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81. Xpert MTB/RIF implementation manual

, and advice on issues to be considered before the test is systematically rolled out in order to optimize its use and the benefits of the technology. The interim diagnostic algorithms were initially developed in consultation with the following Working Groups of the Stop TB Partnership: the Global Laboratory Initiative, the MDR-TB Working Group, the DOTS Expansion Working Group and the TB/HIV Working Group. The algorithms were discussed and then revised during the consultation. Policy recommendations 7 (...) Xpert MTB/RIF implementation manual Global TB Programme World Health Organization Avenue Appia 20, CH-1211 Geneva-27, Switzerland Information Resource Centre HTM/GTB: Email: tbdocs@who.int Website: www.who.int/tb Xpert MTB/RIF implementation manual T echnical and operational ‘how-to’: practical considerations ISBN 978 92 4 150670 0 IMPLEMENTATION MANUAL PERFORMANCE ACCURACY ACCURACY RECOMMENDATIONS MOLECULAR DIAGNOSTICS TUBERCULOSIS DRUG-RESISTANCE NEW DIAGNOSTIC TESTS RIFAMPICIN PULMONAR Y TB

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2014 World Health Organisation Guidelines

82. Guidelines for the screening, care and treatment of persons with hepatitis C infection

at week 12 of treatment Extended rapid virological response (eRVR) Undetectable HCV RNA 4 weeks (rapid) and 12 weeks (extended) after the start of treatment GRADE Grading of Recommendations Assessment, Development and Evaluation Negative predictive value The probability that when a person’s test result is negative, they truly do not have the infection/disease Non-response Detectable HCV RNA throughout treatment Null response Less than 2 log drop in HCV RNA level by week 12 of treatment Partial (...) response 2 log drop in HCV RNA by week 12 of treatment but HCV RNA remains detectable at week 24 or end of treatment Positive predictive value The probability that when a person’s test result is positive, they truly have the infection/disease. Predictive values are influenced by the prevalence of the disease in the population Rapid virological response (RVR) Undetectable HCV RNA 4 weeks after the start of treatment Relapse Undetectable HCV RNA at the end of treatment but detectable HCV RNA within 24

2014 World Health Organisation Guidelines

83. March 2014 supplement to the 2013 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection

– Guidance on operations and service delivery, including rolling out viral load testing, procurement and supply chain management concerns and community models of ART delivery; and Chapter 11 – Monitoring and evaluation, including surveillance of ARV drug toxicity monitoring and surveillance of drug resistance. WHO will issue the next supplement to the consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection in the second half of 2014. This later supplement (...) of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed in Switzerland5 CONTENTS 6 7 8 11 12 17 32 37 43 55 58 69 75 77 81 86 94 100 105 Abbreviations and acronyms Foreword Acknowledgements Executive summary Supplementary sections to Chapter 5 – HIV diagnosis and ARV drugs for HIV prevention 1. HIV self-testing 2. New strategies for diagnosing HIV infection among infants Supplementary sections to Chapter 7 – Antiretroviral

2014 World Health Organisation HIV Guidelines

84. Cardiac Pacing and Cardiac Resynchronization Therapy

intermittent. Provocative testing or an electro- physiological study (EPS) may be required when a bradycardia is suspected but not documented (Figure 2). Since there is no de?ned heart rate below which treatment is indi- cated, correlation between symptoms and bradyarrhythmia is essen- tial when deciding on the need for cardiac pacing therapy. This can be dif?cult to establish in patients with competing mechanisms for their symptoms—for example, HF or pulmonary disease. Another common dilemma (...) , the suspicion should be corroborated by an ECG documen- tation of bradyarrhythmia or, alternatively, by laboratory testing. w25 The most useful tests and their diagnostic yield are listed inTable6. † ECGmonitoring. Short-term monitoring (Holter, telemetry and ex- ternal loop recorder) is useful, soon after the index episode, in patients who have very frequent symptoms (at least once per week). Since most patients with syncope have infrequent symp- toms, recurring over months or years, ILRs are often

2013 European Society of Cardiology

85. Diabetes, Pre-Diabetes and Cardiovascular Diseases

dinucleotide phosphate hydrogen NDR National Diabetes Register NHANES NationalHealth and NutritionExamination Survey ESC Guidelines 3038 Downloaded from https://academic.oup.com/eurheartj/article-abstract/34/39/3035/503593 by guest on 02 April 2019NICE National Institute for Health and Clinical Excel- lence (UK) NNT number needed to treat NO nitric oxide NOAC new oral anticoagulants NYHA New York Heart Association OAT Occluded Artery Trial OGTT oral glucose tolerance test OMT optimal medical treatment (...) Health Organization (WHO) and the American Diabetes Associ- ation (ADA). 2– 6 Glycated haemoglobin A 1c (HbA 1c ) has been recommended as a diagnostic test for DM, 7,8 but there remain con- cerns regarding its sensitivity in predicting DM and HbA 1c values ,6.5% do not exclude DM that may be detected by blood glucose measurement, 7 –10 as further discussed in Section 3.3. Four main aetiological categories of DM have been identi?ed: type 1 diabetes (T1DM), T2DM, ‘other speci?c types’ of DM

2013 European Society of Cardiology

86. Electronic Cigarettes

Electronic Cigarettes Electronic Cigarettes | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search October 2019 September 2019 August 2019 July 2019 June 2019 May 2019 April 2019 March 2019 February 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Electronic Cigarettes A Policy Statement From the American Heart Association , PhD (...) by the manufacturers as high, medium, or low nicotine strength. Some e-liquids are available in 36 mg/mL concentrations. Nicotine solutions of 100 mg/mL for use in making e-cigarette refill liquids are available over the Internet. As a point of context, 1 regular cigarette contains ≈10 to 15 mg of nicotine and delivers a systemic dose of ≈1 mg of nicotine. Testing has revealed that the nicotine content noted in some e-cigarette products and refill solutions has been incorrect and either overestimates

2014 American Heart Association

87. Just how effective are digital mental health workplace interventions?

with hope (or relief) as accessible, scalable tools that employers can offer. The market is being flooded with new tools and re-purposed versions of existing tools. These are targeted at employees and sold into a market very keen on low cost, high volume solutions. In October 2017, I , which welcomed innovation in this field and drew out the necessity of digital interventions to be tested in and adapted for workplace settings for maximum effectiveness. This recent review from Elizabeth Stratton and her (...) stated, we need to do more to understand the factors that affect roll-out in workplace settings. The ideal scenario is creating a crucible where agile development, service design and robust evidence can combine to create products and services that meet an obvious need. We must be aware of the problem or opportunity being addressed, the audience, and the evidence of effectiveness in this context before deploying tools in the workplace. That means collecting good data and engaging employees as well

2018 The Mental Elf

88. Digital interventions for psychosis or bipolar disorder: we don’t know very much at all

associated with more successful completion of interventions. Discussing individual diagnoses the authors say: People with bipolar disorder mentioned concerns on how digital interventions could affect their mental health, and a minority of people with psychosis became paranoid or had symptom exacerbation. They also noted that: high completion outcomes were achieved for smartphone interventions in users with a high functional assessment short test score, more years of smartphone usage, and high premorbid (...) interventions, the application, device or program is solution, the barrel, the needle and the context rolled into one experience. From a systematic review based on looking for data which influenced implementation, it is impossible to ascertain what the interventions had in common in terms of presentation and user experience. The review found there were great differences between studies as to who responded to the interventions: “White users were found to be more engaged with a mobile intervention

2018 The Mental Elf

89. Genetics of depression: understanding risk and improving treatment

of significance for GWAS data (p<5 x 10-8) based on estimates of the number of “independent” tests across the genome (around 1 million). Here, 102 sequence variants (single-nucleotide polymorphisms; SNPs) were significant and statistically independent of each other, compared with 15 (23andMe), 17 (a smaller UKB analysis) and 44 (PGC including smaller parts of 23andMe and UKB). Then, the significance of evidence for association in each gene was tested by combining results from nearby SNPs while accounting (...) and major depressive disorder), using genetic association, linkage and resequencing methodologies. - Follow me here – Logging In... Profile or Comment Name Email Not published Website Last reply was 3 months ago View For the record, there was no actual replication of previous findings, nor did they perform an actual independent GWAS on the 23andMe replication dataset to compare significant variants. In short, to date there has not been a single independently replicated, significant genetic variant

2018 The Mental Elf

90. Should we screen new Dads for depression? #DadsMHday

, but will it work? A fair answer from this research is probably: not yet. The 12-question Edinburgh-Gotland Depression Scale (EGDS) is a step forward in that it combines questions that are perhaps a better fit for the range of symptoms experienced by many new dads with depression. However, this current iteration of the test is not ready for rolling out nationwide, and this is something that the authors accept in their measured conclusion: This is an important first step towards identifying a set of items (...) study carried out by researchers in Sweden aimed to develop a better tool for screening depression in fathers of children aged 0-18 months. Their two main aims were to: “investigate whether depressive symptoms in fathers postnatally comprise both typical depressive symptoms and externalizing, depressive equivalents” “test the hypothesis that the addition to the EPDS of items addressing depressive equivalents would result in increased sensitivity in detecting fathers with elevated, burdening

2018 The Mental Elf

91. Mindfulness may help university students reduce stress

aimed at the well student population, separate from specific mental health services, is a useful addition to robust clinical interventions delivered by university counselling services. The 8-week mindfulness course adapted for university students tested in this trial is an acceptable, feasible, and effective component of wider mental health strategies. Students could benefit from access to a preventative intervention, such as mindfulness. Strengths and limitations This is study had a large sample (...) Faculty of Brain Sciences. She has worked at the Tavistock as an assistant psychologist in both adult and children’s services and, prior to that, worked for several years in book publishing and for a literacy charity, promoting reading in libraries, prisons and schools. She has a particular interest in how reading and reading groups can improve wellbeing, and has run therapeutic readings groups for mental health service users. Follow me here – Logging In... Profile or Comment Name Email Not published

2018 The Mental Elf

92. Teacher burnout: can we prevent it, or is that the wrong question?

at the moment, but is it effective? I know many teachers who roll their eyes when they hear the word. There are a wide range of interventions available to schools and the question is which one should they select? A recent meta-analysis by Iancu et al (2017), categorises interventions into 6 different types: Cognitive Behavioural Therapy (CBT) : this aims to restructure thoughts or enhance problem solving and is aimed at enhancing employee coping skills Mindfulness and relaxation techniques : these encourage (...) of psychosocial interventions, to see which was most promising for reducing levels of teacher burnout. Methods Studies were selected if: They assessed general burnout, core burnout, or its components (exhaustion, depersonalisation or personal accomplishment) They assessed the above variables at both pre-test and post-test They had included a passive control group in the design (i.e. no intervention or waitlist) The burnout levels of the compared groups were equivalent at baseline (i.e., randomised allocation

2018 The Mental Elf

93. Patient Modesty: Volume 89

; basically what the average physician in the area would have done. If the physician documented a reason for denial (including it is my right to), attempted to educate the patient (gave him ACS pamphlet on recommended screening), periodically revisited the topic (and noted refusal again), and did not ignore the patient's request for alternative testing (FOBT vs colonoscopy), then the physician did everything possible and has a defensible position. That does NOT mean the physician will be dismissed from (...) the patient's former occupation and possible asbestos exposure. ..Maurice. At , Anonymous said... Maurice Pleural effusion can also be attributable to CHF, renal disease or a fall. I shudder to think people coming to a diagnosis with occupation first in mind. That the diagnosis could be arrived at after some investigation clinically or after a series of diagnostic tests. I might mention that prior to Hipaa laws in 1995 much of patient information from medical offices was placed in dumpsters. With names

2018 Bioethics Discussion Blog

94. More manual therapy bickering…

, and this needs to be promoted more. There is an argument that many of the manual therapy postgraduate courses do a good job in developing more skilled physiotherapists with better examination and diagnosis skills. Well, this may be true. I have seen many of the postgraduate courses and MSc programs run by manual therapy institutions in the UK such as the and and they do cover some enhanced clinical reasoning and assessment skills such as blood test and radiology interpretation. However, I also know (...) training? Even before I became a physio for years I had my non-trained mother step on my back cause it felt good to get a little “crack” or “pop” out of my spine and it was free, now my non-trained wife has to do it haha. I remember reading an article about how the McGill group discussed how rolling around willy nilly on a foam roller could destabilize the spine and that spinal manipulations should only ever be done by well trained clinicians. Even as a PT student, at the time, I laughed at how

2018 The Sports Physio blog

95. Refinement of anatomic indications for the Nellix System for endovascular aneurysm sealing based on 2-year outcomes from the EVAS FORWARD IDE trial. (PubMed)

. Two-year freedom from composite endoleak was high among both cohorts (95% on-IFU vs 92% off-IFU). Freedom from migration was 97.7% on-IFU vs 93.2% off-IFU (P = .0125). Freedom from aneurysm enlargement was 98.1% on-IFU vs 93.5% off-IFU (P value is not available because of failure of log-rank test assumptions). Composite freedom from migration, type IA endoleak, or aneurysm expansion was 95.9% among the on-IFU cohort vs 85.1% in the off-IFU cohort (P = .0017).Consistent with the introduction (...) for selection of patients.Comprehensive engineering evaluations, statistical analyses, and clinical assessments were conducted looking at patients enrolled in the pivotal trial (N = 150), roll-in cohort (N = 29), and continued access program (N = 154). All patients in all cohorts were treated on-IFU at the time of enrollment. Logistic regression models supported the mechanism that migration with Nellix is associated with a small aortic flow lumen relative to a large aneurysm thrombus burden and large aortic

2018 Journal of Vascular Surgery

96. Patient Modesty: Volume 88

to the interrogations regarding same gender care for males who dare to speak up and declare their rights as a human! When a female worker even “just” rolls her eyes when a male asks for same gender care is a form of abuse and here’s where lawyers are our friends! If as a male (or female) I state I want only same gender care for intimate care, exams, surgeries, etc. then I should not be interrogated or made to explain my choices. My body, my mind, my choice. This choice should be entered in my medical records (...) to the topic of Volume 88. Cont. due to word length -- EO At , Anonymous said... There is no saving the present mak’emsick industry. Let’s see – we already know that drug studies are fraudulent and that physicians seem to be entirely ignorant of this fact. But, writing scripts is about all most of them can do. Super hyped “screening” tests do more harm than good. EBM (Evidence Based Medicine) is essentially a scam as it also relies on fraudulent studies. We’ve seen that the mak’emsick industry is founded

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2018 Bioethics Discussion Blog

97. Nurses aren’t commodities

spinal immobilization to inspect the rest of his body, he was no longer responding to painful stimuli. What came next was literally nauseating. I felt such infuriation and overwhelming grief when we log rolled this beautiful baby and it became evident that he had been subjected to such extensive sexual abuse that I was secretly thankful he was now unresponsive. Just as Josh was out of spinal immobilization, I scooped him into my arms to cradle him in his mother’s absence. Once the charge nurse heard (...) about the test results, he suddenly became concerned about Josh and moved him from the pediatric ED to a trauma bay. I wanted to stay with Josh in the trauma bay; after all, he was my patient, and I was his nurse. Instead, a different nurse would take over. With no choice in the matter, I felt forced into abandoning and dismissing Josh. The move into a trauma bay was futile, and a trauma activation wouldn’t have saved him. Nothing further could be done for him, except to offer him some human touch

2018 KevinMD blog

98. "The Effects of Clinical Pilates Exercises on Cognitive Functions and Speed of Movement in Healthy Young Adults"

Form, Nelson Speed of Movement Test, Verbal Fluency Test and Stroop Test at pre-study, end of the first session, 4th week and end of the study (8th week). Participants in control will keep an activity log. SPSS statistical program will be used for statistical analysis. The Shapiro Wilk test will be performed to determine the normal distribution suitability of the data. The difference between the continuous variables in the groups will be compared with the ANOVA and the Tukey HSD test will be used (...) (Group 1), aerobic exercise group (Group 2), control group (Group 3). The sample size for each group was calculated as 24 people. Considering the possibility of %10 drops, 27 individuals will be included in each group and a total of 81 cases in the study.First, the socio-demographic information of the participants will be collected with a prepared form. Individuals will be assessed by the International Physical Activity Questionnaire-Short Form, Nelson Speed of Movement Test, Verbal Fluency Test

2018 Clinical Trials

99. SKY vs. HEP in PTSD

diagnoses will be screened by the MINI (Mini International Neuropsychiatric Interview). The CAPS5 will also be used to rule out severe depersonalization and derealization as per exclusion criteria. If the participant is above the age of 65 years of age, they will complete a cognitive screening test using the Mini Mental State Examination, MMSE>24 to rule out significant cognitive impairment. Participants meeting all study criteria who wish to join the study will be enrolled and assigned a unique study (...) the participants code on the outside, and information about treatment allocation for the participant inside the envelope. Participants will be given this envelope at the end of their baseline assessment and instructed not to open it until they have left their appointment. TRIAL INTERVENTIONS: The investigators will offer the two interventions in groups of 6-8 participants on a rolling basis 1. Sudarshan Kriya Yoga (SKY): 1. Participants in the SKY group will undergo a 12-week training course conducted

2018 Clinical Trials

100. Study in Pediatric Subjects With Peanut Allergy to Evaluate the Efficacy and Safety of Dupilumab as Adjunct to AR101-CODIT (Peanut Oral Immunotherapy)

to AR101 compared to placebo improves desensitization at the completion of up-dosing, defined as an increase in the proportion of participants who pass a double-blind placebo-controlled food challenge (DBPCFC) at week 28. Secondary objectives are: To assess whether dupilumab as adjunct to AR101 compared to placebo improves desensitization at the completion of up-dosing, defined as an increase in the cumulative tolerated dose (log transformed) of peanut protein during a DBPCFC at week 28 To assess (...) vs placebo plus AR101 who "pass" a double-blind, placebo-controlled food challenge (DBPCFC) with (cumulative) peanut protein [ Time Frame: At Week 28 ] Secondary Outcome Measures : Change in the cumulative tolerated dose (log transformed) of peanut protein during a DBPCFC in participants treated with dupilumab plus AR101 vs placebo plus AR101 [ Time Frame: Baseline to Week 28 ] Proportion of participants treated with dupilumab plus AR101 vs placebo plus AR101 who reach the dose of AR101 [ Time

2018 Clinical Trials

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