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Appearance, Behavior and Attitude Exam

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161. 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

162. 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

163. 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

164. 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

165. 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

166. 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

167. 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

168. 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

169. British guideline on the management of asthma

Non-analytic studies, eg case reports, case series 4 Expert opinion Grades of recommendation Note: The grade of recommendation relates to the strength of the supporting evidence on which the evidence is based. It does not reflect the clinical importance of the recommendation. A At least one meta-analysis, systematic review, or RCT rated as 1 ++ , and directly applicable to the target population; or A body of evidence consisting principally of studies rated as 1 + , directly applicable (...) in adolescents 117 11.1 Definitions 117 11.2 Prevalence of asthma in adolescents 117 11.3 Diagnosis and assessment 117 11.4 Risk factors 118 11.5 Comorbidities and modifiable behaviours 119 11.6 Asthma attacks and the risk of hospital admission 120 11.7 Long-term outlook and entry into the workplace 120 11.8 Non-pharmacological management 120 11.9 Pharmacological management 121 11.10 Inhaler devices 121 11.11 Organisation and delivery of care 122 11.12 Patient education and self management 12312 Asthma

2019 SIGN

170. 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

171. 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

172. 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

173. 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

174. Canadian guidelines on opioid use disorder among older adults

’ Mental Health, Toronto, Canada (2019) Funding for the CCSMH Substance Use Disorder Guidelines was provided by Health Canada, Substance Use and Addictions Program. The CCSMH gratefully acknowledges Health Canada for its ongoing support and continued commitment to the area of seniors’ mental health. We would like to thank the Canadian Centre on Substance Use and Addiction (CCSA) and the Behavioral Supports Ontario Substance Use Collaborative for their support. We would like to thank Dr. Meldon Kahan (...) OF RECOMMENDATION The quality of evidence for each recommendation is determined through an examination of the following factors: (1) Study design and the quality of the studies that were included, (2) the directness of the evidence (generalizability or applicability) and (3) the confidence that patients will benefit from the treatment . The strength of each recommendation is determined through an examination of the following factors: (1) The balance between benefits and undesirable effects/risks, (2

2019 CPG Infobase

175. Health literacy: what lessons can be learned from the experiences of other countries?

and Lifeskills Survey (ALLS, 2003- 2008 5 ). These studies also showed that the level of literacy is influenced by a variety of social factors and that an increase of literacy is related to more opportunities in life, higher levels of employment and more social engagement. These findings led to the perception of literacy as a contributor to health outcomes and as a mediating factor in health disparities. In the late nineties and the first decade of the twenty-first century, a broad range of studies (...) was conducted on relationships between literacy (in general) and health outcomes (in terms of knowledge, behaviour, morbidity and mortality). 6 Much of the literature in this field of research has focused on the serious problems that people with low health literacy face when interacting with healthcare systems (limited participation in health promotion, disease prevention and early detection, inadequate 10 Health literacy KCE Report 322 management of chronic diseases, increased hospitalisation rates

2020 Belgian Health Care Knowledge Centre

176. Cycling in Scotland: review of cycling casualties

hire schemes. Image is a contributory factor to the gender divide in cycling uptake and women express higher concerns about risk compared with men. Cycling is not viewed as socially acceptable among many ethnic communities due to appearance, and associations with cycling and social status. Hostile and dangerous driver behaviour, lack of driver awareness, and stereotypes surrounding people cycling were associated with an increased likelihood of near misses or collisions. Driver error was reported (...) as the primary contributory factor in 63% of cycling-driver collisions between March 2018- April 2019. Negative attitudes and stereotyping of cyclists predict aggressive behaviour towards cyclists. In Scotland we need to make cycling safe, affordable and accessible for all. This can be achieved by making sure safe cycling infrastructure (including new bike hire schemes) is equally available in deprived and affluent areas, by supporting more bike inclusion schemes (like Bikes for All), and by reducing road

2020 Glasgow Centre for Population Health

177. Endometriosis: diagnosis and management

activities and quality of life deep pain during or after sexual intercourse period-related or cyclical gastrointestinal symptoms, in particular, painful bowel movements period-related or cyclical urinary symptoms, in particular, blood in the urine or pain passing urine infertility in association with 1 or more of the above. 1.3.2 Inform women with suspected or confirmed endometriosis that keeping a pain and symptom diary can aid discussions. 1.3.3 Offer an abdominal and pelvic examination to women (...) that she does not have endometriosis, and offer alternative management. 1.6 Staging systems 1.6.1 Offer endometriosis treatment according to the woman's symptoms, preferences and priorities, rather than the stage of the endometriosis. 1.6.2 When endometriosis is diagnosed, the gynaecologist should document a detailed description of the appearance and site of endometriosis. 1.7 Monitoring for women with confirmed endometriosis 1.7.1 Consider outpatient follow-up (with or without examination and pelvic

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

178. Cerebral palsy in under 25s: assessment and management

an impact at any stage of development, including the antenatal, perinatal and postnatal periods. Using MRI to assess cause Using MRI to assess cause 1.2.10 Offer MRI to investigate aetiology in a child or young person with suspected or known cerebral palsy if this is not clear from: antenatal, perinatal and postnatal history their developmental progress findings on clinical examination Cerebral palsy in under 25s: assessment and management (NG62) © NICE 2019. All rights reserved. Subject to Notice (...) of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 46results of cranial ultrasound examinations. 1.2.11 Recognise that MRI will not accurately establish the timing of a hypoxic–ischaemic brain injury in a child with cerebral palsy. 1.2.12 When deciding the best age to perform an MRI scan for a child with cerebral palsy, take account of the following: Subtle neuro-anatomical changes that could explain the aetiology of cerebral palsy may not be apparent until 2 years

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

179. Eating disorders: recognition and treatment

nervosa, addressing pro-anorexic behaviour and ego- syntonic beliefs (beliefs, values and feelings consistent with the person's sense of self) and building self-esteem in the second phase, focus on relevant relationships with other people and how these affect eating behaviour in the final phase, focus on transferring the therapy experience to situations in everyday life and address any concerns the person has about what will happen when treatment ends. Psy Psychological treatment for anore chological (...) #notice-of-rights). Page 15 of 40in family sessions: identify anything in the person's home life that could make it difficult for them to change their behaviour, and find ways to address this discuss meal plans aim to reduce the risk to physical health and any other symptoms of the eating disorder encourage reaching a healthy body weight and healthy eating cover nutrition, relapse prevention, cognitive restructuring, mood regulation, social skills, body image concern and self-esteem create

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

180. Mental health of adults in contact with the criminal justice system

terminology. 1.9.2 Commissioners and providers of criminal justice services and healthcare services should educate all staff about: the stigma and discrimination associated with mental health problems and associated behaviours, such as self-harm the need to avoid judgemental attitudes the need to avoid using inappropriate terminology. 1.9.3 Provide multidisciplinary and multi-agency training (as part of both induction training and continuing professional development) to increase consistency, Mental health (...) with critical incidents, including emergency life support managing stress associated with working in the criminal justice system and how this may affect their interactions with people and their own mental health and wellbeing the recognition, assessment, treatment and management of self-harm and suicide de-escalation methods to minimise the use of restrictive interventions recognition of changes in behaviour, taking into account that these may indicate the onset of, or changes to, mental health problems

2017 National Institute for Health and Clinical Excellence - Clinical Guidelines

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