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341. Impact of Community Health Worker Certification on Workforce and Service Delivery for Asthma and Other Selected Chronic Diseases

and internet skills. Peer leaders had diabetes and underwent 46-hour training program over 12 weeks. Peer leaders need to demonstrate competency in 4 domains: diabetes knowledge, active listening, empowerment-based facilitation, and self-efficacy. There were no statistically significant differences between groups at any timepoint in terms of HbA1c, LDL or HDL cholesterol, systolic or diastolic blood pressure, or waist circumference. Participants assigned to a CHW initially had a greater decrease in BMI (...) could legitimize the role of community health workers and ensure consistency in the quality of care provided, confer opportunities for educational and career advancement, improve employment stability, assure that community health workers have a standard skillset and 2 knowledge base, and increase sustainable funding for services. 4, 7, 9-11 On the other hand, there are important risks associated with community health worker certification. 9 First, the cost of certification could prove

2020 Effective Health Care Program (AHRQ)

342. Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea

Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea e10 © 2019 by the Canadian Association of Gastroenterology and the AGA Institute This article is being published jointly in Journal of the Canadian Association of Gastroenterology and Clinical Gastroenterology and Hepatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc (...) /4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Original Article Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea Daniel C. Sadowski 1 , Michael Camilleri 2 , William D. Chey 3 , Grigorios I. Leontiadis 4 , John K. Marshall 4 , Eldon A. Shaffer 5 , Frances T se 4 , Julian R. F. Walters

2020 Canadian Association of Gastroenterology

343. Diagnosis and Treatment of Clinical Alzheimer’s-Type Dementia

outcomes: memantine versus placebo (none receiving cholinesterase inhibitor) 115 Table 6.13. Summary of findings for primary outcomes: memantine versus placebo (all continuing stable pre-trial cholinesterase inhibitor), by baseline CATD severity 116 Table 7.1. Summary of findings for primary outcomes: Souvenaid ® versus placebo 120 Table 7.2. Summary of findings for primary outcomes: omega-3 fatty acids versus placebo ... 121 Table 8.1. Summary of findings for primary outcomes: galantamine versus (...) of cognition, function, and BPSD in patients with CATD. Two trials each for the nutritional drink Souvenaid ® and omega-3 fatty acids showed no benefit compared with placebo for function and cognition, respectively. Several other trials showed statistically significant benefits compared with placebo for one or more outcomes. However, due to small sample sizes, few trials for each intervention, and study limitations, evidence was insufficient to draw conclusions about the efficacy and safety

2020 Effective Health Care Program (AHRQ)

344. Nonopioid Pharmacologic Treatments for Chronic Pain

of healthcare services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients. This report is made available to the public under the terms of a licensing agreement between the author (...) on Advancing Pain Research, Care, and Education. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: National Academies Press; 2011. doi: 10.17226/13172. PMID: 22553896. 2. Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of Chronic Pain and High- Impact Chronic Pain Among Adults - United States, 2016. MMWR. Morb Mortal Wkly Rep. 2018;67(36):1001-6. doi: 10.15585/mmwr.mm6736a2. PMID: 30212442. 3. Dowell D, Haegerich TM, Chou R. CDC Guideline

2020 Effective Health Care Program (AHRQ)

345. AACE Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made considering local resources and individual patient circumstances.2 Postmenopausal Osteoporosis Guidelines, Endocr Pract. 2020;26(Suppl 1) Copyright © 2020 AACE Abbreviations: 25(OH)D = 25-hydroxyvitamin D; AACE = American Association of Clinical Endocrinologists; ACE = American College of Endocrinology; AFF = atypi- cal femoral fracture; ASBMR = American Society for Bone and Mineral Research; BEL = best (...) evidence level; BMD = bone mineral density; BTM = bone turn- over marker; CI = confidence interval; CPG = clini- cal practice guideline; CTX = C-terminal telopeptide type-I collagen; DXA = dual-energy X-ray absorptiom- etry; EL = evidence level; FDA = U.S. Food and Drug Administration; FRAX ® = Fracture Risk Assessment Tool; GI = gastrointestinal; HORIZON = Health Outcomes and Reduced Incidence with Zoledronic acid ONce yearly Pivotal Fracture Trial (zoledronic acid and zoledronate are equivalent terms

2020 American Association of Clinical Endocrinologists

346. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

hypertriglyceridemia and familial hypercholesterolemia; however, pharmacological treatment is limited because of fetal risks. Pregnancy-related complications such as preeclampsia and gestational diabetes mellitus are associated with triglyceride levels >250 mg/dL. A heart-healthy lifestyle (diet, exercise, weight management) is recommended for all patients. Those with very high triglyceride levels (>500 mg/dL) are at risk for pancreatitis and may benefit from pharmacological agents (omega-3 fatty acids (...) understanding of cardiovascular disease during pregnancy should be a core knowledge area for all cardiovascular and primary care clinicians. This scientific statement provides an overview of the diagnosis and management of cardiovascular disease during pregnancy. Cardiovascular disease (CVD) is the leading cause of pregnancy-related mortality in the United States and has gradually increased over time (from 7.2 to 17.2 deaths per 100 000 live births from 1987–2015). The rise in maternal mortality has been

2020 American Heart Association

347. Guideline on the management of patients with giant cell arteritis Full Text available with Trip Pro

test or the reference standard and the (O) outcomes are true positives, true negatives, false positives, false negatives, complications related to tests, resource use, inconclusive results and the implication of these items on patient-important outcomes as listed below [ ]. For recommendations on treatment, the (P) target population comprises patients with a diagnosis of GCA/patients with a high suspicion of GCA above the treatment threshold, (I) intervention and (C) comparator are the alternative (...) PICO question using Review Manager (RevMan; Cochrane Collaboration, London, UK) and GRADE profiler (GRADEpro) software. The evidence profiles contained the following specific information: Diagnostic studies Diagnostic studies included direct outcomes (true positives, true negatives, false positives, false negatives, sensitivities and specificities; complications of the index test and of the reference standard; resource use), the number of studies and quality assessment related to each

2020 British Society for Rheumatology

348. Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association

activity. Despite these recommendations, patients with T2DM spend less time engaging in physical activity and have lower exercise capacity compared with those without T2DM, , factors associated with a higher risk of cardiovascular events. , Supervised exercise training is preferred to home training because it results in greater improvements in HbA 1c , body mass index, waist circumference, blood pressure, exercise capacity, muscle strength, and cholesterol levels. , Similarly, stable CAD guidelines (...) and potentially to help guide the selection of glucose-lowering medications. Our statement provides a comprehensive summary of effective, patient-centered management of CAD in patients with T2DM, with emphasis on the emerging evidence. Given the increasing prevalence of T2DM and the accumulating evidence of the need to consider T2DM in treatment decisions, this knowledge will become ever more important to optimize our patients’ cardiovascular outcomes. The epidemic of type 2 diabetes mellitus (T2DM), linked

2020 American Heart Association

349. Cardiovascular Health in American Indians and Alaska Natives: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

by either federal or state government. To date, there are 573 federally recognized tribes and 63 state-recognized tribes. American Indian and Alaska Native individuals have struggled to maintain their culture. With colonial expansion in the 19th century, many tribes were forced to leave ancestral lands. In exchange for ceding their land in government-to-government agreements, tribes were offered treaties that provided access to reservation land, health care, and education resources. Tribes that did (...) and Prevention, and the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify risk factors and interventions specific to American Indians and Alaska Natives. Results: Diabetes mellitus is a major contributor to disproportionately higher rates of coronary heart disease among American Indians and Alaska Natives compared with other racial and ethnic groups. Additional risk factors for CVD include low-density lipoprotein cholesterol levels, hypertension

2020 American Heart Association

350. American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases

and recommendations developed and endorsed by the ACR are subject to periodic revision, as warranted by the evolution of medical knowledge, technology, and practice. ACR recommendations are not intended to dictate payment or insurance deci- sions. These recommendations cannot adequately convey all uncertainties and nuances of patient care. The American College of Rheumatology is an independent, professional, medical and scientific society that does not guarantee, warrant, or endorse any commercial product (...) taking mycophenolate mofetil/mycophenolic acid (MMF) use an IUD alone or 2 other methods of contraception together, because MMF may reduce serum estrogen and progesterone levels (in turn reducing the efficacy of oral contraceptives). The Mycophenolate Risk Evaluation and Mitigation Strategy program suggests use of an IUD alone (copper or progestin is not specified), or an estrogen- progestin contraceptive or the progestin implant together with a barrier contraceptive (36). It is not known whether

2020 American College of Rheumatology

351. Prostate Cancer

, J., et al. Is alcohol consumption a risk factor for prostate cancer? A systematic review and meta-analysis. BMC Cancer, 2016. 16: 845. 39. Key, T.J. Nutrition, hormones and prostate cancer risk: results from the European prospective investigation into cancer and nutrition. Recent Results Cancer Res, 2014. 202: 39. 40. Alexander, D.D., et al. Meta-Analysis of Long-Chain Omega-3 Polyunsaturated Fatty Acids (LComega-3PUFA) and Prostate Cancer. Nutr Cancer, 2015. 67: 543. 41. Lippi, G., et al. Fried (...) prostate cancer: results from the REDUCE study. Prostate Cancer Prostatic Dis, 2013. 16: 254. 33. James, N.D., et al. Abiraterone for Prostate Cancer Not Previously Treated with Hormone Therapy. N Engl J Med, 2017. 377: 338. 34. YuPeng, L., et al. Cholesterol Levels in Blood and the Risk of Prostate Cancer: A Meta-analysis of 14 Prospective Studies. Cancer Epidemiol Biomarkers Prev, 2015. 24: 1086. 35. Vidal, A.C., et al. Obesity increases the risk for high-grade prostate cancer: results from

2020 European Association of Urology

352. HRS White Paper on Atrial Fibrillation Centers of Excellence: Rationale, Considerations, and Goals

include those with risk factors, those not receiving guideline-directed therapy, or those whose risk factors are not adequately or completely treated. Identification of patients who can benefit from integrated and specialty care inherent to an AF CoE can also help ensure that adequate resources can be appropriated to AF clinics. AF CoEs also should have systematic methods of outreach to persons with AF in the community, including educational programs and initiatives to improve awareness of AF (...) , or at home with wearable patient monitors or smartphone-based or direct-to-consumer applications. Appropriate triage in these settings has the potential to minimize unnecessary emergency room visits, hospitalizations, and testing and improve patient satisfaction. This triage may be enhanced by direct phone access to knowledgeable staff, such as an appropriately trained nurse or medical assistant in an AF clinic. Same-day or next-day appointments are frequently required to avoid hospitalization

2020 Heart Rhythm Society

353. The impact of care farms on quality of life, depression and anxiety among different population groups: A systematic review Full Text available with Trip Pro

to becoming a “NEET” (a person between the age of 16 and 24 and Not in Education, Employment or Training), which in turns carries an increased likelihood of committing a criminal offence, being in a lower paid job and subsequently a poorer quality of adult life compared to those who complete their education (Audit Commission, ; Public Health England, ). Evidence suggests that the numbers of children that fit within the disengaged category are increasing (McEwan et al., ; Robins, Cohen, Slomkowski (...) ). It also provides care and support to enable people to reach their true potential, that is, although many of the approaches are termed “therapies” or “therapeutic”, they are not necessarily directed at treating or curing conditions and diseases but, as in the case of people with learning difficulties, for example, they provide care, support, training and other opportunities to enable those individuals to develop. Such opportunities are often not available elsewhere (Sempik & Bragg, ). Care farming

2019 Campbell Collaboration

354. What is the added clinical value of preoperative brain natriuretic peptide (BNP/NTproBNP) in predicting post-operative cardiac complications in patients undergoing noncardiac surgery across the MUHC RUIS?

University Health Centre (“MUHC”) was created in order to prepare accurate and trustworthy evidence to inform decision-making and when necessary to make policy recommendations based on this evidence. The objective of the TAU is to advise the hospitals in difficult resource allocation decisions, using an approach based on sound, scientific technology assessments and a transparent, fair decision-making process. Consistent with its role within a university health centre, it publishes its research when (...) appropriate, and contributes to the training of personnel in the field of health technology assessment. The information contained in this report may include, but is not limited to, existing public literature, studies, materials, and other information and documentation available to the MUHC at the time it was prepared, and it was guided by expert input and advice throughout its preparation. The information in this report should not be used as a substitute for professional medical advice, assessment

2020 McGill TAU reports

355. Assessment of elevated creatinine

(0.5 to 1.0 mg/dL) for women. Estimated GFR (eGFR) equations, based on serum creatinine, are generally used to stage chronic kidney disease (CKD). However, the value of eGFR equations in the acute clinical setting has not been validated. Several web-based calculators are available to estimate GFR from serum creatinine values. Pathophysiology of creatinine Creatinine is an amino acid breakdown product of creatine and phosphocreatine and is found almost exclusively (90%) in skeletal muscle (...) creatinine measurement: a report from the Laboratory Working Group of the National Kidney Disease Education Program. Clin Chem. 2006 Jan;52(1):5-18. http://www.clinchem.org/cgi/content/full/52/1/5 http://www.ncbi.nlm.nih.gov/pubmed/16332993?tool=bestpractice.com Combining HPLC with IDMS provides highly accurate results, but is not available in most centres. POCT-based serum creatinine measurement appears to be sufficiently accurate for clinical use. Calzavacca P, Tee A, Licari E, et al. Point-of-care

2018 BMJ Best Practice

356. Obese, overweight with risk factors: liraglutide (Saxenda)

have lost at least 5% of their initial body weight after 12 weeks treatment. There were high dropout rates in all of the studies so continuation with treatment may be a problem in practice. A summary to inform local decision-making is shown in table 1. T T able able 1 Summary of the e 1 Summary of the evidence on effectiv vidence on effectiveness, safety eness, safety, patient factors and resource implications , patient factors and resource implications Obese, overweight with risk factors (...) 3.0 mg compared with 3.3% to 6.0% with placebo across the 4 studies discussed in the evidence summary). Gastrointestinal disorders were the most common adverse events reported in the studies. Across the studies in the clinical development programme, nausea was reported in 39.3% of participants taking liraglutide 3.0 mg daily compared with 13.8% taking placebo (EPAR: Saxenda). Resource implications Resource implications Liraglutide (Saxenda) costs £196.20 for 30 days' supply at the maintenance dose

2017 National Institute for Health and Clinical Excellence - Advice

357. Management of stable angina

Perioperative revascularisation 33 6.3 Drug therapy in patients undergoing non-cardiac surgery 34 7 Psychological health 38 7.1 How does angina affect quality of life? 38 7.2 Improving symptom control with behavioural interventions 39 7.3 The effect of health beliefs on symptoms and functional status 40 8 Provision of information 41 8.1 Information and education about surgery and other interventions 41 8.2 Cardiac waiting times 42 8.3 Follow up in patients with angina 42 8.4 Checklist for provision (...) of information 43 8.5 Publications from SIGN 44 Management of stable angina Contents8.6 Sources of further information 44 9 Implementing the guideline 46 9.1 Implementation strategy 46 9.2 Resource implications of key recommendations 46 9.3 Auditing current practice 46 9.4 Health technology assessment advice for NHSScotland 47 10 The evidence base 48 10.1 Systematic literature review 48 10.2 Recommendations for research 48 10.3 Review and updating 49 11 Development of the guideline 50 11.1 Introduction 50

2018 SIGN

358. Assessment of elevated creatinine

(0.5 to 1.0 mg/dL) for women. Estimated GFR (eGFR) equations, based on serum creatinine, are generally used to stage chronic kidney disease (CKD). However, the value of eGFR equations in the acute clinical setting has not been validated. Several web-based calculators are available to estimate GFR from serum creatinine values. Pathophysiology of creatinine Creatinine is an amino acid breakdown product of creatine and phosphocreatine and is found almost exclusively (90%) in skeletal muscle (...) creatinine measurement: a report from the Laboratory Working Group of the National Kidney Disease Education Program. Clin Chem. 2006 Jan;52(1):5-18. http://www.clinchem.org/cgi/content/full/52/1/5 http://www.ncbi.nlm.nih.gov/pubmed/16332993?tool=bestpractice.com Combining HPLC with IDMS provides highly accurate results, but is not available in most centres. POCT-based serum creatinine measurement appears to be sufficiently accurate for clinical use. Calzavacca P, Tee A, Licari E, et al. Point-of-care

2018 BMJ Best Practice

359. Canadian stroke best practice recommendations: secondary prevention of stroke, sixth edition practice guidelines

, atrial fibrillation, and other cardiac conditions. Notable changes in this sixth edition include the development of core elements for delivering secondary stroke prevention services, the addition of a section on cervical artery dissection, new rec- ommendations regarding the management of patent foramen ovale, and the removal of the recommendations on man- agement of sleep apnea. The Canadian Stroke Best Practice Recommendations include a range of supporting materials such as implementation resources (...) , and those who are hospitalized because of stroke or transient ischemic attack. Each section of these recommendations is supported by detailedevidencetablesandasummaryoftheevidence, a rationale for the importance of the topic, system implications to facilitate timely and e?cient implemen- tation, key quality indicators for measuring perform- ance and resources to support implementation and uptake for health care professionals and for patients. These are available at www.strokebestpractices.ca. Section 1

2018 CPG Infobase

360. Public health service provision by community pharmacies: a systematic map of evidence

; Fajemisin 2013) and might be a person's only point of contact with a healthcare professional (LGA 2013). The range of services provided in community pharmacies are broad and varied, ranging from long- established services such as prescription services and sale of over the counter medicines, to health advice, education, distribution and advice around emergency hormonal contraception (EHC) and condoms and information or testing for specific conditions such as cholesterol testing. Further services (...) : This report should be cited as: Stokes G, Rees R, Khatwa M, Stansfield C, Burchett H, Dickson, K, Brunton G, Thomas J (2019) Public health service provision by community pharmacies: a systematic map of evidence. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University College London. Funding This report is independent research commissioned by the National Institute for Health Research (NIHR) Policy Research Programme (PRP) for the Department of Health and Social Care (DHSC

2019 EPPI Centre

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