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Failure to Thrive in the Elderly


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141. Mentally Healthy Communities

The mental health of Australia’s children and young people remains a top national priority. Close to half of all mental health conditions emerge by the age of 14 years. Early life is a recognised critical period for developing skills and competencies that enable positive mental health, and also as a period for identifying mental health issues before they progress to become clinical disorders. In 2018, Beyond Blue, in partnership with the Australian Government, launched a national education initiative (...) in early learning services for younger aged children. The experiences and unique needs of specific sub-population groups, such as culturally and linguistically diverse populations, was relatively under- explored compared to the overall general population. Some evidence was found to suggest benefits that may be universal to all community members. Despite wide acceptance of whole-community approaches to mental health and wellbeing of children and young people, the evaluation of such approaches is still

2019 Sax Institute Evidence Check

142. Learning Resilience

, and caring for oneself. Values are like a compass: They help a young person make choices. Values connect to goals, or concrete actions. Here is an idealised example of value clarification happening with a 10 year old child. Teacher: What do you want to happen at recess today? Youth: I want to have fun with my friends (the value). Teacher: What will help you do that? Teacher: I guess I should share and not argue so much (the goal). By clarifying and affirming values, the educator can help young people (...) and wellbeing in children and young people. It also identifies proven strategies that educators can use to help children and young people to build social and emotional learning skills and resilience. Educators will best engage with this review if read in conjunction with the Professional Learning modules in the Learning Resilience domain. Suggested citation: Ciarrochi J, Gordon C and Jones S. Learning Resilience, and Social and Emotional (SEL) Skills: an Evidence Check rapid review brokered by the Sax

2019 Sax Institute Evidence Check

143. Early Support

) Likewise, family day care educators’ positive interactions increased and detached interactions decreased for those who had attended the THRIVE program. (16) Positive interactions between students and educators were also found in primary and high school settings in studies included in this review. Abry et al. (29) found that the Responsive Classroom (RC) PD, which encouraged primary school aged children to greet and share news with each other, fostered respectful peer relationships. This in turn led (...) and young people’s mental health and wellbeing. Question 2: What are the key components across the programs identified in Question 1? The 25 identified PD programs covered the following key components, outlined below. These have been reported in line with Beyond Blue’s Be You initiative, which outlines a model for educators of “Noticing, Inquiring and Providing Support” to students. Noticing THRIVE, a capacity-building program for family day care educators that was evaluated by Davis et al. (16) focused

2019 Sax Institute Evidence Check

144. Palliative Care for Adults Institute for Clinical Systems Improvement 14 Palliative Care for Adults Sixth Edition /January 2020 Debility/Failure to Thrive • Greater than three chronic conditions in patient over 75 years old • Functional decline • Weight loss • Patient/family desire for low-yield therapy • Increasing frequency of outpatient visits, emergency department visits, hospitalizations Cancer • Uncontrolled symptoms due to cancer or treatment • Introduced at time of diagnosis – if disease likely incurable (...) within 12 months • Frequent admissions (e.g., more than one admission for same condition within several months) • Admission prompted by difficult-to-control physical or psychological symptoms (e.g., moderate-to-severe symptom intensity for more than 24–48 hours) • Complex care requirements (e.g., functional dependency; complex home support for ventilator/antibiotics/feedings) • Decline in function, feeding intolerance, or unintended decline in weight (e.g., failure to thrive) Secondary Criteria b

2020 Institute for Clinical Systems Improvement

145. Prenatal Care

, congenital anomalies, and failure to thrive. Key Points: Prenatal care summary. Table 1 summarizes the main aspects of prenatal care from preconception through delivery (history and examination; testing and treatment; education and planning). Fetal surveillance. Table 2 shows the common indications for antepartum fetal surveillance with nonstress testing and amniotic fluid index (AFI), the gestational ages at which to initiate testing, and the frequency of testing. Referral. Table 3 summarizes (...) ) Postpartum Care: The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery. (HEDIS) HBsAg testing in Pregnancy: All female patients aged 12 and older who had a live birth or delivery during the measurement period who were tested for hepatitis B surface antigen (HBsAg) during pregnancy within 280 days prior to delivery (CMS) Prenatal/Postpartum Depression Screening: The proportion of live deliveries between 2-14 months prior to the measurement end date

2020 University of Michigan Health System

146. Maternal and Newborn Survival in Sub-Saharan Africa

, is needed, as well as lower cost simpler blood culture and tests for antimicrobial resistance (AMR), and diagnostics for jaundice. Innovative devices for newborn care that are robust and have interoperability such as continuous positive airway pressure (CPAP) machines, infusion pumps, apnoea monitors, pulse oximeters etc. are a key gap. Simpler, cheaper ways to determine gestational age would be beneficial as would low-cost surfactants. Cross-cutting issues Closing the gap for African research (...) to effectively target this policy work, there was a commitment made by the AMS and AAS to explore a future policy workshop in 2019 to set out a pathway forward.Status of maternal and newborn health in Africa 8 It is estimated that in 2018 there were around 5.9 million deaths under the age of five globally, of which 2.5 million occurred in the first month of life. 3 Over 300,000 women died as a result of complications related to pregnancy. 4 An estimated 2.6 million stillbirths occur annually. Most

2019 Academy of Medical Sciences

147. Covid-19: Clinical guide to surgical prioritisation during the coronavirus pandemic

and urological surgery Laparotomy or Stoma Closure to manage intestinal failure with liver disease / complications Infant with Billary Atresia - bladder exstrophy Inguinal hernia under 3/12 of age MDT Directed surgery for Nephroblastoma/ Neuroblastoma/ Rhabdomyosarcoma Crohn’s Disease - stricture/fistula/ optimise medication/nutrition Circumcision for severe BXO Renal transplant Renal Stent Removal/Exchange Paediatric Orthopaedic surgery MDT Directed Suspected, aggressive benign bone tumour Meniscal repair (...) for Failure To Thrive (FTT) Interval appendicectomy for recurrent symptoms Cholecystectomy Paediatric Orthopaedic surgery Developmental Dislocation of the Hip (DDH) - Primary joint stabilisation Congential Talipes Equino Varus (CTEV) - Initial management including tenotmies Limb length discrepancy/ malalignment Please note Any delay in treatment, especially of cancers, trauma and life threatening conditions, may lead to adverse outcomes. Other Specialist Surgery in Paediatric patients is included

2020 NHS England

148. Systematic evidence-based review: outcomes from exome and genome sequencing for pediatric patients with congenital anomalies or intellectual disability

/42, 12%: med change; 4/42, 10%: change in surg; 1/42, 2%: palliative care initiated; 4/42, 10%: change in imaging/ procedure; 10/42, 24%: morbidity avoided (comparison to historical/controls); 1/42, 2%: 83–94% decrease in mortality risk compared with historical/control NR NR NR French et al. 14 2019 UK 12/2016–9/ 2018 195 CA CA; neuro sx; suspected metabolic disease; surg necrotizing enterocolitis; extreme IUGR; or failure to thrive; unexplained Prematurity w/o additional features; known (...) publication identified by the search strategy under- went dual review for eligibility by a team of nine reviewers in a two-step process: title/abstract screening followed by full- text review using the inclusion and exclusion criteria listed in Table 1. Although CA may manifest postinfancy, we limited inclusion of studies to those where CA had onset prior to age 1yearandDD/IDhadonsetpriortoage18years.Studiesthat failed to meet inclusion criteria were excluded in title/abstract review or in full-text

2020 American College of Medical Genetics and Genomics

149. Diagnostic testing for uniparental disomy

chromosome 14 and epigenetic defects. 59,60 Excessive RTL1 expression and absent MEG expression in the q32.2 region of chromosome 14 constitute the primary underlying factors for the phenotypic abnorm- alities in these patients. 59,60 Maternal UPD15 and Prader–Willi syndrome Prader–Willi syndrome (PWS, MIM 176270) is characterized by neonatal hypotonia and poor suck with failure to thrive, developmental delay and/or intellectual disability, childhood- onset obesity, short stature, hypogonadism (...) growth and prominent feeding difficulties with failure to thrive. Most patients do not have dysmorphic features, congenital abnormalities, or major devel- opmental delay. There is a significant phenotypic overlap with RSS and other conditions that predominantly exhibit pre- and postnatal poor growth and short stature. Unexpectedly, in the majority of published cases, CMA testing had genotyping patterns suggesting UPD due to meiosis II error or postzygotic mitotic error, rather than the typically more

2020 American College of Medical Genetics and Genomics

150. Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association

amputations among patients with T2DM in the past 15 years, there has been a recent resurgence in these morbid ischemic complications, particularly among young and middle-aged adults. These alarming statistics highlight the urgent need to refocus on aggressive cardiovascular risk reduction in patients living with T2DM, especially in those who already have established CAD. Thus, to improve the longevity and quality of life in patients with T2DM, practice guidelines increasingly recognize the prevention (...) in patients with albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g) and reduce the risk of both incident and recurrent atherosclerotic ischemic events. , In the HOPE study (Heart Outcomes Prevention Evaluation), 3577 people with diabetes mellitus with cardiovascular disease or at least 1 other cardiovascular risk factor but no proteinuria or heart failure were randomized to ramipril versus placebo. The trial was stopped early (after 4.5 years) because of consistent benefit of ramipril, which

2020 American Heart Association

151. Cardiovascular Health in American Indians and Alaska Natives: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

highest among younger adults <45 years of age. Other forms of CVD such as heart failure and arrhythmia are understudied in American Indians and Alaska Natives. However, the limited data suggest that heart failure mortality rates in American Indians and Alaska Natives approach rates present in whites. Multiple risk factors contribute to high CVD rates in American Indians and Alaska Natives. This statement will highlight the historical context of care, pertinent risk factors, and social determinants (...) Heart Study demonstrates that age and diabetes mellitus are important predictors, as well as smoking status, hypertension, ratio of HDL/LDL, renal function, history of CHD or left ventricular hypertrophy, parental history of stroke, waist circumference, and alcohol consumption. When echocardiographic measures were added to the model for risk prediction, they did not improve the estimate of risk. In the Strong Heart Study, high levels of vascular brain injury were also identified among older American

2020 American Heart Association

152. Sleep Disorder Management

, irritability, decreased libido, and nocturia. Although OSA may occur in all age groups, it is most common in patients between 40 and 70 years old. The incidence of OSA in obese patients is considerably higher than in non-obese individuals. OSA is associated with higher mortality because patients with OSA are more likely to have cardiac arrhythmias, coronary artery disease, congestive heart failure, stroke, diabetes, and treatment-resistant hypertension (persistent hypertension in a patient taking three (...) , respiratory airflow, and respiratory effort (e.g., thoracoabdominal movement) 95807 Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist 95808 Polysomnography; Any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist 95810 Polysomnography; Age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist 95811 Polysomnography; Age 6 years

2020 AIM Specialty Health

153. Abdominal and pelvic imaging

for evaluation of symptoms persisting 2 or more weeks following nondiagnostic radiographs when ANY of the following are present: Imaging of the Abdomen and Pelvis Copyright © 2020 AIM Specialty Health ® All Rights Reserved. 16 ? Failure of medical management ? Failure to thrive ? Fever ? Vomiting ? Following barium enema or anal manometry when there is suspicion for ANY of the following: o Anal stenosis o Impaction in patients younger than 1 year of age o Tight empty rectum IMAGING STUDY - CT abdomen (...) that the prior intervention was never administered. Imaging of the Abdomen and Pelvis Copyright © 2020 AIM Specialty Health ® All Rights Reserved. 8 Imaging of the Abdomen and Pelvis General Information/Overview Scope These guidelines address advanced imaging of the abdomen and pelvis in both adult and pediatric populations. For interpretation of the Guidelines, and where not otherwise noted, “adult” refers to persons age 19 and older, and “pediatric” refers to persons age 18 and younger. Where separate

2020 AIM Specialty Health

154. Pediatric Endoscopy in the Era of Coronavirus Disease 2019: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper

Suspected gastrointestinal malignancy Planned polypectomy, EMR/ESD for complex/high-risk lesions In?ammatoryboweldisease(IBD):highsuspicionofnewIBDdiagnosis;guidetreatmentdecisions(including?are)inpatientwithmoderatetosevereactivity;guidetreatmentdecisions for complications of established/new diagnosis IBD (eg, partial bowel obstruction) Severe and progressive failure to thrive, unresponsive to medical management Severe chronic diarrhea, unresponsive to medical management Severe Clostridioides dif (...) Program and an Early Researcher Award from the OntarioMinistryofResearchandInnovation.Thefundershadnorolein thedesignandconductofthereview,decisiontopublishandpreparation, review, or approval of the manuscript. Dr Diana G. Lerner is senior responsible author. All members were required to complete the disclosure statement. These statements are maintained at the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition in Ambler, United States, and pertinent disclosures

2020 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

155. Cystic fibrosis

newborn screen failure to pass meconium failure to thrive voracious appetite wet-sounding cough recurrent infection chronic sinusitis genital abnormalities in males haemoptysis malabsorptive stool with steatorrhoea digital clubbing gastro-oesophageal reflux wheeze increased anteroposterior (AP) diameter of the chest hx of pancreatitis hx of acute appendicitis enlarged liver or spleen FHx of CF known carrier status of both parents ethnicity Diagnostic investigations sweat test immunoreactive (...) Cystic fibrosis Cystic fibrosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cystic fibrosis Last reviewed: February 2019 Last updated: September 2018 Summary Genetic multisystem disease associated with abnormalities in salt and water transport across epithelial surfaces. Age of onset of symptoms is highly variable; implementation of newborn screening in some countries allows for early detection and treatment

2018 BMJ Best Practice

156. Lactase deficiency

brush border (microvilli) of the small intestine, usually at the age of weaning. Matthews SB, Waud JP, Roberts AG, et al. Systemic lactose intolerance: a new perspective on an old problem. Postgrad Med J. 2005 Mar;81(953):167-73. Heyman MB; American Academy of Pediatrics, Committee on Nutrition. Lactose intolerance in infants, children, and adolescents. Pediatrics. 2006 Sep;118(3):1279-86 (...) and rate of lactose reaching the colon, as well as the type and amount of colonic flora. Matthews SB, Waud JP, Roberts AG, et al. Systemic lactose intolerance: a new perspective on an old problem. Postgrad Med J. 2005 Mar;81(953):167-73. History and exam presence of risk factors symptoms after ingestion of dairy products diarrhoea distension lethargy mouth ulceration headache poor short-term

2018 BMJ Best Practice

157. Hypogammaglobulinaemia

with Streptococcus pneumoniae or Haemophilus species infection with atypical pathogens repeated antibiotic use respiratory crackles, high-pitched inspiratory squeaks, rhonchi absence from school/work failure to thrive diarrhoea sinusitis pallor tympanic membrane perforation illness after live vaccines weight loss, night sweats, fevers oedema alopecia, goitre, vitiligo eczema small/absent tonsils lymphadenopathy and hepatosplenomegaly hx of coeliac disease or transfusion reactions muscle fatigability, ptosis (...) , diplopia (if thymoma present) dysmorphic features neurological involvement young children and early adulthood (primary disease) old age (secondary disease) male gender positive FHx of primary immunodeficiency severe protein-losing state haematological malignancy anticonvulsant and immunosuppressive drugs Diagnostic investigations FBC serum IgG serum IgA serum IgM serum and urine electrophoresis urine dipstick serum creatinine serum albumin liver function tests (LFTs) sputum culture stool culture chest

2018 BMJ Best Practice

158. Foreign body ingestion

the gastrointestinal tract. History and exam presence of risk factors dysphagia non-specific abdominal pain stridor and wheezing drooling gagging, nausea/vomiting, neck/throat pain atypical chest pain or non-cardiac chest pain choking signs of upper gastrointestinal obstruction lower gastrointestinal bleeding odynophagia fever, poor feeding, failure to thrive, and irritability (in children) acute or chronic asthma-like symptoms or recurrent pneumonia signs of sepsis sign of acute drug intoxication age <15 years (...) Foreign body ingestion Foreign body ingestion - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Foreign body ingestion Last reviewed: February 2019 Last updated: November 2018 Summary Foreign body ingestion is a common clinical problem. Those at increased risk include children, older people, people who have an intellectual disability, patients with psychiatric pathologies, prisoners/inmates, and those with underlying

2018 BMJ Best Practice

159. Ventricular septal defects

ventricles. Eisenmenger's syndrome is shunt reversal (blood flowing from the right to the left ventricle) leading to the distribution of de-oxygenated blood to the systemic arterial circulation. History and exam presence of risk factors systolic murmur left parasternal region failure to thrive shortness of breath recurrent pulmonary infections loud pulmonary component of the second heart sound cyanosis finger clubbing recent myocardial infarction (usually within 2-5 days) recent trauma family history (...) declares that he has no competing interests. Peer reviewers Acting Head Department of Cardiology Royal Children's Hospital Melbourne Australia Disclosures MC declares that he has no competing interests. Consultant Paediatric Cardiologist and Honorary Senior Lecturer Great Ormond Street Hospital and Institute of Child Health London UK Disclosures SK declares that he has no competing interests. Attending Pediatric Cardiothoracic Surgeon Medical University of South Carolina Children's Hospital Charleston

2018 BMJ Best Practice

160. Atrial septal defects

enlargement, cardiac arrhythmias, and heart failure over time. Secundum, primum, and coronary sinus defects with small shunts (ratio of pulmonary flow to systemic flow, Qp:Qs, <1.5) do not require treatment. Corrective closure is required if the shunt is larger (Qp:Qs ratio ≥1.5), there is right atrial enlargement, or the patient has a sinus venosus defect. Corrective closure, if required, is usually performed at 2 to 4 years of age but can be performed at a younger age in symptomatic patients (...) DJ. Fundamentals of pediatric cardiology. Philadelphia, PA: Lippincott Williams & Wilkins; 2006:73-8. There are 4 types of ASD: ostium secundum, ostium primum, sinus venosus, and unroofed coronary sinus. History and exam systolic ejection murmur fixed splitting of the second heart sound presence of risk factors mid-diastolic murmur congestive cardiac failure failure to thrive symptoms of atrial arrhythmias cyanosis finger clubbing female sex maternal alcohol consumption positive FHx Diagnostic

2018 BMJ Best Practice

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