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Emergency Medicine Treatment and Labor Act

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681. Guidelines for the Management of Major Regional Analgesia

or nerve root pain may signify the presence of an epidural abscess or haematoma (see also item 3.3.4). Page 5 PS03 2014 3.3.3 Protocols for the recognition and treatment of adverse effects, whether pharmacological or physiological, resulting from the use of analgesic drugs including local anaesthetic, opioid, or adjuvant medication, should be available. 3.3.4 Protocols for the recognition and management of complications resulting from dural puncture and the use of indwelling catheters should (...) is a medical practitioner, with training and experience in the technique, or trainees under the supervision of such a practitioner. An understanding of the relevant anatomy (including sonoanatomy where relevant), physiology, pharmacology, equipment used and potential complications of the particular procedure and the contraindications to its use is essential for safe conduct of these procedures. Prompt treatment of side effects or complications may be critical. Page 2 PS03 2014 2.2 Complications of major

2014 Australian and New Zealand College of Anaesthetists

682. Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Full Text available with Trip Pro

should be made based on a woman’s intentions for future pregnancy, because some categories of medications are associated with various risks if continued during pregnancy ( ). 120a,121* Table 4. Summary of Antihypertensive Drugs Used During Pregnancy Category Maternal Side Effects Teratogenicity or Fetal-Neonatal Adverse Effects Class/Level of Evidence (see ) Centrally acting α2-adrenergic agonist (eg, methyldopa) Sedation, elevated LFTs, depression No IIa/C Diuretics (thiazide) Hypokalemia No III/B β (...) and the AHA’s Manuscript Oversight Committee. Multiple disciplines are represented, including neurology, neuroscience research, internal medicine, obstetrics/gynecology, cardiology, pharmacology, nursing, epidemiology, and public policy. The panel reviewed relevant articles on adults using computerized searches of the medical literature through May 15, 2013. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology

2014 American Heart Association

683. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack Full Text available with Trip Pro

among survivors of ischemic stroke or TIA. The current average annual rate of future stroke (≈3%–4%) represents a historical low that is the result of important discoveries in prevention science. These include antiplatelet therapy and effective strategies for treatment of hypertension, atrial fibrillation (AF), arterial obstruction, and hyperlipidemia. Since the first of these therapies emerged in 1970, when results of the Veterans Administration Cooperative Study Group trial of hypertension therapy (...) delivery is planned, it is reasonable to discontinue LMWH ≥24 hours before induction of labor or cesarean section (Class IIa; Level of Evidence C ). New recommendation In the presence of a low-risk situation in which antiplatelet therapy would be the treatment recommendation outside of pregnancy, UFH or LMWH, or no treatment may be considered during the first trimester of pregnancy depending on the clinical situation (Class IIb; Level of Evidence C ). New recommendation Breastfeeding In the presence

2014 American Heart Association

684. The Role of Worksite Health Screening Full Text available with Trip Pro

Information Nondiscrimination Act of 2008 generally prohibits employers from requiring, requesting, or purchasing genetic information of their employees. Individually identifiable information can be provided to the participating employee and to certain medical professionals, but should not be released to those who make employment decisions (eg, managers, supervisors). However, if participation in a worksite health screening or health and wellness program is voluntary, the program may report employee (...) agencies to reach large segments of the population and address the problems that contribute to poor health. , Justification for this transformation in US healthcare delivery can be made from several perspectives, namely the renewed focus on prevention. However, one of the most compelling arguments in the current economic environment is the financial benefit of shifting the focus towards prevention. Direct medical costs associated with CVD in the United States are projected to increase from $273 billion

2014 American Heart Association

685. Tinnitus

that include hearing aids and specific forms of sound therapy, cognitive behavioral 1 Otolaryngology–Head and Neck Surgery, Johns Hopkins Outpatient Center, Baltimore, Maryland, USA; 2 Division of Otolaryngology–Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA; 3 Partnership for Health Analytic Research, LLC, Los Angeles, California, USA; 4 Department of Otolaryngology, State University of New Y ork at Downstate Medical Center, Brooklyn, New Y ork, USA; 5 (...) of Iowa, Iowa City, Iowa, USA; 22 Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama, USA; 23 Consumers United for Evidence-Based Healthcare, Fredericton, New Brunswick, Canada. Corresponding Author: David E. T unkel, MD, Otolaryngology–Head and Neck Surgery, Johns Hopkins Outpatient Center, 601 North Caroline Street, Room 6231, Baltimore, MD 21287-0006, USA. Email: dtunkel@jhmi.eduTunkel et al S3 therapy (CBT), medications, dietary changes and supplements

2014 American Academy of Otolaryngology - Head and Neck Surgery

686. Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States Full Text available with Trip Pro

Medicaid eligibility to adults with incomes up to 138% of the federal poverty level. Although millions of uninsured US Hispanics will be eligible for coverage under the 2010 Patient Protection and Affordable Care Act, undocumented immigrants will continue to be ineligible for coverage under its provisions. Noncitizens or undocumented immigrants who lack continuous, comprehensive, and preventive care will continue to depend on episodic or emergency healthcare services. Not only are Hispanics (...) likely to receive preventive health services. Spanish-speaking Hispanics were far less likely to be knowledgeable of heart attack and stroke symptoms than English-speaking Hispanics, NHBs, and NHWs. Language and Health Literacy There is an important role for health literacy, because it influences the ability to negotiate health systems, understand and act on health treatment and advice, and seek timely and appropriate health care. , Lower health literacy predicted increased all-cause mortality among

2014 American Heart Association

687. Standards of Practice for Superficial Femoral and Popliteal Artery Angioplasty and Stenting

treatment for PAD patients remains controversial and may depend on local practice, other cardiovascular comorbidities, severity of leg symptoms, and anatomical extent of the disease. Emerging evidence from the CHARISMA clinical trial suggests that a combination of aspirin and clopidogrel is more bene?cial in reducing adverse vascular events and may be offered to high-risk PAD patients who are at low risk for bleeding [29, 30]. Recommended best medical therapy for PAD is summarized in Table 2 [20, 23, 24 (...) is the proposed treatment of choice in the majority of patients with IC or CLI on the basis of its reduced perioperative morbidity and mortality, and reduced in-hospital stay [5, 6]. To date, several new technologies, such as bare metal stents made from nitinol, drug-eluting stents (DES), covered stents, and drug-coated balloons (DCB), have emerged with the aim to improve long-term patency outcomes following angioplasty of the femoral and popliteal arteries [7–11]. A literature review was performed

2014 Cardiovascular and Interventional Radiological Society of Europe

688. The Management of Upper Extremity Amputation Rehabilitation (UEAR)

, Occupational Therapy, Physiatry, Physical Medicine & Rehabilitation, Physical Therapy, Prosthetics, Psychology, Recreational Therapy, Social Work and Surgery. The guideline development process for the 2014 CPG update consisted of the following steps: 1. Formulating evidence questions (Key Questions) 2. Conducting the systematic reviewVA/DoD Evidence-Based Clinical Practice Guideline for the Management of Upper Extremity Amputation Rehabilitation Page 13 of 149 3. Convening a face-to-face meeting (...) is a physician-led, patient-centered, multidisciplinary approach to provide a comprehensive treatment plan and ensure lifelong management. The care team approach for patients with upper extremity amputation is unique due to varying patient factors and the myriad of medical, surgical, rehabilitation and prosthetic specialists involved, including: • Rehabilitation physicians • Anesthesiologists • Surgeons (hand specialists, orthopedic surgeons, plastic surgeons) • Mental and behavioral health specialists

2014 VA/DoD Clinical Practice Guidelines

689. Working with Families to Promote Safe Sleep for Infants 0-12 Months of Age

factors. It recommended the back as the only sleeping position, a drug-free pregnancy, the promotion of breastfeeding and the use of a firm mattress and light blankets. The campaign recommended against cigarette smoke in the environment, overheating, and products used to maintain infant sleep position (e.g., sleep positioners). However, in light of the emerging research in this area and changing trends in infant care practices, a review of these safe sleep recommendations is warranted. Some experts (...) appropriate education and experience. All nurses should seek consultation in instances where the client’s care needs surpass the individual nurse’s ability to act independently. The focus of this guideline was narrowed over the course of its development. The initial purpose was to provide recommendations to promote safe sleep among infants aged 0-24 months. However, because most of the evidence identified in the literature search focused on safe sleep for infants aged 0-12 months, the scope of the review

2014 Registered Nurses' Association of Ontario

690. HTA of Public Access Defibrillation

a defibrillator is made available, for any harm or damage as long as they have acted in good faith, unless the person has acted with gross negligence, failed to properly maintain the defibrillator or where the premises is a healthcare facility. Based on these findings the Authority’s advice to the Minister for Health is as follows: Ireland already has a high level of dispersal of AEDs on a voluntary basis. However this system is not standardised, coordinated or linked to emergency medical services. Based (...) Barton, Consultant in Emergency Medicine, St Vincent’s University Hospital nominated by the National Clinical Programme for Emergency Medicine and the Irish Association for Emergency Medicine ? Dr Angie Brown, Medical Director, Irish Heart Foundation and nominated by the Irish Cardiac Society ? Mr Brendan Cavanagh, Programme Manager, Health Service Executive (HSE) Acute Coronary Syndrome Programme ? Dr Michael Colquhoun, Chair of BLS/AED Sub-Committee, Resuscitation Council (UK) ? Professor Kieran

2014 Health Information and Quality Authority

691. Clinical practice guideline for care in pregnancy and puerperium

) during pregnancy? Medication during pregnancy 45. What widely used drugs are safe during pregnancy? Alcohol and smoking during pregnancy 46. What are the consequences of drinking alcohol during pregnancy? 47. Are there programs to reduce alcohol consumption targeting pregnant women? 48. What are the consequences of active and passive smoking during pregnancy? 49. Are there specific smoking cessation programs targeting pregnant women? Exercise during pregnancy 50. Is it necessary to perform physical (...) . Medication during pregnancy v During pregnancy, the least amount of drugs should be prescribed and the lowest possible dose, limiting its use to those circumstances in which the expected benefits to the mother and foetus outweigh the known risks to the foetus.28 CLINICAL PRACTICE GUIDELINES IN THE SNS Alcohol and smoking during pregnancy Weak We suggest that women who are pregnant or planning pregnancy do not consume alcohol. v Women should be informed that excessive drinking during pregnancy (defined

2014 GuiaSalud

692. Commissioning in health, education and social care: Models, research bibliography and in-depth review of joint commissioning between health and social care agencies

commissioning between health and social care agencies REPORTCommissioning in health, education and social care: Models, research bibliography and in-depth review of joint commissioning between health and social care agencies TECHNICAL REPORT Report by Mark Newman, EPPI-Centre Mukdarut Bangpan, EPPI-Centre Naira Kalra, EPPI-Centre Nicholas Mays, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine Irene Kwan, EPPI-Centre Tony Roberts, South Tees Hospitals NHS (...) to the bureaucratic distinctions between the scope of different agencies. Particularly since the early 1970s, but arguably from the inception of the NHS in 1948, a series of measures have been introduced to improve the co-ordination and efficiency of health and social care at local level. Joint commissioning is one such approach. In the last decade, the former Labour Government developed a vision of a system marked by far greater ‘integration’ of health and social care than had previously been the case in order

2012 EPPI Centre

693. Assets in Action: Illustrating asset based approaches for health improvement

and how they live their lives within the wider community and their private life. These two realms were described by one case as “parallel tracks”. It is the subsequent intersection of these tracks that emerged as an important point within the individual’s journey; where the work of the project meets and begins to in? uence how the participant thinks, feels and acts outside of the project. It would seem that, for many of the cases studied, success comes from the ‘spilling over’ of the positive (...) with communities as equal partners: this helps to mobilise the resources in an area, thereby protecting and promoting sustainable health and wellbeing. So, can working in this way help to create healthy, ? ourishing and connected communities? A dialogue around redressing the balance between creating good health and wellbeing and identifying risk, preventing illness and reducing premature death is Introduction 07 August 2012 emerging (Foot, 2012). Whilst there is a growing body of evidence relating to health

2012 Glasgow Centre for Population Health

694. Creating Better Stories: Alcohol and gender in transitions to adulthood

and female respondents described factors that led to more moderate, less excessive drinking. The most consistently reported message was around a process of moderation linked to changes in identity as drinkers progressed through the transition to adulthood. Key processes included having a growing sense of self- confidence, more fixed friendship groups and a preference for higher quality leisure experiences, often linked to a sense of personal development and growth. The emergence of new risks Despite (...) conditions has led policymakers in Scotland to question whether cultural attitudes in relation to alcohol should remain so tolerant of harm and misuse. The recent Independent Enquiry on Scotland’s Drug and Alcohol Use (2010) highlights Leon and McCambridge’s (2006) finding that despite historical antecedents, alcohol related harm 13and mortality has increased in Scotland since the early 1990s. These increases have been linked to a harmful set of background cultural norms being given much freer expression

2012 Glasgow Centre for Population Health

695. Findings Series 32 - Young people, gender and alcohol

’ mortality was seen across virtually the whole population: all ages (except the very young), both males and females, in deprived and non-deprived neighbourhoods. • For premature mortality, SMRs tended to be higher for the more deprived areas (particularly among males), and around a half of ‘excess’ deaths under 65 were directly related to alcohol and drugs. • Analyses of historical data suggest it is unlikely that the deprivation profile of Glasgow has changed significantly relative to Liverpool (...) and drugs. • Analyses of historical data suggest it is unlikely that the deprivation profile of Glasgow has changed significantly relative to Liverpool and Manchester in recent decades; however, the mortality gap appears to have widened in the last 30 years, indicating that the ‘effect’ may be a relatively recent phenomenon. • The results emphasise that while deprivation is a fundamental determinant of health and, therefore, an important driver of mortality, it is only one part of a complex picture

2012 Glasgow Centre for Population Health

696. Maximising Opportunities: final evaluation report of the Healthier, Wealthier Children project

likely than men to go without in order to provide for families, and have responsibility for most of the management of poverty and debt which is likely to impact adversely on their mental health and wellbeing. 4 There is also considerable evidence that families with disabled children, refugees, most minority ethnic groups and women with drug problems are at greater risk of poverty. 5;6;7 2.2. Providing advice services in health care settings Most studies that investigated advice service provision (...) with drug problems – may not be in regular contact with primary health care services and are more likely to be in contact with other parts of the NHS, such as Maternity and Addiction Services which may be better placed to ensure access to advice. 16 To avoid a ‘one size fits all’ response, it has been argued that what is needed is the delivery of appropriate and accessible advice services for different individuals and groups. 17 12 2.3. Developing partnership responses An investigation into partnership

2012 Glasgow Centre for Population Health

697. Evaluating a national surveillance system

For men who have sex with men, urban areas (for example, >500 000 population) n For persons who inject drugs, areas with large numbers of drug arrests (for example, >1000 drug arrests per year) n For female sex workers, areas with transport hubs or destination points of migrant labour Selecting groups and locations for… Description Examples HIV sentinel surveillance in populations at higher risk Base on where services or targeted interventions are provided to the group. Cut-off points for selection (...) seems to be driving new infections in different parts of the country ? list areas where there are few infections and likely to be little transmission ? distinguish between areas with few infections and areas where there is no information ? describe what systems are in place to detect areas with emerging epidemics and how sensitive these systems are likely to be. Two dimensions determine where most new infections are occurring: ? geographical dimension ? risk behaviours and context dimension

2013 World Health Organisation HIV Guidelines

698. Guidelines for second generation HIV surveillance

/district General population Sex worker Men who have sex with men Persons who inject drugs Other group Province A District A1 (capital) District A2 District A3 Province B District B1 District B2 District B3 2.2. Identify key populations at increased risk for HIV As the surveillance inventory is developed and the data studied, areas where there is more HIV infection (HIV prevalence is high and risk behaviours are prevalent) will begin to emerge. Follow these four steps to identify key populations (...) numbers of overlapping sex partners. In these epidemics, there is evidence that the so-called key populations may also play an important role in HIV transmission. Four key populations are at higher risk for HIV because of their behaviour. HIV is likely to be transmitted rapidly or emerge ?rst in the following groups: ? persons who inject drugs ? male, female or transgender sex workers ? clients of sex workers ? men who have sex with men, particularly those who have a large number of partners

2013 World Health Organisation HIV Guidelines

699. Review of Food Safety Interventions and Evaluation in Food Service Establishments

. New York State Department of Health and Mental Hygiene. Food safety and community sanitation: field operation / inspections - definitions. New York, NY; 2011; http://www.nyc.gov/html/doh/html/inspect/idefine. shtml. 5. Food and Drug Act, RSNL1990 Chapter F-21 (1997 c39; 2004 c36 s15 2006). St John’s, Newfoundland and Labrador; http://www.assembly.nl.ca/legislation/sr/statutes/f 21.htm. 6. The Food Safety and Related Amendments Act, Bill 7, Manitoba, Canada (2008); http://web2.gov.mb.ca/bills/39-3 (...) in level of foodborne pathogens as a result of intervention Field samples (from environment and food) - Requires active sampling; not always conducted during inspections - A more objective, scientific approach than visual inspection - Resource and labour intensive - Requires large-scale sampling to assess changes in food hygiene 6 Other Correlation between the number of foodborne illness outbreaks and the implementation rate of intervention (i.e., % of staff certified, number of annual inspections

2013 National Collaborating Centre for Environmental Health

700. Clinical practice guidelines for the management of rotator cuff syndrome in the workplace

Collaborative Team Approach 31 7.1.6 Cultural and Language Issues 32 8.0 T reatment 33 8.1 Pain Management 33 8.1.1 Medication 33 8.1.2 Heat/Ice 35 8.2 Return to Work Program 35 8.3 Prescribed Exercise 39 8.4 Manual Therapy 40 8.5 Acupuncture 41 8.6 Electro-physical Agents 41 8.6.1 Transcutaneous Electromagnetic Stimulation (TENS) 42 8.6.2 Bipolar Interferential Current 42 8.6.3 Pulsed Electromagnetic Field Therapy (PEMF) 42 8.6.4 Low Level Laser Therapy (LLLT) 42 8.6.5 Therapeutic Ultrasound 42 8.7 (...) Calcific Tendonitis 43 8.8 Emerging Treatments 43 8.9 Supplements 44 9.0 Review 45 9.1 Recovery 45 9.2 Rotator Cuff Pathology 46 9.3 Patient Experiencing Significant Persisting Pain and/or Activity Restriction 46 9.3.1 Diagnostic Imaging 46 9.3.2 Preferred Imaging for Rotator Cuff Syndrome 48 9.4 Subacromial Injections of Corticosteroids 48 9.5 Referral for Specialist Opinion 495 9.6 Rotator Cuff Tears 49 9.6.1 Rotator Cuff Surgery 50 9.6.2 When should Surgery be Performed for Rotator Cuff Syndrome? 50

2013 Clinical Practice Guidelines Portal

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