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141. Enhancing Health System Integration of Nurse Practitioners in Ontario

that nurse practitioners have longer consultations and patients request more follow-up visits, but all of the reviews cited limitations as a result of the quality and amount of evidence available. • Improved patient satisfaction for care provided by nurse practitioners was found in emergency departments, long-term care, as well as care provided in rural and remote communities, and no significant differences were found for oncology care provided by nurse practitioners and in a comparison of nurse (...) costs resulted from lower salaries and a reduced number of patient visits, and that families who were cared for by nurse practitioners spent half the amount compared to families who saw dermatologists (accounted for by time costs and out-of-pocket expenditures).(29) The primary study compared outcomes for patients with rheumatoid arthritis who were cared for by a team that included a nurse practitioner to those that did not include a nurse practitioner.(43) The longitudinal study found supportive

2018 McMaster Health Forum

142. Reducing Acute Care Length of Stay in Newfoundland & Labrador

& Labrador Centre for Applied Health Research, established in 1999, contributes to the effectiveness of the health and community services system of the province and the physical, social, and psychological well-being of the population. NLCAHR accomplishes this mandate by building capacity in applied health research, supporting high quality research, and fostering more effective use of research evidence by decision makers and policy makers in the province’s health system. About the Contextualized Health (...) interventions: ? based on the involvement of pharmacists; 3 ? involving the planning, coordination, and delivery of outpatient services; or ? requiring new infrastructure investments. Comparator(s) Standard or usual care. Outcome(s) Average Length of Stay (ALOS) is the primary outcome of interest for this project. ALOS is generally defined as the period of time that a patient remains in hospital for of a single episode of care, based on the number of nights the patient spent in hospital. A patient who

2018 Newfoundland and Labrador Centre for Health Information

143. Agitation and Aggression in Long-Term Care Residents with Dementia

review of the literature. J Psychiatr Ment Health Nurs. 2014 Dec;21(10):879–88. 17. Brasure M, Jutkowitz E, Fuchs E, Nelson VA, Kane RA, Shippee T, et al. Nonpharmacologic Interventions for Agitation and Aggression in Dementia [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016. Available from: 18. Chang Y-S, Chu H, Yang C-Y, Tsai J-C, Chung M-H, Liao Y-M, et al. The efficacy of music therapy for people with dementia: A meta (...) -analysis of randomised controlled trials. J Clin Nurs. 2015 Dec;24(23–24):3425–40. 19. Disalvo D, Luckett T, Agar M, Bennett A, Davidson PM. Systems to identify potentially inappropriate prescribing in people with advanced dementia: a systematic review. BMC Geriatr. 2016 May 31;16:114. 20. Jutkowitz E, Brasure M, Fuchs E, Shippee T, Kane RA, Fink HA, et al. Care-Delivery Interventions to Manage Agitation and Aggression in Dementia Nursing Home and Assisted Living Residents: A Systematic Review and Meta

2018 Newfoundland and Labrador Centre for Health Information

144. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD

5600 Fishers Lane Rockville, MD 20857 Contract No. 290-2015-00013-I Prepared by: Mayo Clinic Evidence-based Practice Center Rochester, MN Investigators: Claudia C. Dobler, M.D., Ph.D. Allison S. Morrow, B.A. Magdoleen H. Farah, M.B.B.S. Bradley Beuschel, B.S.P.H. Abdul M. Majzoub, M.D. Michael E. Wilson, M.D. Bashar Hasan, M.D. Mohamed O. Seisa, M.D. Lubna Daraz, Ph.D. Larry J. Prokop, M.L.S. M. Hassan Murad, M.D., M.P.H. Zhen Wang, Ph.D. AHRQ Publication No. 19(20)-EHC024-EF October (...) questions about the optimal nutritional support for patients with ECOPD. 31, 32 Established treatments for ECOPD, such as antibiotics and systemic corticosteroids, may not be indicated in every single episode of an ECOPD. One uncertainty relates to the need for antibiotics in mild and moderately severe ECOPD, especially in an outpatient setting. 33 While antibiotics for treatment of severe ECOPD have been shown to be beneficial in some studies, the need for antibiotics in less severe forms of COPD

2019 Effective Health Care Program (AHRQ)

145. Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory

or by palliative care specialists may be FIGURE 1 Clinical Course of Heart Failure Improving towards target Improving towards target Not improved/ worsening Stalled Focus of Care Transition to Oral Therapies Admission Discharge First Follow-up Visit Clinical decompensation Discharge coordination Ongoing optimization of outpatient care Guideline-directed medical therapy Evaluation for long-term trajectory Early acute phase Late acute phase Optimization phase Early post- discharge phase Transition to chronic (...) Patients Hospitalized with Heart Failure: Risk Assessment, Management, and Clinical Trajectory EXPERT CONSENSUS DECISION PATHWAY 2019 ACC Expert Consensus Decision PathwayonRiskAssessment, Management, and Clinical Trajectory of Patients Hospitalized With Heart Failure A Report of the American College of Cardiology Solution Set Oversight Committee Writing Committee Steven M. Hollenberg, MD, FACC, Chair Lynne Warner Stevenson, MD, FACC, Vice Chair Tariq Ahmad, MD, MPH, FACC Vaibhav J. Amin, MD

2019 American College of Cardiology

146. Recommendations for Prevention and Control of Influenza in Children, 2019–2020

of outpatient clinic and emergency department visits for influenzalike illness, high influenza-related hospitalization rates, and high numbers of deaths. – Influenza A(H3N2) viruses predominated through February 2018; influenza B viruses predominated from March 2018 onward. Although hospitalization rates for children that season did not exceed those reported during the 2009 pandemic, they did surpass rates reported in previous high-severity A(H3N2)-predominant seasons. Excluding the 2009 pandemic, the 186 (...) season, replacing the LAIV3. The most commonly reported reactions in children are runny nose or nasal congestion, headache, decreased activity or lethargy, and sore throat. The safety of LAIV in people with a history of asthma, diabetes mellitus, or other high-risk medical conditions associated with an elevated risk of complications from influenza (see Contraindications and Precautions) has not been firmly established. In postlicensure surveillance of LAIV (including LAIV3 and LAIV4), the Vaccine

2019 American Academy of Pediatrics

147. Guidelines for the Economic Evaluation of Health Technologies in Ireland

) is an independent authority established to drive high-quality and safe care for people using our health and social care services in Ireland. HIQA’s role is to develop standards, inspect and review health and social care services and support informed decisions on how services are delivered. HIQA aims to safeguard people and improve the safety and quality of health and social care services across its full range of functions. HIQA’s mandate to date extends across a specified range of public, private and voluntary (...) at SAG meetings as appropriate ? be prepared to occasionally provide expert advice on relevant issues outside of SAG meetings, as requested ? support HIQA in the generation of guidelines to establish quality standards for the conduct of HTA in Ireland ? support HIQA in the development of methodologies for effective HTA in Ireland ? advise HIQA on its proposed HTA Guidelines Work Plan and on priorities as required ? support HIQA in achieving its objectives outlined in the HTA Guidelines Work Plan

2019 Health Information and Quality Authority

148. Recurrent Uncomplicated Urinary Tract Infections in Women

of urinary tract infections (UTIs) in the operative or procedural setting. In this document, the term UTI will refer to acute bacterial cystitis unless otherwise specified. This document seeks to establish guidance for the evaluation and management of patients with rUTIs to prevent inappropriate use of antibiotics, decrease the risk of antibiotic resistance, reduce adverse effects of antibiotic use, provide guidance on antibiotic and non-antibiotic strategies for prevention, and improve clinical outcomes (...) as at least two culture-proven symptomatic uncomplicated acute cystitis episodes in six months or three within one year in which symptom resolution occurred between culture- proven events. Microbial confirmation at the time of acute-onset urinary tract-associated symptoms and signs, which primarily include dysuria, urinary frequency and urgency, and new or worsening incontinence with or without gross hematuria, is a critical component to establish a diagnosis of rUTI. Continued documentation of cultures

2019 American Urological Association

149. Acute Treatment of Migraine in Children and Adolescents

Nicole Licking, DO, 8 Michael Sowell, MD, 9 M. Cristina Victorio, MD, 10 Elaine M. 7 Gersz, 11 Emily Leininger, 12 Heather Zanitsch, 13 Marcy Yonker, MD, 14 Kenneth Mack, MD, 8 PhD, 15 9 10 1. Departments of Pediatric and Neurology/Neurosurgery, McGill University, Montréal, 11 Canada 12 2. Department of Pediatrics (Neurology), Northwestern University Feinberg School of 13 Medicine, Chicago, IL 14 3. Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health 15 Sciences, Cumming (...) subcommittee meetings where drafts of manuscripts were reviewed. All authors on the panel 14 were reimbursed by the AAN for expenses related to travel to in-person meetings. 15 16 17 18 19 5 1 2 3 4 5 6 DISCLOSURES 7 M. Oskoui has no relevant disclosures for this guideline. 8 Y. Holler-Managan serves on the editorial advisory board for Neurology Now. 9 T. Pringsheim has no relevant disclosures for this guideline. 10 S. Potrebic has received funding from the AAN for travel to biennial Guidelines

2019 American Academy of Neurology

150. Safe Delivery of paediatric ENT surgery in the UK- a national strategy

):453-60. 27. Slovik Y, Tal A, Shapira Y, Tarasiuk A, Leiberman A. Complications of adenotonsillectomy in children with OSAS younger than 2 years of age. Int J Pediatr Otorhinolaryngol. 2003;67(8):847-51. 28. Kalantar N, Takehana CS, Shapiro NL. Outcomes of reduced postoperative stay following outpatient pediatric tonsillectomy. Int J Pediatr Otorhinolaryngol. 2006;70(12):2103-7. 29. Theilhaber M, Arachchi S, Armstrong DS, Davey MJ, Nixon GM. Routine post-operative intensive care is not necessary (...) DG, et al. A pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA. Int J Pediatr Otorhinolaryngol. 2011;75(11):1385-90. 33. McCormick ME, Sheyn A, Haupert M, Thomas R, Folbe AJ. Predicting complications after adenotonsillectomy in children 3 years old and younger. Int J Pediatr Otorhinolaryngol. 2011;75(11):1391-4. 34. Horwood L, Nguyen LH, Brown K, Paci P, Constantin E. African American ethnicity

2019 Association of Paediatric Anaesthetists of Great Britain and Ireland

151. Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Luminal Crohn’s Disease

, naltrexone, and enteral nutrition. Only human studies published in English were considered; fur- ther details regarding the search strategies used for preparing the initial consensus statements can be found in Supplementary Appendix 1. Additional focused (but non-systematic) searches were also performed up to the September 2016 consensus meeting. Review and Grading of Evidence Two non-voting methodologists (G.L., P .M.) used the GRADE approach 11 to assess the risk of bias (of individual studies (...) assessed symptomatically without endoscopy; therefore, the QoE was often downgraded for indirect outcomes, resulting in a low or very low QoE, making it difficult to approve strong recommendations in many cases. At the meeting, the group was unable to reach consensus on 5 of the initial statements (No recommendation A–E); thus, these statements were rejected. In addition, because of the ab- sence of evidence the group decided not to vote on 2 statements (No recommendation F and G) regarding strategies

2019 Canadian Association of Gastroenterology

152. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

. Carpenter, MD 23 Deborah B. Diercks, MD, MSc 24 Seth R. Gemme, MD 25 Charles J. Gerardo, MD, MHS 26 Steven A. Godwin, MD 27 Sigrid A. Hahn, MD, MPH 28 Nicholas E. Harrison, MD (EMRA Representative 2017-2019) 29 Benjamin W. Hatten, MD, MPH 30 Jason S. Haukoos, MD, MSc (Methodologist) 31 Amy Kaji, MD, MPH, PhD (Methodologist) 32 Heemun Kwok, MD, MS (Methodologist) 33 Bruce M. Lo, MD, MBA, RDMS 34 Sharon E. Mace, MD 35 Devorah J. Nazarian, MD 36 Jean Proehl, RN, MN, CEN, CPEN, TCRN (ENA Representative 2015 (...) -2019) 37 Susan B. Promes, MD, MBA 38 Kaushal H. Shah, MD 39 Richard D. Shih, MD 40 Scott M. Silvers, MD 41 Michael D. Smith, MD, MBA 42 Molly E. W. Thiessen, MD 43 Christian A. Tomaszewski, MD, MS, MBA 44 Jonathan H. Valente, MD 45 Stephen P. Wall, MD, MSc, MAEd (Methodologist) 46 Stephen V. Cantrill, MD (Liaison with the ACEP Quality and Patient Safety Committee and the E-QUAL Steering 47 Committee) 48 Jon M. Hirshon, MD, PhD, MPH (Board Liaison 2016-2019) 49 Travis Schulz, MLS, AHIP, Staff

2019 American College of Emergency Physicians

153. Home-Based Cardiac Rehabilitation: Scientific Statement

services (e.g., medications, outpatient care, inpatient care), 2 reports found no signi?cant difference in use between HBCR and CBCR (41,70), and 1 study reported fewer medical visits and hospitalizations with HBCR (53). Quality-adjusted life-years were reported in 2 studies, and both found no signi?cant difference in quality-adjusted life-years be- tweenHBCRandCBCR(41,70).OnestudyfromtheUnited Statesincludedlimitedcostdataandsuggestedthatcosts may be lower for HBCR compared with CBCR (35). Risk (...) are generally not covered by third-party payers in the United States. One exception is the MULTIFIT home-based pro- gram implemented at Kaiser Permanente Northern Cali- fornia (77). This nurse-based case management system starts during hospitalization for acute MI or revasculari- zation and is followed over the subsequent 6 months by up to 12 nurse-initiated telephone contacts, up to 4 outpatient visits with a nurse case manager, and computer-generated progress reports based on patient

2019 American College of Cardiology

154. National Early Warning Score

and available resources.National Clinical Effectiveness Committee (NCEC) The National Clinical Effectiveness Committee (NCEC) was established as part of the Patient Safety First Initiative in September 2010. The NCECs mission is to provide a framework for national endorsement of clinical guidelines and audit to optimise patient and service user care. The NCEC has a remit to establish and implement processes for the prioritisation and quality assurance of clinical guidelines and clinical audit so (...) and clinical treatment. • Any outpatient/day service patients who attend acute hospitals for an invasive procedure or who receive sedation. • All patients attending an Acute Medical Unit/Acute Medical Assessment Unit/Medical Assessment Unit. The National Clinical Guideline applies to healthcare professionals, doctors, nurses, physiotherapists and other staff involved in the clinical care of patients and managers responsible for the development, implementation, review and audit of deteriorating patient

2019 National Clinical Guidelines (Ireland)

155. Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland

Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland Surveillance, Diagnosis and Management of Clostridium difficile Infection in Ireland National Clinical Guideline No. 3 June 2014National Clinical Effectiveness Committee (NCEC) The National Clinical Effectiveness Committee (NCEC) was established as part of the Patient Safety First Initiative in September 2010. The NCECs mission is to provide a framework for national endorsement of clinical guidelines and audit (...) to optimise patient and service user care. The NCEC has a remit to establish and implement processes for the prioritisation and quality assurance of clinical guidelines and clinical audit so as to recommend them to the Minister for Health to become part of a suite of National Clinical Guidelines and National Clinical Audit. National Clinical Guidelines are “systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and service users’ decisions about

2019 National Clinical Guidelines (Ireland)

156. Brief psychological interventions for young people with common mental health conditions

. 2015;20(1):49-55. 34. Piet J, Hougaard, E., Hecksher, M. S. & Rosenberg, N. K. . A randomized pilot study of mindfulness- based cognitive therapy and group cognitive- behavioral therapy for young adults with social phobia. Scandinavian Journal of Psychology. 2010;51:403–410. 35. Walsh E, Eisenlohr-Moul T, Baer R. Brief mindfulness training reduces salivary IL-6 and TNF-alpha in young women with depressive symptomatology. J Consult Clin Psychol. 2016 Oct;84(10):887-97. 36. Baer RA. Mindfulness Training (...) as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology: Science and Practice. 2003;10(2):125-143. 37. Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010 Jun;68(6):539-44. 38. Fjorback LO, Arendt M, Ornbol E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review

2019 Orygen, The National Centre of Excellence in Youth Mental Health

157. What is the evidence on availability and integration of refugee and migrant health data in health information systems in the WHO European Region?

, was established at the WHO Regional Office for Europe in 2011 to support Member States to strengthen the health sector’s capacity to provide evidence-informed responses to the public health challenges for refugee and migrant health. The programme operates under the umbrella of the European health policy framework Health 2020 and provides support to Member States under four pillars: technical assistance; health information, research and training; policy development; and advocacy and communication (...) systems for the general population because this is also likely to improve the availability of data on refugee and migrant health; • integrate key data elements related to refugees and migrants (e.g. country of birth, nationality, length of stay, reason for migration) into existing data collection systems to facilitate stratified data analysis, identify at-risk subgroups and ensure cross-border comparability; • establish and/or strengthen a tailored, proactive approach to data collection for refugees

2019 WHO Health Evidence Network

158. What are the roles of intercultural mediators in health care and what is the evidence on their contributions and effectiveness in improving accessibility and quality of care for refugees and migrants in the WHO European Region?

and Health programme, formerly known as Public Health Aspects of Migrants in Europe (PHAME), was established in 2011 to support Member States of the WHO European Region to strengthen the health sector’s capacity to provide evidence-informed responses to the public health challenges of refugee and migrant health. The programme operates under the umbrella of the European health policy framework Health 2020. The programme provides support to Member States under four pillars: technical assistance; health (...) providers were found to be lacking. Policy considerations Based on the review findings, the following policy considerations to improve the equity of health services for refugees and migrants can be considered by Member States: • establish clear and coherent definitions of the roles and responsibilities of intercultural mediators working in the health sector; • establish professional guidelines, standards and quality assurance processes to support the recognition and full professionalization

2019 WHO Health Evidence Network

159. Multiplex polymerase chain reaction gastrointestinal pathogen panels for people with suspected gastroenteritis

of infectious intestinal disease. Clin Infect Dis. 2012;54(9):1275-86. 11. 11. Woodward DL, Clark CG, Caldeira RA, Ahmed R, Rodgers FG. Verotoxigenic Escherichia coli (VTEC): a major public health threat in Canada. Can J Infect Dis. 2002;13(5):321-30. 12. 12. Locking ME, Pollock KG, Allison LJ, Rae L, Hanson MF, Cowden JM. Escherichia coli O157 infection and secondary spread, Scotland, 1999-2008. Emerg Infect Dis. 2011;17(3):524-7. 13. 13. Farthing M, Salam MA, Lindberg G, Dite P, Khalif I, Salazar-Lindo E (...) of the infection. The majority of cases resolve within several days without the need for treatment 2 . As such, most cases are self-managed in the community. If severe or persistent symptoms occur, patients may require admission to hospital for observation and symptom management. SHTG Evidence Synthesis | 6 In a minority of cases, infectious pathogens can cause complications which lead to chronic illness or mortality. Infectious gastroenteritis caused by toxin-producing pathogens, such as Verotoxigenic E. coli

2019 SHTG Advice Statements

160. Challenges with Implementing the Centers for Disease Control and Prevention Opioid Guideline: A Consensus Panel Report Full Text available with Trip Pro

, USA. Tel: 317-274-9046; Fax: 317-274-9304; E-mail: . Search for other works by this author on: Daniel P Alford, MD, MPH Boston University School of Medicine, Boston, Massachusetts Search for other works by this author on: Charles Argoff, MD Albany Medical College, Albany, New York Search for other works by this author on: Bernard Canlas, MD Veterans Affairs Puget Sound Health Care System, Seattle, Washington Search for other works by this author on: Edward Covington, MD Cleveland Clinic, Cleveland (...) by this author on: Stefan G Kertesz, MD, MSc Birmingham Veterans Affairs Medical Center, Birmingham, Alabama Search for other works by this author on: Richard L Kravitz, MD, MSPH Department of Internal Medicine, University of California, Davis, California Search for other works by this author on: Erin E Krebs, MD, MPH Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota Search for other works by this author on: Steven P Stanos, Jr., DO Swedish Health System, Seattle, Washington Search

2019 American Academy of Pain Medicine

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