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4441. Preventing and Mitigating Nurse Fatigue in Health Care

prohibition or limitation against copying appears, the balance of this document may be produced, reproduced and published in its entirety, without modification, in any form, including in electronic form, for educational or non-commercial purposes. Should any adaptation of the material be required for any reason, RNAO written permission must be obtained. Appropriate credit or citation must appear on all copied materials as follows: Registered Nurses’ Association of Ontario. (2011). Preventing

2011 Registered Nurses' Association of Ontario

4442. Oral anticoagulation with warfarin - 4th edition

( ) and then report their INR to a healthcare professional who is then responsible for dosing advice. Such advice can be given verbally initially but should also be sent in writing or electronically ( ). Alternatively, patients may be trained to both monitor their INR and adjust their dose of warfarin based upon the result. In a recent Cochrane systematic review, patients who self‐monitored or self‐managed their anticoagulants improved the overall quality of their oral anticoagulation therapy compared to standard (...) and to improve overall anticoagulation control in patients with an unexplained instability of response to warfarin ( ; ; ; ). 10.5 Patient records All patients on warfarin should have a written copy of their lNR result, which should indicate any dose changes that are necessary and the date for the next INR check. Patients should be aware of the reasons for anticoagulation, their target INR and the duration of treatment. 10.6 Drug interactions Many drugs, whether prescribed, over the counter, herbal

2011 British Committee for Standards in Haematology

4443. Laboratory investigation of heritable disorders of platelet function

) ( ). There is very sparse peer review literature comparing impedance and LTA methods and a lack of clinical validation in the diagnosis of heritable platelet function defects. Other tests Platelet alpha granule proteins [e.g. Platelet Factor 4 (PF4) and Beta‐Thromboglobulin (βTG)] can be measured by ELISA, radioimmunoassay or Western blotting and may be helpful for the diagnosis of Quebec platelet disorder ( ). Electron microscopy has also proven very useful for defining ultrastructural abnormalities associated (...) with a variety of platelet defects ( ). The simpler whole mount electron microscopy technique has proven useful for confirming dense granule defects ( ). Molecular genetic diagnosis of heritable platelet disorders may offer valuable confirmation of diagnosis in affected individuals, in family members where phenotypic testing of platelets is impractical and for ante‐natal diagnosis. Molecular diagnosis is most feasible in GT and BSS where the number of candidate genes is small and there are already accessible

2011 British Committee for Standards in Haematology

4444. Effective Smoking Cessation Strategies in Primary Care

benefit-risk balance” for use of varenicline. Varenicline use has also been associated with the occurrence of neuropsychiatric side effects, including depressed mood, thoughts of harm to self and others, agitation, hostility and behavioural changes. Health Canada endorsed a safety announcement from Pfizer (13) stating that of the 708 534 varenicline prescriptions filled in Canada between April 2007 and 30 April 2008, 226 Canadian cases of neuropsychiatric adverse events were reported. Prescribers (...) of electronic medical records to assist physician cessation practice. 4 1 Issue Smoking remains the single largest preventable cause of disease and premature death. It is responsible for 30% of all cancer deaths. Smokers have a 70% greater chance of dying from coronary heart disease than non-smokers. Currently in Peel Region, approximately 15.5% (1) of the population, aged 15 years and older, are smokers. Thus, more than 170,500 individuals are at an increased risk of tobacco-related illness. Peel Public

2011 Peel Health Library

4445. Health Literacy Interventions and Outcomes: An Update of the Literacy and Health Outcomes Systematic Review of the Literature

discussion. Results Search Results and Included Studies Our searches of electronic databases and review articles produced 3,496 unduplicated records. Ultimately, for the two main questions, we included studies rated either good or fair quality: 81 studies (95 articles) addressed Key Question 1 and 42 studies (45 articles) addressed Key Question 2. Key Question 1 results are presented separately in relation to health literacy (86 articles) and numeracy (16 articles). Of these, we identify the 7 articles (...) . The strength of evidence for the many other outcomes we examined adherence, self-efficacy, smoking, alcohol use, healthy lifestyle, review of prescription information, HIV risks and sexual behaviors, chronic disease prevalence, HIV severity and symptoms, asthma severity and control, diabetes control and related symptoms, hypertension control, prostate cancer control, quality of life, and costs was either low or insufficient. The literature consisted of only a small number of studies, poorly designed

2011 Effective Health Care Program (AHRQ)

4447. Stroke Prevention in the Setting of a Patent Foramen Ovale: A ?Hole? in the Evidence

was prescribed daily aspirin for secondary prevention of future strokes. Due to the lack of evidence for the optimal management strategy, the risks and benefits of the various management options were considered. In order to select the optimal management strategy, it is important to note that this was the patient’s first episode of a cryptogenic stroke. Given the similar efficacy of aspirin and warfarin according to the PICSS trial, as well as the increased risk of minor hemorrhages with warfarin therapy (...) ” in the Evidence ” Comments are closed. Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

4448. Working Arrangements for Consultant Anaesthetists in the United Kingdom

and duration of work that an individual consultant undertakes. An ongoing diary of work activity is accurate, is individually specific and can accommodate the normal workload variation between working weeks for a consultant anaesthetist. There are several electronic diary systems available, both commercial and freely available. An appropriate diary system must be capable of recording the time spent on different work activities and should deliver information acceptable to both parties in a job plan (...) spent on these activities in aggregate so as to ensure that the prescribed balance of activities is being delivered. After all, a typical consultant anaesthetist is paid about 20% of his/her pay slip income for these 2.5 SPAs in his/her job plan. This is also where job planning objectives come in. By agreeing objectives and working towards them, one can take to the job plan review or the appraisal meeting a record of the outcomes achieved during SPA time. This is not only valuable to keep track

2011 Association of Anaesthetists of GB and Ireland

4449. Early Repolarization: Not as Innocent as Once Thought!

the medication. In addition, catheter ablation was shown to eliminate ectopy in approximately 60% of the population studied (five out of a total of eight subjects evaluated); however, this was only a short term elimination. Although these interventions were focused on a small number of patients evaluated, there appears to be some promising preventive and/or curative measures which need to be further studied before costly procedures and medications should be prescribed for this particular patient population (...) . Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

4450. Best Practice in the Management of Epidural Analgesia in the Hospital Setting

regimens for children must be adapted for age and weight with maximum dosage clearly defined to minimise the risk of cumulative local anaesthetic toxicity, especially in neonates and infants < three months of age. 11 9.3 Clear protocols for prescription, monitoring and troubleshooting of paediatric epidural infusions should be used. Infusion devices should be programmed and double checked with extreme care as there is an increased risk of error when managing small infants and neonates. 129 9.4 Hourly (...) for parents and older children 13 is available on the Royal College of Anaesthetists’ website.10 Best pr ac tic e in the management of epidur al anal gesia in the hospit al set ting 10 Documentation, guidelines and protocols 10.1 Contemporaneous records must be kept of events throughout the period of epidural analgesia. This includes consent, insertion and removal of the catheter, prescription of the infusion, monitoring, additional doses and notes about any complications or adverse events. 10.2 Safety

2011 Association of Anaesthetists of GB and Ireland

4451. Clinical practice guidelines for surveillance colonoscopy - in adenoma follow-up; following curative resection of colorectal cancer; and for cancer surveillance in inflammatory bowel disease (December 2011)

to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from Cancer Council Australia to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Copyright Officer, Cancer Council Australia, GPO Box 4708, Sydney NSW 2001, Australia. Website: www.cancer.org.au Email: info@cancer.org.au ISBN: 978-0-9807421-4-5 Suggested citation: Cancer Council Australia Colonoscopy Surveillance Working Party (...) preference in each individual case. The guidelines are designed to provide information to assist in decision-making. They are based on the best evidence available at time of compilation. The guidelines are not meant to be prescriptive. These guidelines can be accessed from the Cancer Council Australia Cancer Guideline Portal at http://wiki.cancer.org.au/australia/Guidelines:Colorectal_cancer/Colonoscopy_surveillance

2011 Clinical Practice Guidelines Portal

4452. These Guardian / Independent stories are dodgy. Traps in data journalism.

from 2000 to 2005 – the boom before the bust these journalists are writing about – antidepressant prescribing also increased, by 36%. This isn’t very different to 43%, so it feels unlikely that the present increase in prescriptions is due to the recession. That’s not the only problem here. It turns out that the number of prescriptions for an SSRI drug is a rubbish way of measuring how many people are being treated for depression: not just because people get prescribed SSRIs for all kinds of other (...) things, like anxiety, PTSD, hot flushes, and more; and not just because doctors have moved away from older types of antidepressants, so would be prescribing more of the newer SSRI drugs even if the number of people with depression had stayed the same. Excitingly, it’s a bit more complicated than that. A looked at prescribing and diagnosis rates in Scotland. Overall, again, the number of prescriptions for antidepressants increased from 1.5 million in 1996 to lion in 2001 (that is, it almost doubled

2011 Bad Science

4453. Dance Therapy in Parkinson?s Disease: Can the Argentine Tango Improve Motor Function?

backwards.[5] Traditionally, physical therapy is prescribed along with medical treatment to address these symptoms. In 2007, Keus and colleagues made evidence-based recommendations regarding the four key components of physical therapy design for PD patients: 1) cueing strategies to improve gait; 2) cognitive movement strategies to improve transfers of weight; 3) exercises to improve balance; and 4) training of joint mobility and muscle power to improve physical capacity.[6] Based (...) :109-127. Share: | | 2 comments on “ Dance Therapy in Parkinson’s Disease: Can the Argentine Tango Improve Motor Function? ” Comments are closed. Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

4454. Medicine By Numbers: 131 Million

1. Available from: [3] Heavey S. FDA seeks less acetaminophen in prescription drugs. Reuters ; 2011 January 13. Available from: [4] Costelloe C., et al. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. British Medical Journal . 2010;340:c2096. Available from: Share: | | Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030 (...) Medicine By Numbers: 131 Million Medicine By Numbers: 131 Million – Clinical Correlations Search Medicine By Numbers: 131 Million October 28, 2011 4 min read By Maryann Kwa, MD Faculty Peer Reviewed 131 million : The number of times the most popular medication in the United States was prescribed in 2010. Recently, IMS Health, a company that monitors annual sales for pharmaceutical and healthcare industries, published a list of the most prescribed [1]. Medication Number of Prescriptions in 2010

2011 Clinical Correlations

4455. From The Archives: The Skinny on Cachexia?Can it be Treated?

thrombosis, hypertension, impotence, edema, and suppression of the pituitary-adrenal axis. In cancer patients, who already have an increased risk of thrombosis, the physician must prescribe judiciously. Dronabinol (Marinol) and nabilone (Cesamet) are cannabinoids that are often used to treat chemotherapy related nausea and vomiting. Cannabinoids work on central CNS receptors, and have also been found to improve appetite in cancer and AIDS patients. However, this class was found to induce weight gain only (...) Medical Center Share: | | Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

4456. Red Yeast Rice: Nature?s Statin?

level, since both of her parents died of heart disease; however, she is hesitant to take a prescription medication due to the side effects she experienced. She asks you about red yeast rice (RYR). She says that her neighbor noticed a dramatic drop in her LDL after starting this dietary supplement. Red yeast rice ( Monascus purpureus ) is a food additive used in Chinese cooking that has been found to decrease serum cholesterol levels.[1] Its popularity has been rapidly growing in the United States (...) : Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

4457. Personal Responsibility and Medicine Today

such an experiment.[3] The approved new plan, Mountain Health Choices, permits West Virginia to offer two types of Medicaid plans, a Basic Plan and an Enhanced one. Any person eligible for Medicaid is automatically enrolled in the Basic Plan. For children, the Basic Plan includes both inpatient and outpatient services, limited home health, limited non-emergency medical travel, four prescription drugs per month, and limited vision and dental coverage. For adults, the Basic Plan covers inpatient and outpatient (...) services, limited home health, nursing home services, four prescriptions per month, and limited non-emergency medical travel. As expected, the Enhanced Plan offers many more services. For children, these include skilled nursing care, prosthetics/orthotics, diabetes care, nutrition counseling, and mental health services. Under the Enhanced Plan, adults are eligible for cardiac rehab, diabetes care, nutrition counseling, tobacco cessation programs, and most importantly mental health services. In order

2011 Clinical Correlations

4458. Could it be your medicine? Common symptoms that could be causedby adverse drug reactions

reactions to drugs, and a relationship between the drugs or classes of drugs most frequently implicated. The list could represent a helpful tool for the e-prescribing software of the electronic medical record. Key words: adverse reactions, drug induced symptoms, pharmacovigilance. Author : Javier Garjón. Drug Prescribing Service, Navarre Regional Health Service. Spain Enviar comentario You can send us a comment or suggestion and we will respond to most frequently asked questions Competing interests

2011 Drug and Therapeutics Bulletin of Navarre (Spain)

4459. Avastin and the Meaning of Evidence

cancer [13, 14] Hua and colleagues have reported an association between VEGF polymorphism and survival in breast cancer, which might be explored in relation to treatment responses.[15] Surely, it is important to place restrictions on the prescription of drugs (expensive or not) of doubtful efficacy, while avoiding the scientific and ethical issues that such restrictions may raise. Finding appropriate and just solutions is not easy, yet we wish to offer two possible strategies for consideration by all (...) : humanity must inform our science and science must inform our humanity. Comments are closed. Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

4460. Does Medical School Erode Student Empathy?

of the definition of empathy: the ability to communicate it to patients. This struggle seems to surface during the third year of medical school. Perhaps it is the fractured nature of clinical experience, or the competitive drive to appear impervious that is to blame. However, since empathy affects clinical outcomes just as much as prescribing the right medication, it is worth treating. Research suggests the remedy may be for students to talk to each other about struggles with empathy. Only by improving (...) and compassion. Also, we invite you to post a link to your article about empathy to our Empathy Center Facebook page. I posted a link to your article in our Empathy and Health Care Magazine The latest news about empathy and compassion from around the world Comments are closed. Sites We Follow: Useful Links: Questions? Comments? Contact us! © New York University. All rights reserved. Electronic ISSN 1944-0030. The content of this site is intended for health care professionals.

2011 Clinical Correlations

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