, disability and frailty in later life - mid-life approaches to delay or prevent onset

and dementia, disability and frailty. Show how a wide range of domestic, leisure and work activities can help people to be physically active and explain how even modest increases in physical activity, at any age, can be beneficial. Include information on how physical activity: reduces the risk of illness in both the short and long term, preserves memory and cognitive ability, reduces risk of falls and leads to a healthier old age, improving wellbeing and quality of life is enjoyable and can have social (...) not be able to quit, or who do not want to quit, to switch to less harmful sources of nicotine (see NICE's pathway on tobacco: harm-reduction approaches to smoking). 6 Impro 6 Improving the en ving the environment to promote ph vironment to promote physical activity ysical activity Local government, local enterprise partnerships, transport professionals and other organisations involved with the built and natural environment or with road safety (see who should take action?), should improve environments

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

133. Chronic kidney disease: managing anaemia

circumstances of the patient. They should include the following key areas: Practical information about how anaemia of CKD is managed. Knowledge (for example, about symptoms, iron management, causes of anaemia, associated medications, phases of treatment). Professional support (for example, contact information, community services, continuity of care, monitoring, feedback on progress of results). Lifestyle (for example, diet, physical exercise, maintaining normality, meeting other patients). Adaptation (...) be given information and support to help the child or young person to make decisions about their treatment. If it is clear that the child or young person fully understands the treatment and does not want their family or carers to be involved, they can give their own consent. Healthcare professionals should follow the Department of Health's advice on consent. If someone does not have capacity to make decisions, healthcare professionals should follow the code of practice that accompanies the Mental

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

134. Bladder cancer: diagnosis and management

infection, pain, bleeding or need for a catheter the impact of treatment on their sexual health and body image, including how to find support and information relevant to their gender diet and lifestyle, including physical activity smoking cessation for people who smoke how to find information about bladder cancer, for example through information prescriptions, sources of written information, websites or DVDs how to find support groups and survivorship programmes how to find information about returning (...) urothelial bladder cancer who are otherwise physically fit (have an Eastern Cooperative Oncology Group [ECOG] performance status of 0 or 1) and have adequate renal function (typically defined as a glomerular filtration rate [GFR] of 60 ml/min/1.73 m 2 or more). 1.7.3 Offer carboplatin in combination with gemcitabine [3] to people with locally advanced or metastatic urothelial bladder cancer with an ECOG performance status of 0–2 if a cisplatin-based chemotherapy regimen is unsuitable, for example

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

135. Preventing excess weight gain

regular walking, particularly brisk walking, or cycling as a form of active travel (to school, work or other local destinations). (See NICE's guideline on walking and cycling.) Increasing activities during leisure time and breaks at work or school (including some periods of moderate-to-vigorous physical activity). This could include any form of physical activity, sport or exercise such as walking, cycling, swimming, dancing or gardening. Increasing activity as part of daily routines (such as taking (...) behaviour was limited, the Committee recognised that sedentary activity would be reflected in the evidence considered on TV viewing or other screen time, or total leisure time activity. (T otal leisure time activity is any physical activity outside of school or work, including play but excluding active travel.) 3.18 The Committee was of the view that some unexpected associations may have been the result of 'reverse causality' . This is likely to have been the reason for the observed association between

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

136. Type 1 diabetes in adults: diagnosis and management

is it for? 5 Introduction 6 Reasons for the update 6 Medicines 8 Patient-centred care 9 Key priorities for implementation 10 Education and information 10 Blood glucose management 10 Insulin therapy 11 Awareness and management of hypoglycaemia 11 Care of adults with type 1 diabetes in hospital 11 1 Recommendations 12 Blood glucose and plasma glucose 12 1.1 Diagnosis and early care plan 12 1.2 Support and individualised care 15 1.3 Education and information 17 1.4 Dietary management 18 1.5 Physical activity (...) of the person and carers their preferences in nutrition and physical activity other relevant factors, such as substance use cultural and educational assessment to identify prior knowledge and to enable optimal advice and planning about: treatment modalities diabetes education programmes assessment of emotional state to determine the appropriate pace of education. The results of the assessment should be used to agree a future care plan. Some items of the initial diabetes assessment: acute medical history

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

137. Diabetic foot problems: prevention and management

and children (2015) NICE guideline NG7 Diabetes in pregnancy (2015) NICE guideline NG3 Obesity: identification, assessment and management of overweight and obesity in children, young people and adults (2014) NICE guideline CG189 Exercise referral schemes to promote physical activity (2014) NICE guideline PH54 Lipid modification (2014) NICE guideline CG181 Pressure ulcers (2014) NICE guideline CG179 VibraTip for testing vibration perception to detect diabetic peripheral neuropathy (2014) NICE medical (...) technology guidance 22 Neuropathic pain – pharmacological management (2013) NICE guideline CG173 T obacco: harm reduction approaches to smoking (2013) NICE guideline PH45 Physical activity: brief advice for adults in primary care (2013) NICE guideline PH44 Lower limb peripheral arterial disease (2012) NICE guideline CG147 Walking and cycling (2012) NICE guideline PH41 Preventing type 2 diabetes: risk identification and interventions for individuals at high risk (2012) NICE guideline PH38 Preventing type

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

138. Weight management: lifestyle services for overweight or obese adults

people's weight, eating habits and physical activity to support monitoring in line with the Department of Health's information governance and data protection requirements (for example, see the Public Health Services Contract 2014/ 15: guidance on the non-mandatory contract for public health services.) Train staff to accurately measure and record height and weight to determine body mass index (BMI) and to accurately measure waist circumference. They should also be sensitive to how people feel about (...) 25 to 30 kg/m 2 ) (Statistics on obesity, physical activity and diet: England 2014, Health and Social Care Information Centre 2014). Although there are people in all population groups who are overweight or obese, obesity is related to social disadvantage (Fair society, healthy lives: strategic review of health inequalities in England post-2010, The Marmot Review 2010). Prevalence varies by population characteristics (for example see Public Health England briefing papers). For women, obesity

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

139. Obesity: identification, assessment and management

CG184), as well as psychological and psychiatric morbidities. The Health and Social Care Information Centre reported that in 2011/12 there were 11,740 inpatient admissions to hospitals in England with a primary diagnosis of obesity: 3 times as many as in 2006/07 (Statistics on obesity, physical activity and diet – England, 2013). There were 3 times as many women admitted as men. In the UK obesity rates nearly doubled between 1993 and 2011, from 13% to 24% in men and from 16% to 26% in women. In 2011 (...) ake into account the person's current physical fitness and ability for all activities. Encourage people to also reduce the amount of time they spend inactive, such as watching television, using a computer or playing video games. [2006] [2006] Children Children 1.6.4 Encourage children and young people to increase their level of physical activity, even if they do not lose weight as a result, because of the other health benefits exercise can bring (for example, reduced risk of type 2 diabetes

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

140. Developing evidence informed, employer-led workplace health

reviews on health topics falling outside of physical activity and mental health interventions, such as healthy eating, cancer prevention and cardiovascular risk. • The relative costs of different interventions and the cost-effectiveness of interventions. • ‘Business outcomes’ of relevance to stakeholders; for example, stakeholders may view lower staff turnover or lower business health expenditure costs as more important than ‘presenteeism’ or ‘absenteeism’. • Longer-term outcomes of both interventions (...) to influence their success. To address these issues, we undertook a systematic review of three sources of evidence: systematic reviews examining intervention effectiveness; research on stakeholders’ views and experiences; and key workplace health policy documents. What did we find? We identified 24 systematic reviews of WHPs which examined statistically the impact on a variety of outcomes, including mental health, weight management, absenteeism (and its costs), work ability and job stress. The reviews

2016 EPPI Centre

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