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Perception Exam

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81. Guidelines for diagnosing and managing pediatric concussion

5.4a(v) Refer the child/adolescent to a pediatric sleep specialist if sleep has not improved. C 5.4b(i) Take a history of any headaches. B 5.4b(ii) Establish the degree and duration of the disability that the headaches cause. B 5.4b(iii) Perform a neurological exam and a head/neck exam. C 5.4b(iv) Consider non-pharmacological, complementary and/or alternative medicine therapies for headache. C 5.4b(v) Consider treating migraine headaches with prescription medication. B Chapter: Tipsheet Guidelines (...) the following tools as appropriate. o Tool 2.1: Management of Acute Symptoms Algorithm. o Tool 2.2: Acute Concussion Evaluation (ACE). o Tool 0.2: ChildSCAT3 Sport Concussion Assessment Tool for Children aged 5-12 (symptom evaluation). o Tool 1.1: SCAT3 Sport Concussion Assessment Tool for Athletes aged 13+ (symptom evaluation). o Tool 2.4: Neurologic and Musculoskeletal Exam. • Consider signs and symptoms in context with the child/adolescent’s normal performance, especially for those with learning

2019 CPG Infobase

82. Best practice for managing outpatient bookings

-based triage approaches to care in the out-patient setting have significantly improved waiting times. Extending the scope of practice of non-medical health professionals with the proper training has contributed to patient satisfaction and the efficient use of resources without notable adverse effect on patient outcomes. • The expectations of patients need to be managed to ensure that there is no perception of compromise to quality of care delivered. Waiting lists for specialist clinics need

2019 Monash Health Evidence Reviews

83. Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/EEA

. • Provide screening, referral, and linkage to care and treatment for all individuals who require it. • Address the individual, community and health system barriers (for example, low risk perception; disease- related stigma; socio-economic, cultural and linguistic barriers; lack of entitlement to healthcare or to free healthcare) that limit migrants’ uptake of screening and vaccination, and subsequent uptake and completion of treatment. • Consider the unique needs of newly arrived migrants when offering (...) . Public health programmes may have to adapt their communication and approaches. Better understanding of migrant perceptions about infectious diseases, screening, testing and vaccination, and the acceptability and accessibility of healthcare services, is critical. Tailored approaches such as multiple testing, integrated care for infectious diseases and other health needs, and migrant-friendly services, are also needed. Since the vast majority of preventative and curative healthcare for migrant

2019 European Centre for Disease Prevention and Control - Public Health Guidance

84. Oral care and people with learning disabilities

the things that can be done to help her daughter have her teeth examined: In the past we have had numerous problems with dental care for my daughter. Now, Anna attends a specialist community-based dental service where the staff try to help in any way to be able to examine her teeth. She can stay in her wheelchair with the use of a tipping plate that allows it to tilt backwards. It is important she remains in her wheelchair. She feels safe there, she is more likely to allow the exam which makes (...) Assessing local population needs Despite the barriers faced by people with learning disabilities in accessing dental services, there has been minimal research exploring their perceptions and experiences. National surveys of the dental health of adults have often excluded people with learning disabilities. Below is information about a local oral-health-needs assessment where the voices of children and adults with learning disabilities were included: The school of clinical dentistry in Sheffield

2019 Public Health England

85. Using Multi-source Feedback and Other Practice Assessments for Quality Assurance in Nursing

finding multi-source feedback useful to improve clinical practice. However, one recent medium-quality review and one primary study reported negative perceptions regarding the short time constraints in providing feedback, poor assessor engagement and understanding of the assessment, a lack of formal training on workplace assessments, and difficulty linking feedback to a change in practice. Additional key findings from the literature we identified are summarized in Table 1 below. McMaster Health Forum 7 (...) to the curriculum in areas where students historically underperformed.(4) Key findings related to implementation • One recently published study reported two challenges for implementing multi-source feedback, including difficulty in engaging enough raters and not having enough time to collect and collate the feedback.(5) Key findings related to nurses’ perceptions of MSF • One recent primary study found nurses reported multi-source feedback assessments as being useful to improving performance, perceiving

2019 McMaster Health Forum

86. Baseline Staging Imaging for Distant Metastasis in Women with Stage I, II, and III Breast Cancer

According to the AJCC: Physical examination, breast and axillary US, and MRI in a few cases: 109 FDG-PET/CT 3 (1): I 43 (18): IIA 66 (28): IIB 82 (35): IIIA 16 (7): IIIB 24 (10): IIIC Judgement of two experienced nuclear medicine physicians, histopathology, MRI, US Distant metastasis (unclear if symptomatic) Lebon et al., 2017 [16] 2006-2015 RET 214 107 40 and 18 According to AJCC: Physical exam, mammography, breast ultrasound and MRI FDG-PET/CT 32 (38) II 53 (62) III Histopathology or imaging follow-up (...) , and pelvis CT, whole- body bone scintigraphy Unsuspected distant metastases Riedl et al., 2014 [19] 2003-2012 RET 134 75 ER+HER2- 26 HER2+ 28 TNBC 5 Unspecified 36 (22-40) According to AJCC: Physical exam, mammography, breast ultrasound and MRI FDG-PET/CT 20 (15) I 44 (33) IIA 47 (35) IIB 13 (10) IIIA 8 (6) IIIB 2 (1) IIIC Histopathology Unsuspected distant metastases Include ER+/HER2- (75), HER2+ (26), Triple-negative (28) Jeong et al., 2014 [15] 2010-2013 RET 178 Clinical negative axillary nodal

2019 Cancer Care Ontario

87. Learning Resilience

10–19 years. The review found that the interventions resulted in significant effects in young people’s psychological adjustment, specifically reductions in emotional distress and improvements in self-perceptions. Curran and Wexler (19) examined the effectiveness of school-based positive youth development interventions for students in grades 6–12 through a systematic literature review of studies published after 2000. Twenty-four articles of varying levels of methodological quality were included (...) with these resilience intervention programs (as defined in the research evidence), along with the components that they typically target, are listed below in Table 1. As seen in Table 1, researchers use a number of different names to describe social and emotional learning skills, which can make it challenging to focus on a specific SEL skill. A number of improvements in mental health and wellbeing were demonstrated through the studies, such as improved self-perceptions, social competence, coping strategies and pro

2019 Sax Institute Evidence Check

89. Patient Perception of Mammogram Guidelines

Patient Perception of Mammogram Guidelines Patient Perception of Mammogram Guidelines - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Patient Perception of Mammogram Guidelines The safety and scientific (...) to Brief Summary: The purpose of this study was to determine attitudes regarding the 2009 USPSTF Guidelines for breast cancer screening for women in their 40's and assess the effect of one of two newspaper articles on their attitudes. The population studied was women seeing their private gynecologist for annual exams in the 39-49 year old age group. Condition or disease Intervention/treatment Phase Attitude Practice Guideline Breast Cancer Other: read unfavorable article prior to answering questions

2010 Clinical Trials

91. Narcolepsy

eye movement sleep intrusion into the wake state. In its classic form, seen in only 10% to 15% of cases, it is characterised by a tetrad of excessive daytime sleepiness, cataplexy (generalised muscle weakness leading to partial or complete collapse), hypnagogic/hypnopompic hallucinations (visual or auditory perceptions on falling asleep or on awakening), and sleep paralysis. American Academy of Sleep Medicine. International classification of sleep disorders - third edition (ICSD-3). 2014 [Internet (...) publication]. http://www.aasmnet.org/library/default.aspx?id=9 History and exam presence of risk factors excessive daytime sleepiness cataplexy hypnagogic/hypnopompic hallucinations sleep paralysis chronic fatigue or tiredness poor performance at work poor memory and concentration car accidents slurred speech blurred vision irregular breathing pattern sleep attacks fragmented nocturnal sleep symptoms of other sleep disorders obesity status cataplecticus hepatomegaly paresis HLA-II DQA1*0102-DQB1*0602

2018 BMJ Best Practice

92. Tinnitus

Tinnitus Tinnitus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Tinnitus Last reviewed: February 2019 Last updated: October 2018 Summary Perception of sound in the absence of any external auditory stimulus. Sounds may be described as ringing, humming, buzzing, hissing, clicking, or pulsing. May occur intermittently or constantly. Diagnosis is based on clinical evaluation and audiometry. There may be a role (...) for additional studies, such as auditory brainstem responses, otoacoustic emissions, and neuroimaging. Treatment is challenging as tinnitus is a symptom, not a disease. Thus intervention depends on treating the underlying cause. Definition Tinnitus is the perception of sounds in the absence of external auditory stimulus. It is a symptom, not a diagnosis. Tinnitus may be the result of hearing loss, noise damage, ageing, medication use, sounds produced by adjacent structures, or other disease processes

2018 BMJ Best Practice

93. Acne vulgaris

have profound psychological and social impact on patients. Koo J. The psychosocial impact of acne: patient's perceptions. J Am Acad Dermatol. 1995 May;32(5 Pt 3):S26-30. http://www.ncbi.nlm.nih.gov/pubmed/7738224?tool=bestpractice.com Karimkhani C, Dellavalle RP, Coffeng LE, et al. Global skin disease morbidity and mortality: an update from the Global Burden of Disease Study 2013. JAMA Dermatol. 2017 May 1;153(5):406-12. http://www.ncbi.nlm.nih.gov/pubmed/28249066?tool=bestpractice.com History (...) and exam presence of risk factors skin lesions skin tenderness depression, social isolation systemic complaints age 12 to 24 years genetic predisposition greasy skin/increased sebum production endocrine disorders dietary factors female sex/oestrogens obesity/insulin resistance hyperandrogenism medications halogenated aromatic hydrocarbons exposure Diagnostic investigations clinical diagnosis hormonal evaluation bacterial culture Treatment algorithm ONGOING Contributors Authors Professor of Dermatology

2018 BMJ Best Practice

94. Alcohol-use disorder

use of alcohol. History and exam presence of risk factors withdrawal tolerance increased/decreased liver size, jaundice, ascites nicotine dependence comorbidity social, economic, legal, or psychological problems nausea, vomiting, abdominal pain, haematemesis muscle cramps, pain, tenderness, altered sensory perception hypertension and tachycardia impaired nutritional status cutaneous manifestations alterations in normal dental hygiene broad-based gait family history of alcoholism antisocial

2018 BMJ Best Practice

95. Tinnitus

Tinnitus Tinnitus - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Tinnitus Last reviewed: February 2019 Last updated: October 2018 Summary Perception of sound in the absence of any external auditory stimulus. Sounds may be described as ringing, humming, buzzing, hissing, clicking, or pulsing. May occur intermittently or constantly. Diagnosis is based on clinical evaluation and audiometry. There may be a role (...) for additional studies, such as auditory brainstem responses, otoacoustic emissions, and neuroimaging. Treatment is challenging as tinnitus is a symptom, not a disease. Thus intervention depends on treating the underlying cause. Definition Tinnitus is the perception of sounds in the absence of external auditory stimulus. It is a symptom, not a diagnosis. Tinnitus may be the result of hearing loss, noise damage, ageing, medication use, sounds produced by adjacent structures, or other disease processes

2018 BMJ Best Practice

96. Schizoaffective disorder

criteria for research. 1993 (updated for 2016) [internet publication]. http://apps.who.int/classifications/icd10/browse/2016/en#/ A schizoaffective episode is diagnosed only when the patient does not meet criteria for either schizophrenia or a depressive or manic episode. Schizoaffective disorder is further classified as manic type when manic or mixed symptoms are prominent; or a depressive type when only schizophrenia and depressive symptoms have been present. History and exam positive symptoms (...) negative symptoms disorder of perception delusions disturbances in emotions disorders of stream and form of thought cognitive abnormalities deficit symptoms neurological deficit family history disorders of behaviour family history of schizophrenia substance use age of the father at patient's birth psychological stress environment Diagnostic investigations urine drug screen sexually transmitted disease screening full blood count thyroid function tests laboratory studies to exclude organic causes CT/MRI

2018 BMJ Best Practice

97. Amblyopia

://www.ncbi.nlm.nih.gov/pubmed/5498493?tool=bestpractice.com History and exam presence of risk factors infant not tracking parent's face abnormal red reflex asymptomatic subnormal visual acuity for age in 1 or both eyes asymmetric corneal light reflex unequal behavioural response to alternate eye occlusion abnormal cover/uncover testing blurred vision eye strain congenital nystagmus abnormal pupil exam abnormal external eye exam age <9 years prematurity FHx of amblyopia or strabismus strabismus (misalignment (...) (perception of depth or 3-dimensionality) and binocular vision testing assessment of fixation, ocular alignment, and ocular motility anterior segment examination using a slit lamp dilated fundoscopy cycloplegic retinoscopy binocular red reflex test (Brückner test) visual evoked potentials Treatment algorithm ONGOING Contributors Authors Professor of Ophthalmology Department of Neuroscience, Psychology and Behaviour University of Leicester Ulverscroft Eye Unit Leicester Royal Infirmary UK Disclosures IG

2018 BMJ Best Practice

98. Personality disorders

disorders involve a chronic pattern of both internal perception and observable behaviour in at least two of the following four symptom domains: cognitive-perceptual, affect, interpersonal functioning, and impulse control. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Arlington, VA: American Psychiatric Association; 2013. Personality disorders have been categorised into three general categories or clusters: cluster A (odd/eccentric); cluster B (dramatic (...) Apr;152(4):571-8. http://www.ncbi.nlm.nih.gov/pubmed/7694906?tool=bestpractice.com History and exam paranoia odd thinking restricted range of emotions anger and irritability excessive emotionality and unstable mood states anxiety and tension impulsive behaviours grandiosity evidence of self harm (e.g., scars, burns) history of abuse family history of schizophrenia negative parenting interactions emotional/disruptive disorder in childhood Diagnostic investigations clinical interview suicide risk

2018 BMJ Best Practice

99. Chronic pelvic pain in women

ultrasound, cystoscopy with hydrodistension, and diagnostic laparoscopy. Because chronic pain is sometimes a disorder of pain perception, minimal if any pathological change may be found. Treatment is targeted at each organ system involved in pain production. Global pain in all organs or refusal of non-narcotic management may represent drug-seeking behaviour. Complications are inherent to all treatments, which frequently include surgery. Definition Chronic pelvic pain is inconsistently defined (...) ?tool=bestpractice.com Patients typically present with at least two of several common pain-related diagnoses: interstitial cystitis, irritable bowel syndrome, fibromyalgia, levator ani syndrome (pelvic floor tension myalgia), endometriosis, adenomyosis, leiomyoma, or vulvodynia. Common comorbid conditions include depression, anxiety, and traumatic stress disorder. History and exam presence of risk factors dysuria dyspareunia dysmenorrhoea abdominal trigger points levator ani tenderness cervical

2018 BMJ Best Practice

100. Chronic pain syndromes

with ongoing degenerative illnesses, such as rheumatoid arthritis, or other chronic conditions, like migraine or neuropathic pain. Neuropathic pain is characterised by allodynia and hyperalgesia. Allodynia is the perception of non-noxious stimuli as painful. In hyperalgesia, noxious stimuli produce exaggerated or prolonged pain. Pain severity may fluctuate in patients with chronic pain, with times of increased pain or pain flares occurring either in relation to increased activity or stress, or insidiously (...) pathways and muscle spasm From Marcus DA. Headache and chronic pain syndromes. The case-based guide to targeted assessment and treatment. Totowa, NJ: Humana Press; 2007 [Citation ends]. History and exam presence of risk factors duration of pain more than 3 months physical comorbidity psychological comorbidity previous history of acute pain episodes pain causing difficulty in performing routine activities of daily living precipitating factors for myofascial pain precipitating factors for musculoskeletal

2018 BMJ Best Practice

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