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161. Teduglutide (Revestive) - short bowel syndrome (SBS)

outcome was the percentage of patients who achieved a response (defined as a 20% to 100% reduction from baseline in the weekly parenteral support volume) at week 20 which was maintained at week 24 and was analysed in the intention to treat population which included all randomised patients. Response was achieved by 63% (27/43) of patients in the teduglutide group and 30% (13/43) of patients in the placebo group (p=0.002). The study used a step-down testing procedure for six secondary outcomes (...) with no formal statistical testing after the first non- significant difference. Secondary outcomes included the percentage change from baseline to week 24 in parenteral support (32% versus 21% of patients in the teduglutide and placebo groups respectively, p=0.030) and the mean absolute change from baseline to week 24 in parenteral support (-4.4 litres/week [from a baseline of 12.9 litres/week] in the teduglutide group compared with -2.3 litres/week [from a baseline of 13.2 litres/week] in the placebo group

2020 Scottish Medicines Consortium

162. Surgical mesh repair of primary inguinal hernia in men

hernia repair available on the market 5 . Six suppliers have been awarded a contract by National Procurement to provide mesh products for hernia repair in NHSScotland: B Braun, Bard Ltd, Covidien (UK) Ltd, Elemental Healthcare Ltd, Johnson & Johnson Medical Ltd and PFM Medical UK Ltd (Mr P Hornby, Head of Strategic Sourcing & Commercial, National Procurement. Personal communication, SHTG Advice | 8 08 May 2019). Organic mesh products are no longer within the scope of this national contract, but may (...) be contracted separately if required. Epidemiology Risk factors for developing an inguinal hernia include having a personal or family history of hernia, older age, being male, chronic cough, prolonged constipation, abdominal wall injury and smoking 6 . The estimated lifetime risk of a groin hernia (inguinal or femoral hernia) is 27% in men compared with 3% in women 6 . In 2014–2015, audit data from NHS England indicated that 92% of patients undergoing an inguinal hernia repair were men 3 . Incidence

2020 SHTG Advice Statements

163. Diagnosis and Treatment of Low Back Pain

are written utilizing a standard language that indicates the strength of the recommendation. “A” recommendations indicate a test or intervention is “recommended”; “B” recom- mendations “suggest” a test or intervention and “C” recommendations indicate a test or intervention “may be considered” or “is an option.” “I” or “Insufficient Evidence” statements clearly indicate that “there is insufficient evidence to make a recommendation for or against” a test or intervention. Work group con- sensus statements (...) clearly state that “in the absence of reliable evidence, it is the work group’s opinion that” a test or intervention may be appropriate. Recommendations were developed based on a specific definition, inclusion/exclusion criteria, and the resulting literature which excluded conditions such as presence of a neurological deficit or leg pain experienced below the knee, among others. Given the exclusion criteria, these guideline rec- ommendations address a subset of low back pain care as opposed to low

2020 North American Spine Society

164. Recognition and Initial Management of Fulminant Myocarditis: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

peptide) or NT-proBNP (N-terminal pro-BNP) should be sent to confirm the presence of increased myocardial wall stress and evidence of myonecrosis. Table 2. Initial Ancillary Testing in the Emergency Department for the Hemodynamically Stable Patient With Suspected Early FM ECG: ST-T–wave changes, concave ST-segment elevation, focal ST-segment elevation mimicking an AMI in a particular coronary distribution. Diffuse ST-segment elevation with PR depression may be present, suggesting inflammation (...) nervous system drugs such as clozapine and carbamazepine. Avoid NSAIDs because they may increase Na retention, cause myocardial harm, and exacerbate renal hypoperfusion. ACS indicates acute coronary syndrome; AHF, acute heart failure; EMB, endomyocardial biopsy; FM, fulminant myocarditis; LFT, liver function test; NSAID, nonsteroidal anti-inflammatory drug; RHF, right-sided heart failure; RUQ, right upper quadrant; URI, upper respiratory infection; and VAD, ventricular assist device. Unique Diagnostic

2020 American Heart Association

165. 2020-2023 Value Assessment Framework

, devices, tests, and delivery system innovations, as well as earlier iterations of the framework. During that time ICER has actively sought the input of all stakeholders and made iterative changes to its methods and overall procedures to enhance their transparency and to improve the ability of all parties to participate meaningfully in the process. ICER has also benefitted from public comment opportunities during each framework revision cycle, including two comment periods for the 2020-2023 framework (...) patients. 1.3. The Population Perspective and Intended Uses of the ICER Value Assessment Framework The ICER Value Assessment Framework describes the conceptual framework and set of associated methods that guide the development of ICER evidence reports. ICER reports are intended to support deliberation on medical policies related to health services (e.g., tests or treatments) and delivery system interventions (e.g., preventive programs, changes to the organization of medical personnel). To inform

2020 California Technology Assessment Forum

166. 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

167. Oral care and people with learning disabilities

Services (GDS) These services are directly accessed by the public such as high-street dental services. These are commissioned via NHS England and each practice is an independent business with a contract with the NHS to deliver a set amount of work, or units of dental activity ( : Band 1 – this includes examination, diagnostics, such as X-rays and prevention Band 2 – this includes fillings and dental extractions Band 3 – this is for additional treatments such as crowns, bridges and dentures Some groups (...) the need to have a dental anxiety scale validated for use with people with learning disabilities . This could be used to flag people who may need extra support and to assess the value of any adjustments and interventions. There are changes that can be made to the environment that can help reduce people’s anxiety levels. The waiting room can be a stressful environment, particularly for those already anxious about the appointment. It is important to keep people informed about any delays while

2019 Public Health England

169. Health matters: life course approach to prevention

in the and the . Establishing vaccination status pre-pregnancy, such as , such as blood tests for infectious diseases, eye screening for diabetes and the newborn hearing, infant physical examination and blood spot screening, are recommended as timely interventions can significantly impact on vertical transmission and neonatal morbidity and mortality. Vaccinations in pregnancy help protect in 3 ways: firstly, they prevent illness and death in the pregnant women themselves, secondly, they reduce the risk of pregnancy loss (...) . Young people who are not resilient will be more likely to respond to stress by developing anxiety and depression. The components for promoting resilience combine: development of individual skills access to the right information at the right time availability of suitable or relevant or expert services and resources when they are needed tackling the wider determinants of unequal health outcome Find out more in . Improving educational attainment At this stage of the life course, schools and colleges

2019 Public Health England

170. 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

171. 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

172. 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

173. 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

174. 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

176. Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain

Quality Index PTSD Post-traumatic stress disorder QALYs Quality-adjusted life years QOL Quality of life PENS Percutaneous electrical nerve stimulation RCT Randomized controlled trial RMDQ Roland Morris Disability Questionnaire ROAD Research on Osteoarthritis/ Osteoporosis against Disability RTW Return to work SCL-90-R Symptom Checklist SEBT Star excursion balance test SF-36 Medical Outcome Study Short Form- 36 SFMPQ Short-Form McGill Pain Questionnaire Recommendations were developed based (...) levels of evidence inform the grades of recommendation and the standard nomenclature used within the recom- mendations see Appendix C. Guideline recommendations are written utilizing a standard language that indicates the strength of the recommendation. “A” recommendations indicate a test or intervention is “recommended”; “B” recom- mendations “suggest” a test or intervention and “C” recommendations indicate a test or intervention “may be considered” or “is an option.” “I” or “Insufficient Evidence

2020 American Society of Regional Anesthesia and Pain Medicine

177. KDOQI Clinical Practice Guidelines for Nutrition in CKD

.) in comparison with no intervention or minimal intervention. For assessment questions, only studies that tested the validity, reliability or relationship of an assessment tool against a comparative tool (reference standard) or mortality were included in this review. The list of titles and abstracts were independently reviewed and marked for inclusion or exclusion (along with the reason) and any differences were resolved by discussion with a third reviewer. Full texts of articles meeting inclusion criteria (...) - and over-reporting of dietary intake in this population. ? Further development and testing of dietary assessment tools to integrate technology and assist individuals with limited literacy, vision, and are culturally appropriate. Guideline on Nutrition in CKD Page 74 GUIDELINE 2: MEDICAL NUTRITION THERAPY 2.1 Statements on Medical Nutrition Therapy (MNT) MNT to Improve Outcomes 2.1.1 In adults with CKD 1-5D, we recommend that a registered dietitian nutritionist (RDN, USA or international nutrition

2020 National Kidney Foundation

179. 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

180. 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

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