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Appearance, Behavior and Attitude Exam

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121. Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities. (Abstract)

Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities. Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM (N = 871). The authors examined demographic differences in health care access and the relation between access and health-related attitudes, health behaviors, and HIV (...) transmission risk. They operationalized health care access in terms of three indicators: perceived barriers, insurance status, and recent medical visit. Twenty-seven percent (n = 227) of MSM reported zero or one health care access indicator. African American and Latino race/ethnicity, lower income, and HIV-unknown status were associated with limited health care access. Limited health care access was related to health care attitudes (mistrust in the health care system and difficulty disclosing MSM status

2012 Health Education & Behavior

122. THE BEHAVIOR OF BACILLUS LEPRÆ IN COLD-BLOODED ANIMALS Full Text available with Trip Pro

THE BEHAVIOR OF BACILLUS LEPRÆ IN COLD-BLOODED ANIMALS Before proceeding to a discussion of the experiments upon cold-blooded animals, it is necessary to review briefly some of the work recently done with the bacillus of leprosy. The appearance of the bacillus in man and its behavior under artificial cultivation, and in the tissues of lower animals, should be considered in order that comparisons may be drawn. In their studies with the organism under cultivation, Duval and Gurd pointed out (...) degenerates into a granular mass shortly after inoculation; in others that are less refractory, typical lesions appear, but they seldom extend from the point of inoculation; and while the bacilli multiply slowly, they do not infiltrate the tissues, but disappear after a short time, the lesions healing. That multiplication of Bacillus leprae occurs in the tissues of cold-blooded animals is shown by the fact that while animals examined a few days after inoculation show but a few scattered organisms, those

1911 The Journal of experimental medicine

123. Challenging the role of social norms regarding body weight as an explanation for weight, height, and BMI misreporting biases: development and application of a new approach to examining misreporting and misclassification bias in surveys. Full Text available with Trip Pro

approach to examining weight, height, and BMI misreporting biases and used this approach to examine the association between socially non-normative weight and misreporting biases in adults.The Survey of Lifestyles, Attitudes, and Nutrition 2007 (SLÁN 2007), a nationally representative survey of the Republic of Ireland (N = 1942 analyzed) was used. Self-reported weight (height) was classified as under-reported by ≥ 2.0 kg (2.0 cm), over-reported by ≥ 2.0 kg (2.0 cm), or accurately reported within 2.0 kg (...) Challenging the role of social norms regarding body weight as an explanation for weight, height, and BMI misreporting biases: development and application of a new approach to examining misreporting and misclassification bias in surveys. Cultural pressures to be thin and tall are postulated to cause people to misreport their body weight and height towards more socially normative (i.e., desirable) values, but a paucity of direct evidence supports this idea. We developed a novel non-linear

2011 BMC Public Health

124. Advising people with back pain to take time off work: A survey examining the role of private musculoskeletal practitioners in the UK. Full Text available with Trip Pro

, and physiotherapists) beliefs and reported clinical behaviours in reference to patients' work. A cross-sectional postal questionnaire of 900 musculoskeletal practitioners included the Attitudes to Back pain in musculoskeletal practitioners questionnaires, reported frequency of four work-related behaviours, and a new measure of practitioners' work-related beliefs. Data from 337 respondents (37%) were analysed. Eighty percent of respondents reported recommending work absence to patients with LBP sometimes, and 14 (...) behaviours. Our study confirms that, in contrast to current guidelines, many practitioners believe that LBP necessitates work absence. Overall, practitioners perceived their role in returning patients to work as limited, and believed that direct contact with employers was beyond their remit. In the UK, physiotherapists appear to be better placed to liaise with work in terms of both their beliefs and activities.Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V

2011 Pain

125. Mental status examination Full Text available with Trip Pro

of the clinical process in practice. It is a structured way of observing and describing a 's psychological functioning at a given point in time, under the domains of appearance, , behavior, mood, and affect, speech, , thought content, , , insight, and . There are some minor variations in the subdivision of the MSE and the sequence and names of MSE domains. The purpose of the MSE is to obtain a comprehensive cross-sectional description of the patient's mental state, which, when combined with the biographical (...) , or needle track marks from intravenous drug abuse. Observations can also include any odor which might suggest poor personal due to extreme self-neglect, or . Weight loss could also signify a depressive disorder, physical illness, anorexia nervosa or chronic anxiety. Attitude [ ] Attitude, also known as or cooperation, refers to the patient's approach to the interview process and the quality of information obtained during the assessment. Behavior [ ] Abnormalities of behavior, also called abnormalities

2012 Wikipedia

126. COVID-19 and Pregnant Patients

to that provided to any critically ill pregnant person ultrasound elective ultrasound exams should not be performed if risk of exposure and infection within the community is greater than benefit of testing, consider postponing or canceling some testing or exams detailed mid-trimester anatomy ultrasound examination may be considered following first trimester maternal COVID-19 infection ultrasound assessment of fetal growth is indicated in pregnant women with COVID-19 infection due to risk of fetal growth (...) for self or arrange follow-up if necessary if yes to any answers on examine patient as soon as possible in an ambulatory setting with resources to determine severity of illness, preferably in a setting where patient can be isolated clinical assessment for respiratory compromise includes physical exam pulse oximetry chest x-ray arterial blood gas as clinically indicated chest computed tomography with abdominal shielding if clinically recommended if patient is determined to have respiratory compromise

2020 DynaMed Plus

127. COVID-19 and Patients With Cancer

immunosuppression both and appear to be associated with increased risk of severe illness during COVID-19 include limiting exposure to patients and staff, utilization of telemedicine, and rescheduling/postponing nonurgent appointments for COVID-19 may have atypical presentation or present with mild symptoms and deteriorate rapidly consider that symptoms of neutropenic sepsis and pneumonitis related to therapy can mimic symptoms of COVID-19 PubMed 32170865 Journal of medical virology J Med Virol 20200314 (...) to be taken if the infection rates increase for patients with late-stage disease or with comorbid conditions who may become infected with COVID-19 consider which treatment would have the most success and benefit consider prognosis if patient would require mechanical ventilation conduct proactive palliative and end-of-life conversations as soon as possible supportive care attempt to decrease transfusions when possible anticipating blood product shortages consider limiting or postponing supportive therapies

2020 DynaMed Plus

128. Opinion leaders and changes over time: a survey. Full Text available with Trip Pro

Opinion leaders and changes over time: a survey. Opinion leaders represent one way to disseminate new knowledge and influence the practice behaviors of physicians. This study explored the stability of opinion leaders over time, whether opinion leaders were polymorphic (i.e., influencing multiple practice areas) or monomorphic (i.e., influencing one practice area), and reach of opinion leaders in their local network.We surveyed surgeons and pathologists in Ontario to identify opinion leaders (...) for colorectal cancer in 2003 and 2005 and to identify opinion leaders for breast cancer in 2005. We explored whether opinion leaders for colorectal cancer identified in 2003 were re-identified in 2005. We examined whether opinion leaders were considered polymorphic (nominated in 2005 as opinion leaders for both colorectal and breast cancer) or monomorphic (nominated in 2005 for only one condition). Social-network mapping was used to identify the number of local colleagues identifying opinion

2011 Implementation Science

129. Twin and triplet pregnancy

a second opinion from a senior sonographer or refer the woman to a healthcare professional who is competent in determining chorionicity and amnionicity by ultrasound scan as soon as possible. [2011, amended 2019] [2011, amended 2019] 1.1.7 If it is difficult to determine chorionicity, even after referral (for example, because the woman has booked late in pregnancy), manage the pregnancy as a monochorionic pregnancy until proved otherwise. [2011] [2011] 1.1.8 Provide regular training so (...) (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 59anxiety. [2011] [2011] Diet, lifestyle and nutritional supplements Diet, lifestyle and nutritional supplements 1.2.2 Give women with a twin or triplet pregnancy the same advice about diet, lifestyle and nutritional supplements as in routine antenatal care (see NICE's guideline on antenatal care for uncomplicated pregnancies). [2011] [2011] 1.2.3 Be aware of the higher incidence of anaemia in women with a twin or triplet

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

130. Thyroid disease: assessment and management

. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 53Ov Overview erview This guideline covers investigating all suspected thyroid disease and managing primary thyroid disease (related to the thyroid rather than the pituitary gland). It does not cover managing thyroid cancer or thyroid disease in pregnancy. It aims to improve quality of life by making recommendations on diagnosis, treatment, long-term care and support. NICE is also developing (...) of different treatment options on new and existing thyroid eye disease (for example, radioactive iodine may precipitate or worsen thyroid eye disease) the need for thyroid hormone replacement if treatment leads to life-long hypothyroidism. Th Thyroid enlargement (also known as goitre yroid enlargement (also known as goitre) ) 1.1.6 Provide people with thyroid enlargement, and their family or carers if appropriate, with written and verbal information on: the causes of thyroid enlargement, including the fact

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

131. Diverticular disease: diagnosis and management

and laxatives and there was no evidence on non-steroidal anti-inflammatory drugs (NSAIDs). The evidence that was available didn't help the committee to understand the impact of these interventions on the progression of disease or people's quality of life. The committee used formal consensus methods together with their expertise and knowledge to make recommendations on diet and lifestyle advice and how to manage pain and cramping. Bulk-forming laxatives are effective as they help to soften the stool and can (...) disease if a person presents with one or both of the following: intermittent abdominal pain in the left lower quadrant with constipation, diarrhoea or occasional large rectal bleeds (the pain may be triggered by eating and relieved by the passage of stool or flatus) tenderness in the left lower quadrant on abdominal examination. Be aware that: in a minority of people and in people of Asian origin, pain and tenderness may be localised in the right lower quadrant symptoms may overlap with conditions

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

132. Prostate cancer: diagnosis and management

and and that there is limited evidence for some treatment options. [2014] [2014] 1.1.11 Ensure that mechanisms are in place so people with prostate cancer and their primary care providers have access to specialist services throughout the course of their disease. [2008] [2008] 1.1.12 T ell people with prostate cancer and their partners or carers about the effects of prostate cancer and the treatment options on their: sexual function physical appearance continence Prostate cancer: diagnosis and management (NG131) © NICE 2019 (...) . All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 51other aspects of masculinity. Support people and their partners or carers in making treatment decisions, taking into account the effects on quality of life as well as survival. [2008] [2008] 1.1.13 Offer people with prostate cancer, and their partners or carers, the opportunity to talk to a healthcare professional experienced in dealing with psychosexual issues at any

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

133. Depression in children and young people: identification and management

and young people: identification and management (NG134) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 22 of 441.6.18 A child or young person prescribed an antidepressant should be closely monitored for the appearance of suicidal behaviour, self-harm or hostility, particularly at the beginning of treatment, by the prescribing doctor and the healthcare professional delivering the psychological therapy. Unless it is felt (...) Intensive psychological therapy +/– fluoxetine, sertraline, citalopram, augmentation with an antipsychotic Tier 3 or 4 Abbreviations: CBT, cognitive–behavioural therapy; IPT, interpersonal psychotherapy; IPT-A, IPT for adolescents; NDST, non-directive supportive therapy. 1 June 2019 – terminology is under revision and may change in the future in line with NHS England's Future in Mind and the Care Quality Commission's report Are we listening. We have retained the tiers terminology and will revise

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

134. Canadian Stroke Best Practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; 6th edition update 2019

and observational studies and expert opinion. People with stroke, families, and caregivers have expressed, through formal and informal assess- ment, that transitions in care, resuming life roles, and increasing community participation represent some of the greatest challenges faced after stroke. The CSBPR are responsive to this need; inclusion of some recom- mendationsbasedonexpertopinionandexperienceare intended to facilitate a holistic approach to person and family-centered care to promote optimal outcomes (...) limitations, role participation restrictions, environmental factors, and the presence of modifiable stroke risk factors (such as lifestyle behaviors) should be considered within two weeks of stroke onset (Evidence Level C). (vi) Onceapatientwithstrokehasundergoneassessments,astandardizedapproachisrecommendedtodetermine the appropriate setting for rehabilitation (inpatient, outpatient, community, and/or home-based settings) (Evidence Level C). a. This standardized criteria for admission to any

2020 CPG Infobase

135. Management of osteoporosis and the prevention of fragility fractures

and a significant risk that the relationship is not causal 3 Non-analytic studies, eg case reports, case series 4 Expert opinion Recommendations Some recommendations can be made with more certainty than others. The wording used in the recommendations in this guideline denotes the certainty with which the recommendation is made (the ‘strength’ of the recommendation). The ‘strength’ of a recommendation takes into account the quality (level) of the evidence. Although higher-quality evidence is more likely (...) , and patients who have hip fractures and vertebral fractures have a decreased life expectancy compared with population-based controls. A wide range of treatments that can reduce the risk of fractures occurring in patients with osteoporosis is now available. These have the potential to improve clinical outcomes for patients with osteoporosis and to reduce societal costs of medical care associated with fractures. 1.2 Remit of the guideline 1.2.1 Overall objectives This guideline provides recommendations based

2020 SIGN

136. Decision-making and mental capacity

of life can be potentially distressing, and a person may feel overwhelmed with having to make a difficult decision at a difficult time and having to deal with possibly conflicting opinions. Decision-making and mental capacity (NG108) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 13 of 411.2.13 Give people time during the decision-making process to communicate their needs and feel listened to. Be aware that this may (...) decisions, for example, about their personal welfare, medical treatment, property or affairs facilitating their involvement in decisions that may be made, or are being made under the Mental Capacity Act 2005. 1.1.8 As a minimum, independent advocacy must be offered by local authorities as described in the Care Act 2014, Mental Capacity Act 2005 and Mental Health Act 2007. [This recommendation is adapted from the NICE guideline on learning disabilities and behaviour that challenges: service design

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

137. Flu vaccination: increasing uptake

responsibility at a national or local level for the provision, commissioning, regulation or improvement and oversight of government-funded health and care services. Underserv Underserved groups ed groups This term is used in this guideline to mean adults and children from any background who are 'underserved' if their social circumstances, language, culture or lifestyle (or those of their parents or carers) make it difficult to: recognise they are eligible for flu vaccination (for example, they have (...) and appropriate clinical and economic data. We developed new economic models for carers and for health and social care staff because there were no existing models for these populations. We considered interventions to be cost effective if they cost up to £20,000 per quality-adjusted life year (QAL Y). We conducted scenario analyses to determine the intervention cost that would be cost effective for a given increase in uptake. A multicomponent approach The discussion below explains how the committee made

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

138. Attention deficit hyperactivity disorder: diagnosis and management

or young person presents in primary care with behavioural and/or attention problems suggestive of ADHD, primary care practitioners should determine the severity of the problems, how these affect the child or young person and the parents or carers, and the extent to which they pervade different domains and settings. [2008] [2008] 1.2.7 If the child or young person's behavioural and/or attention problems suggestive of ADHD are having an adverse impact on their development or family life, consider (...) - pharmacological treatments, potential adverse effects and non-response rates) the benefits of a healthy lifestyle, including exercise their preferences and concerns (it is important to understand that a person's decision to start, change or stop treatment may be influenced by media coverage, teachers, family members, friends and differing opinion on the validity of a diagnosis of ADHD) how other mental health or neurodevelopmental conditions might affect treatment choices the importance of adherence

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

139. Physical activity and the environment

ownership 51 6 Interaction between behavioural and environmental interventions 51 Update information 53 Changes to wording of recommendations from the 2008 guideline for clarification only (no change to meaning) 53 Glossary 54 Active travel 54 Blue spaces 54 Built environment 54 Connectivity 54 Cycling 54 Footpaths 54 Footways 54 Green spaces 55 Greenways 55 Grey spaces 55 Home Zones 55 Inactivity 55 Land use mix 55 Metabolic equivalents or METs per unit of time 55 Natural environment 56 Pavement (...) parking 56 Physical activity 56 Physical activity measurements 56 Public transport 57 Sedentary behaviour 57 Street furniture 57 Physical activity and the environment (NG90) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 57Translational research 57 Vending boards 57 Physical activity and the environment (NG90) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

140. Genome-Wide Sequencing for Unexplained Developmental Disabilities or Multiple Congenital Anomalies

on patient care (including clinical decision making, timing) o Impact of test results on family care (including family planning) Literature Screening A single reviewer conducted an initial screening of titles and abstracts using Covidence 29 and then obtained the full texts of studies that appeared eligible for review according to the inclusion criteria. The same reviewer then examined the full-text articles and selected studies eligible for inclusion. The reviewer also examined reference lists for any (...) , metabolic, and genetic tests over a period of years without diagnosis. Genome-wide sequencing, as whole exome or whole genome sequencing, can examine the entire genetic makeup of a person in a single test, capturing genetic information that other genetic tests (such as targeted gene tests) can miss. A genetic diagnosis can help these people and their families better understand their condition and help them connect with others who have the same condition. This health technology assessment looked at how

2020 Health Quality Ontario

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