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Emergency Medicine Treatment and Labor Act

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221. Evidence Map of Mindfulness

of the evidence to inform policy and clinical decision making. 1 Evidence Map of Mindfulness Evidence-based Synthesis Program INTRODUCTION Many Veterans desire complementary and alternative medicine or integrative medicine modalities, both for treatment and for the promotion of wellness. Given the VA’s desire to promote evidence-based practice, this evidence mapping project aims to help provide guidance to VA leadership about the distribution of evidence on mindfulness approaches. Mindfulness, often (...) potentially relevant studies in detail against specified inclusion and exclusion criteria, and summarize results across individual studies. Studies may be synthesized in a meta-analysis, a statistical technique to pool data across published studies. Meta-analysis is instrumental in detecting treatment effects across individual, often small and statistically underpowered, studies. To give a very broad indication of the clinical effectiveness, we used the results reported across randomized controlled trials

2014 Veterans Affairs Evidence-based Synthesis Program Reports

222. Patient Dignity (Formerly: Patient Modesty): Volume 95

Patient Dignity (Formerly: Patient Modesty): Volume 95 Bioethics Discussion Blog: Patient Dignity (Formerly: Patient Modesty): Volume 95 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent (...) patient that included having sex while he was receiving treatment in hospital. Well, to be fair I might as well get into the contributing references, even as statistical outliers, regarding published "bad girls of medicine" and their "damaged male patients". ..Maurice. At , Ray B. said... You're correct Biker; Sparks is an ENT. Must have had a lapse. If I recall, there were jokes about her "work" going around the hospital -- "Hey Doc; that's a long way from the throat." "ENT stands for Ears, Nuts

2019 Bioethics Discussion Blog

223. Patient Dignity (Formerly: Patient Modesty): Volume 94

Patient Dignity (Formerly: Patient Modesty): Volume 94 Bioethics Discussion Blog: Patient Dignity (Formerly: Patient Modesty): Volume 94 What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent (...) neglect listing it bc you know it is the standard to use them. To all I believe how medical treatment is delivered needs to change. My husband was present during my emergency C-section when my gut was cut into w/o any prep. I didn't get an infection from hair or from him being present. He wasn't in the way. There is no reason why patients cannot have an advocate with them or behind a glass wall where they can see and hear everything. If what happens was more upfront and not so secretive then half

2019 Bioethics Discussion Blog

224. Hot off the Press: SGEM #257 - EMTALA - It's the Law of the Land. (PubMed)

Hot off the Press: SGEM #257 - EMTALA - It's the Law of the Land. The Office of the Inspector General has the authority to levy fines relating to violations of the Emergency Medicine Treatment and Labor Act (EMTALA) for both medical and psychiatric care. Terp et al. have described the incidence of violations and penalties levied for psychiatric cases and compared them to that for medical. This article reviews that article and the podcast recorded with Dr. Terp and the ensuing discussion (...) in the podcast and online.© 2019 by the Society for Academic Emergency Medicine.

2019 Academic Emergency Medicine

225. Communication in Cancer Care (PDQ®): Health Professional Version

of Communication with Cancer Patients Most studies of provider-patient communication have focused on primary care or general internal medicine settings. Although many of the findings may be applicable to oncology, several unique elements present in oncology are not present in many other medical settings. Cancer is a life-threatening illness. Although recent treatments have increased the hope for cure or at least the arrest of the disease, the diagnosis of cancer results in significant fear, uncertainty (...) of patients from curative to palliative treatment. Decreased oncologist stress and burnout. The scientific study of communication skills in oncology, however, is still in its infancy. Three key concepts have nonetheless emerged in defining the importance of interpersonal and communication skills in the interaction of providers with cancer patients and their families: A patient-centered approach best describes the most effective way of providing comprehensive cancer care,[ ] and communication skills

2017 PDQ - NCI's Comprehensive Cancer Database

226. 2014 CHEST-CTS Guideline: Prevention of Acute Exacerbation of COPD

with underlying COPD.” 17,18 Exacerbation in clinical trials has been defined for operational reasons based on whether there is an increase in treatment beyond regular treatment or urgent treatment is required in an emergency room or hospital. Exacerbation treatment in clinical trials is usually defined by the use of antibiotics and/or systemic corticosteroids. 19 The severity of the exacerbation is then ranked or stratified according to the outcome: mild, when the clinical symptoms are present but no change (...) of COPD (Grade 2C). Underlying values and preferences: This recommendation places high value on reducing the risk of acute exacerbations of COPD. PICO 3: In patients greater than 40 years of age who are previous or current smokers diagnosed with COPD, does oral therapy prevent/decrease acute exacerbation of COPD? Background In the administration of treatment medication for COPD, the inhalation route has been favored for the last 30 years. This technique enables the drugs to act directly on the airways

2014 Canadian Thoracic Society

227. A physicist clueless about cancer lectures cancer biologists on…cancer!

suggests that our cells physically revert from their current form—a complex piece in the even more complex puzzle that makes a lung or a kidney or a brain—to a primitive state akin to algae or bacteria, a notion that seems preposterous to many scientists. Yet gradually, evidence is emerging that Davies could be right. If he is—if cancer really is a disease in which our cells act like their single-celled ancestors of eons ago—then the current approach to treatment could be all wrong. "Gradually evidence (...) has come up with a radical approach for understanding it. He theorizes that cancer is a return to an earlier time in evolution, before complex organisms emerged. When a person develops cancer, he posits, their cells regress from their current sophisticated and complex state to become more like the single-celled life prevalent a billion years ago. But while some researchers are intrigued by the theory that cancer is an evolutionary throwback, or atavism, plenty more think it’s silly. That theory

2017 Respectful Insolence

228. The annals of “I’m not antivaccine,” part 26: Hating on those who won’t let their antivax freak flag fly high

of fact cannot be insolent." The miscellaneous ramblings of a surgeon/scientist on medicine, quackery, science, and pseudoscience (and anything else that interests him). The annals of “I’m not antivaccine,” part 26: “No, I’m not an ‘vaccine safety’ advocate” It is my contention that, as much as they try to deny it over and over and over again, the “thought leaders” (if you can call it thought) of the antivaccine movement are indeed truly antivaccine. That’s why, whenever I see Andrew Wakefield deny (...) will contract disease during an outbreak, but that’s because no vaccine is perfect. Even so, . Here’s another one: 1. How can vaccines be both safe, as touted by doctors, government regulators, and the media, and unavoidably unsafe, meaning inherently dangerous, as declared by the U.S. Supreme Court in 2011? Both statements cannot be true. I even . Next up: 2. If vaccines are safe, why then do we have the 1986 National Childhood Vaccine Injury Act, the Vaccine Adverse Events Reporting System, the Vaccine

2017 Respectful Insolence

229. The annals of “I’m not antivaccine,” part 26: “No, I’m not an ‘vaccine safety’ advocate”

be insolent." The miscellaneous ramblings of a surgeon/scientist on medicine, quackery, science, and pseudoscience (and anything else that interests him). The annals of “I’m not antivaccine,” part 26: “No, I’m not an ‘vaccine safety’ advocate” It is my contention that, as much as they try to deny it over and over and over again, the “thought leaders” (if you can call it thought) of the antivaccine movement are indeed truly antivaccine. That’s why, whenever I see Andrew Wakefield deny that he (...) disease during an outbreak, but that’s because no vaccine is perfect. Even so, . Here’s another one: 1. How can vaccines be both safe, as touted by doctors, government regulators, and the media, and unavoidably unsafe, meaning inherently dangerous, as declared by the U.S. Supreme Court in 2011? Both statements cannot be true. I even . Next up: 2. If vaccines are safe, why then do we have the 1986 National Childhood Vaccine Injury Act, the Vaccine Adverse Events Reporting System, the Vaccine Injury

2017 Respectful Insolence

230. ImmunoCAP ISAC 112 and Microtest for multiplex allergen testing

allergy in under 19s states that information should be given to the child or young person and their parent or carer on when, where and how an oral food challenge or food reintroduction procedure may be done. However, they should not be done in primary care, and should only be done in a setting that is fully equipped for emergency treatment if anaphylaxis occurs. Management and treatment Management and treatment 2.13 Management depends on the type and severity of the allergy. Mild allergies can (...) ://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 9 of 502.15 NICE's guideline on anaphylaxis recommends that after emergency treatment for suspected anaphylaxis, people should be offered an appropriate adrenaline injector as an interim measure before the specialist allergy service appointment. 2.16 NICE's guideline on atopic eczema in under 12s recommends that healthcare professionals should use a stepped approach for managing atopic eczema in children and should adapt the treatment

2016 National Institute for Health and Clinical Excellence - Diagnostics Guidance

231. Social Determinants of Risk and Outcomes for Cardiovascular Disease

of acute stroke care (eg, less stroke symptom recognition by blacks or African Americans). Delay in arrival at the emergency department decreases the odds of receiving acute stroke treatment. Recommendations and Conclusions: Access to Care Barriers to access are many and include issues involving patient beliefs, literacy, culture, and language. There is also a poor geographic distribution of cardiac services. Barriers to improving access to subspecialty care for patients with Medicaid are a critical (...) Nursing, Council on Lifestyle and Cardiometabolic Health, and Stroke Council Originally published 3 Aug 2015 Circulation. 2015;132:873–898 You are viewing the most recent version of this article. Previous versions: Introduction An Institute of Medicine report titled U.S. Health in International Perspective: Shorter Lives, Poorer Health documents the decline in the health status of Americans relative to people in other high-income countries, concluding that “Americans are dying and suffering from

2015 American Heart Association

232. Workplace Wellness Recognition for Optimizing Workplace Health

. Furthermore, there is limited scientific evidence related to the correlations among different scorecards and recognition systems, program quality, and improvements in employee health over time. The American Heart Association (AHA)/American Stroke Association (ASA) is uniquely positioned as a national professional organization that is focused on the prevention and treatment of CVD and stroke to play an important role in defining and increasing the adoption of CWWPs. In fact, a key strategic impact goal (...) , and to describe how the AHA/ASA programs would be differentiated from and provide incremental value to current recognition programs. Background Despite impressive reductions in mortality from CVD and stroke as a result of improved prevention and treatment strategies, these 2 conditions remain the first and fifth leading causes of death in the United States, respectively. An estimated 730 000 people die of heart disease and stroke each year, which represents 29% of all deaths in the United States. Substantial

2015 American Heart Association

233. State-of-the-Art Methods for Evaluation of Angiogenesis and Tissue Vascularization

or injured tissue. Recent studies additionally suggest that the endothelium acts as a paracrine source for signals that determine tissue regeneration versus fibrosis after injury. Excessive vascularization, however, might also be unwanted, as in the case of cancer, neovascular eye diseases including diabetic retinopathy, atheroma growth, or the expansion of vasa vasorum, which leads to adverse vessel wall remodeling. Neovascularization is a tightly regulated and essential process that results (...) of therapeutic strategies to either promote or inhibit vessel growth depends on reproducible measures and end points in experimental models that are relevant for the treatment of human diseases. Accordingly, the selection of an appropriate experimental model is critical to study specific aspects of the molecular and cellular mechanisms that are of physiological or pathological relevance. This scientific statement summarizes in vitro assays and in vivo models suitable for gaining insights into the basic

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2015 American Heart Association

234. 2015 ACC/AHA Focused Update of Secondary Prevention Lipid Performance Measures

the paradigm of treating patients to LDL-C targets and instead replace it with a more tailored treatment approach (ie, personalized care), which aims not only to improve patient outcomes but also reduce harms and costs caused by overtreating patients at low risk. , For patients with ACS, which includes unstable angina, NSTEMI, and STEMI, the general period of assessment is the inpatient hospitalization or related emergency department visit. For other patients (non-ACS patients), the PM is intended (...) exceeds risk, and 2) patients deliberating on how treatments fit with their preferences, values, and personal context. In this framing, the clinician is the expert on evidence-based medicine and guidelines, and the patient is the expert on his or her preferences, values, and personal context. SDM mitigates the power differential between these 2 experts and acknowledges that both perspectives contribute equal weight to decision making. By incorporating patient preferences, values, and personal context

2015 American Heart Association

235. Professional Practice Guidelines for Integrating the Role of Work and Career Into Psychological Practice

experience long-term unemployment are more likely to suffer (Herbig, Dragano & Angerer, 2013). Underemployment, which can include working in a position that under-utilizes one’s skills or knowledge, and/or being employed at a lower level or at a lower rate of pay (Feldman, Leana, & Bolino, 2002), is another area worthy of attention by psychologists. Although infrequently the focus of empirical study (Swanson, 2012), there is emerging evidence that underemployment also has important implications for well (...) that work- related concerns can emerge in multiple settings, and are not limited to psychotherapeutic services that are identified specifically as career counseling or vocational psychology. In fact, to overlook the impact of work and career development across domains and settings is inconsistent with the basic ethical principle of Beneficence and Nonmaleficence (Principle A) and the Ethical Standard of Competence (Standard 2) of the Ethical Principles of Psychologists and Code of Conduct (American

2015 American Psychological Association

236. Public health aspects of migrant health: a review of the evidence on health status for undocumented migrants in the European Region

medical services and requesting emergency services (126). An Italian study indicated that the inappropriate use of accident and emergency departments for non-urgent conditions was potentially caused by barriers to accessing primary health care (25). Many multicentre European studies, relying on interviews with migrants, have reported that language barriers and general differences in cultural norms, religious practices and customs are potential obstacles to direct examination and treatment for mental (...) . Undocumented migrants mostly have only access to emergency care across Europe, and even in the countries where they are fully entitled to health care, formal and informal barriers hinder their access. This raises concerns for both public health and migrant care. On the basis of findings, policy options are suggested regarding data collection, research, entitlement to health care, information and communication, training and intersectoral approaches. keywords DELIVERY OF HEALTH CARE, EVIDENCE-BASED HEALTH

2015 WHO Health Evidence Network

237. Executive Summary: Prevention of Acute Exacerbation of COPD

for all-cause 888 Evidence-Based Medicine [ 147#4 CHEST APRIL 2015 ] hospitalization. A lower value was placed on the lack of statistically signifi cant diff erences in changes in lung function, quality of life, and patient symptoms between the two drug groups. 15. In patients with moderate to severe COPD, we suggest the use of a short-acting muscarinic antagonist compared with short-acting b 2 -agonist monotherapy to prevent acute mild-moderate exacerbations of COPD (Grade 2C) . Underlying Values (...) -acting anticholinergic monotherapy, since both are eff ective to prevent acute exacerbations of COPD (Grade 2C) . Underlying Values and Preferences: Th is recommen- dation places high value on reducing the risk of acute exacerb a t io n s o f C O PD . PICO 3: In Patients Aged . 40 Years Who Are Previous or Current Smokers With COPD, Does Oral Therapy Prevent/Decrease Acute Exacerbations of COPD? Backg r o und: In the administration of treatment medication for COPD, the inhalation route has been

2015 American College of Chest Physicians

238. AUA White Paper on Implementation of Shared Decision Making into Urological Practice

. F. et al. Decision aids for people facing health treatment or screening decisions . Cochrane Database Syst Rev . 2014 1 : CD001431 Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press, 2001 Makoul, G. and Clayman, M. L. An integrative model of shared decision making in medical encounters . Patient Educ Couns . 2006; 60 : 301 Charles, C., Gafni, A., and Whelan, T. Shared decision-making in the medical encounter (...) -and-reports/?pageaction=displayproduct&productid=1749. 11-12-2013. 4-7-2015 Hoffman, A. S., Volk, R. J., Saarimaki, A. et al. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas . BMC Med Inform Decis Mak . 2013; 13 Suppl 2 : S13 Flynn, D., Ford, G. A., Stobbart, L., Rodgers, H., Murtagh, M. J., and Thomson, R. G. A review of decision support, risk communication and patient information tools for thrombolytic treatment in acute stroke

2015 American Urological Association

239. Ethical Considerations for Including Women as Research Participants

at determining appropriate tocolysis for prevention of preterm birth or interventions for treatment of gestational diabetes can be conducted only during pregnancy. In addition, research during the process of labor and delivery is vital to improving care for women and their newborns. The fact that a pregnant woman is entering labor or in labor does not preclude her from consenting to participate in research. A pregnant woman in labor may be able to undergo the appropriate informed consent process for research (...) , similar to individuals with conditions that may have parallel connotations to labor, including life-threatening, emotionally distressing, or emergency situations (eg, appendicitis, cancer diagnosis, and myocardial infarction). Non-Pregnancy-Related Interventions That May Benefit a Woman During Pregnancy A significant proportion of pregnant women undergo therapies aimed at managing nonobstetric medical conditions. Studies have estimated that more than 60% of pregnant women use at least one prescription

2015 American College of Obstetricians and Gynecologists

240. Physical Activity and Exercise During Pregnancy and the Postpartum Period

Physical Activity and Exercise During Pregnancy and the Postpartum Period Physical Activity and Exercise During Pregnancy and the Postpartum Period - ACOG Menu ▼ Physical Activity and Exercise During Pregnancy and the Postpartum Period Page Navigation ▼ Number 650, December 2015 (Replaces Committee Opinion Number 267, January 2002) (Reaffirmed 2017) Committee on Obstetric Practice This document reflects emerging clinical and scientific advances as of the date issued and is subject to change (...) . The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Physical Activity and Exercise During Pregnancy and the Postpartum Period ABSTRACT: Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise

2015 American College of Obstetricians and Gynecologists

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