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201. Characteristics of Existing Asthma Self-Management Education Packages

Characteristics of Existing Asthma Self-Management Education Packages Characteristics of Existing Asthma Self-Management Education Packages Technical Brief Number 35 RTechnical Brief Number 35 Characteristics of Existing Asthma Self-Management Education Packages Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00005-I Prepared by: ECRI Institute – Penn Medicine Evidence (...) ; results are mixed for outcomes such as hospitalizations, emergency department visits, and quality of life iii This report is based on research conducted by the ECRI Institute – Penn Medicine Evidence- based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00005) with funding provided by the Centers for Disease Control and Prevention (CDC). The findings and conclusions in this document are those of the authors, who

2020 Effective Health Care Program (AHRQ)

202. Opioid Treatments for Chronic Pain

Opioid Treatments for Chronic Pain Opioid Treatments for Chronic Pain Comparative Effectiveness Review Number 229 R Comparative Effectiveness Review Number 229 Opioid Treatments for Chronic Pain Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00009-I Prepared by: Pacific Northwest Evidence-based Practice Center Portland, OR Investigators: Roger Chou, M.D. Daniel Hartung (...) ], long-acting opioid [3c], short plus long-acting opioid [3d], scheduled, continuous dosing [3e], opioid dose escalation [3f], opioid rotation [3g], treatments for acute exacerbations of chronic pain [3h], decreasing opioid doses or tapering off opioids [3i], tapering protocols and strategies [3j]) KQs 4a-b: Instruments, genetic metabolic tests for predicting risk of opioid use disorder, abuse, misuse, and overdose KQ 4c: Risk mitigation strategies (opioid management plans, patient education, urine

2020 Effective Health Care Program (AHRQ)

203. Nonopioid Pharmacologic Treatments for Chronic Pain

Nonopioid Pharmacologic Treatments for Chronic Pain Nonopioid Pharmacologic Treatments for Chronic Pain Comparative Effectiveness Review Number 228 R Comparative Effectiveness Review Number 228 Nonopioid Pharmacologic Treatments for Chronic Pain Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015-00009-I Prepared by: Pacific Northwest Evidence-based Practice Center Portland (...) increased risk of serious gastrointestinal, liver dysfunction, and cardiovascular adverse events. iii This report is based on research conducted by the Pacific Northwest Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2015-00009-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views

2020 Effective Health Care Program (AHRQ)

204. Noninvasive Nonpharmacological Treatment for Chronic Pain

Noninvasive Nonpharmacological Treatment for Chronic Pain Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update Comparative Effectiveness Review Number 227 R Comparative Effectiveness Review Number 227 Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No. 290-2015 (...) for common chronic pain conditions. Key Messages • Interventions that improved function and/or pain for =1 month: o Low back pain: Exercise, psychological therapy, spinal manipulation, low-level laser therapy, massage, mindfulness-based stress reduction, yoga, acupuncture, multidisciplinary rehabilitation (MDR) o Neck pain: Exercise, low-level laser, mind-body practices, massage, acupuncture o Knee osteoarthritis: Exercise, cognitive behavioral therapy (CBT) o Hip osteoarthritis: Exercise, manual

2020 Effective Health Care Program (AHRQ)

205. 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

, for example, depression, anxiety, personality disorders, schizophrenia and posttraumatic stress disorders are a leading cause of disability in the occidental cultures (Murray et al., ). In some countries, such as the UK, the prevalence of major depression is increasing and imposing huge personal and economic costs (Centre for Mental Health, ). Likewise in Spain, although indicators of physical health have constantly improved during the last three decades, indicators of healthy habits (rates of cholesterol (...) be an increasingly attractive option. As such, there is great potential to increase the use of care farms as an intervention to bring beneficial outcomes to a range of different population groups. The growth in care farming in recent years is partly attributable to their commissioning successes with a range of health and social sector organisations through patient‐referral and contracts for provision of support to health, social‐care and probation clients. Their sustainability is important given the increasing

2019 Campbell Collaboration

206. Individualized funding interventions to improve health and social care outcomes for people with a disability: A mixed?methods systematic review

quality of support provided); and a lack of resources/available support, exacerbated by an inaccurate estimation of need and subsequent delay in reviewing /adjusting budgets. This, amongst other things, can lead to conflict and tensions in working relationships, which are also hampered by disabling practices (e.g., exclusion from decision‐making). Lastly, financial hardship is commonly cited, with hidden costs or administrative charges widely identified as a source of considerable concern and stress (...) services whereby ‘consumers of care’ increasingly act as employers without necessarily having the human resource skills or knowledge of available care choices (Woods, ). In contrast, evidence suggests that people availing of individualized funding are capable of acquiring the necessary skills, or indeed able to outsource certain tasks in order to successfully bypass the service providers and contract their support services directly (Fleming et al., ). Thus, there exists a tension between individuals

2019 Campbell Collaboration

207. Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain from a Multispecialty, International Working Group Full Text available with Trip Pro

prevalence raises questions regarding the accuracy of diagnostic testing in the absence of any non-interventional diagnostic reference standard. The poor correlation between facet joint pathology on imaging and LBP further fuels debate. For diagnostic criteria, research and review articles abound on the ideal cut-off for designating a block as positive, and the optimal number of blocks that should be performed before lumbar facet radiofrequency ablation (RFA) treatment, with no consensus emerging. Lumbar (...) Clinical studies evaluating the association of physical examination findings with facet block results Fairbank et al assessed range of motion in multiple directions, straight leg raising test and tenderness based on digital palpation in 25 patients with acute back and/or leg pain. Based on the site of maximal tenderness, the most painful area was chosen for an IA injection with 1.5 mL of local anesthetic (LA). A second injection was performed at a level randomly chosen among the nine remaining lumbar

2020 American Society of Regional Anesthesia and Pain Medicine

208. Abdominal and pelvic imaging

evaluation of the patient. This includes a history and physical examination and, where applicable, a review of relevant laboratory studies, diagnostic testing, and response to prior therapeutic intervention. ? The anticipated benefit of the recommended intervention should outweigh any potential harms that may result (net benefit). ? Current literature and/or standards of medical practice should support that the recommended intervention offers the greatest net benefit among competing alternatives. ? Based (...) , repeated testing of the same anatomic location for the same indication should be limited to evaluation following an intervention, or when there is a change in clinical status such that additional testing is required to determine next steps in management. At times, it may be necessary to repeat a test using different techniques or protocols to clarify a finding or result of the original study. Repeated testing for the same indication using the same or similar technology may be subject to additional

2020 AIM Specialty Health

209. BTS Guideline for Long Term Macrolide Use

of macrolide therapy to assess QTc interval. If QTc is >450 ms for men and >470 ms for women, this is considered a contraindication to initiating macrolide therapy. Baseline liver function tests should also be measured. ? Patients should be counselled about potential adverse effects before starting therapy including gastrointestinal upset, hearing and balance disturbance, cardiac effects and microbiological resistance. ? Microbiological screening of sputum before and during macrolide therapy may (...) of life assessed at baseline. ? A risk:benefit profile should be considered in each individual if significant side effects from oral macrolide therapy develop. If gastroin- testinal side effects occur at the higher dose of azithromycin (500 mg thrice weekly), a dose reduction to azithromycin 250 mg thrice weekly could be considered if macrolide therapy has been of clinical benefit. ? Liver function tests should be checked 1 month after starting treatment and then every 6 months. An ECG should

2020 British Thoracic Society

210. The Use of Bronchoscopy During the COVID-19 Pandemic: CHEST/AABIP Guideline and Expert Panel Report

. 4.Priortoperformingbronchoscopyinasymptomatic patients in an area where community transmission of COVID-19 infection is present, we suggest testing for COVID-19 infection (Ungraded Consensus-Based Statement). Remarks: This strategy is contingent on the availability of testing in the local setting. In all patients with negative results, we suggest that the procedure is performed using personal protection equipment including face shield, gown, gloves and N-95 respirators or powered air purifying (...) respirators (PAPR). When test results are positive prior to bronchoscopy, we suggest postponing all non-emergent bronchoscopies. In patients who require emergent bronchoscopy who have positive SARS-CoV-2 test results, we suggest using personal protection equipment including face shield, gown, gloves and N-95 respirators or powered air purifying respirators (PAPR) in pre, intra, and post bronchoscopy settings as would be with every SARS-Cov-2 positive patient. 5. When bronchoscopy is indicated

2020 American College of Chest Physicians

211. Overview of pregnancy complications

. 2016;388:891-897. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27372398?tool=bestpractice.com It is recommended that all pregnant women be tested for HIV infection as early as possible. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137. http://www.cdc.gov/std/tg2015/ http://www.ncbi.nlm.nih.gov/pubmed/26042815?tool (...) the uterus may be caused by trauma, hypertension, or coagulopathy. Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006;108:1005-1016. http://www.ncbi.nlm.nih.gov/pubmed/17012465?tool=bestpractice.com It is a common cause of bleeding in the third trimester. Pre-term birth occurs between 24 and 37 weeks' gestation. In two-thirds of cases, it occurs following spontaneous onset of labour. Only a minority of women who present with pre-term contractions known as threatened pre-term labour (TPTL

2018 BMJ Best Practice

212. Cardiac arrhythmias in coronary heart disease

of ischaemic VT induced at electrophysiological study, sudden death and out-of-hospital collapse. R Revascularisation should be considered in patients who have had sustained VT or VF. 9 Patients with previous sustained VT/VF should undergo assessment for inducible ischaemia by stress testing or myocardial perfusion imaging followed, if appropriate, by coronary arteriography and revascularisation. These patients should all be considered for implantable cardioverter defibrillator therapy. 5.2.2 IMPLANTABLE

2018 SIGN

213. Premature labour

contractions preterm premature rupture of membranes (PPROM) advanced cervical dilation cervical length <2 cm increased maternal or fetal heart rate non-specific lower abdominal or back pain fever vaginal bleeding previous premature labour previous cervical trauma previous induced abortion maternal infections multifetal pregnancies short cervical length positive fetal fibronectin test preterm premature rupture of membranes (PPROM) fetal abnormalities smoking body mass index (BMI) <19 kg/m^2 social factors (...) and ethnicity polyhydramnios domestic violence poor dental hygiene Diagnostic investigations non-stress cardiotocogram tocography transvaginal ultrasound of the cervix cervico-vaginal swab for fetal fibronectin FBC CRP urine dipstick urine microscopy, culture, and sensitivity high vaginal/rectal swab nitrazine test microscopy of vaginal fluid Kleihauer blood test urine toxicology screen IGFBP-1 (insulin-like growth factor binding protein-1) test placental alpha microglobulin-1 (PAMG-1) Treatment algorithm

2018 BMJ Best Practice

214. Non-sustained ventricular tachycardias

catecholaminergic polymorphic VT FHx of sudden death mental or physical stress Diagnostic investigations ECG electrolyte panel troponin CK-MB 24-hour ambulatory ECG monitoring echocardiogram cardiac catheterisation cardiac MRI with gadolinium electrophysiological testing stress testing genetic screening Treatment algorithm ONGOING Contributors Authors Professor of Medicine Mayo Medical School Division of Cardiovascular Diseases Department of Medicine Mayo Clinic Florida Jacksonville FL Disclosures FK declares (...) risk factors such as structural heart disease. Patients at risk for sudden cardiac death and who also have discordant contraction of left ventricular function may benefit from cardiac resynchronisation therapy (CRT). Prognosis dependent on presence or absence of cardiac disease. Left ventricular function in post-MI patients remains the most important prognostic tool for overall mortality and risk for sudden cardiac death. No increase in mortality demonstrated in those patients without associated

2018 BMJ Best Practice

215. Overview of pregnancy complications

. 2016;388:891-897. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30902-3/fulltext http://www.ncbi.nlm.nih.gov/pubmed/27372398?tool=bestpractice.com It is recommended that all pregnant women be tested for HIV infection as early as possible. Workowski KA, Bolan GA; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137. http://www.cdc.gov/std/tg2015/ http://www.ncbi.nlm.nih.gov/pubmed/26042815?tool (...) the uterus may be caused by trauma, hypertension, or coagulopathy. Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006;108:1005-1016. http://www.ncbi.nlm.nih.gov/pubmed/17012465?tool=bestpractice.com It is a common cause of bleeding in the third trimester. Pre-term birth occurs between 24 and 37 weeks' gestation. In two-thirds of cases, it occurs following spontaneous onset of labour. Only a minority of women who present with pre-term contractions known as threatened pre-term labour (TPTL

2018 BMJ Best Practice

216. Assessment of palpitations

aetiologies that occur during normal sinus rhythm. A significant proportion of palpitations are due to non-life-threatening, treatable cardiac conditions. They include premature ventricular contractions, premature atrial contractions, and supraventricular tachycardias such as atrial fibrillation, atrial flutter, atrioventricular nodal re-entry tachycardia, atrial tachycardia, and atrioventricular re-entry tachycardia or Wolff-Parkinson-White syndrome. Ironically, the most common rhythm seen when (...) evaluating patients for palpitations is sinus rhythm. A heightened sense of normal rhythm can be seen in settings of emotional or physical stress, or in conjunction with use of caffeine, alcohol, or other stimulants. However, palpitations are occasionally a manifestation of potentially life-threatening conditions, especially in the setting of structural heart disease - for example, ventricular tachycardia, which may lead to sudden cardiac death. Inherited conditions such as hypertrophic cardiomyopathy

2018 BMJ Best Practice

217. Diagnosis and management of epilepsy in adults

3.5 Hand-held video 11 3.6 Brain imaging 11 3.7 Electrocardiography 11 3.8 Genetic testing 12 4 Treatment 13 4.1 When to start antiepileptic treatment 13 4.2 Antiepileptic drug monotherapy 13 4.3 Management of drug-resistant epilepsy 14 4.4 Antiepileptic drug blood levels 16 4.5 Management of provoked seizures 17 4.6 Antiepileptic drug adverse effects 17 4.7 Antiepileptic drug withdrawal 19 4.8 Complementary therapy 20 4.9 Surgical referral 23 4.10 Management of prolonged seizures including status (...) CLINICAL FACTORS AND DIAGNOSIS Attack disorders such as faint and epilepsy produce their effects because some element of physiology becomes disordered, temporarily disturbing the function of the brain. For a test to positively identify the nature of an attack disorder, an attack must be recorded, and the disturbed physiology detected. As this is usually impractical, the routine diagnosis of attack disorders is largely clinical, based on history. The history should make clear what occurred before

2018 SIGN

218. What helps to support people affected by Adverse Childhood Experiences? A Review of Evidence

and running the stakeholder workshop. We are also grateful to Amber Derosa from the National Children’s Bureau, Young NCB, and the seven young people who contributed so generously to the stakeholder workshop. Funding This review was commissioned by the National Institute for Health Research (NIHR) Policy Research Programme (PRP) for the Department of Health and Social Care (DHSC). It was funded through the NIHR PRP contract with the EPPI Centre at UCL (Reviews facility to support national policy (...) a person who is under the age of 18. ABBREVIATIONS ACE Adverse Childhood Experience CBT Cognitive Behavioural Therapy CDC Centers for Disease Control and Prevention EMDR Eye Movement Desensitisation and Reprocessing Therapy nRCT Non-Randomised Controlled Trial OoHC Out-of-Home-Care PTSD Post-Traumatic Stress Disorder RCT Randomised Controlled Trial RoB Risk of Bias RoR Review of Reviews (used to describe the systematic review of systematic reviews) SMD Standardised Mean Difference TAU Treatment

2019 EPPI Centre

219. Canadian Urological Association guideline for the diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction

, renal function) Review of relevant systems Bowel function Sexual function Coexisting non-NLUTD dysfunction (prostatic enlargement, stress incontinence) Gross hematuria Gynecological/pregnancy history Genitourinary/pelvic pain Motor abilities (hand function, ability to transfer) Cognitive function Support systems/caregivers CIC: clean intermittent catheterization; MS: multiple sclerosis; NLUTD: neurogenic lower urinary tract dysfunction; SCI: spinal cord injury; UTI: urinary tract infection.CUAJ (...) , and the behaviour of the urinary sphincters during voiding. The availability of videoUDS is not universal, and a voiding cystogram is an acceptable alternative in some cases. Urodynamic diagnoses, such as neurogenic detrusor overactivity (NDO), impaired compli- ance, reduced bladder capacity, or a high detrusor leak point pressure (DLPP, defined as the lowest vesical pressure at which urine leaks from the bladder in the absence of a detrusor contraction or increased abdominal straining) can identify a patient

2019 Canadian Urological Association

220. European Championships Glasgow 2018: survey of volunteer applicants

information obtained during the application phase with responses to an online questionnaire exploring expectations, experiences and potential influence of the volunteer programme on volunteer applicants and to reflect on how learning from the Glasgow 2014 Commonwealth Games recruitment strategy shaped this. 2.2 Survey design A draft questionnaire was developed predominately using questions tested in previous studies and validated scales. The questionnaire covered a variety of topics exploring experiences (...) % 46% 16% 5% Long-term condition or illness (n=2,331) Yes No 15% 85% Employment (n=2,341) Employed full time (including self-employed) Employed part time (including self-employed) Employed casually (e.g. temporary contract) Retired or pensioner Unemployed and/or looking for employment Full-time pupil or student Full-time carer or parent Other 39% 13% 2% 28% 3% 10% 1% 4% Ethnicity (n=2,344) White Scottish White English White Welsh White Northern Irish White British White Irish White Polish White

2019 Glasgow Centre for Population Health

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