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141. 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

142. 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

143. 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

144. Horizon scanning: what's next for medical and health research?

sequencing in a ‘lab-on-a-chip’ format are expected to be used to diagnose infections rapidly in a universal test requiring only limited laboratory space and operational training. ? By 2048, the aspiration was that the clinical value of genetic testing would shift from diagnosis and treatment to disease prediction. This has the potential to allow pharmaceutical and non-pharmaceutical interventions to prevent ill health before disease has even occurred. ? As knowledge of the genome’s function continues (...) with special needs. ? Online or app-based avatars will be used not just to improve access but also to increase adherence, for example to Cognitive Behavioural Therapy (CBT) to treat anxiety and post-traumatic stress disorder. ? Robots were predicted to be used to assist with routine tasks, freeing capacity for healthcare professionals to address tasks that are more complex. Public health ? By 2048, public health research was predicted to use data for intelligent monitoring of population health, to assess

2019 Academy of Medical Sciences

145. From innovation to implementation: team science two years on

contributions but do not have a university contract (e.g. senior postdoctoral researchers). 24 In addition, all named individuals on a grant will be encouraged to clarify their contribution.14 Team science and the funding community Future priorities Although the funding community has implemented welcome changes, and opportunities are being created and embraced, it was felt that challenges still remain. Participants suggested that the following issues should be addressed as a priority: • ‘Team science’ teams (...) commonly viewed as rewarding a single discipline mentality and therefore biasing against team science. Professor Iredale stressed that higher education institutes should not be deterred from submitting

2019 Academy of Medical Sciences

146. 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

147. Guidelines on Supraventricular Tachycardia (for the management of patients with) (Full text)

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

2019 European Society of Cardiology

148. 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

149. 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

150. Diagnosis and Management of Acute Pulmonary Embolism (Full text)

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

2019 European Society of Cardiology

152. Public health guidance on prevention and control of blood-borne viruses in prison settings

was commissioned by the European Centre for Disease Prevention and Control (ECDC), coordinated by Lara Tavoschi with the support of Dagmar Hedrich from EMCDDA, Helena de Carvalho Gomes from ECDC and the ECDC Library, and produced by Pallas Health Research and Consultancy and Health Without Barriers (framework contract number ECDC/2015/028, specific contract number ECD.5855), in cooperation with Università degli Studi di Sassari (UNISS). Authors Anouk Oordt, Marije Vonk-Noordegraaf and Hilde Vroling (Pallas (...) a given intervention is accessible to the target population (availability of good health services within reasonable reach and when needed) Active case finding Interventions aimed at promoting early diagnosis by means of provider- initiated systematic offer for testing, at entrance and/or during stay (including at release) Client-initiated testing Testing which is voluntary and performed as the result of individual’s health- seeking behaviour, triggered by symptoms development or other reasons (i.e

2019 European Centre for Disease Prevention and Control - Public Health Guidance

153. Programmatic management of latent tuberculosis infection in the European Union

opinions; the evidence collection, appraisal and synthesis; the expert consultation and the first draft of this guidance were produced by Marije Vonk Noordegraaf-Schouten, Femke van Kessel and Anouk Oordt, members of a consortium of Pallas Health Research and Consultancy (Rotterdam) and Erasmus University Medical Center (framework contracts no ECDC/2013/005 and ECDC/2014/032). Invaluable input was received from ad hoc scientific panel chairs Gerard de Vries (the Netherlands) and Dominik Zenner (United (...) for risk of LTBI among vulnerable and hard-to-reach populations 13 Table 7. Evidence base on progression to active TB among vulnerable and hard-to-reach populations 13 Table 8. Evidence base for risk of LTBI and progression to active TB among occupational risk groups 14 Table 9. Evidence base for risk of LTBI and progression to active TB among other risk groups 15 Table 10. Evidence base for effectiveness of diagnostic test for LTBI 16 Table 11. Evidence base for cost-effectiveness of LTBI diagnostic

2019 European Centre for Disease Prevention and Control - Public Health Guidance

154. 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

155. 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

156. 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

157. Clinical Aggression Training: A Rapid Review

used methods which were noted once included reading assignments, case studies and workshop. Targeted outcomes The target outcomes included in the 13 interventional studies included empathy, staff efficacy, number of adverse events, work engagement, aggression, stress and patient satisfaction. Though all the studies were focused on communication skills, only quarter of the studies (25%) aimed to assess the impact of training on communication skills. The scales used to measure the change (...) No eligible studies addressed reductions in seclusion or restraints for staff training, risk assessment, multimodal, or environmental protocols. Harms of Strategies To Prevent Aggressive Behaviour No eligible studies examined risk assessments, multimodal interventions, environmental interventions, or medication protocols. Harms of Strategies To De-Escalate Aggressive Behaviour No eligible studies tested staff training, risk assessments, multimodal, or environmental protocols. Harms of Strategies To Reduce

2019 Monash Health Evidence Reviews

158. Guidelines For Professional Ultrasound Practice

SCREENING EXAMINATIONS USING ULTRASOUND 19 1.9 ERGONOMIC PRACTICE INCLUDING MANAGING THE HIGH BMI PATIENT 21 1.10 INTIMATE EXAMINATIONS AND CHAPERONES 23 1.11 EXAMINATION TIMES 24 1.12 THE 6 C’s, PATIENT IDENTIFICATION, COMMUNICATION AND CONSENT 25 1.13 CLINICAL GOVERNANCE 27 1.14 E-LEARNING FOR HEALTHCARE 29 1.15 IMAGING SERVICES ACCREDITATION SCHEME (ISAS) 29 1.16 ULTRASOUND EQUIPMENT AND QUALITY ASSURANCE TESTING 30 1.17 RAISING CONCERNS; SAFEGUARDING; STATUTORY REQUIREMENTS FOR REPORTING FEMALE (...) 2.7.5 Pelvic ultrasound reporting 57 2.7.6 Reporting Examples 57 2.8 ABDOMINAL ULTRASOUND EXAMINATIONS 59 2.8.1 General principles 59 2.8.2 Ultrasound examination of the liver 63 2.8.3 Ultrasound examination of the gallbladder and biliary tree 65 2.8.4 Transabdominal ultrasound examination of the pancreas 66 2.8.5 Ultrasound examination of the spleen 68 2.8.6 Ultrasound examination of the abdominal aorta 71 2.8.7 Ultrasound examination of the bowel 72 2.9 URO-GENITAL SYSTEM INCLUDING TESTES

2019 British Medical Ultrasound Society

160. Staff and associate specialist (SAS) grade handbook

, Association of Anaesthetists3 Association of Anaesthetists | The SAS Handbook 2020 Back to contents Click arrows below to view sections Contents 1. Why Join the Association of Anaesthetists? 2. Other support mechanisms and organisations Employment issues 3. Model Charter for SAS grades 4. SAS contract and job planning 5. Revalidation and appraisal 6. Working less than full-time 7. Addiction, sickness and returning to work 8. Clinical governance and professional development 9. Medico-legal pitfalls (...) departments have dedicated SAS mentors (consultants or senior SAS doctors) whose role is to support and guide SAS doctors in their professional practice, personal wellbeing, and personal and professional development. The Department of Health, the BMA, several deaneries and many independent organisations offer mentoring schemes and training. It has been proven in several studies that mentoring helps to improve confidence and reduce stress. Deanery support Most deaneries have dedicated Associate Deans

2020 Association of Anaesthetists of GB and Ireland

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