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Contraction Stress Test

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141. Evidence Brief - Barriers and Facilitators to Use of Medications for Opioid Use Disorder

by the Substance Abuse and Mental Health Services Administration (SAMHSA). 9 OTPs can exist in multiple settings including intensive outpatient programs, residential programs, and hospital settings. OTPs are highly regulated, with requirements that patients receive psychosocial supports, complete frequent urine drug tests, and receive a limited number of take-home medications (thereby requiring frequent visits). 4 As of 2018, VHA operated 32 OTPs nationwide, but also contracts with an unknown number of OTPs

2019 Veterans Affairs Evidence-based Synthesis Program Reports

142. Evidence for smoking quitlines

37 NHMRC level IV: Case series with post-test or pre-test/post-test outcomes 41 6 Quality assessment of evidence 48 Review Question 1 – key components 48 Evidence Base [A rating] 48 Consistency [B rating] 48 Clinical impact [C rating] 48 Generalisability [B rating] 49 Applicability [B rating] 49 Review question 2 – barriers and facilitators 50 Evidence Base [B rating] 50 Consistency [C rating] 50 Clinical impact [C rating] 50 Generalisability [B rating] 50 Applicability [B rating] 50 7 Analysis (...) be classified according to the NHMRC level of evidence, including: systematic reviews of randomised controlled trials, randomised controlled trials, pseudo-randomised controlled trials, comparative studies with concurrent controls, comparative studies without concurrent controls, case series with either post-test or pre-test/post-test outcomes. Participants and interventions: Studies were included if they were conducted with any participants recruited from within a quitline service, used data from quitline

2019 Sax Institute Evidence Check

143. Preventing and Managing Infectious Diseases Among People who Inject Drugs in Ontario

living with concurrent mental health problems. Many other groups warrant serious consideration as well, and a similar approach could be adopted for any of them. † The PROGRESS framework was developed by Tim Evans and Hilary Brown (Evans T, Brown H. Road traffic crashes: operationalizing equity in the context of health sector reform. Injury Control and Safety Promotion 2003;10(1-2): 11–12). It is being tested by the Cochrane Collaboration Health Equity Field as a means of evaluating the impact (...) infections without being addressed; • curable but long-term or hard-to-diagnose infections (e.g., hepatitis C); • chronic and incurable infections (e.g., HIV); and • life-threatening infections that require timely intervention with antibiotics or surgery (e.g., endocarditis, osteomyelitis and serious complications from invasive group A streptococcus). For example, HIV estimates in Canada have found that PWID are 59 times more likely to contract HIV than people who do not inject drugs. In 2014

2019 McMaster Health Forum

144. Learning from the Experience of Accountable Care Organizations in the U.S.

public ACOs have been largely stewarded by the Centre for Medicare and Medicaid. Beneficiaries are attributed to public ACOs based on being a Medicare beneficiary that also meets an agreed-upon definition, typically reliant on seeking a certain amount of care from providers included in the ACO.(3) However, providers attached to the ACO may also be delivering care to non-ACO beneficiaries. ACOs are reimbursed using shared-savings arrangements which are outlined in a shared-savings contract between (...) the payer (in the public system this is Medicare or Medicaid, and in the commercial, a private insurer) and the ACO. The shared savings contract defines the terms of the arrangement including a common understanding of the baseline cost of care from which improvements are benchmarked, as well as the extent of risk taken on by the ACO.(3) Providers attached to the ACO have been traditionally reimbursed for their services using traditional fee-for-service payments, although this is increasingly shifting

2019 McMaster Health Forum

145. The management of urinary incontinence in women

or OAB. Weight 1.2.3 Advise women with UI or OAB who have a BMI greater than 30 to lose weight. 1.3 Physical therapies Pelvic floor muscle training 1.3.1 Offer a trial of supervised pelvic floor muscle training of at least 3 months’ duration as first-line treatment to women with stress or mixed UI. 1.3.2 Pelvic floor muscle training programmes should comprise at least 8 contractions performed 3 times per day. 1.3.3 Do not use perineometry or pelvic floor electromyography as biofeedback as a routine (...) Assessment of pelvic floor muscles 6 Bladder diaries 6 Absorbent products, urinals and toileting aids 6 Indwelling urethral catheters 6 General principles when using overactive bladder (OAB) medicines 7 Choosing OAB medicines 7 Surgical approaches for stress urinary incontinence (SUI) 7 The multidisciplinary team (MDT) 7 Maintaining and measuring surgical expertise and standards for practice 7 1. Recommendations 8 1.1 Assessment and investigation 8 1.2 Lifestyle interventions 11 1.3 Physical therapies 11

2019 Best Practice Advocacy Centre New Zealand

146. Acute Kidney Injury (AKI)

detection algorithm. (1B) We suggest that, when the true, reference serum creatinine (SCr) is uncertain, the presence of an active episode of AKI occurring in secondary care can be inferred from frequent SCr testing (e.g. at 12 and 24 hours after the index value). (2D) 2. Recognition of the patient at risk of AKI Guideline 2.1 - Adults and Paediatrics (unless otherwise stated) We recommend that: ? patients at risk of AKI should be identified by the most appropriate risk factor profile (...) for that population or, where no specific risk factor profile exists, through clinical judgement and recognition of generic risk factors for AKI; in this way, appropriate preventative measures may be instituted as early as possible (1C) ? in-patients deemed at high risk of AKI should be closely monitored for AKI, particularly if there has been a new exposure. Urine output should be monitored and serum creatinine tested daily (for adults) or regularly (for paediatric patients, reflecting the potential burden

2019 Renal Association

147. Haemodialysis

guideline, as are many aspects of dialysis, including: ? Planning, initiation & withdrawal of Renal Replacement Therapy ? Vascular Access for Haemodialysis ? Cardiovascular Disease ? Blood Borne Viruses ? Assessment of the Potential Kidney Transplant Recipient ? Nutrition ? Anaemia ? CKD-Mineral and Bone Disorder ? Water Treatment Facilities, Dialysis Water and Dialysis Fluid Quality We have removed the section on targets for blood testing since these are better covered in other guidelines, and have (...) of competencies, using an individualised approach to training method and speed. [2D] We suggest units form a contract with patients outlining responsibilities, including an agreement to dialyse as per prescription and trained technique, and including a policy for re-imbursement of directly arising patient costs. [2D] We suggest supporting patients with a specific team including nephrologists, technicians, and nurses, with rapid access to dialysis in-centre when required. [2C] We suggest an agreed

2019 Renal Association

148. A Case Management Tool for TB Prevention, Care and Control in the UK

assessment (Form: 3) 41 – DOT chart/log (Form: 4) 43 2. Sample DOT contract 44 3. Sample social/network questionnaire 46 4. Standard case management – flow chart 47 5. Tips for giving medication to children 48 6. Home isolation policy 49 7. Sample cohort review action log 52 8. Cohort review incident reporting form 53 9. Outreach and safe practice 54 10. Methadone and anti-tuberculous treatment containing rifamycins 55 11. Managing treatment interruptions 58 12. Drug therapy – adverse effects requiring (...) specialties) • emergency departments • active case finding – contact investigations, new entrant screening and under-served populations (USP) • microbiology, histopathology and radiology • clinical teams working with local USP groups • open access service/s or walk-in clinics. Diagnosis of TB can be confirmed rapidly, for example, by polymerase chain reaction or nucleic acid amplification test, which also provides a useful indication of some forms of drug resistance. TB services should be accessible

2019 Royal College of Nursing

149. Guidelines on Supraventricular Tachycardia (for the management of patients with)

literature review, weigh the strength of evidence for or against a particular treatment or procedure, and include estimates of expected health outcomes where data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that might influence the choice of particular tests or therapies were considered, as were frequency of follow-up and cost-effectiveness. In controversial areas, or with regard to issues without evidence other than usual clinical practice, consensus was achieved (...) or AVRT, although an AT may also present in this way. Characteristics in terms of the regularity or irregularity are helpful. The duration of individual episodes may help in terms of differentiation. Re-entrant tachycardias tend to last longer than AT episodes, which may occur in a series of repetitive runs. Clear descriptions of pounding in the neck (the so-called ‘frog sign’) or ‘shirt flapping ’ would point to the possible competing influences of atrial and ventricular contraction on the tricuspid

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2019 European Society of Cardiology

150. Diagnosis and Management of Acute Pulmonary Embolism

of clinical (pre-test) probability 12 4.3 Avoiding overuse of diagnostic tests for pulmonary embolism 13 4.4 D-dimer testing 13 4.4.1 Age-adjusted D-dimer cut-offs 13 4.4.2 D-dimer cut-offs adapted to clinical probability 13 4.4.3 Point-of-care D-dimer assays 13 4.5 Computed tomographic pulmonary angiography 13 4.6 Lung scintigraphy 14 4.7 Pulmonary angiography 15 4.8 Magnetic resonance angiography 15 4.9 Echocardiography 15 4.10 Compression ultrasonography 16 4.12 Computed tomography venography 18 5 (...) 8.2 Anticoagulant-related bleeding risk 34 8.3 Regimens and treatment durations with non-vitamin K antagonist oral anticoagulants, and with other non-vitamin K antagonist antithrombotic drugs 34 8.5 Management of pulmonary embolism in patients with cancer 36 9 Pulmonary embolism and pregnancy 37 9.1 Epidemiology and risk factors for pulmonary embolism in pregnancy 37 9.2 Diagnosis of pulmonary embolism in pregnancy 37 9.2.1 Clinical prediction rules and D-dimers 37 9.2.2 Imaging tests 37 9.3

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2019 European Society of Cardiology

152. Individualised funding interventions to improve health and social care outcomes for people with a disability

concern and stress. Staff mention involvement of local support organisations, availability of a support network for the person with a disability and timely relevant training as factors supporting implementation. Staff also highlight logistical challenges in support needs in an individualised way including, for example, responding to individual expectations, and socio-demographic differences. What do the findings of this review mean? This review provides an up-to-date and in-depth synthesis (...) , the Katz Index of ADLs (Katz, Ford, Moskowitz, Jackson, & Jaffee, 1963 as cited in Kane & Radosevich, 2011a). • Costs data, measured for example by: size of personal financial package available; brokerage/management fees; cost of individual services; and cost of recruiting staff (for self- managed). Adverse outcomes • Adverse psychological impact, as measured by symptoms of depression, anxiety, stress, social dysfunction, and feelings of isolation. Depression can be measured as clinical (e.g

2019 Campbell Collaboration

153. Re-imagining Community Healthcare Services

to be involved meaningfully and consistently. ? Putting in place financial models to facilitate change. ? Commissioning and contracting differently. ? Exploiting innovations in technology. ? Developing quality and improvement skills – Improving performance in healthcare services and transforming care on a sustainable basis depends in part on building capabilities for quality improvement among the staff delivering care. ? Getting the basics right – capacity to engage with stakeholders and measure and monitor (...) for the first time, the provider already knows their details. Their journey and scheduling are integrated. ? People at risk of particular conditions have easier access to follow-up tests and services and benefit from more individually tailored treatment and management plans. ? The quality of healthcare is high as health workers spend quality time with people, make fewer errors and make better decisions. Potential benefits to the hospital setting when re-imagining community healthcare services Emerging

2019 Monash Health Evidence Reviews

154. 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

155. Cost-effectiveness analysis of HPV vaccination of boys in Belgium

in Belgium in 2015 and those due to the HPV types included in each vaccine, per gender (Table 4). These numbers are approximations as no systematic HPV testing is applied on cancer cases in Belgium and we used different sources for cases (Cancer Registry) and for the proportion of HPV types by disease (literature). For penile cancers, we selected the Belgian study for the proportion of HPV-attributable penile cancers, i.e. 61%, although this might be an overestimation. 27 . Overall, we estimated

2019 Belgian Health Care Knowledge Centre

156. 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

157. 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

158. 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

159. 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

160. 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

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