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12001. Disability in Older People

. [ ] Camberwell Assessment of Need in the Elderly. Management General points [ , ] Important aspects of management Treatment of unstable medical conditions and any treatable problems contributing to the disability. Reviewing drug treatment (including polypharmacy). Early mobilisation. Nutritional support. Comprehensive rehabilitation. Who should be involved in management? A multidisciplinary approach can be helpful. This has been shown to be beneficial - eg, following stroke and fractured neck of femur (...) our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; General Medical Council (2014) ; NICE Guidance (December 2015) ; British Geriatrics Society - Best Practice Guide 3.2 (May 2008) ; World Health Organization ; Aging, disability and frailty. Ann Nutr Metab. 200852 Suppl 1:6-11. Epub 2008 Mar 7. ; Age UK, January 2011 ; Ageing populations: the challenges ahead. Lancet. 2009 Oct 3374(9696):1196-208. ; Population attributable risk for functional

2008 Mentor

12002. Difficult Patients

in the frequency of GP consultations. Br J Gen Pract. 1999 May49(442):363-7. Eric Berne. Games people play.; Penguin Books 1964 ; Striking variations in consultation rates with general practice reveal family BMC Fam Pract. 2007 Jan 188:4. ; Do patients with unexplained physical symptoms pressurise general practitioners for somatic treatment? A qualitative study. BMJ. 2004 May 1328(7447):1057. Epub 2004 Mar 31. ; Patients' unvoiced agendas in general practice consultations: qualitative study. BMJ. 2000 May 6320 (...) Difficult Patients Helping Patients Avoid Doctor Dependency. Advice and info | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Helping Patients Avoid Doctor Dependency Authored by | Last edited 22 Mar 2010 This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines

2008 Mentor

12003. Diabetes Education and Self-management for Ongoing and Newly Diagnosed (DESMOND) Full Text available with Trip Pro

Diabetes Education and Self-management for Ongoing and Newly Diagnosed (DESMOND) Diabetes Education and Self-management Programmes. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Diabetes Education and Self-management Programmes Authored by , Reviewed by | Last edited 2 Dec 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals (...) activity. Reducing the need for - and potentially better targeting of - medication and other items such as blood testing strips. Diabetes education must be flexible enough to suit the needs of the individual - eg, cultural, linguistic, cognitive and literacy needs. There are several different programmes available across the UK: For people with type 1 diabetes The Dose Adjustment for Normal Eating (DAFNE) Programme [ ] . The X-PERT Insulin Programme is suitable for people with type 1 diabetes who feel

2008 Mentor Controlled trial quality: uncertain

12004. Email Consultations in Healthcare

on research evidence, UK and European Guidelines. You may find one of our more useful. In this article In This Article Email Consultations in Healthcare In this article The use of email is so widespread in our domestic and working lives that many patients would like to be able to communicate with their doctor by email, seeing it as a straightforward extension of normal medical services. Emails have revolutionised communication in General Practice over the last decade and take many forms: Internal email (...) to facilitate repeat prescriptions, appointment booking and clinical enquiries and found that 'it worked well within an urban practice, was deemed helpful by patients and resulted in no apparent increase in GP workload'. [ ] Doctors have tended to be more reserved in their enthusiasm for the clinical use of emails generally and many have not adopted email consultations, as they continue to have legitimate professional concerns regarding quality, confidentiality, liability and remuneration. [ , ] The current

2008 Mentor

12005. Edinburgh Postnatal Depression Score Calculator

and antipsychotic medication. Prevention [ ] NICE recommends that women be proactively screened for mental health problems and high-risk patients identified. It is advised that when women present for booking and at the postnatal check, health professionals (including midwives, obstetricians, health visitors and GPs) should ask questions to screen for depression and anxiety (as in the 'Diagnosis' section, above). At the first contact they should also ask about: Past or present severe mental illness including (...) our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; University of California, San Francisco ; Royal College of General Practitioners ; Motherhood and mental illness--part 2--management and medications. Aust Fam Physician. 2009 Sep38(9):688-92. ; Depression drug treatment outcomes in pregnancy and the postpartum period: a systematic review and meta-analysis. Obstet Gynecol. 2014 Sep124(3):526-34. doi: 10.1097/AOG.0000000000000410. ; Antenatal

2008 Mentor

12006. Dyslexia

Dyslexia Dyslexia. Early signs of dyslexia & treatment info at Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Dyslexia Authored by , Reviewed by | Last edited 13 Mar 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may (...) . Inability to distinguish sounds or shapes on the page. Associated features include poor spelling and handwriting, and mathematical difficulties. Assessment Assessment is usually carried out by an educational psychologist following a referral from a parent or teacher. Standardised measures, such as the Wechsler Intelligence Scale for Children, are used to assess general intellectual ability. More specific tools (eg, the Dyslexia Early Screening Test for testing early years, the Dyslexia Screening Test

2008 Mentor

12007. Congenital HIV Infection and its Prevention

HIV Association (CHIVA), January 2014 ; aidsmap.com, 2015 ; General Medical Council (various dates) ; AIDSinfo ; Long-term virological outcome in children on antiretroviral therapy in the UK and Ireland. AIDS. 2014 Oct 2328(16):2395-405. ; Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life. HIV Med. 2015 Feb 3. doi: 10.1111/hiv.12217. ; Safety, immunogenicity and efficacy (...) Congenital HIV Infection and its Prevention Congenital HIV and Childhood AIDS information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Congenital HIV and Childhood AIDS Authored by , Reviewed by | Last edited 4 Apr 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based

2008 Mentor

12008. Childhood AIDS

, 2015 ; General Medical Council (various dates) ; AIDSinfo ; Long-term virological outcome in children on antiretroviral therapy in the UK and Ireland. AIDS. 2014 Oct 2328(16):2395-405. ; Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life. HIV Med. 2015 Feb 3. doi: 10.1111/hiv.12217. ; Safety, immunogenicity and efficacy of pneumococcal conjugate vaccine in HIV-infected individuals (...) Childhood AIDS Congenital HIV and Childhood AIDS information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Congenital HIV and Childhood AIDS Authored by , Reviewed by | Last edited 4 Apr 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK

2008 Mentor

12009. Drug Misuse and Dependence: UK Guidelines

for the use of substitute prescribing in the treatment of opioid dependence in primary care published by the Royal College of General Practitioners (RCGP) in 2011 [ ] . See also separate , and articles. Clinical Editor's notes (July 2017) Dr Hayley Willacy would like to draw your attention to the latest version of the Drug misuse and dependence guidelines - often referred to as 'The Orange Book' [ ] . There have been major changes to the delivery of health and social care in the past decade (...) of drug-using parents. Effective treatment of the parent can greatly improve the situation. GPs have a responsibility to provide general medical services to drug misusers: Local drug treatment systems should be based on local need, and local partnerships can be formed and commissioned. GPs with a special interest in drug misuse can become involved in care. Good clinical governance systems will enable high-quality care. There should be no prejudice or discrimination: Drug misusers have the same

2008 Mentor

12010. Chronic Lymphocytic Leukaemia

Chronic Lymphocytic Leukaemia CLL Leukemia | Doctor | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Chronic Lymphocytic Leukaemia Authored by , Reviewed by | Last edited 15 Feb 2017 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may (...) be required. Virtually all patients requiring therapy should also be given to prevent . Lymphomatous transformation - immunoblastic transformation to a terminal lymphoma (Richter's syndrome) occurs in 5-10% patients. Patients with CLL have an increased risk of developing secondary malignancies, including secondary myelodysplastic syndromes or acute myelogenous leukaemia as well as solid tumours [ ] . Prognosis CLL is generally associated with long overall survival [ ] . However, there is considerable

2008 Mentor

12011. Abdominal Trauma

Abdominal Trauma Abdominal Trauma. Injury to the Abdomen information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Abdominal Trauma Authored by , Reviewed by | Last edited 28 Dec 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) and pencils. They are usually more predictable with regard to injured organs. However, a high index of suspicion must be maintained to avoid missing occult injuries. Assessment History Initially, evaluation and resuscitation occur simultaneously. In general, do not obtain a detailed history until life-threatening injuries have been identified and therapy has been initiated. However, to predict injury patterns better and to identify potential pitfalls, ascertain the mechanism of injury from bystanders

2008 Mentor

12012. Barthel's Index of Activities of Daily Living

. [ ] Camberwell Assessment of Need in the Elderly. Management General points [ , ] Important aspects of management Treatment of unstable medical conditions and any treatable problems contributing to the disability. Reviewing drug treatment (including polypharmacy). Early mobilisation. Nutritional support. Comprehensive rehabilitation. Who should be involved in management? A multidisciplinary approach can be helpful. This has been shown to be beneficial - eg, following stroke and fractured neck of femur (...) our . Thank you, we just sent a survey email to confirm your preferences. Further reading and references ; General Medical Council (2014) ; NICE Guidance (December 2015) ; British Geriatrics Society - Best Practice Guide 3.2 (May 2008) ; World Health Organization ; Aging, disability and frailty. Ann Nutr Metab. 200852 Suppl 1:6-11. Epub 2008 Mar 7. ; Age UK, January 2011 ; Ageing populations: the challenges ahead. Lancet. 2009 Oct 3374(9696):1196-208. ; Population attributable risk for functional

2008 Mentor

12013. Back Manipulation

evidence, UK and European Guidelines. You may find one of our more useful. In this article In This Article Complementary and Alternative Medicine In this article Complementary and alternative medicine (CAM) includes a group of diverse medical and healthcare systems, practices and products that are not generally considered part of conventional medicine. Complementary medicine is generally regarded as additional treatment that is used alongside conventional medicine, whereas alternative medicine (...) Back Manipulation Complementary and Alternative Medicine. CAM information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Complementary and Alternative Medicine Authored by , Reviewed by | Last edited 11 Feb 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research

2008 Mentor

12014. Agoraphobia

General principles Before prescribing, consider age, previous treatment, tolerability, other medication, comorbidities, personal preference, cost and risk of self-harm (selective serotonin reuptake inhibitors (SSRIs) are less dangerous than tricyclics in overdose). Inform the patient about possible side-effects (including a temporary increase in anxiety at the start of treatment), delay in onset of effect, possible discontinuation symptoms, the length of treatment and the need to follow dosage (...) Agoraphobia Agoraphobia - Doctor's Information. Fear of open spaces | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Agoraphobia Authored by , Reviewed by | Last edited 28 Dec 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may

2008 Mentor

12015. Anti-D (Rho) Immunoglobulin

Anti-D (Rho) Immunoglobulin Anti-D (Rho) Immunoglobulin; Rho(D) immune globulin | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Anti-D (Rho) Immunoglobulin Authored by , Reviewed by | Last edited 11 Feb 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK (...) and European Guidelines. You may find the article more useful, or one of our other . In this article In This Article Anti-D (Rho) Immunoglobulin In this article The development of anti-D antibodies generally results from feto-maternal haemorrhage (FMH) occurring in rhesus D (RhD)-negative women who carry an RhD-positive fetus. In later pregnancies, anti-D antibodies can cross the placenta, causing worsening rhesus haemolytic disease with each successive rhesus-positive pregnancy. All RhD-negative pregnant

2008 Mentor

12016. Antenatal Screening for Down's Syndrome

Antenatal Screening for Down's Syndrome Prenatal Screening for Down's Syndrome | Doctor | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Prenatal Screening for Down's Syndrome Authored by , Reviewed by | Last edited 4 Oct 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research (...) (the combined test) [ ] : The blood sample can be taken from the mother between 10 weeks and 14 weeks + 1 day of pregnancy. The ultrasound scan can be carried out between 11 weeks + 2 days and 14 weeks + 1 day of pregnancy. The serum screen measures free beta human chorionic gonadotrophin (beta-hCG) and pregnancy-associated plasma protein A (PAPP-A) (see 'Serum markers for Down's syndrome', below). If a woman books later in pregnancy (when nuchal translucency is not as accurate, or if it is not technically

2008 Mentor

12017. Blindness and Partial Sight

and use a good reading light. Enhance contrast where possible such as using large print books (don't forget talking books, the radio). Encourage the patient or relatives to find local support groups - these may be found through the Royal National Institute of Blind People's (RNIB) generic website (see below) or by looking up specific conditions. Consider referral to a low visual aids clinic (contact your Eye Department for local arrangements) where further advice can be given especially with regard (...) Blindness and Partial Sight Severe and Partial Sight Impairment Information Page | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Severe and Partial Sight Impairment Authored by , Reviewed by | Last edited 16 Apr 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence

2008 Mentor

12018. Aromatherapy

, UK and European Guidelines. You may find one of our more useful. In this article In This Article Complementary and Alternative Medicine In this article Complementary and alternative medicine (CAM) includes a group of diverse medical and healthcare systems, practices and products that are not generally considered part of conventional medicine. Complementary medicine is generally regarded as additional treatment that is used alongside conventional medicine, whereas alternative medicine is regarded (...) Aromatherapy Complementary and Alternative Medicine. CAM information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Complementary and Alternative Medicine Authored by , Reviewed by | Last edited 11 Feb 2016 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence

2008 Mentor

12019. Coping with Uncertainty in Primary Care

Coping with Uncertainty in Primary Care Coping with Uncertainty in Primary Care. Free information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Coping with Uncertainty in Primary Care Authored by | Last edited 20 Apr 2010 This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence (...) , UK and European Guidelines. You may find one of our more useful. This page has been archived. It has not been updated since 20/04/2010. External links and references may no longer work. In this article In This Article Coping with Uncertainty in Primary Care In this article Background People often prefer certainty in their lives. Generally people avoid risk and uncertainty. There is an expectation that professional people, including doctors, will give clear and unequivocal advice. However

2008 Mentor

12020. Controlled Drugs

Controlled Drugs Controlled Drugs. Information about Controlled Drugs. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Controlled Drugs Authored by , Reviewed by | Last edited 16 Apr 2014 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European (...) of Management and Use) Regulations 2006 came into effect on 1st January 2007. [ ] Schedule 1 (Controlled Drug licence) Have no recognised medicinal use and include cannabis, coca leaf, lysergic acid diethylamide (LSD) and mescaline. Production, possession and supply of these drugs are limited to research or other special purposes. Practitioners and pharmacists may not lawfully possess Schedule 1 drugs except under licence. Schedule 2 (Controlled Drugs) Includes diamorphine (heroin), morphine, remifentanil

2008 Mentor

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