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Elderly Drivers with Cognitive Impairment


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161. Management of Stroke Rehabilitation

individuals annually in the United States (U.S.). Approximately 75% of these are first-time strokes, while the remaining 25% are recurrent strokes.[2] While often viewed as a disease of the elderly, stroke can occur at any age. Approximately 10% of all strokes occur in individuals aged 18-50.[2] Currently, stroke is the fifth most common cause of death in the U.S. and a leading cause of long-term disability.[2] While younger patients may be more physically capable of recovering from stroke than older (...) /DoD Clinical Practice Guideline for the Management of Stroke Rehabilitation July 2019 Page 6 of 170 Disability from stroke can present in a myriad of ways depending on the affected area(s) of the central nervous system. The most common presentations include focal weakness and sensory disturbances, speech and swallowing impairments, vision loss or neglect, cognitive problems with inattention or memory loss, as well as emotional difficulties with mood or anxiety. The early management of stroke

2019 VA/DoD Clinical Practice Guidelines

162. Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) – (4th Edition)

in a timely manner for all patients. Ischaemic heart disease has been a significant burden to this country, and it is projected that the burden will continue to increase with the rising number of cardiovascular risk factors and an ageing population. I believe this CPG will be an invaluable guiding document for healthcare providers involved in the management of STEMI and subsequently be translated to an improved clinical outcome for patients suffering from ischaemic heart disease. DATUK DR NOOR HISHAM (...) 13.3.6 Others 95-101 14 SPECIAL GROUPS 14.1 STEMI in the Older population 14.2 STEMI in Diabetics 14.3 STEMI in Women 14.4 STEMI in Renal Disease 101-108 15 CARDIAC REHABILITATION 109-112 16 CHECK LIST FOR FOLLOW UP VISITS 112 17 PERFORMANCE MEASURES 113 18 ALGORITHMS 114-117 19 APPENDICES 118-124 20 REFERENCES 125-145 21 ACKNOWLEDGEMENTS DISCLOSURE STATEMENT SOURCES OF FUNDING 146MANAGEMENT OF ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) 2019 8 RATIONALE AND PROCESS OF GUIDELINE

2019 Ministry of Health, Malaysia

163. Registries for Evaluating Patient Outcomes: A User's Guide

of a CDM for a specific purpose, adapted from the SAFTI Net Project 88 Appendixes Appendix A. Data Harmonization and Standardization Efforts Appendix B. Key Questions When Planning To Obtain Data From Other Sources 1 Chapter 1. Health Information Technology (IT) and Patient Registries Authors (alphabetical) Robert S. Miller, M.D., FACP, FASCO Medical Director, CancerLinQ American Society of Clinical Oncology Kristi Mitchell, M.P.H. Senior Vice President, Center for Healthcare Transformation Avalere (...) and interventional procedures, the impact of environmental factors on disease, and the health needs of minorities and patients with special needs. 8 He noted that the databases comprising the learning health system could be organized per insured population, provider type, health conditions (disease registries), age cohorts, minority populations, and others. A fully realized learning health system could modernize the Medicare/Medicaid reimbursement structure, enable a coordinated national clinical trials

2019 Effective Health Care Program (AHRQ)

164. Autologous haematopoietic stem cell transplant for patients with highly active relapsing remitting multiple sclerosis not responding to high efficacy disease modifying therapies

autologous haematopoietic stem cell transplant (AHSCT) for patients with highly active relapsing remitting multiple sclerosis (RRMS) not responding to high-efficacy disease-modifying therapies (DMTs). Why is this important? The annual incidence rate of multiple sclerosis in Scotland is 8.64 cases per 100,000 people, which represents a high incidence relative to other countries. Of the total cases, around 85% of patients have the relapsing remitting form of the disease. A number of high-efficacy drug (...) cells to maintain blood counts and immunity, supportive care and close monitoring are required. This may include use of antibiotics (prophylactic and therapeutic), blood transfusions and growth factors. Epidemiology The annual incidence rate of MS in Scotland is 8.64 cases per 100,000 people. Across Scotland, incidence rates vary, ranging from 6.24 cases per 100,000 people in NHS Borders to 17.36 cases per 100,000 people in NHS Orkney, which is consistent with the association between geographical

2019 SHTG Advice Statements

165. Clostridium botulinum neurotoxin type A (Xeomin) - chronic sialorrhoea due to neurological disorders

hardship. Unmanaged drooling also has a very significant impact on unpaid carers, causing emotional distress, social isolation, and increased domestic tasks. ? Sialorrhoea is often untreated, as existing treatment options are not clinically appropriate for some people with neurological disorders. The medicines which are available may cause side effects such as dry mouth and skin irritation and they may make common cognitive and neuropsychiatric symptoms worse in patients with Parkinson’s. Sialorrhoea (...) , and atropine and recommends that glycopyrronium should be used as first-line treatment in 12 patients who have cognitive impairment, because it has fewer central nervous system side effects. 9 The National Institute for Health and Care Excellence (NICE) published Motor neurone disease: assessment and management: NICE guideline 42 in 2010 and the guidance was subsequently updated in 2019. 12 This guideline recommends that an antimuscarinic medicine should be considered as the first line treatment

2019 Scottish Medicines Consortium

166. BTS/SIGN British Guideline on the Management of Asthma

, respectively, and in section 4.3 on predicting future risk of asthma attacks, each recommendation has been graded and the supporting evidence assessed for adults and adolescents over 12 years old, children 5–12 years, and children under 5 years. Further information on managing asthma in adolescents (10–19 years of age as defined by the World Health Organization) 3 is given in section 11.2 British guideline on the management of asthma The guideline considers diagnosis of asthma and management in all (...) patients with a diagnosis of asthma, although there is less evidence available for people at either age extreme. The guideline does not cover patients whose primary diagnosis is not asthma, for example those with chronic obstructive pulmonary disease (COPD) or cystic fibrosis, but patients with these conditions can also have asthma. Under these circumstances many of the principles set out in this guideline will apply to the management of their asthma symptoms. 1.2.2 Target users of the guideline

2019 British Thoracic Society

167. Heart Disease and Stroke Statistics Full Text available with Trip Pro

. The prevalence of cardiopulmonary resuscitation training was lower in Hispanic/Latino people, older people, people with less formal education, and the lower-income group. Incidence of emergency medical services–assessed out-of-hospital cardiac arrest in people of any age was 110.8 per 100 000 population (95% CI, 108.9–112.6), or 356 461 people (quasi-CI, 350 349–362 252) based on extrapolation from the ROC registry (Resuscitation Outcomes Consortium) of out-of-hospital cardiac arrest to the total population (...) could be attributed to modifiable risk factors (such as high BP, obesity, hyperglycemia, hyperlipidemia, and renal dysfunction), and 74% could be attributed to behavioral risk factors, such as smoking, sedentary lifestyle, and an unhealthy diet. Globally, 29% of the risk of stroke was attributable to air pollution. Although global age-adjusted mortality rates for ischemic and hemorrhagic stroke decreased between 1990 and 2015, the absolute number of people who have strokes annually, as well

2019 American Heart Association

168. FSRH/BASHH Standards for Online and Remote Providers of Sexual and Reproductive Health Services

It is recommended that individuals who are aged under 16 years should be offered face-to-face consultations and that clear pathways are in place to signpost them appropriately. 1.2.6 It is recommended that all sexually active young people (16 to 18 years) should have a risk assessment performed for Child Sexual Exploitation (CSE) such as ‘Spotting the Signs’ (Appendix 2) by an appropriately trained health professional. 8 1.2.7 Services should have mechanisms for risk assessment of recreational drug and alcohol (...) (lead author) Chair FSRH Clinical Standards Committee Consultant in Community Sexual and Reproductive Healthcare, Hywel Dda University Health Board Rajul Patel FRCP Chair BASHH Clinical Standards Unit Senior Lecturer, University of Southampton, Consultant in Genitourinary and HIV Medicine, Solent NHS Trust Savita Brito-Mutunayagam MFSRH Specialist Registrar in Sexual and Reproductive Health, Honorary Research Fellow University of Aberdeen Elizabeth Carlin FRCP Immediate Past President of the British

2019 Faculty of Sexual & Reproductive Healthcare

169. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures

Examination Survey (NHANES) 2013–2016 dataset, 38.9% of US adults and 18.5% of youth aged 2–19 years had obesity (6, 7). This translates into 93.3 million adults and 13.7 million children and youth, respectively. More women (40.8%) than men (36.5%) were obese, with non-Hispanic black women (55.9%) showing the highest rates of prevalence (6, 7). Although the prevalence of obesity has been steady among adults since 2011–2012, rates of prevalence in certain subpopulations continue to rise, particularly (...) for those with severe (class III, body mass index [BMI] =40 kg/m 2 ) obesity where overall age-adjusted rates of prevalence are 5.5% and 9.8% for men and women, respectively, and 16.8% for non-Hispanic women (8). The global burden of obesity is driven by the association between BMI and increased morbidity and mortality. Although BMI is simplistic (it is only an anthropometric calculation of height-for-weight; or more specifically, weight in kilograms [kg] divided by height in meters squared) and has

2019 American Association of Clinical Endocrinologists

170. Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association

of treated HIV in the face of an aging HIV population. An older person with a history of HIV for decades likely has a distinct risk profile for CVD compared with a newly diagnosed individual who was started on newer ART immediately. PLWH have high rates of traditional risk factors, including dyslipidemia, metabolic disease, smoking, hypertension, and substance use, as described in the sections below. Aside from traditional risk factors, HIV-specific issues are implicated in CVD and include ART, chronic (...) cause of cardiomyopathy and HF in general and is common in HIV (particularly alcohol, methamphetamine, and cocaine). However, this is unlikely to be the primary driver of HF in HIV, particularly in light of the aforementioned VACS analysis demonstrating greater HF risks in HIV after the analyses were restricted to people without substance use. Cardiac arrhythmias contribute to myocardial dysfunction and may be particularly common in HIV. PLWH appear to have a several-fold greater risk of sudden

2019 American Heart Association

171. ASCIA Guidelines: Chronic Spontaneous Urticaria (CSU)

is superior to second generation antihistamines despite carrying a higher degree of sedation, anticholinergic effects and cognitive impairment (Grant et al, 1998; Monroe et al, 1992; Monroe, 1992; Breneman, 1996; Kalivas et al, 1990; Shamsi & Hindmarch, 2000). Randomised controlled trials comparing loratadine vs hydroxyzine (not available in Australia) (Monroe et al, 1992; Monroe, 1992) and cetirizine vs hydroxyzine (Breneman, 1996; Kalivas et al, 1990) did not demonstrate any significant difference (...) ; Curto 2018) and 600mg 4 weekly (Valdas 2017). Obesity, age >57 years and prior ciclosporin therapy predicts treatment failures at standard doses (Curto et al, 2018). ASCIA INFORMATION FOR HEALTH PROFESSIONALS 11 The common side effects include headache, fatigue and injection site reactions (Bernstein et al, 2018). More unusual reported side effects include serum sickness in a 12 year old girl (Eapen & Kloepfer, 2018) and transient hair loss (Konstantinou, Chioti & Daniilidis, 2016, Noshela & Thomsen

2019 Australasian Society of Clinical Immunology and Allergy

172. WHO Guideline: recommendations on digital interventions for health system strengthening

in technology. From the development of modern sanitation to the advent of penicillin, anesthesia, vaccines and magnetic resonance imaging, science, research and technology have always been key drivers of better health. It’s no different today. Advances in technology are continuing to push back the boundaries of disease. Digital technologies enable us to test for diabetes, HIV and malaria on the spot, instead of sending samples off to a laboratory. 3-D printing is revolutionizing the manufacture of medical (...) devices, orthotics and prosthetics. Telemedicine, remote care and mobile health are helping us transform health by delivering care in people’s homes and strengthening care in health facilities. Artificial intelligence is being used to give paraplegic patients improved mobility, to manage road traffic and to develop new medicines. Machine learning is helping us to predict outbreaks and optimize health services. Propelled by the global ubiquity of mobile phones, digital technologies have also changed

2019 World Health Organisation Guidelines

173. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

in approaching the various aspects of prevention with patients (S1-6). An increasing number of ideal cardiovascular health factors have been associated with a lower prevalence and incidence of ASCVD events, heart failure, atrial fibrillation, cancer, depression, and cognitive impairment (S1-7). Therefore, moving individuals toward ideal cardiovascular health is critically important for prevention of many important health conditions. The ACC/AHA Task Force on Clinical Practice Guidelines has commissioned (...) 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease Arnett et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease Page 1 of 98 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Geriatrics Society, the American

2019 American Heart Association

174. Primary Prevention of Cardiovascular Disease

cardiovascular health,” referred to as Life’s Simple 7 (S1-5). Clinicians will find the 2018 Journal of American College of Cardiology (JACC) Cardiovascular Health Promotion Series very helpful in approaching the various aspects of prevention with patients (S1-6). An increasing number of ideal cardiovascular health factors have been associated with a lower prevalence and incidence of ASCVD events, heart failure, atrial fibrillation, cancer, depression, and cognitive impairment (S1-7). Therefore, moving (...) of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Geriatrics Society, the American Society of Preventive Cardiology, and the Preventive Cardiovascular Nurses Association WRITING COMMITTEE MEMBERS Donna K. Arnett, PhD, MSPH, FAHA, Co-Chair Roger S. Blumenthal, MD, FACC, FAHA, Co-Chair Michelle A. Albert, MD, MPH, FAHA* Erin D. Michos, MD, MHS, FACC, FAHA* Andrew B. Buroker, Esq

2019 American College of Cardiology

175. AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm Full Text available with Trip Pro

be individualized based on numerous factors, such as age, life expectancy, comorbid conditions, duration of diabetes, risk of hypoglycemia or adverse consequences from hypoglycemia, patient motivation, and adherence. Glycemic control targets include fasting and postprandial glucose as determined by self-monitoring of blood glucose (SMBG). In recent years, continuous glucose monitoring (CGM) has become more available for people with T2D and has added a considerable degree of clarity for the patient's (...) approaches. In ADVANCE, the starting A1C was 7.5% (58 mmol/mol), and rates of hypoglycemia were higher in the intensive therapy group ( ). In the ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial, intensive glycemic control significantly reduced the risk and/or progression of retinopathy, nephropathy, and neuropathy ( , ). However, in ACCORD, which involved older and middle-aged patients with long-standing T2D who were at high risk for or had established ASCVD and a baseline A1C >8.5% (69

2019 American Association of Clinical Endocrinologists

176. Impaired updating ability in drivers with Parkinson's disease. Full Text available with Trip Pro

Impaired updating ability in drivers with Parkinson's disease. Driving activity requires major involvement of executive functions. The main objective of our study was to determine whether mental flexibility and the updating of information in working memory are affected in drivers with mild to moderate Parkinson's disease (PD).The study included 25 patients, aged 58-76, with mild to moderate PD and 25 healthy controls matched for age, sex and education, with an average mileage of over 3000 km (...) -processing speed task) while driving.An updating impairment was found in PD patients in the n-back and simulator tasks; patients recalled significantly fewer road signs. No notable differences were observed between groups in the plus-minus task or in the simulator task evaluating flexibility. There was no significant difference between patients and controls in information-processing speed tasks. Regression analysis showed that the Trail-Making test (B-A) accounted for 40.7% of the variation in PD drivers

2010 Neurosurgery and Psychiatry

177. Later school start times for supporting the education, health, and well?being of high school students: a systematic review Full Text available with Trip Pro

were associated with better grades and a higher motivation to do well in school. In a further critical review of the literature relating sleep loss to learning capacity and academic performance, researchers found evidence that sleep loss was associated with poorer memory, computational speed, problem solving, verbal creativity, abstract thinking, executive functioning, and other higher level cognitive functioning ( ), all aspects that are related to school performance and educational outcomes (...) body of literature on the effects of even mild sleep deprivation on young people, with research pointing to associations between insufficient sleep and depression ( ), substance use ( ), and poor academic performance ( ). Additionally, governmental groups have offered guidance for possible adjustments to school start times in the hopes of increasing sleep duration (ASWG 2014). At the request of parents, teachers, school council members and others, school administrators and educational policymakers

2017 Campbell Collaboration

178. Atrial Fibrillation Full Text available with Trip Pro

best practice use of antiarrhythmic drugs • increasing availability of AF ablative procedures; • an increasing prevalence of AF in older people and Aboriginal and Torres Strait Islander peoples. International guidelines on the diagnosis and management of AF are available [ x [1] Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B. et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J . 2016 ; | | , x [2] January (...) updated recommendations reflecting more recent evidence generation. 2. Key Recommendations Recommendation GRADE quality of evidence GRADE strength of recommendation Screening and prevention—screening for silent atrial fibrillation (AF) Opportunistic point-of-care screening in the clinic or community should be conducted in people aged 65 years or more. Moderate Strong Screening for asymptomatic AF in patients with pacemakers and implanted devices Pacemakers and defibrillators should be interrogated

2018 Cardiac Society of Australia and New Zealand

179. Heart Failure Full Text available with Trip Pro

decisions should carefully consider individual patient characteristics with known associations with poor prognosis due to vulnerability. These include cultural and linguistic diverse populations including recent migrants; Indigenous Australians; the cognitively impaired; those living in rural or remote areas; people of advanced age; and those who are incarcerated or institutionalised. 3. Definition and Classification of Heart Failure 3.1. Epidemiology of Heart Failure Heart failure currently affects (...) ., and McGill, D.A. Prevalence of heart failure and systolic ventricular dysfunction in older Australians: the Canberra Heart Study. Med J Aust . 2006 ; 184 : 151–154 | | , x [7] Sahle, B.W., Owen, A.J., Mutowo, M.P., Krum, H., and Reid, C.M. Prevalence of heart failure in Australia: a systematic review. BMC Cardiovasc Disord . 2016 ; 16 : 32 | | ], and the National burden of heart failure has been estimated using international prevalence rates. In 2014, it was estimated that there were 480,000 people aged

2018 Cardiac Society of Australia and New Zealand

180. Adult Type 1 diabetes mellitus

Excellence (NICE) NG17 “Type 1 diabetes in adults: diagnosis and management” guideline, published in 2015. Using this National Clinical Guideline This National Clinical Guideline applies to adults (aged 18 years and older) with type 1 diabetes in Ireland. It does not apply to children living with type 1 diabetes, adults living with type 2 diabetes or individuals living with monogenic (or other rarer forms of) diabetes. This National Clinical Guideline is relevant to all healthcare professionals working (...) , see the full guideline (https://www.nice. Table 3: Members of the NICE Guideline Development Group Name Job title and affiliation Stephanie Amiel Professor of Diabetic Medicine, King’s College London Augustin Brooks Consultant Diabetologist, Bournemouth Hospital Arthur Durrant Patient member Michael Flynn Consultant Physician, Kent and Canterbury Hospital Roger Gadsby Visiting Professor, Institute of Diabetes in Older People, University of Bedfordshire; GP

2018 National Clinical Guidelines (Ireland)

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