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161. Effects of Dietary Sodium and Potassium Intake on Chronic Disease Outcomes and Risks

about the effectiveness and safety of a clinical intervention. In the context of developing recommendations for practice, systematic reviews can help clarify whether assertions about the value of the intervention are based on strong evidence from clinical studies. For more information about AHRQ EPC systematic reviews, see www.effectivehealthcare.ahrq.gov/reference/purpose.cfm. AHRQ expects that these systematic reviews will be helpful to health plans, providers, purchasers, government programs

2018 Effective Health Care Program (AHRQ)

162. WHO recommendations: intrapartum care for a positive childbirth experience

has also gradually expanded beyond the survival of women and their babies, to also ensuring that they thrive and achieve their full potential for health and well-being. These efforts have been catalysed by the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030), and the Every Woman Every Child movement. In addition, the third goal of the 2030 agenda for sustainable development affirms global commitment to ensuring healthy lives and the promotion of well-being for all at all (...) not exposing them to financial hardship. An integral part of these efforts is the design of the package of essential services across the spectrum of health disciplines, including reproductive, maternal, newborn, child and adolescent health, from which a set of basic service-delivery indicators can be identified for use in monitoring countries’ progress towards UHC. This guideline is a consolidated set of new and existing recommendations on essential labour and childbirth practices that should be provided

2018 World Health Organisation Guidelines

163. Alternating Electric Fields ("Tumour- Treating Fields") for the Treatment of Glioblastoma

) a customized backpack. 18,19 The Optune system allows the patient to be mobile, using the battery pack and backpack, while receiving treatment, or the system can be plugged into a regular electrical outlet when the patient is seated or asleep. 19 It weighs about 1.3 kg, including the battery. 18,20 Patients must shave their heads to allow the transducers to properly adhere to their scalp with a thin layer of conductive hydrogel similar to that used for electrocardiogram pads. 19,21 The transducer arrays (...) the past decade; 13 the most recent evidence includes two randomized controlled trials (EF-14 30 ,38 and EF-11 39 ) and the PRiDe Patient Registry Dataset. 40 In the remainder of this section, the trials and the registry study are described first, followed by summaries of the main outcomes: overall survival, progression-free survival, compliance, quality-of-life, and safety. Smaller case series and subgroup analyses are also noted under the relevant outcomes sections. Some trials included patients

2018 CADTH - Issues in Emerging Health Technologies

164. British Association of Dermatologists' guidelines for the management of lichen sclerosus

with resis- tant LS? FRR6 What are the safety and ef?cacy of adalimumab in male patients with urethral stenosis caused by LS? FRR7 Set up a national registry for extensive extragenital LS to identify the treatments involved and outcomes achieved FRR8 What is the role of urine in the pathogenesis of genital LS and paediatric genital LS? FRR9 Is there a role for systemic therapy in genital LS? FRR10 What proportion of patients with LS remit completely? 4.0 Algorithm The recommendations and discussions (...) and their obstetrician. 5.4.3 Child female anogenital The lesions are similar to those in adult women, but ecchymosis may be very striking and potentially mistaken as evidence of sex- ual abuse. However, the two are not mutually exclusive as some cases of LS may possibly be caused or aggravated by sexual abuse through Koebnerization. 49 Features that should arouse suspicion of this include LS arising in older prepubertal girls, poor response to treatment, the presence of associated sexually transmitted infection

2018 British Association of Dermatologists

165. Clinical Appropriateness Guidelines: Radiation Oncology Brachytherapy, intensity modulated radiation therapy (IMRT), stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) treatment guidelines

for when services are medically necessary ? To assist the practitioner as an educational tool ? To encourage standardization of medical practice patterns ? To curtail the performance of inappropriate and/or duplicate services ? To advocate for patient safety concerns ? To enhance the quality of healthcare ? To promote the most efficient and cost-effective use of services AIM’s guideline development process complies with applicable accreditation standards, including the requirement that the Guidelines (...) , limitations and safety aspects of image-guided therapy. IGRT is an integral part of the delivery of highly conformal treatments such as intensity modulated radiation therapy (IMRT), stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS). Recognition of this fact has resulted in changes to the current procedural terminology (CPT) definitions such that the technical aspect of IGR T is now bundled with IMRT delivery. Similarly, image guidance procedures have always been bundled for SBRT

2018 AIM Specialty Health

166. Hypothalamic - Pituitary and Growth Disorders in Survivors of Childhood Cancer

to hypothalamic–pituitary axis radiation treatment and with a diagnosis of isolated growth hormone deficiency in childhood. (1∣⊕⊕OO) Treatment of growth hormone deficiency in childhood cancer survivors 2.8 We recommend offering growth hormone treatment in childhood cancer survivors with confirmed growth hormone deficiency based on the safety and efficacy demonstrated in that population. (1∣⊕⊕OO) 2.9 We suggest waiting until the patient has been 1 year disease-free, following completion of therapy (...) loss of spinal height SD relative to lower leg length SD ( ). This disproportionate growth may be evident as early as 1 year following spinal radiation and becomes progressively more evident during puberty ( ). Survivors treated with high-dose CSI ( e.g. , >30 Gy for medulloblastoma) demonstrate the most significant losses in seated and standing AH ( , , ). Treatment of short stature/impaired linear growth in childhood cancer survivors 1.3 We suggest against using GH in cancer survivors who do

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2018 The Endocrine Society

167. Sodium and Potassium Intake: Effects on Chronic Disease Outcomes and Risks

about the effectiveness and safety of a clinical intervention. In the context of developing recommendations for practice, systematic reviews can help clarify whether assertions about the value of the intervention are based on strong evidence from clinical studies. For more information about AHRQ EPC systematic reviews, see www.effectivehealthcare.ahrq.gov/reference/purpose.cfm. AHRQ expects that these systematic reviews will be helpful to health plans, providers, purchasers, government programs

2018 Effective Health Care Program (AHRQ)

168. All-Terrain Vehicle Injuries, Prevention of

. Compliance with laws is often low, however, possibly due to poor enforcement. We recommend helmet use when riding on an ATV to reduce TBI. We conditionally recommend implementing ATV safety legislation as a means to reduce ATV injuries, noting that enforcement must go hand in hand with enactment to ensure compliance. Overview The US Consumer Product Safety Commission (CPSC) defines all-terrain vehicles (ATVs) as “off-road, motorized vehicles having…four low-pressure tires, a straddle seat (...) injury prevention data: when legislation is strictly enforced, safety measure use increases and mortality decreases. Primary enforcement of legislation allows law enforcement to stop and cite violators independent of any other traffic behavior. Secondary enforcement allows citation only when violators are stopped for another reason. [ ] In a recent national analysis, compared to states with secondary enforcement of seat belt laws, primary enforcement states had an adjusted reduced incidence rate

2018 Eastern Association for the Surgery of Trauma

169. Respiratory Management of the Patient With Duchenne Muscular Dystrophy

and beyond.? Effective transition of respiratory care from pediatric to adult medicine is vital to optimize patient safety, prognosis, and quality of life.? With genetic and other emerging drug therapies in development, standardization of care is necessary to accurately assess treatment effects in clinical trials.? This revision of respiratory recommendations preserves a fundamental strength of the original guidelines: namely, reliance on a limited number of respiratory tests to guide patient assessment (...) and, with their caregivers, be educated about assessing and managing respiratory complications.? Starting at 5 to 6 years of age, annual measurements of seated forced vital capacity (FVC) should be made, to train patients in spirometry and to start assessing each patient’s course of pulmonary function over time (Fig 1).? Serial monitoring of pulmonary function is critical because FVC will eventually decline silently (in the absence of dyspnea) in nonambulatory patients.? In general, FVC increases with growth until

2018 American Academy of Pediatrics

170. Evidence in Focus: Nusinersen Use in Spinal Muscular Atrophy

of the American Academy of Neurology David Michelson , Emma Ciafaloni , Stephen Ashwal , Elliot Lewis , Pushpa Narayanaswami , Maryam Oskoui , Melissa J. Armstrong First published October 12, 2018, DOI: https://doi.org/10.1212/WNL.0000000000006502 David Michelson From the Department of Pediatrics, Division of Child Neurology (D.M., S.A.), Loma Linda University School of Medicine, CA; Department of Neurology (E.C.), University of Rochester Medical Center, NY; Beth Israel Deaconess Medical Center (P.N (...) .), Harvard Medical School, Boston, MA; Department of Pediatrics and Neurology & Neurosurgery (M.O.), McGill University, Montreal, Canada; and Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville. Emma Ciafaloni From the Department of Pediatrics, Division of Child Neurology (D.M., S.A.), Loma Linda University School of Medicine, CA; Department of Neurology (E.C.), University of Rochester Medical Center, NY; Beth Israel Deaconess Medical Center (P.N.), Harvard Medical

2018 American Academy of Neurology

171. Management of Pregnancy

these guidelines does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor. Version 3.0 – 2018VA/DoD Clinical Practice Guideline for the Management of Pregnancy March 2018 Page 2 of 147 Prepared by: The Management of Pregnancy Work Group With support from: The Office of Quality, Safety and Value, VA, Washington, DC & Office of Evidence Based Practice, U.S. Army (...) to foster normal and healthy development of the baby, culminating in a full-term birth. The physical, psychological, and social support that the mother receives during her pregnancy can help reduce health problems in her and the child’s life. Evidence-based care during pregnancy can have a life-long impact on both mother and baby. VA/DoD Clinical Practice Guideline for the Management of Pregnancy March 2018 Page 7 of 147 Table 1. Gestational Age at Birth Predicts Offspring Outcomes [ ] 2-5 Term

2018 VA/DoD Clinical Practice Guidelines

172. Respiratory Management of the Patient With Duchenne Muscular Dystrophy

of guidelines, survival of individuals with Duchenne muscular dystrophy has increased. With contemporary medical management, survival often extends into the fourth decade of life and beyond. Effective transition of respiratory care from pediatric to adult medicine is vital to optimize patient safety, prognosis, and quality of life. With genetic and other emerging drug therapies in development, standardization of care is necessary to accurately assess treatment effects in clinical trials. This revision (...) ambulatory, individuals with DMD should learn pulmonary function testing and, with their caregivers, be educated about assessing and managing respiratory complications. Starting at 5 to 6 years of age, annual measurements of seated forced vital capacity (FVC) should be made, to train patients in spirometry and to start assessing each patient’s course of pulmonary function over time ( ). Serial monitoring of pulmonary function is critical because FVC will eventually decline silently (in the absence

2018 American Academy of Pediatrics

173. Induction of labour

by competent medical or midwifery staff · Contact a more experienced clinician if there are 2 unsuccessful attempts Prepare the balloon catheter · Stylet used with double balloon: o Loosen the fitting on the proximal hub of the stylet so that the distal tip of the stylet is even with the distal tip of the balloon o Tighten the fitting so that the wire does not move during manipulation o Seat the adjustable handle firmly into the blue port labelled “S” Insertion · Digital placement of the catheter is less (...) Queensland Clinical Guideline: Induction of labour Refer to online version, destroy printed copies after use Page 22 of 30 4.2.1 Dinoprostone administration Table 19. Dinoprostone administration Aspect Dinoprostone administration Administration · Maternal and fetal safety outcomes do not seem to differ whether prostaglandins are administered in the morning or evening, but women may prefer morning administration 94 · Pessary use may avoid repeated application of the gel · Gel may be more appropriate where

2018 Queensland Health

174. Chronic Pelvic Pain

al. Chronic pelvic pain and previous sexual abuse. Obstet Gynecol, 2000. 96: 929. 50. Angst, J. Sexual problems in healthy and depressed persons. Int Clin Psychopharmacol, 1998. 13 Suppl 6: S1. 51. Leonard, L.M., et al. Sexual functioning in women reporting a history of child sexual abuse: review of the empirical literature and clinical implications. Annu Rev Sex Res, 2002. 13: 346. 52. McGowan, L., et al. Chronic pelvic pain: A meta-analytic review. Psychol Health, 1998. 13: 937. 53. Roelofs, K (...) with prostatitis: a population-based cross-sectional study in Finland. BJU Int, 2001. 88: 35. 134. O'Leary, M.P., et al. A brief male sexual function inventory for urology. Urology, 1995. 46: 697. 135. Weidner, W., et al. Acute bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: andrological implications. Andrologia, 2008. 40: 105. 136. van Ophoven, A., et al. Safety and efficacy of hyperbaric oxygen therapy for the treatment of interstitial cystitis: a randomized, sham controlled

2018 European Association of Urology

176. Community engagement report: the M74 study

is usually controversial, and likely to have some impact on neighbourhoods along the route. Community concerns about noise and air pollution, health, road safety and accessibility are typically raised. These impacts have implications for environmental justice if the motorway is to the detriment of deprived communities while advantaging others from outside the community. In the M74 study the main elements of community engagement were: • An initial scoping of community issues and perceptions, to inform (...) with cars described driving on the motorway frequently. However, another resident felt that the motorway had helped to increase local investment in the Gorbals because it was now an accessible area encircled by roads – whereas Govanhill, on the outside, was languishing. One attendee mentioned that their child had suffered from asthma and other respiratory complaints after the motorway opened (they lived very near), and described the air as smoggy and stuffy: “it’s in their lungs, it’s in their hair

2017 Glasgow Centre for Population Health

177. Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services

External Beam Radiotherapy EC Endoscopic ED Emergency Department ENT Ear, Nose, and Throat ERCP Endoscopic Retrograde Cholangiopancreatography ERNs European Reference Networks ESRG Extended Service Related Groups ET Endocrine Tumour EU European Union EUS Endoscopic ultrasound FANC – ACFN Federaal Agentschap voor Nucleaire Contrôle/Agence Fédérale de Contrôle Nucléaire/ FDP-PET Fluorodeoxyglucose - Positron Emission Tomography FOD – SPF Federal Public Service Health, Food Chain Safety and Environment

2017 Belgian Health Care Knowledge Centre

178. Governance models for hospital collaborations

. First, a clear demarcation of the governance structures has shown to contribute to a more transparent decision-making process. Evidence shows that operational decisions must be taken by management, while the hospital board must be entrusted with all tasks of a supervisory nature. 30 Secondly, health policy debates recognise the important role of hospital boards in overseeing patient quality and safety, and a growing body of empirical research has sought to elucidate that role. 31 The composition (...) , accreditation and stakeholder consultations are becoming more important. 5 As a consequence, the concept of ‘clinical governance‘ is gaining importance in healthcare literature. 34 Clinical governance, however, is not focused on the governance of the organisation, it aims to improve the quality and safety checks in healthcare. It was initially established as a framework through which National Health Services (NHS) organisations are accountable for continually improving the quality of their services

2017 Belgian Health Care Knowledge Centre

179. Protective Stabilization for Pediatric Dental Patients

):5-7.270 RECOMMENDATIONS: BEST PRACTICES REFERENCE MANUAL V 40 / NO 6 18 / 19 should have been with their child when he/she was placed on a rigid stabilization board to increase the child’s security and/ or comfort. 26 In addition, 90 percent recognized that immo- bilization protected the children from harm. 26 The dentist should consider allowing parental presence in the operatory or direct visual observation of the patient during use of protective stabilization unless the health and safety (...) approach that is individualized for each patient in the context of promoting a positive dental attitude for the patient, while ensuring the highest standards of safety and quality of care. Methods Recommendations on protective stabilization were developed by the Council on Clinical Affairs and adopted in 2013. This document is a revision of the previous version and is based on a review of the current dental and medical literature re- lated to the use of protective stabilization devices and restraint

2017 American Academy of Pediatric Dentistry

180. Staff and Associate Specialist Grade Handbook (Third Edition)

These fall into four domains: 1. Knowledge, skills and performance 2. Safety and quality 3. Communication, partnership and team work 4. Maintaining trust Domains Each domain has areas of attributes, with generic standards that map to these attributes. The RCoA has produced specialty specific guidance to match these generic standards: Knowledge, skills and performance • Maintain your professional performance • Apply knowledge and experience to practice • Keep clear, accurate and legible records Safety (...) and quality • Put into effect systems to protect patients and improve care • Respond to risks to safety • Protect patients and colleagues from any risk posed by your health Communication, partnership and teamwork • Communicate effectively • Work constructively with colleagues and delegate effectively • Establish and maintain partnerships with patients Maintaining trust • Show respect for patients • Treat patients and colleagues fairly and without discrimination • Act with honesty and integrity Portfolio

2017 Association of Anaesthetists of GB and Ireland

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