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141. Xpert MTB/RIF implementation manual Full Text available with Trip Pro

, 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

2014 World Health Organisation Guidelines

142. 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

143. Laboratory Diagnosis of Tuberculosis by Sputum Microscopy: The Handbook

or molecular testing only is requested refrigeration is not required • Store specimens to be cultured in a refrigerator or keep as cool as possible – Do not freeze What you need • Permanent marker to write details on the side of the container • Plastic bag for each specimen • Transport box • Master List of specimens • Laboratory Request Forms Approved secondary packaging (transport box) must: • Be leak proof and strong • Contain absorbent material, bench roll etc. • Keep Laboratory Request Forms separate (...) **. Moreover, microscopy can be decentralised to peripheral laboratories. Despite its advantages sputum smear microscopy does fall short in test sensitivity, especially for certain patient groups such as those living with HIV/AIDS, and also in the laboratory diagnosis of childhood and extrapulmonary disease. New diagnostic tools endorsed by WHO (such as liquid culture, line probe assay, Xpert MTB/RIF) overcome many of the limitations of smear microscopy, especially for patients living with HIV/AIDS

2013 International Union Against TB and Lung Disease

144. Impact of Percutaneous Coronary Intervention Performance Reporting on Cardiac Resuscitation Centers Full Text available with Trip Pro

Impact of Percutaneous Coronary Intervention Performance Reporting on Cardiac Resuscitation Centers Impact of Percutaneous Coronary Intervention Performance Reporting on Cardiac Resuscitation Centers | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies (...) of data and to individual providers using a rolling 3-year period of data. Any hospital or operator found to be an outlier is notified. The hospital-specific outcomes are reported publicly and can be found at . For patients with cardiogenic shock or STEMI, factors including age, renal failure, left main PCI, emergency or salvage procedure, ejection fraction <30%, and cardiogenic shock were noted to be significant predictors. As a result of the recognition of the limitations of risk modeling in some

2013 American Heart Association

145. Prehospital Cervical Spinal Immobilization After Trauma Full Text available with Trip Pro

and Manix tested the effectiveness of strapping techniques to reduce lateral motion of the spine of adults restrained on a backboard. Subjects were restrained on a wooden backboard with 4 different strapping techniques. The backboard was rolled to the side, and lateral motion of the torso was measured. The authors found that additional strapping securing the torso to the backboard reduced lateral motion of the torso. Finally, the traditional method of moving a patient onto a long backboard has typically (...) victims. Farrington , championed the concept of prehospital immobilization. Dick and Land note in their review of spinal immobilization devices that techniques of prehospital spinal immobilization appeared in standard EMS texts and in the American Academy of Orthopedic Surgeons Committee on Injuries Emergency text as early as 1971. Initially, the preferred method to immobilize the cervical spine was the use of a combination of a soft collar and a rolled-up blanket. This was followed

2013 Congress of Neurological Surgeons

146. Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease Full Text available with Trip Pro

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you (...) platelet receptor. Increased shear stress, such as occurs normally in arterioles or pathologically in stenotic vessels, can result in platelet activation independently of endothelial damage resulting from vWF multimer extension exposing active sites to bind platelet glycoprotein Ib-IX-V. Platelets bind and become temporarily tethered to vWF. The bond is then released; platelets roll on the endothelium; and a new glycoprotein Ib-IX-V/vWF bond forms. In the absence of endothelial damage or an artificial

2013 American Heart Association

147. Hip Pain and Mobility Deficits ? Hip Osteoarthritis

walk test, 30-second chair stand, stair measure, timed up-and-go test, self-paced walk, timed single- leg stance, 4-square step test, and step test. A Clinicians should measure balance performance and activities that predict the risk of falls in adults with hip osteoarthritis, especially those with decreased physical function or a high risk of falls because of past history. Recommended balance tests for patients with osteoarthritis include the Berg Balance Scale, 4-square step test, and timed (...) single-leg stance test. F Clinicians should use published recommendations from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association 6 to guide fall risk management in patients with hip osteoarthritis to assess and manage fall risk. EXAMINATION – PHYSICAL IMPAIRMENT MEASURES 2017 Recommendation A When examining a patient with hip pain/hip osteoarthritis over an episode of care, clinicians should document the flexion, ab - duction, and external rotation (F ABER

2017 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

148. Street triage: all it’s cooked up to be?

background rate of 136 use. Statistical hypothesis testing suggested large differences in 136 rate in the before versus the after period. Given that 136 did not fall in areas where street triage was not happening, an effect of street triage on 136 seems plausible, under the assumption that nothing else important changed in those particular areas over the study period, that might have affected the occurrence of 136 detentions. However, this assumption doesn’t seem to be covered in much detail in the paper (...) and the experiences of patients . This must take the form of better descriptions of who is detained using this Section and for what reasons, in order to identify what reasonable clinical outcomes we should be measuring. In clinical practice, we see many patients who, without the use of 136 powers, would not have seen a clinician until much further into an episode of illness. In a resource-poor NHS, how realistic it is to comprehensively roll out mental health staff to accompany police officers remains to be seen

2017 The Mental Elf

149. Self-guided iCBT for depression: effective but still not sticky enough

) and treatment response (β = 0.53; odds ratio, 1.95; 95% CI, 1.52 to 2.50; number needed to treat, 8 ). The authors indicate that heterogeneity across studies was moderate to high , and significant. A secondary result is that treatment response was not moderated by a broad range of socio-demographic or clinical characteristics tracked by the researchers across their chosen studies. All statistical tests use p=0.001 as a significant level. The authors did identify adherence to treatment as a moderating factor (...) . Implications for practice Health professionals who introduce their clients to iCBT, or who are interested in developing an iCBT service, might consider how best to help their clients sustain their engagement with any technology that they offer. Making self-guided online interventions more sticky is essential before they can be rolled out to routine care. Conflicts of interest Stefan Rennick-Egglestone has previously engaged in funded research work with members of the SilverCloud design team. Links Primary

2017 The Mental Elf

150. Do we need a Truth and Reconciliation process in psychiatry?

comes in the wake of austerity politics, a recovery agenda that now individualises and makes patients reponsible for their own mental health care, and the promotion of a rolling back of State and communal responsibility for those of us who experience mental distress (Harper and Speed, 2015). The article considers T and R processes in the context of increasing interest in (TIAs), which Sarah explored in a previous blog summarising emerging evidence that many people who access mental health services (...) to inform a healing process in the wake of institutional abuse and neglect in psychiatric services in the UK. They also acknowledge the ideas and work of the service user and survivor movement, most notably that of pioneering UK survivor activist Jan Wallcraft (2010). In order to test their position, they respond to four objections to T and R in mental health systems : What if psychiatry would not accept any wrongdoing and apologise? Surely psychiatric harm is not equivalent to other human rights abuses

2017 The Mental Elf

151. Pulling back the curtain on ‘The Doctors’ and ‘The Dr. Oz Show:’ What our analysis revealed

of the suggested treatments were often overlooked. And, the hosts on the show frequently hawked products made by companies that advertise on the show. How we collected information My colleague Dr. Jeffrey Weinfeld, medical librarian Michele Malloy, and I enlisted a group of medical students to tape and view all episodes of “The Doctors” and “The Dr. Oz Show” airing during a full month. Our students logged all the health recommendations made on the shows, and noted whether harms or costs were discussed (...) . A scene from “The Doctors” TV show. Our results lent further support to the general feeling among many scientists and clinicians of the shows’ sub-par level of evidence and low quality of information. Many of the studies we identified as potentially providing support for the claims made on the shows were problematic–with only a few people enrolled, or they were animal-based, or “test tube” studies. If these sources we found are indeed the sources of information used for the shows, then it appears

2018 HealthNewsReview

152. Stephen Colbert sells out to Gwyneth Paltrow and Goop

brand, and her In Goop Health summit. It starts with a softball question of why she started her Goop lifestyle brand, in which she basically brags how she started the brand out of curiosity and wondering whether she could “get answers” and actually launch a company and now has 150 people working for her. The next softball is a the question, “What do you say to people who roll their eyes at a catalog where you can buy an island in Belize?” My reaction was: WTF? The Goop catalog features an island you (...) understand that- like the guy described above- it’s much easier to dispense knowledge rather than to await reception of it and actively absorb it but that’s reality. None of us know very much in the scheme of things in the universe BUT we can learn more if we are honest about our own level of expertise in designated areas. For example, I suppose that I might be expert in certain areas in psychology and the arts BECAUSE I studied them formally and have been tested many, many times, pursuing degrees

2018 Respectful Insolence

153. A crisis map: charting the topography of home treatment

A crisis map: charting the topography of home treatment A crisis map: charting the topography of home treatment - National Elf Service Search National Elf Service Search National Elf Service » » » » A crisis map: charting the topography of home treatment Feb 16 2017 Posted by >, The NHS Plan of 2000 (Dept of Health, 2000) mandated the national roll-out of Crisis Resolution Teams (CRTs) , with guidance on their design and implementation. The major principles were to help avoid hospital admission (...) to standards , and CRTs are providing a less comprehensive service than was initially envisioned, with no clear pattern of change since a smaller survey that was reported in 2008. The authors argue that resources need to be developed and tested to support CRTs in their care interventions, not least in determining what might be the optimal model of a CRT. The US Evidence Based Practice Programme (Mueser et al, 2003) is put forth as a template for the evaluation of complex mental health service models

2017 The Mental Elf

154. Self-guided iCBT for depression: effective but still not sticky enough

) and treatment response (β = 0.53; odds ratio, 1.95; 95% CI, 1.52 to 2.50; number needed to treat, 8 ). The authors indicate that heterogeneity across studies was moderate to high , and significant. A secondary result is that treatment response was not moderated by a broad range of socio-demographic or clinical characteristics tracked by the researchers across their chosen studies. All statistical tests use p=0.001 as a significant level. The authors did identify adherence to treatment as a moderating factor (...) . Implications for practice Health professionals who introduce their clients to iCBT, or who are interested in developing an iCBT service, might consider how best to help their clients sustain their engagement with any technology that they offer. Making self-guided online interventions more sticky is essential before they can be rolled out to routine care. Conflicts of interest Stefan Rennick-Egglestone has previously engaged in funded research work with members of the SilverCloud design team. Links Primary

2017 The Mental Elf

155. In search of the sweet spot: the links between dysglycaemia and first episode psychosis

. Except this idea is but a small, solid sugar cube. For many years, this lonely cube sits patiently at the top of the great hill, the world turning around it, waiting for just the right propelling gust of wind. Eventually, that long-awaited gust of wind arrives, tipping the cube from its resting point at the top, and into motion. Our cube begins to roll, at first haphazardly, down the powdery white hill. As it whirls, the sweet sticky powder sticks to the cube, growing not just in size but also (...) birthweight, preterm birth, gestational diabetes and maternal malnutrition (Onwuameze, O. et al, 2016). The research in this area has been expanding much like our sugary snowball rolling down the hill, culminating in two recent meta-analyses. The first was published in The Lancet Psychiatry in November 2016 and of which I am an author (Perry, B. et al, 2016) and the second, the subject of this blog, published in JAMA in January 2017 (Pillinger, T. et al, 2017). The prevalence of type 2 diabetes

2017 The Mental Elf

156. The outcomes of a school-based intervention for depressive symptoms in adolescents do not echo the promising findings of earlier studies Full Text available with Trip Pro

, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here The outcomes of a school-based intervention for depressive symptoms in adolescents do not echo the promising findings (...) setting, using a model of delivery that could be scaled up for national dissemination. Care was taken to address some of the weaknesses of previous studies with rigorous trial design conducted in a real-world setting, testing a model that could be implemented in practice and, most particularly, the use of an attention control group. Disappointingly, the positive results from the earlier trials , were not replicated. Few previous studies used an attention control group and many preventive interventions

2014 Evidence-Based Mental Health

157. Measurement and Interpretation of the Ankle-Brachial Index Full Text available with Trip Pro

Measurement and Interpretation of the Ankle-Brachial Index Measurement and Interpretation of the Ankle-Brachial Index | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access (...) % Confidence limit for limbs without PAD 0.97 Sumner and Strandness, 1979 48 Control subjects Normal minus 2 SD (1.08±0.08) 0.92 Bernstein et al, 1982 Patients with angiographically significant PAD 95% Confidence limit for limbs without PAD 0.85 Ouriel et al, 1982 218 PAD patients (56 limbs not tested, 247 limbs with claudication, 58 with rest pain, ulcers, or gangrene), 25 control subjects (<30 y old, no RF, triphasic Doppler waveforms) ROC curve analysis 0.97 Stoffers et al, 1996 Community and vascular

2012 American Heart Association

158. Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery

Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery:An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Visual Loss | Anesthesiology | ASA Publications 2282095993 ASA Publications Log in to access full content You must be logged in to access this feature. ASA members enjoy complimentary access to ASA publications, as well as a variety of educational (...) be logged in to access this feature. | | What other guideline statements are available on this topic? This Practice Advisory updates the “Practice Advisory for Perioperative Visual Loss Associated with Spine Surgery,” adopted by the ASA in 2005 and published in 2006.* Why was this Advisory developed? In October 2010, the Committee on Standards and Practice Parameters elected to collect new evidence to determine whether recommendations in the existing Practice Advisory were supported by current evidence

2012 American Society of Anesthesiologists

159. 2012 KDIGO Clinical Practice Guideline for the Evaluation and Management of CKD

demonstrating a positive reagent strip test for albuminuria/proteinuria or quantitative albuminuria/proteinuria test 57 Figure 17. GFR and albuminuria grid to reflect the risk of progression 63 Figure 18. Distributionoftheprobabilityofnonlinearitywiththreeexampletrajectoriesdemonstratingdifferentprobabilities of nonlinearity 69 Figure 19. Summary estimates for risks of all-cause mortality and cardiovascular mortality associated with levels of serum phosphorus, PTH, and calcium 86 Figure 20. Prevalence (...) International Supplements (2013) 3,5–14 summary of recommendation statements3.3:CKD METABOLIC BONE DISEASE INCLUDING LABORATORY ABNORMALITIES 3.3.1: We recommend measuring serum levels of calcium, phosphate, PTH, and alkaline phosphatase activity at least once in adults with GFRo45ml/min/1.73 m 2 (GFR categories G3b-G5) in order to determine baseline values and inform prediction equations if used. (1C) 3.3.2: We suggest not to perform bone mineral density testing routinely in those with eGFRo45ml/min/1.73 m

2012 National Kidney Foundation

160. Evaluating Parents and Adult Caregivers as ?Agents of Change? for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps Full Text available with Trip Pro

Evaluating Parents and Adult Caregivers as ?Agents of Change? for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February (...) , in the simplest terms, means writing down or keeping track of a target behavior (eg, food consumption, physical activity) every time it occurs. Self-monitoring serves to raise awareness of the frequency with which the target behavior typically occurs before “intervention” begins, a critical skill because many adults and children lack such awareness. There are a variety of diaries, forms, and logs that can be used for self-monitoring. Indeed, an emerging area of interest involves Internet-based tracking

2012 American Heart Association

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