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Appearance, Behavior and Attitude Exam

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161. The Geriatricians’ Perspective on Medical Services to Residential Aged Care Facilities (RCFs) in Australia.

Zealand Society for Geriatric Medicine. This Statement was approved by the Federal Council of the ANZSGM on 22nd August 2011. Authors: Drs Penny Harvey and Sam Scherer. BACKGROUND PAPER Introduction The practice of medicine in the complex circumstances of a RCF requires a doctor with particular skills, interests, attitudes [1] and competence in aged care, preferably acquired through dedicated post-graduate training [2]. Adverse events suffered by aged care residents when treated sub- optimally (...) ) was introduced in the USA in 1990 and has been utilised as an international benchmark for practice and research in quality health care for long term care settings. The RAI attempts to link regulation and funding with quality care processes and outcomes and has in the US been demonstrated to reduce the use of psychotropic drugs, restraints, indwelling catheters as well as increasing continence, documented advance directives and behaviour management. [8, 9,10,11,12] Local research studies into the use of RAI

2020 Australian and New Zealand Society for Geriatric Medicine

162. How will seasonal changes impact the COVID-19 pandemic?

with the behaviour of a seasonal respiratory virus o So early in the pandemic, correlations are weak and there is insufficient evidence to determine whether COVID-19 will behave seasonally like influenza; or will spread in all seasons like MERS ? There is consistent advice about the need to replicate analyses and models incorporating new data as the pandemic progresses ? The Centre for Evidence-Based Medicine published a review on weather conditions and transmissions, concluding emerging evidence appears (...) and infection control efforts. Sajadi, 2020 US Observation al Modelling Study findings suggest that the distribution of community outbreaks along a restricted latitude, temperature and humidity are consistent with the behaviour of a seasonal respiratory virus. Study used ERA-5 reanalysis to examine climate data from cities with significant COVID-19 transmission and compared data to areas that are not affected or do not have community spread. It was found that while there is an association between average

2020 Covid-19 Ad hoc papers

163. Implementation of Falls Prevention Strategies in the in-patient Setting: A Rapid Review

validated for the specific population should be used. Two assessment tools used together would better evaluate the characteristics of falls by the elderly. Combining functional measures with subjective screening tools may optimise performance and accuracy of identifying falls risk. Further, with respect to fall prevention interventions, no single intervention has been shown to be universally effective. It appears that multifactorial, patient-centered interventions may be of most benefit. From (...) the evidence about fall risk assessment and interventions (or strategies) to prevent falls we examined whether we could gain insights into the implementation process of these strategies. This examination only revealed details about the content of the strategies and whether it made a difference to preventing falls or rates of risk assessments undertaken. Implementation processes that we were interested in included, but were not limited to: steps undertaken with respect to engaging clinicians

2020 Monash Health Evidence Reviews

164. Conservative Care of Urinary Incontinence in Women

, nurses, midwives, and pelvic health physiotherapists. Target Population Women (>18 years of age) with urinary incontinence. Options Assessment options include gathering of a detailed history, physical examination, laboratory analysis, urodynamic evaluation, and cystoscopy. Conservative management options include lifestyle management, pelvic floor muscle training, behavioural management, and mechanical devices. Outcomes To provide an evaluation-based summary of current available evidence concerning (...) urinary incontinence): • Although current published studies have limitations, currently there does not appear to be any clear added benefit of using adjunctive therapies (biofeedback, electrical stimulation, or vaginal cones). 9 Management – behavioural; bladder training (mixed urinary incontinence, urge urinary incontinence): • Scheduled voiding regimens represent an important and effective management strategy as a stand-alone therapy or part of a multicomponent therapy that includes lifestyle

2020 Society of Obstetricians and Gynaecologists of Canada

165. Coronavirus (COVID-19) infection and pregnancy

should be provided for any service rationalisation required.’ 9 13.5.20 3.3 (Now 2.3): Statement added: ‘When reorganising services, maternity units should be particularly cognisant of emerging evidence that black, Asian and minority ethnic group (BAME) individuals are at particular risk of developing severe and life-threatening COVID-19. There is already extensive evidence on the inequality of experience and outcomes for BAME women during pregnancy and birth in the UK. Particular consideration (...) should be given to the experience of women of BAME background and of lower socioeconomic status, when evaluating the potential or actual impact of any service change.’ 9 13.5.20 4.6 (Now 3.6): Recommendation to be aware that myocardial injury is common among individuals with COVID-19, and reference added to NICE Guidance on diagnosis of myocardial injury in patients with suspected or confirmed COVID-19. 9 13.5.20 4.8.1 (Now 3.8.1): Reference added to Resuscitation Council guidance on neonatal life

2020 Royal College of Obstetricians and Gynaecologists

166. Activities delivered at home by family carers to maintain cognitive function in people with dementia socially isolating during COVID-19: Evidence for Non – technology based activities / interventions

encourages participants to give their opinions and engages participants in an optimal learning environment, usually with the social benefits of a group. More recently home-based programmes of individual cognitive stimulation therapy (iCST) delivered by family caregivers have been developed. (RCT) included 356 people with mild to moderate dementia and their caregivers found that while there was no evidence that iCST has an effect on cognition or QoL for people with dementia, participating in iCST appeared (...) the past in a group, which has a narrative and informative function, and that which has a focus on the individual making sense of their own life story, which is described as having an integrative function. reported that whilst there was only a small benefit on quality of life and cognition immediately following RT delivered to people with dementia in care homes, there was a slight benefit on depression scales associated with individual RT when compared with group RT. also found a small body of evidence

2020 Oxford COVID-19 Evidence Service

167. Effects of preventive nutrition interventions among adolescents on health and nutritional status in low? and middle?income countries Full Text available with Trip Pro

behaviours (Riebl Shaun et al., ; Stang Jamie & Stotmeister, ). Therefore, promotion of healthy nutrition during adolescence is vital to inculcate sustainable healthy dietary habits. Nutrition education and counselling at this stage can create knowledge through active, fun and interactive processes and promote behaviour changes in food attitudes and practices (Baldasso, Galante Andrea, & De Piano Ganen, ). Such programmes can increase adolescents' ability to understand proper food practices and encourage (...) and adolescents, suffer from micronutrient deficiencies in the developing world (Stanger et al., ). In 2014, iron deficiency anaemia was one of the three most common causes of disability‐adjusted life years (DALYs) lost among adolescents along with other micronutrient deficiencies accounting for over 2,500 DALYs per 100,000 adolescents (Akseer, Al‐Gashm, Mehta, Mokdad, & Bhutta, ; WHO, ). Adolescence is a critical age group with key changes in health and its determinants later in life. Adequate nutrition

2020 Campbell Collaboration

168. What works to prevent COVID-19 in ‘care at home’ settings?

of interest were retrieved. A study carried out in north-eastern USA[5], used a questionnaire to explore the knowledge and attitudes of 359 nurses, employed by two home healthcare agencies, towards infection prevention and control. It also examined the factors that may impact upon these. Attitudes were found to be significantly correlated with compliance with hand hygiene practices (based on self-reported data), but no association was observed for knowledge of infection control practices, and compliance (...) with infection control practices in home healthcare: findings from a survey of nurses' knowledge and attitudes toward infection control. Am J Infect Control 46(11), 1211-1217 (2018). 6. Moralejo D, El Dib R, Prata RA, Barretti P, Correa I. Improving adherence to Standard Precautions for the control of health care-associated infections. Cochrane Database Syst Rev 2 CD010768 (2018). 7. Luong Thanh BY, Laopaiboon M, Koh D, Sakunkoo P, Moe H. Behavioural interventions to promote workers' use of respiratory

2020 Covid-19 Ad hoc papers

169. Designing mental health facilities that prevent the use of seclusion and restraint

tools. 13 The JBI critical appraisal tools address a wide range of study types including qualitative and quantitative studies (non-randomised) and expert opinion publications. Each publication is scored individually and is reported. Key findings This Evidence Check identified 38 publications relating to the research questions. 12, 14-50 Using the JBI critical assessment tools, we found most of the studies scored low or unclear on more than one item. Of the 38 included publications assessed using (...) the JBI checklists, one case-controlled study 12 scored unclear for all 10 items. Of the 26 assessed using the quasi/non-randomised trials checklist, we found 22 were unclear or ‘no’ for two or more items. 14, 15, 18, 20, 21, 24, 26, 27, 30, 34-37, 41, 43-50 Of the 10 publications assessed using the qualitative studies checklist, we found seven were unclear or ‘no’ for two or more items. 16, 29, 40, 42, 45, 47, 51 Two 25, 33 of the four expert opinion publications were assessed as unclear

2020 Sax Institute Evidence Check

170. The developing brain in health and disease - report

of the scientific meeting and this associated report. The Academy is also grateful to Alzheimer's Research UK, the Company of Biologists, F1000 Research, the Guarantors of the Brain, the International Brain Research Organization, the International Society for Developmental Neuroscience, the Loulou Foundation, Peak Labs and the Wellcome Trust, who kindly provided financial contributions towards the meeting. Opinions expressed in this report do not necessarily represent the views of all participants at the event (...) the lifespan. A better understanding of brain development will shed light not only on the processes underlying cognition and behaviour, but also on the underlying causes of many conditions with neurodevelopmental origins, such as autism and schizophrenia. There is widespread concern amongst professionals and government agencies in the UK about rising rates of mental health conditions in children and young people, supporting the view that new directions in research and ways of working are needed. There has

2020 Academy of Medical Sciences

171. Artificial intelligence and health

– beyond publications. Industry perspective Pamela Spence, Global Health Sciences and Wellness Industry Leader and Life Sciences Industry Leader at Ernst & Young, introduced the area from an industry perspective. She observed that medicine is moving from a clinical science supported by data to a data science that will be supported by clinicians. Behaviour change is an area where AI and new digital technologies may be transformative. Many smaller companies are generating apps focussed on behaviour (...) , charities and industry to maximise the value of research to patients and the economy. The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government. Opinions expressed in this report do not necessarily represent

2020 Academy of Medical Sciences

172. Coronavirus (COVID-19) infection and pregnancy

-19. 13 In non-pregnant individuals, a UK study of 20,133 patients admitted 8to high dependency and intensive care with COVID-19 found uncomplicated diabetes was one of the most common comorbidities (21%, 3650/17, 599); a further 7% (n=1299) of individuals had complicated diabetes. 35 Lifestyle measures such as regular exercise, a healthy diet and vitamin D supplementation are recommended in pregnancy and throughout life to prevent obesity, type 2 diabetes mellitus and vitamin D deficiency. 1.6 (...) professionals based on a combination of available evidence, good practice and expert consensus opinion. The priorities are: (i) The reduction of transmission of COVID-19 to pregnant women. (ii) The provision of safe, personalised and woman-centred care during pregnancy, birth and the early postnatal period during the COVID-19 pandemic. (iii) The provision of safe, personalised and woman-centred care to pregnant and postnatal women with suspected/confirmed COVID-19. Please be aware that this is very much

2020 Royal College of Obstetricians and Gynaecologists

173. Point-of-care diagnostic testing in primary care for strep A infection in sore throat

to a clinical scoring system has the potential to change patient behaviour, and manage expectation or demand for GP appointments. If used in primary care, it could reduce unnecessary antibiotic prescribing. The specialists agreed that this technology is not widely used in the NHS. Potential patient impact There were differences in opinion among the specialists about the groups of people that would particularly benefit from this technology. Although 1 specialist thought that the test would benefit anyone (...) the strip, which contains strep A antigen and causes a test line to appear if strep A is present. A control line shows technical success. Results are read by either visual inspection or by using a test reader. One of the rapid antigen detection tests uses a turbidimetric immunoassay, which is based on the change in optical properties in the presence of an antigen-antibody complex. The other 2 tests use nucleic acid amplification techniques, either polymerase chain reaction (PCR) or isothermal nucleic

2018 National Institute for Health and Clinical Excellence - Advice

174. Hazardous alcohol use interventions with emergency patients: Self-reported practices of nurses, and predictors of behaviour. Full Text available with Trip Pro

Hazardous alcohol use interventions with emergency patients: Self-reported practices of nurses, and predictors of behaviour. The present study examined Australian ED nurses' practices in asking patients about alcohol and assisting them to manage their alcohol consumption. It also investigated strategies to support ED nurses in these interventions.A two-stage survey was administered to ED nurses. The first questionnaire measured theoretical and organizational predictors of behaviour (...) , and underlying beliefs, and the subsequent questionnaire explored rates of asking and assisting patients.A total of 125 nurses returned the first questionnaire. Participants held generally positive attitudes, perceived norms, feelings of legitimacy and perceived ability to ask about and intervene for alcohol, but lower role adequacy. The 71 ED nurses who completed the second questionnaire had intervened with almost 500 patients concerning alcohol in the previous week. Participants asked approximately one

2011 Emergency medicine Australasia

175. Canadian guideline for Parkinson disease

sleep behaviour disorder can pre-date the diagnosis of Parkinson disease. PALLIATIVE CARE n The palliative care needs of people with Parkinson disease should be considered throughout all phases of the disease. n If the patient asks, the option of medical assistance in dying should be discussed. TREATMENT n Levodopa is the most eective medication and may be used early. n A regular exercise regimen begun early has proven benet. n Patients with possible diagnosis of Parkinson disease may benet from (...) disorders specialist. n No therapies are eective for slowing or stopping brain degeneration in Parkinson disease. NONMOTOR FEATURES n Botulinum toxin A helps control drooling. n Drug therapy for low blood pressure includes midodrine, udrocortisone and domperidone. n Management of depression should be tailored to the individual and their current therapy. n Dementia should not exclude a diagnosis of Parkinson disease, even if present early. n Rapid eye movement sleep behaviour disorder can pre-date

2019 CPG Infobase

176. Safe nurse staffing levels in acute hospitals

care. 38 Although the evidence about healthcare assistants is not as well established as that about nurse staffing levels, it clearly shows that healthcare assistants cannot act as substitutes for RNs. 43 Nursing work environment The complexity of the staffing – outcome relationship is also illustrated by the body of evidence that links factors of the nursing work environment (e.g. shift lengths, physician-nurse relationships, leadership style) with patient outcomes. It is possible

2020 Belgian Health Care Knowledge Centre

177. Polyvalent immunoglobulins – Part 1: A rapid review

purpura QALYs Quality-Adjusted Life Years QMGS Quantified Myasthenia Gravis Score QoL Quality of Life 6 Immunoglobulines KCE Report 327 RCT Randomised controlled trial RoB Risk of Bias RR Relative Risk SCIg Subcutaneous Immunoglobulin SID Secondary Immunodeficiency SR Systematic Review STSS Streptococcal toxic shock syndrome TSS Toxic shock syndrome WTP Willingness to Pay KCE Report 327 Immunoglobulines 7 ? SCIENTIFIC REPORT 1 INTRODUCTION 1.1 Background Immunoglobulins (Ig), also called antibodies (...) . Specialist completes reimbursement request form 2 12 months INTRAVENOUS: Iqymune ® , Multigam ®, Nanogam ®, Octagam ®, , Privigen ®, Sandoglobuline ® Multifocal motor neuropathy (MMN) 1. Diagnosis made in a neuromuscular reference center 5 , including an electromyographic examination 6 months INTRAVENOUS: Iqymune ® , Multigam ®, KCE Report 327 Immunoglobulines 11 reimbursed indication condition/ prerequisite validity product + distortion daily functioning 2. Neurologist or neuropsychiatrist completes

2020 Belgian Health Care Knowledge Centre

178. Towards integrated antenatal care for low-risk pregnancy

. The whole process of organogenesis ends at the 15 th week of the intra-uterine life. However, during the embryo phase (eight first weeks), these organs are more vulnerable. For example, nutritional deficit (folic acid), viral attacks (rubella, varicella) and toxics (such as alcohol, drugs) may impact the development of the nervous system of the foetus. Preconception counselling encourages the adoption of healthy lifestyles (e.g. weight management, eating behaviour, tobacco use cessation, etc.). Besides (...) ’ PERSPECTIVES 36 5.1 PARENTS’ PERSPECTIVE 36 5.1.1 Design, sampling and recruitment 36 5.1.2 Data analysis 37 5.1.3 Results 37 5.1.4 Parents’ expectations, choices and involvement in ANC 41 5.2 HEALTHCARE PROFESSIONALS’ PERSPECTIVE 42 5.2.1 Methods 42 5.2.2 Results 43 5.2.3 Professionals’ opinions regarding clinical follow-up, birth and postpartum preparation 44 5.2.4 Professionals’ opinions regarding preconception care 45 5.2.5 Professionals’ opinions about quality of ANC 46 5.2.6 Professionals’ opinions

2020 Belgian Health Care Knowledge Centre

179. Optimisation of RIZIV – INAMI lump sums for incontinence

for other incontinence material. The primary aim of this study is to examine the adequacy of the current payment model as to how it contributes to the triple aim of (1) improving quality of care, (2) improving health, whilst (3) limiting the cost per capita. More specifically, the main questions posed are: • Does the current payment model ensure fair access to the payments, as well as to treatments and the use of materials? • Is the current payment model an effective way to financially compensate (...) in Belgium, covering the reimbursement provided by RIZIV – INAMI but also by federated instances. Chapter 4 gives an overview of the available data on incontinence in Belgium. We examine both reimbursement and treatment data. In Chapter 5 we look at other countries to identify best practices in terms of reimbursement and care delivery models. In Chapter 6 we bring together existing data on real costs from the patient’s perspective in a Belgian and Dutch context. In Chapter 7 we assess the possible use

2020 Belgian Health Care Knowledge Centre

180. Biomarker tests to help diagnose preterm labour in women with intact membranes

, cervix or placenta some chronic conditions, such as high blood pressure and diabetes smoking or drug use being underweight or overweight before pregnancy and stressful life events. 2.7 The Department of Health and Social Care's toolkit for high-quality neonatal services (2009) describes 3 types of hospital units providing neonatal care for preterm babies: Special care units (level 1) provide special care for their local population, and may also provide some high dependency services. Local neonatal (...) , problems breathing and feeding, and higher risk of infection. The main concerns include: chronic lung disease at 36 weeks (corrected age) intraventricular haemorrhage necrotising enterocolitis retinopathy of prematurity. 2.10 Babies who are born early, particularly those born before 28 weeks of pregnancy, may have lifelong disabilities. These include physical disabilities, learning disabilities, behavioural problems, and visual and hearing problems. The diagnostics and care pathways Clinical assessment

2018 National Institute for Health and Clinical Excellence - Diagnostics Guidance

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