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Emergency Medicine Treatment and Labor Act


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241. Iron Deficiency – Diagnosis and Management

) screening for GU bleeding with urinalysis screening for celiac disease Management The objective of treatment is to replenish iron stores: normalize hemoglobin levels and ferritin. Target normal ferritin >100 µg/L. Iron replacement therapy should begin as soon as iron deficiency is detected, whether or not anemia is also present. The exception is: patients with microcytic anemia should not be given iron supplements until iron deficiency is confirmed by testing ferritin. Low MCV in the setting of normal (...) , age, pregnancy status, and diet. Refer to for recommended daily intake values, and foods high in iron. Consider dietitian referral. Patients can also call 8-1-1 to speak to a dietitian. Treatment with Oral Iron Oral iron replacement is almost always preferred to intravenous (IV) therapy. Refer to for a list of commonly used oral iron preparations, doses, and costs. Advise patients that iron can be toxic to children and should always be safely stored. Oral iron intolerance is very common: Oral iron

2019 Clinical Practice Guidelines and Protocols in British Columbia

242. Critical Assessment of Diabetes Guidelines

is associated with increased risk of unnecessary infection (Kcentra is partly produced from blood from non-donors). Another problem is that they are valuable medical resource that can be obtained only from blood donations. In case of emergency, they are not easily accessible. It also requires consent from patients (their families) prior to treatment. The MHLW denies causality between the drug and deaths, but this cannot be trusted [10-12]. High-risk patients are essentially the ones who need an effective (...) their pharmacologic therapies. ? The recent diabetic medicines are all costly. If the guidelines of the Japanese Diabetes Society are followed, high drug costs and medical costs would be needed. In addition, hypoglycemic attacks and cardiovascular diseases would occur frequently and life expectancy would be negatively affected, as well. On the other hand, the ACP guidance would reduce medical costs and improve health and life expectancy of patients with type 2 diabetes. ? Type 2 diabetes may develop and aggravate

2019 Med Check - The Informed Prescriber

243. Janus Kinase Inhibitors and Biosimilars for Rheumatoid Arthritis: Effectiveness and Value

, 26.3, and 25.7 compared with 2.4, 2.2, 24.6, and 24.0 for the reference product. The proportion of patients with “Good” and “Moderate” EULAR response was similar between the two groups. With respect to patient-reported outcomes, the Visual Analog Scale (VAS) for patient assessment of pain showed similar reductions from baseline in both groups (30.2 vs. 28.4 at week 54). There were no differences in the immunologic outcomes, including the development of anti-drug antibodies. Treatment-emergent (...) value. • If pricing does not fairly align with patient benefit, plan sponsors may consider the option of benefit designs requiring patients to switch from their current therapy to a lower cost, equally effective option. In all such efforts the clinical effectiveness of the required therapy and the cost overall should be closely monitored. • Requiring switching for patients who have achieved adequate treatment response on a particular drug raises the risk of irremediable harm should the new treatment

2020 California Technology Assessment Forum

244. Prenatal Care

Prenatal Care 1 Quality Department Guidelines for Clinical Care Ambulatory Prenatal Care Guideline Team Team Leader Mark C. Chames, MD Obstetrics / Gynecology Team Members Joanne M. Bailey, CNM, PhD Obstetrics / Gynecology Grant M. Greenberg, MD, MA, MHSA Family Medicine R. Van Harrison, PhD Medical Education Jocelyn H. Schiller, MD Pediatrics Consultant Christa B. Williams, MD Family Medicine Initial Release December 2013 Interim/Minor Revision October 2015 January 2019 UMHS Guidelines (...) for high-risk women, including those with initial hemoglobin 100,000 CFU/mL, treatment at the time of diagnosis is recommended. Evidence is insufficient to recommend a test of cure after completion of antibiotic therapy, except in the case of GBS bacteriuria, for which a test of cure is recommended. Cervical cancer screening. Women who are current with routine screening for cervical cancer do not need to undergo additional testing. Rates of false positive cervical cytology increase in pregnancy

2020 University of Michigan Health System

245. Maternal and Newborn Survival in Sub-Saharan Africa

year, where the death occurs during labour. Almost all of these are preventable with timely, high-quality care at birth. Implementation science: Participants highlighted an urgent need to identify new labour monitoring systems, following the WHO’s decision to stop recommending the use of the partograph. Improved monitoring of high rates of stillbirths is key for accountability and could be included in perinatal audits. More research on the use of clinical audits, feedback and medical dashboards (...) suggests that globally, in 2012, an estimated 930,000 cases of maternal syphilis caused 350,000 adverse pregnancy outcomes, including 143,000 early fetal deaths and stillbirths. 17 This burden could be reduced by greater use of syphilis screening and subsequent appropriate treatment in sub-Saharan Africa. HIV: Great progress in the prevention of primary HIV infection, elimination of mother-to-child transmission and sustaining patients with antiretroviral therapy has led to reductions in mortality

2019 Academy of Medical Sciences

246. Public health guidance on prevention and control of blood-borne viruses in prison settings

Direct-acting antivirals DOT Directly observed therapy EEA European Economic Area EFTA European Free Trade Association EMCDDA European Monitoring Centre for Drugs and Drug Addiction EU European Union HAV Hepatitis A virus HBV Hepatitis B virus HCV Hepatitis C virus HIV Human immunodeficiency virus IFN Interferon MSM Men who have sex with men NR Not reported NSP Needle and syringe programme OST Opioid substitution treatment PEP Post-exposure prophylaxis PLHIV People living with HIV PrEP Pre-exposure (...) or uptake in one EU/EEA country. Half of the countries in the EU/EEA do not provide HIV treatment for undocumented migrants and in some countries, undocumented migrants are only entitled to emergency healthcare, in the absence of legal residence status and/or health insurance [37,46]. 2.4 Throughcare Transition planning has long been identified as the weakest link in the effective management of the admission into prison and/or the re-entry into community of individuals with drug use disorders

2019 European Centre for Disease Prevention and Control - Public Health Guidance

247. Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA

protection, commonly referred to as asylum applicants, are entitled to necessary healthcare, which must include at least emergency care and essential treatment of illness, as well as necessary medical or other assistance for those who have special needs. • Persons granted international protection, namely refugees and subsidiary protection status holders, have equal access to healthcare to that of a Member State national. • Various EU law instruments contain a duty by Member States to address the urgent (...) medical needs of people intercepted or apprehended at the border, including those rescued at sea. • Victims of trafficking in human beings are entitled to necessary medical treatment, including psychological assistance, counselling and information. • People in return procedures are entitled to the same level of healthcare granted to asylum applicants – namely ‘emergency healthcare and essential treatment of illness’ – if they have been given a period for voluntary departure or if their removal

2019 European Centre for Disease Prevention and Control - Public Health Guidance

248. Unsupported Price Increase Assessment

to be assessed.©Institute for Clinical and Economic Review, 2019 Page 5 Unsupported Price Increase Report We compared these percentage increases in WAC to the increase in the medical care consumer price index (CPI) over the same period and excluded those drugs with a WAC increase that was not greater than 7.32%, which is two times the increase in medical care CPI over this period. The medical care CPI is one of eight major components of the CPI recorded and reported by the US Bureau of Labor Statistics. 5 (...) twice the increase in medical consumer price increase (CPI) over the same period. For the remaining 77 drugs, we determined, where possible, the increase in spending on these drugs in the US during 2017-18 that was due to increases in net price. From this list of 77, the intent was to select the top 10 drugs for assessment. Under the UPI Protocol, manufacturers submitted information for two drugs showing that they did not belong in the top 10. Based on public input, lenalidomide (Revlimid®

2020 California Technology Assessment Forum

249. Crizanlizumab, Voxelotor, and L-Glutamine for Sickle Cell Disease: Effectiveness and Value

7,000 residents living with the condition. 32 Attitude toward New Therapies There is consensus in the SCD community about the dire need for disease-modifying drugs. Over the past several years, few treatment options aside from analgesia were available. Barriers to accessing and utilizing the few available options, such as pharmaceutical-grade L-glutamine and hydroxyurea are many; these include insufficient payer coverage, a lack of pharmacies that stock these drugs, a lack of awareness among (...) a patient’s race or ethnicity, even a well-meaning doctor may make presumptions that influence how he or she communicates with and medically treats a patient.” 1 – Rouse, 2009 ©Institute for Clinical and Economic Review, 2020 Page 13 Evidence Report - Crizanlizumab, Voxelotor, and L-Glutamine for SCD Return to Table of Contents Pain Relief Racial bias and treatment disparities are glaringly obvious in the dispensing of analgesics for patients with SCD. Patients who present at emergency rooms in crisis

2020 California Technology Assessment Forum

250. Practice Recommendations on Neuraxial Anesthesia and Peripheral Nerve Blocks during the COVID-19 Pandemic

guidance to reduce the risk of local anesthetic systemic toxicity (LAST). 19 The benefit of perineural adjuvants must be balanced against the risks of possible immunosuppression (dexamethasone), sedation, bradycardia and hypotension (clonidine and dexmedetomidine), drug errors, and drug contamination. The decision to insert and maintain perineural catheters needs to be made on a case-by-case basis. While continuous catheter techniques can be labor and resource intensive and may require frequent patient (...) A, Chatwin M, et al. Evaluation of droplet dispersion during non-invasive ventilation, oxygen therapy, nebuliser treatment and chest physiotherapy in clinical practice: implications for management of pandemic influenza and other airborne infections. Health Technol Assess. 2010;14:131-72. doi: 10.3310/hta14460-02. Society of Obstetric Anesthesia and Perinatology (SOAP). Interim considerations for obstetrical anesthesia care related to COVID19. Updated March 18, 2020. Available at . Accessed March 31, 2020

2020 American Society of Regional Anesthesia and Pain Medicine

251. Occupational liver diseases

of liver injury. Whilst acknowledging that viral infections in hospital workers are recognised as OLDs, herein, attention will only be paid to chemically induced liver injuries. These recommendations are intended to provide standardis- ation of nomenclature, de?nitions and classi?cation of the type of liver injuries, based in part on the criteria for drug-induced liver injury (DILI), which attempt to grade their severity. 4,5 The main focus will be to increase awareness of OLDs within the medical (...) was mistakenly ascribed to carbamazepine. 69 The predisposition to severe liver and renal injury in a worker using CCl 4 toclean paintings, prob- ably due to microsomal induction by concomitant treatment with phenobarbital, underscores the importance of not over- looking the potential for drug/xenobiotic interactions at the workplace. 70 In addition, we should also keep in mind the potentialofxenobioticinteractionsinindustryworkersexposed to multiple chemicals at once. Thus, a mixed exposure to chlo- rinated

2019 European Association for the Study of the Liver

252. Clinical Guideline: Perinatal care of suspected or confirmed COVID-19 in pregnant women

and requirements for PPE • Alert midwifery/obstetric/neonatal/infectious diseases teams • Limit visitors • Symptomatic treatment as indicated Retrieval/transfer • COVID-19 positive alone not an indication Antenatal • Perform necessary medical imaging • Fetal surveillance as clinically indicated • Maternal surveillance and SpO 2 Birth • Negative pressure room (if possible) • Mode of birth not influenced by COVID-19 unless urgent delivery indicated • Early consideration of neuraxial blockade (to minimise risk (...) -clinicians • To the extent possible: use single rooms and negative pressure rooms • If cohorting of confirmed cases is required, follow Queensland Health guidance and recommendations for patient placement 3 • Alert obstetric/midwifery/neonatal/infectious diseases teams of admission • Review the woman’s psychological and emotional needs Treatment • Currently no proven antiviral treatment 5 • Treatment (e.g. anti-pyrexic medicines, anti-diarrheal medicines, intensive care unit admission) is directed

2020 Queensland Health

253. Covid-19: Recommendations for GDM screening and oral glucose tolerance test (OGTT) during pregnancy and postpartum

of Medicine LGA Large for gestational age MNT Medical nutrition therapy NDSS National Diabetes services scheme OGTT Oral glucose tolerance test – 75 gram glucose load USS Ultrasound scan Definition of terms Antenatal contact In this guideline the term antenatal contact includes all forms of interaction between the pregnant woman and her care providers for the purpose of providing antenatal care. For example, telephone consults or SMS messaging, email, home visits, scheduled hospital appointments (...) printed copies after use Page 19 of 38 3.4 Self-monitoring Results from BGL self-monitoring form only part of the clinical decision regarding the need for pharmacological treatment in an individual woman. Also consider the potential for improved glucose control with medical nutrition therapy, enhanced physical activity and assessment of fetal growth. Refer to Section3.2, 3.5, and 3.6. Table 15. Self-monitoring Aspect Considerations Context • Self-monitoring of BGLs before and after meals is a key part

2020 Queensland Health

254. Evidence summary of immunity response following infection with COVID-19

infection with SARS-CoV-2 or other human coronaviruses Health Information and Quality Authority Page 4 of 97 Evidence summary of the immune response following infection with SARS-CoV-2 or other human coronaviruses 1. Introduction The Health Information and Quality Authority (HIQA) has developed a series of ‘Evidence Summaries’ to assist the Clinical Expert Advisory Group (EAG) in supporting the National Public Health Emergency Team (NPHET) in their response to COVID-19. These summaries are based (...) patients (3) and the median age of patient cohorts ranged from 41.5 (41) to 62 years. (66) For studies conducted in China, patients were discharged in accordance with the Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment: (1) normal temperature for three days or more, (2) significant improvement in respiratory symptoms, (3) chest radiology findings show substantial improvement of acute exudative lesions, (4) two consecutive negative nucleic acid tests using respiratory tract

2020 Health Information and Quality Authority

255. Review of restrictive public policy measures to limit COVID-19

are patrolled and groups dispersed. Playgrounds and some individual sites have been closed by the Gardaí/local councils. Public transport and passenger travel are restricted to those who are buying food or medicines, carers, going to medical appointments and essential workers. Measures are reflected in the regulations under the Health (Preservation and Protection and Other Emergency Measures in the Public Interest) Act 2000 and will be enforced by the Garda Síochána. As of 7 April empowered to arrest (...) , the Spanish government extended the State of Emergency until 9 May, however, it is now permitting anyone under 14 years of age to go for a walk with one of their Review of restrictive public policy measures to limit the spread of COVID-19 Health Information and Quality Authority Page 8 of 66 parents or accompany them on trips out to buy food, medicine, or go to the bank, once a day between 9am and 9pm within a one-kilometre radius of their homes. Less restrictive measures can be found in Germany, (39

2020 Health Information and Quality Authority

256. European Academy of Neurology guideline on the diagnosis of coma and other disorders of consciousness

lead to inappropriate treatment. Delirium scales such as the CAM-ICU [89], the Intensive Care Delir- ium Screening Checklist [90] or the Confusion Assess- ment Protocol [91] may be useful to diagnose and monitor delirium in conscious and communicative patients (emerged from MCS; possibly MCS+ with intentional communication). However, in severely brain-injured patients, data on delirium screening tools are sparse [92] and likely to be confounded by sedation, consciousness and cognitive impairments (...) of the EAN Panel on Coma, Disorders of Consciousness ,† a Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen; b Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; c Department of Neurosciences, Norwegian University of Science and Technology, Trondheim, Norway; d Department of Neurology, Ludwig-Maximilians-Universit€ at M€ unchen, Munich; e Therapiezentrum Burgau, Burgau, Germany; f Department of Clinical Neurosciences, Centre Hospitalier

2020 European Academy of Neurology

257. Single?track year?round education for improving academic achievement in U.S. K?12 schools: Results of a meta?analysis Full Text available with Trip Pro

‐Bicakci, ; White & Cantrell, ). Conversely, the effect of multitrack YRE may actually be negative (Graves, ; Graves, McMullen, & Rouse, ). In both the Kneese ( ) and Cooper et al. ( ) meta‐analyses, the authors found a larger treatment effect for single‐track than multitrack YRE. Estimating the effect of grouped single‐ and multitrack YRE as a single treatment of “year‐round education” would require ignoring the important guidance provided by prior research findings. As a result, the current study (...) calendars are introduced for different reasons and suffer different disadvantages, but furthermore that multitrack YRE may have no treatment effect, whereas single‐track YRE has been found to have a positive effect. Some studies also lacked the information necessary to calculate an effect size and were excluded for that reason. Figure 1 Search process flow diagram, adapted from Moher et al. ( ) [Color figure can be viewed at] 4.3.2 Data extraction and management Student outcomes

2019 Campbell Collaboration

258. The impact of care farms on quality of life, depression and anxiety among different population groups: A systematic review Full Text available with Trip Pro

, diabetes, hypertension, allergies and obesity) and mental health (such as the number of suicides and the number of psychological treatments) have worsened (Spanish National Ecosystem Assessment, ). As an early treatment, approximately 70% of depressed patients in UK primary care are prescribed antidepressant medication (Kendrick, Stuart, Newell, Geraghty, & Moore, ); however, adherence may be as low as one third (Bull et al., ). An alternative or adjunct to antidepressants is talking therapies (...) categories, ranging from general everyday contact such as viewing, working or undertaking recreational activities, through to using nature deliberately as a therapeutic or treatment resource (i.e., green care) involving activities like wilderness therapy, social and therapeutic horticulture, animal‐assisted therapy and care (social) farming (see Figure ). Green care has been defined as follows: Figure 1 The different contexts in which an individual may engage with nature. Source : (Bragg & Atkins

2019 Campbell Collaboration

259. Individualized funding interventions to improve health and social care outcomes for people with a disability: A mixed?methods systematic review

-text version of this article with your friends and colleagues. Copy URL Share a link Share on ). Historically, the types of supports available to people with a disability were based on medical needs only. More recently, however, the importance of social care needs, such as keeping active and socializing, has been recognized (Malley et al., ). There is now an international policy imperative for people with a disability to live autonomous, self‐determined lives whereby they are empowered (...) . 2. A number of barriers, whilst viewed as generally manageable in the short term, were considered potentially problematic in the longer term. These include: inaccurate or inaccessible information sometimes due to an unclear understanding of individualized funding (compounded by an absence of practitioner training); cumbersome systems that duplicate work and are framed within the directive medical model (i.e., based on a perception that staff inappropriately focus on targets and costs rather than

2019 Campbell Collaboration

260. Incentives for climate mitigation in the land use sector—the effects of payment for environmental services on environmental and socioeconomic outcomes in low? and middle?income countries: A mixed?methods systematic review Full Text available with Trip Pro

Rica, PES pilot in Malawi and PSAH in Costa Rica, with effects close to the line of no effects. Finally, the only low risk of bias study reporting effects on socioeconomic outcomes, while being underpowered, do not find a difference between the treatment and comparison groups in a PES pilot in Malawi (Jack and Santos, 2017). Taken together, these limitations questions the generalisability of the results for socioeconomic outcomes. They may reflect the true effect of the PES programmes (...) of design, implementation and context factors in influencing effectiveness of PES programmes. The main themes emerging from the qualitative synthesis are outlined below. 2. Targeting (programme design): PES programmes need to be carefully targeted at the most relevant programme participants to support environmental and social outcomes . Targeting is of particular relevance to support social outcomes such as poverty reduction and equity objectives. We find that the effects of PES are heterogeneous both

2019 Campbell Collaboration

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