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

. Moderate levels of anxiety make us alert and improve performance, and even high lev- els of anxiety will be appropriate when they are consistent with the demands of the situation. For example, moderate levels of anxiety before a sporting event, an exam or a job interview will increase alertness and performance, while high arousal in situations of real danger will enable people to focus on the threat and act quickly to escape or ward off the danger. The problem is that high anxiety can reduce a person’s (...) not be expected when the intervention is delivered by other clinicians), from publication bias, and from clinical trial design that results in samples unrepresentative of clinical populations (Malhi et al., 2015). The use of different outcome measures makes direct comparisons between studies difficult, although authors have addressed this in various ways, including by calculat- ing standardised mean differences (SMDs). Some meas- ures, such as the Clinical Global Impression scale (CGI), appear to give rise

2018 Royal Australian and New Zealand College of Psychiatrists

23. Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory

alertness, and often recent intolerancetoneurohormonalinhibition.Sleepiness,impaired concentration,andverylowurineoutputmayalsobepresent. Thesepatientsmayrequireadjunctivetherapywithvasodilator or inotropic agents or decrease of medications with negative inotropic effects to improve cardiac output and facilitate diuresis. Patients who appear to have low cardiac output without clinical congestion (cold and dry pro?le) often have unrecognized elevation of ?lling pressures, which may (...) bypass surgery. Exercise program/cardiac rehabilitation. Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: US Preventive Services Task Force Recommendation Statement Malnutrition Assess for protein calorie malnutrition. Referral to dietician. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient Frailty, deconditioning Assess for frailty, consider physical therapy and/or referral for rehabilitation

2019 American College of Cardiology

24. Interventions to improve the labour market outcomes of youth: a systematic review of training, entrepreneurship promotion, employment services and subsidized employment interventions

the findings of this review mean? The evidence suggests that investing in youth through active labour market measures may pay off. Skills training and entrepreneurship promotion interventions appear to yield positive results on average. So, there are potential benefits from combining supply- and demand-side interventions to support youth in the labour market. The evidence indicates the need for careful design of youth employment interventions. The “how” seems to be more important than the “what (...) into the labour market may succeed in enhancing employment and earnings outcomes and have 16 The Campbell Collaboration | www.campbellcollaboration.org potential to increase human capital and employment prospects in the long-term. The evidence suggested that programmes targeting disadvantaged youth are particularly effective. Entrepreneurship promotion and skills training programmes appear to be a particularly promising intervention for improving employment, earnings and business performance, but the evidence

2017 Campbell Collaboration

25. A Guideline for the Clinical Management of Opioid Use Disorder

equivalent methadone doses (40–85 mg/day and = 85 mg/day). Buprenorphine and methadone appear to be equally effective for reducing illicit opioid use. 67 A recent meta-analysis comparing buprenorphine and methadone for treatment of prescription opioid dependence reached similar conclusions; buprenorphine and methadone appear to be equally effective in reducing opioid use and retaining individuals in treatment for this specific patient population, although authors note that the evidence base is limited (...) through more flexible take-home dosing schedules that are safe and feasible with buprenorphine/naloxone. 88-91 There is also potential for additional costs savings during treatment initiation, as buprenorphine/naloxone induction is much faster (days to weeks) than methadone stabilization (weeks to months), requiring fewer clinical visits overall to achieve a stable dose. In terms of gender-related differences, while opioid use is generally more prevalent among men than women, 22 there do not appear

2017 Clinical Practice Guidelines and Protocols in British Columbia

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

) or secondary outcomes (health behaviors, health and safety indicators, social outcomes, family outcomes, school outcomes, or community outcomes) were eligible. The evidence base covers 17 studies reporting on 11 unique interventions with 297,994 participants. Six studies took place in the USA, and one study each was in Brazil, Canada, Croatia, Israel, and New Zealand. What are the main results in this review? Later school start times appear to increase sleeping time. And there is a positive association (...) and depression (Chorney 2007). • Pre-frontal cortex dysfunction (inappropriate behavioral responses, negative impact on creative thinking, decreased goal-oriented behavior) (Drummond 1999; Harrison 1996). • Slow performance or lapses of performance, slower reaction times, difficulty concentrating (Sadeh 2003). • Low achievement and achievement motivation (Epstein 1998; Meijer 2000). It appears, therefore, that later school start times, if associated with sleep time increases, could have positive impacts

2017 Campbell Collaboration

27. Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults

mindfulness. What is this review about? Stress and stress-related mental health problems are major causes of illness and disability. MBSR is a group-based health promotion intervention to improve health and the way people deal with stress and life’s challenges. The core ingredient is mindfulness training through physical and mental exercises practiced daily for eight weeks. The mindful non-judgmental attitude of being present with what arises is practiced in the formal exercises and in everyday situations (...) (4-7) are offered and others omit the all-day session. The weekly sessions have standardized core elements consisting of different mental and physical mindfulness exercises. In particular body scan exercises, mental exercises focusing one’s attention on the breath, physical exercises with a focus on being aware of bodily sensations, and practicing being fully aware during everyday activities. Essential to all parts of the Program is developing an accepting and non-reactive attitude to what one

2017 Campbell Collaboration

28. Outcome Measures Framework: Information Model Report

, nearly two thirds (n=947, 61.3%) of the studies did not have one listed (Table 2). Of those listing an intervention, 190 (12.3%) studies were categorized as Other, 150 (9.7%) listed Device, 109 (7.1%) listed Procedure, and 94 (6.1%) listed Drug. Other intervention types, such as behavioral, biological, dietary supplement, genetic, and radiation, each represented less than two percent of the records. Table 2. Frequency of intervention type selection in registries in ClinicalTrials.gov Intervention N (...) % Behavioral 14 0.9 Biological 11 0.7 Device 150 9.7 Dietary Supplement 4 0.3 Drug 94 6.1 Genetic 8 0.5 Other 190 12.3 Procedure 109 7.1 Radiation 18 1.2 Missing 947 61.3 The distribution of primary and secondary outcomes is shown in Table 3. In ClinicalTrials.gov, one outcome is required. There were 1,305 (84.5%) records with only one outcome, 236 (15.3%) with two or more, 119 (7.7%) with three or more, and 69 (4.5%) with four or more. Fewer records listed secondary outcome measures, likely due

2018 Effective Health Care Program (AHRQ)

29. Erectile Dysfunction

Erectile Dysfunction Erectile Dysfunction (ED) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL/Certifications Exam (...) be supported by any body of evidence strength. When body of evidence strength is Grade A, the statement indicates that benefits and risks/burdens appear balanced, the best action depends on the man's circumstances, and future research is unlikely to change confidence . When body of evidence strength Grade B is used, benefits and risks/burdens appear balanced, the best action also depends on individual man's circumstances and better evidence could change confidence . When body of evidence strength Grade C

2018 American Urological Association

30. Non-medical Prescription Stimulant Use among Post-secondary Students

(e.g., cardiovascular events), and appears to be associated with risk behaviours (e.g., hazardous drinking) and poorer well-being. ? Increasing prevention efforts on campuses are needed, including strategies aimed at enhancing awareness among students of the potential risks and consequences of inappropriate prescription stimulant use. Non-medical Prescription Stimulant Use among Post-secondary Students Canadian Centre on Substance Use and Addiction • Centre canadien sur les dépendances et l’usage (...) , aged 18–25, reported past month non-medical prescription stimulant use, compared to 0.6% of the general population (Center for Behavioral Health Statistics and Quality, 2016). Not only are prevalence rates highest among emerging adults, evidence also suggests that these rates are on the rise. Between 2006 and 2011, a 67% increase in non-prescribed use of Adderall in young adults, aged 18–25, was observed, along with a 156% increase in associated emergency room visits (Chen et al., 2016). Prevalence

2018 Canadian Centre on Substance Abuse

31. Erectile Dysfunction

by the AUA Board of Directors April 2018 Authors’ disclosure of po- tential conflicts of interest and author/staff contribu- tions appear at the end of the article. © 2018 by the American Urological Association American Urological Association (AUA) ERECTILE DYSFUNCTION: AUA GUIDELINE Arthur L. Burnett, MD; Ajay Nehra, MD; Rodney H. Breau, MD; Daniel J. Culkin, MD; Martha M. Faraday, PhD; Lawrence S. Hakim, MD; Joel Heidelbaugh, MD; Mohit Khera, MD; Kevin T. McVary, MD; Martin M. Miner, MD; Christian J (...) to change confi- dence Benefits > Risks/Burdens (or vice versa) Net benefit (or net harm) is substantial Applies to most patients in most circumstances but better evidence could change confidence Benefits > Risks/Burdens (or vice versa) Net benefit (or net harm) appears substantial Applies to most patients in most circumstances but bet- ter evidence is likely to change confidence (rarely used to support a Strong Recommendation) Moderate Recommendation (Net benefit or harm moderate) Benefits > Risks

2018 American Urological Association

32. Comprehensive Systematic Review Summary: Disease-modifying Therapies for Adults with Multiple Sclerosis

protein, myelin oligodendrocyte glycoprotein, and proteolipid protein). e9 Analysis of oligoclonal bands has also failed to reveal a consistent antibody pattern across people with MS. e10 Cloned antibodies from CSF oligoclonal bands have not revealed a common antigenic target. e11 Thus, intrathecal synthesis of gamma globulins, the immunochemical hallmark of MS, does not appear to be associated with specific CNS targets. e12,e13 Despite an inability to conclusively determine an autoimmune target

2018 American Academy of Neurology

33. Hoarseness (Dysphonia)

, neurologic, metabolic, neoplastic, congenital, and behavioral factors ( ). Table 6. Etiologies of Dysphonia and Examples from Each Category. Table 6. Etiologies of Dysphonia and Examples from Each Category. The history should include, but not be limited to, reviewing the duration of the dysphonia, type of onset (eg, sudden, gradual), potential inciting events, how the condition is affecting the patient, associated symptoms (eg, swallowing, breathing difficulties), modifying factors, current medications

2018 American Academy of Otolaryngology - Head and Neck Surgery

35. COPD Disease Education in Pulmonary Rehabilitation: A Workshop Report

application of self-management strategies. Enhanced health: the goal of successful behavior change WORKSHOP REPORT Workshop Report 771 activity, and long-term adherence with regular exercise have been added (15). Although patients have indicated a desire for education on advance directives (23, 24), the inclusion of most content areas appears to have been determined by HCPs (15, 18). To date, no literature has identi?ed essential or desirable topics for inclusion, and the list of possible topics (...) to understandarecommendedbehavior;or 3) promotes an attitude change about the behavior. Educational material provides direct support for the learning goals, with the goals being the focus of questions to determine if a patient has mastered and understood the key information presented. Teach-back con?rms understanding of each concept until mastery is attained. Research into the impact of including health literacy screening, including cost– bene?t and burden of completion, for educational design in PR is required to determine

2018 American Thoracic Society

36. Management of Pregnancy

to complications experienced in pregnancies of Active Duty Service Members, which appear to be similar to those of the dependent spouses of Active Duty Service Members.[ , ] Between 2012 and 2016, pre-term labor, obesity related complications, preeclampsia, and GDM affected 17.7%, 9.2%, 6.8%, and 6.3% of live births, respectively. Over the same time period, the percentage of live births affected by preeclampsia and GDM remained relatively stable, while the percentages of live births affected by preterm labor

2018 VA/DoD Clinical Practice Guidelines

37. End-of-Life Care for People Experiencing Homelessness

of practitioners experienced in homeless health care with expertise in end-of-life care and behavioral health care. Sources: Hopper et al., 2010; Hwang et al., 2008; Morrison, 2007; Waldmann in O’Connell, 2004 The assessment process represents an opportunity for a care provider to foster a therapeutic alliance with a patient. This section will present detailed guidelines for taking a patient’s history, conducting a physical exam, and using appropriate assessment and diagnostic tools. As underlying guidelines (...) care and end-of-life care. Patient Assessment and Evaluation 1. Focus primarily on assessing the social, emotional, mental, and environmental needs that affect the delivery of care for the terminally ill patient experiencing homelessness. 2. Focus the initial physical exam on the patient’s area of concern or areas most likely to be affected given the diagnosis or chief complaint. Perform serial focused exams as tolerated (if needed). Attempt to evaluate the stage of the patient’s condition. Look

2018 National Health Care for the Homeless Council

38. Heavy Episodic Drinking Among Post-secondary Students: Influencing Factors and Implications (Report at a Glance)

. The study, Heavy Episodic Drinking among Post-secondary Students: Influencing Factors and Implications, examined student perceptions and attitudes, expectations, reasons and consequences influencing heavy episodic drinking. The study also explored three high- risk drinking issues: alcohol-induced blackouts, pre-drinking and drinking to cope. The findings from the report continue to demonstrate the extreme nature of heavy episodic drinking and the risks posed to students. In response, this study suggests (...) , appears to be riskier due to the uncontrolled environment and the overall excessive drinking that often takes place, including later at the party or bar, which can lead to increased negative consequences. ? Heavy episodic drinking is not recognized as a serious issue by most participants, but is a continued concern for the negative short- and long-term consequences of drinking. ? Despite reporting largely negative experiences, participants perceive drinking as predominantly positive, with minimal

2018 Canadian Centre on Substance Abuse

39. Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients

pages to the selected reprint or otherwise clearly identifies the reprint as having been produced by AACC. Otherwise, this document may not be reproduced in whole or in part, stored in a retrieval system, translated into another language, or transmitted in any form without express written permission of AACC. Such permission may be requested from AACC, 900 Seventh St, NW, Suite 400, Washington, DC 20001. Permission will ordinarily be granted, provided the AACC logo and the following notice appear (...) ) to classify prescription opioid analgesic abuse as an epidemic. This appears to be due in large part to individuals using a prescription drug non-medically, most often an opioid an- algesic. Drug-induced deaths have rapidly risen and continue to be one of the leading causes of death in Americans. In 2011, the Office of National Drug Control Policy established a multifaceted approach to address prescription drug abuse, including Prescrip- tion Drug Monitoring Programs (PDMPs) that allow practitioners

2018 American Academy of Pain Medicine

40. Early Breast Cancer: ESMO Clinical Practice Guidelines

for a reduced hospital stay [I, A]. With appropriate training in the dual radiocolloid/blue dye technique or others (indocyanine green fluorescence technique or superparamagnetic iron oxide), high identification rates (over 97%), low false-negative rates, and favourable axillary recurrence rates following SLNB are achievable [74]. There is no definite consensus for the pathological assessment of SLNB. The significance of occult micrometastases in terms of surgical management and patient outcome appears (...) -abstract/doi/10.1093/annonc/mdz173/5499075 by guest on 25 June 201917 If invasive cancer appears in the specimen, SLNB after conservative surgery is feasible and accurate for staging the axilla. Lobular neoplasia [formerly called lobular carcinoma in situ (LCIS)], unlike DCIS, is considered a non-obligate precursor to invasive cancer. It is regarded as a risk factor for future development of invasive cancer in both breasts [relative risk (RR): 5.4–12] and does not require active treatment

2019 European Society for Medical Oncology

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