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Insight and Judgement

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701. Medical emergencies in adults overview

is not inclusive; patients with other signs may also be time critical, this is where the clinical judgement of the Paramedic is important. ? CORRECT A AND B PROBLEMS ON SCENE, THEN COMMENCE TRANSPORT TO NEAREST SUITABLE RECEIVING HOSPITAL. If airway and breathing cannot be corrected, or haemorrhage cannot be controlled, evacuate immediately, continuing resuscitation as appropriate en- route and alert. Provide a Hospital Alert Message. En-route – continue patient MANAGEMENT (see below). HISTORY In order (...) Remember that the patient history may give you valuable insight into the cause of the current condition. The following may be of great help in your diagnosis: ? relatives, carers or friends with knowledge of the patient’s history. ? packets or containers of medication (including domiciliary oxygen) or evidence of administration devices, e.g. nebuliser machines. ? medic alert type jewellery (bracelets or necklets) which detail the patient’s primary health risk (e.g. diabetes, anaphylaxis, Addison’s

2006 Joint Royal Colleges Ambulance Liaison Committee

702. Professionalism in Nursing

that will enhance further understanding of the complexities of the concepts and how they can interact with the work environment. Although professionalism is a traditional concept that has stood the test of time, it has been a challenge to write a corresponding “best practice” guideline. However, a guideline is only meant to be an outline that provides further insight into the meaning of the term professionalism. The concept has not been scrutinized by the usual methods of research owing in part to its

2007 Registered Nurses' Association of Ontario

703. Nursing Management of Hypertension

and consensus resulted in revisions to the draft document prior to publication and evaluation. Nursing Management of Hypertension 2021 Definition of Terms Adherence: Adherence, the extent to which a client’s behaviour (taking medication, following a diet, modifying habits or attending clinics) coincides with healthcare giver advice, is the single most important modifiable factor that compromises treatment outcome (Haynes et al., 2002; WHO, 2003). The term adherence is intended to be non judgemental

2005 Registered Nurses' Association of Ontario

704. Assessment and Management of Venous Leg Ulcers

, following the appraisal process, identified the following guidelines, and related updates, to adapt and modify recommendations: Clement, D. L. (1999). Venous ulcer reappraisal: Insights from an international task force. Journal of Vascular Research, 36(Suppl.1), 42-47. Clinical Resource Efficiency Support Team (CREST) (1998a). Guidelines for the assessment and management of leg ulceration. CREST, Belfast, Northern Ireland [On-line]. Available: http://www.ni-nhs.uk/crest/index.htm Compliance Network

2004 Registered Nurses' Association of Ontario

706. Cost-effectiveness of donepezil in the treatment of mild or moderate Alzheimer's disease

to ensure the validity of primary studies No criteria to ensure the validity of primary studies were reported. Methods used to judge relevance and validity, and for extracting data The authors did not report any judgement criteria to assess the validity of the primary studies included in the review. Number of primary studies included Four primary studies were included in the review. Methods of combining primary studies The authors pooled the results of the 24-week trial that was used to estimate (...) as a methodological demonstration that provides insights into the possible effects of donepezil and highlights the need for more data to enable informed decision-making. The authors suggest that future studies could investigate the cost-effectiveness of other interventions, including non-pharmacological interventions, for Alzheimer's disease. Source of funding Supported by a grant from Pfizer Inc. to the Harvard Program on the Economic Evaluation of Medical Technology. Bibliographic details Neumann P J, Hermann R

1999 NHS Economic Evaluation Database.

707. Clinical practice guidelines for the management of advanced breast cancer

re-uptake inhibitors SSRI selective serotonin re-uptake inhibitors TCA tricyclic antidepressant TENS transcutaneous electrical nerve stimulation UICC Union Internationale Contre le Cancer (International Union Against Cancer) WHO World Health Organizationix Clinical practice guidelines for the management of advanced breast cancer IM P ORTA N T N OT ICE This document is a guide to appropriate practice, to be followed subject to the clinician’s judgement in each case. The guidelines are designed (...) . Locally advanced breast cancer is defined by the presence of a tumour that has one of the following characteristics: ‘peau d’orange’, skin ulceration, or fixation to the underlying intercostal or serratus anterior muscles or bones of the chest wall or inflammatory carcinoma. This corresponds to stage III in the International Union Against Cancer (UICC) classification. 1 Local recurrence applies to recurrence after previous treatment and is an ill-defined term, usually based on clinical judgement

2000 Cancer Australia

708. Clinical practice guidelines for the psychosocial care of adults with cancer

ethics and related issues. This document is a general guide to appropriate practice, to be followed subject to the clinician’s judgement and the patient’s preference in each individual case. The guidelines are designed to provide information to assist decision-making and are based on the best evidence available at the time of publication. This is the first edition of the Clinical practice guidelines for the psychosocial care of adults with cancer. These guidelines are based on the Psychosocial (...) practice guidelines for the psychosocial care of adults with cancerIMPORTANT NOTICE This document is a general guide to appropriate practice, to be followed subject to the clinician’s judgement and the patient’s preference in each individual case. The guidelines are designed to provide information to assist decision-making and are based on the best evidence available at the time of publication. Clinical practice guidelines for the psychosocial care of adults with cancer ixEXECUTIVE SUMMARY Cancer has

2002 Cancer Australia

709. A review of the effectiveness and appropriateness of peer-delivered health promotion interventions for young people

to suggest how methods for systematically reviewing health promotion literature may be improved, or able to comment on judgements made during this review is invited to contact the EPI- Centre. EPI-Centre Social Science Research Unit Institute of Education University of London 18 Woburn Square London WC1H 0NS Tel: 0171 612 6816 Fax: 0171 612 6400 E-mail: health@ioe.ac.uk ISBN 085473-614XTable of Contents SUMMARY 1 Recommendations for the practice of peer-delivered health promotion . . . . . . . . 3

1999 EPPI Centre

710. PHASE: Promoting Health After Sifting the Evidence

promotion. Time was allowed for discussion in workshops and planning meetings to: a) give some insight into the decision-making processes during the planning and delivery of health promotion programmes b) identify sources of research reports which currently inform health promotion services c) identify outcomes and processes of health promotion programmes of greatest interest to purchasers and providers d) reveal commissioners’ and providers’ views of what is feasible and what is acceptable in health

1996 EPPI Centre

711. Effectiveness reviews in health promotion

emphasises dissemination and should favour efforts at this stage. C Research gaps need to be explicitly stated. C A balance is needed between tables and text, which may mean presenting tables as an appendix. C Detail should not be sacrificed to increase accessibility. Elements essential to a review were considered to be: C Bibliography. C Transparent methodology. C Full discussion and critical appraisal of findings, including discrepancies but not value judgements. C Clear summary. 9 Elements important

1999 EPPI Centre

712. Getting evidence into practice

This bulletin aims to summarise the available evidence on changing professional practice, and to give a range of helpful and relevant advice to those involved in changing practice. Authors' conclusions This overview of empirical research, theoretical perspectives and insights from practical experience offers guidance on bringing about change. Whilst the research base is incomplete, it is possible to make informed judgements on how best to influence the behaviour of health professionals. It is clear that any (...) and interviews and informed judgement. From material presented in this bulletin such an analysis might include: 1. identification of all groups involved in, affected by or influencing the proposed change(s) in practice 2. assessment of the characteristics of the proposed change that might influence its adoption 3. assessment of the preparedness of the health professionals to change and other potentially relevant internal factors within the target group 4. identification of potential external barriers

1999 Health Technology Assessment (HTA) Database.

713. Supporting and Strengthening Families Through Expected and Unexpected Life Events

to assist the family to find meaningful and satisfactory caregiving roles. B. Assessing Need Family assessments are critical in identifying how the family has been affected by the expected or unexpected life event. A family assessment is an exploration between the nurse and family to gain insight into the family’ s perspective of the event, their strengths and need for support (Neabel, Fothergill-Bourbonnais, & Dunning, 2000). This perspective provides an understanding of how the quality of health

2002 Registered Nurses' Association of Ontario

714. BeneFIX (nonacog alfa(

be informed of early signs of hypersensitivity reactions, such as hives or shortness of breath, and of the possibility of anaphylactic reaction. The initial administrations of BeneFIX should, according to the treating physician’s judgement, be performed under medical observation where proper medical care for allergic reactions could be provided. If allergic or anaphylactic-type reactions occur, the administration of BeneFIX has to be discontinued immediately and an appropriate treatment has (...) unknown. The company has been asked to carefully monitor and investigate patients exhibiting allergic reactions and to continue their investigations into the possibility of inhibitor development. Post-marketing experience has produced data in a larger patient population with haemophilia B and has provided additional insight into potential emerging safety issues with the use of BeneFIX. In preparation for post-marketing surveillance, the MAH initially identified 2 areas a priori that would require

2005 European Medicines Agency - EPARs

715. Neurodegenerative disease and the evolution of art: the effects of presumed corticobasal degeneration in a professional artist. (PubMed)

Neurodegenerative disease and the evolution of art: the effects of presumed corticobasal degeneration in a professional artist. Production of art is a complex process involving a combination of technical skill and a unique talent. Changes in artistic ability may accompany neurodegenerative disorders when they occur in an artist. The nature of these changes in the context of definable regional neuropathological disturbances may provide insight into the structural basis of the creative process (...) . We describe a professional artist in whom presumed corticobasal degeneration (CBD) was associated with an alteration of his artistic judgement and production. Disinhibition, perseveration, and left hemispatial neglect, features of his cognitive profile were readily discernible in his work. The differences in his style are examined with respect to his main neuroanatomic abnormalities, namely right cerebral hemiatrophy as defined by magnetic resonance and single-photon emission computed tomography

2003 Movement Disorders

716. The relevance of oral health for attenders and non-attenders: a qualitative study. (PubMed)

The relevance of oral health for attenders and non-attenders: a qualitative study. Low expectations of health mean that oral health becomes a low priority for some people, an appreciation of which would help dentists when a non-attender does come to the surgery.To provide an insight into why oral health is not important to some people and how this attitude might hinder access to dental care.In this qualitative study, purposive sampling was used to recruit two groups of participants (...) 'normal' state of oral health, the perceived causes of oral health and disease, the degree of trust held in dentistry, perceptions of oral 'health' as a commodity, perceptions of the accessibility of oral health care, perceptions of 'natural' oral health and judgements of character.If certain aspects of oral health are not relevant, little that is said about those aspects will be meaningful to people. The key is to either emphasize or gently challenge those ideas and beliefs that allow or hinder

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2007 British Dental Journal

717. Prevalence and predictors of mental incapacity in psychiatric in-patients. (PubMed)

and a binary judgement of capacity was made, guided by the MacArthur Competence Tool for Treatment. Demographic and clinical information was collected from an interview and case notes.Of the 112 participants, 49 (43.8%) lacked treatment-related decisional capacity. Mania and psychosis, poor insight, delusions and Black and minority ethnic group were associated with mental incapacity. Of the 49 patients lacking capacity, 30 (61%) were detained under the Mental Health Act 1983. Of the 63 with capacity, 6

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2005 British Journal of Psychiatry

718. The problem of appraising qualitative research. (PubMed)

of qualitative research. There will be difficulties in doing this because some aspects of qualitative research, particularly those relating to quality of insight and interpretation, will remain difficult to appraise and will rely largely on subjective judgement.

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2004 Quality and Safety in Health Care

719. Appraisal of family doctors: an evaluation study. (PubMed)

Appraisal of family doctors: an evaluation study. Appraisal has evolved to become a key component of workforce management. However, it is not clear from existing proposals for appraisal of doctors whether employers, health authorities or primary care organisations should take responsibility for appraisal processes.To evaluate the introduction of a pilot peer appraisal system in general practice and to gain insight into the reactions of appraisers and doctors.Semi-structured telephone interviews (...) -based pilot study where participation was recompensed. The majority of participating clinicians were positive, with appraisers reporting the most gain. Appraisers were enthusiastic, provided the process remained non-judgemental and did not threaten or burden their colleagues. Appraised doctors were less enthusiastic but the most significant perceived benefit was the opportunity to reflect on individual performance with a supportive colleague. There were, however, repeated concerns about time

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2003 The British Journal of General Practice

720. The "Oxford Heup Score": the translation and validation of a questionnaire into Dutch to evaluate the results of total hip arthroplasty. (PubMed)

postoperative year the score was very sensitive to changes, whereas in the second year it did not change significantly. The two added hip-specific questions were both filled out positively by more than 50% of the patients and thus fit perfectly into a hip-specific patient outcome questionnaire such as the OHS.The OHS proves to be an appropriate instrument for assessment of the outcome of total hip replacement from the patient's perspective. Together with the judgement of the surgeon, it provides useful (...) insights into the question of whether this operation has been a success or not.

2005 Acta Orthopaedica

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