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41. For the management of Gout in UK Primary Care: is nurse-led management more effective than GP-led management?

For the management of Gout in UK Primary Care: is nurse-led management more effective than GP-led management? Getting Evidence in Clinical Practice: General Practice Nurse Evidence Based Practice (CAT group) Date: Nov 2018 CAT Lead: Andrew Finney, Rachel Viggars and Charlotte Harper Date: CAT completed: Nov 2018 Email: a.finney@keele.ac.uk Date: CAT to be reviewed: Nov 2021 Clinical bottom line Nurse-led gout care has been shown to be efficacious and cost-effective when compared with usual care (...) (GP-led). The findings of the key literature illustrate the benefits of educating and engaging patients in gout management and reaffirm the importance of a treat-to-target urate-lowering treatment strategy to improve patient- centred outcomes. Why is this important? People commonly think of gout as a ‘rich man’s disease’ caused by dietary excess and overconsumption of alcohol, evoking images of people like King Henry VIII (Richardson et al, 2016). This negative perception of the condition

2018 Home Modification Information Clearinghouse

42. Review on the prevalence, risk factors and disease Management of Hypertension among floating population in China during 1990–2016 (PubMed)

Review on the prevalence, risk factors and disease Management of Hypertension among floating population in China during 1990–2016 To have a basic and comprehensive understanding about the prevalence, risk factors and disease management situation of hypertension among floating population in China.We used "(hypertension or hypertensive or chronic disease) and (floating population or migrant worker)" as the key words, to search in the China academic literature database (CNKI), Wan Fang database (...) , PubMed and Web of Science for relevant literature and extracted the data about the prevalence of hypertension, relevant risk factors and disease management of floating population in China from 1990 to 2016.The 23 related studies that entered into final analysis were all articles in Chinese. The prevalence of hypertension in floating population is lower than that in both general population and local residents. The prevalence of hypertension in male floating population is higher than that in females

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2018 Global health research and policy

43. The impact of social capital on clinical risk management in nursing: a survey in Iranian public educational hospitals (PubMed)

The impact of social capital on clinical risk management in nursing: a survey in Iranian public educational hospitals This study aimed to explore the social capital impact on clinical risk management from nurses' viewpoints.This was a cross-sectional and analytical study conduct in six public educational hospitals affiliated to Tehran University of Medical Sciences (TUMS).Questionnaires were used as the data collection tool. Data were analysed using descriptive statistics, parametric and non (...) -parametric tests by SPSS 16 at a significance level of 0.05.Risk management, social capital and all its three dimensions evaluated in moderate level. It is confirmed that the social capital is one of the factors associated with the improvement of clinical risk management. There was a significant relationship between clinical risk management and social capital. In this respect, hospital managers and decision-makers could enhance clinical risk management by identifying and increasing different dimensions

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2018 Nursing open

44. Efficacy of a proactive health and safety risk management system in the fire service (PubMed)

Efficacy of a proactive health and safety risk management system in the fire service This study evaluated the efficacy of a fire department proactive risk management program aimed at reducing firefighter injuries and their associated costs.Injury data were collected for the intervention fire department and a contemporary control department. Workers' compensation claim frequency and costs were analyzed for the intervention fire department only. Total, exercise, patient transport, and fireground (...) operations injury rates were calculated for both fire departments.There was a post-intervention average annual reduction in injuries (13%), workers' compensation injury claims (30%) and claims costs (21%). Median monthly injury rates comparing the post-intervention to the pre-intervention period did not show statistically significant changes in either the intervention or control fire department.Reduced workers' compensation claims and costs were observed following the risk management intervention

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2018 Injury epidemiology

45. An agent based architecture for high-risk neonate management at neonatal intensive care unit (PubMed)

An agent based architecture for high-risk neonate management at neonatal intensive care unit In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision (...) support tools.To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management.This study was a basic research for medical informatics method development that was carried out in 2017. The requirement analysis was done by reviewing articles on NICU Decision Support Systems

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2018 Electronic physician

46. Risk Factor Management in Atrial Fibrillation (PubMed)

Risk Factor Management in Atrial Fibrillation Atrial fibrillation (AF) is the most common clinical arrhythmia and is associated with increased morbidity and mortality. There is growing evidence that numerous cardiovascular diseases and risk factors are associated with incident AF and that lone AF is rare. Beyond oral anticoagulant therapy, rate and rhythm control, therapy targeting risk factors and underlying conditions is an emerging AF management strategy that warrants better implementation (...) in clinical practice. This review describes current evidence regarding the association between known modifiable risk factors and underlying conditions and the development and progression of AF. It discusses evidence for the early management of underlying conditions to improve AF outcomes. It also provides perspective on the implementation of tailored AF management in daily clinical practice.

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2018 Arrhythmia & electrophysiology review

47. Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases (PubMed)

Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs (...) for the management of hypertension. We report the lessons learnt from the field. From each of the studies, we obtained information on the types of tasks shifted, the professional level from which the task was shifted, the training provided and the challenges faced. Additionally, we collected more granular data on 'lessons learnt ' throughout the implementation process and 'design to implementation' changes that emerged in each project. The tasks shifted to NPHWs included screening of individuals, referral

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2018 BMJ global health

48. Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer

Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer Familial breast cancer: classification, care Familial breast cancer: classification, care and managing breast cancer and related and managing breast cancer and related risks in people with a family history of risks in people with a family history of breast cancer breast cancer Clinical guideline Published: 25 June 2013 nice.org.uk/guidance/cg164 © NICE 2018 (...) NICE recommendations wherever possible. Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer (CG164) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 48Contents Contents Overview 4 Who is it for? 4 Recommendations 5 1.1 Clinical significance of a family history of breast cancer 5 1.2 Information and support 8 1.3 Care

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

49. Cost-effectiveness of risk stratified medication management for reducing premature cardiovascular mortality in Kenya. (PubMed)

Cost-effectiveness of risk stratified medication management for reducing premature cardiovascular mortality in Kenya. Cardiovascular disease (CVD) is a major contributor to the burden from non-communicable diseases in Sub-Saharan Africa and hypertension is the leading risk factor for CVD. The objective of this modeling study is to assess the cost-effectiveness of a risk stratified approach to medication management in Kenya in order to achieve adequate blood pressure control to reduce CVD (...) future events (for individual who survive the initial event) and other causes. We present cost and DALYs gained due to medication management for men and women 25 to 69 years.Treating high risk individuals only was generally more cost-effective that treating high and moderate risk individuals. At the anticipated base levels of effectiveness, medication management was only cost-effective under the low cost scenario. The incremental cost per DALY gained with low cost ranged from $1,505 to $3,608, which

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2019 PLoS ONE

50. Real-world study of efficacy, risk management and reasons for discontinuation of natalizumab for treatment of multiple sclerosis in Russia. (PubMed)

Real-world study of efficacy, risk management and reasons for discontinuation of natalizumab for treatment of multiple sclerosis in Russia. NTZ is approved in Russia for the treatment of highly active relapsing remitting multiple sclerosis and is reimbursed via federal budget program. However, no data about NTZ treatment in Russia and the effect of federal reimbursement have been performed so far.To characterize the population of patients receiving natalizumab and assess the efficacy and risk (...) -management plan (RMP) implementation of NTZ therapy in routine clinical practice in Russia.We analyzed data for 334 patients, who received at least one infusion of NTZ. Relapse rate, MRI activity, NEDA-3 status after 2 years were assessed. Anti-JC virus antibodies status and RMP implementation were evaluated. Drop-out rate and reasons for therapy discontinuation were analyzed.Patients switched to natalizumab in Russia are mainly female (63%), with median EDSS score of 3.5 and high disease activity: 93

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2019 PLoS ONE

51. The association between vitamin D status and clinical events in high-risk older patients with non-ST elevation acute coronary syndrome undergoing invasive management. (PubMed)

The association between vitamin D status and clinical events in high-risk older patients with non-ST elevation acute coronary syndrome undergoing invasive management. There is a higher incidence of vitamin D deficiency in older adults. This may play a plausible mechanistic role in the occurrence of increased adverse events after non-ST elevation acute coronary syndrome (NSTEACS). This study investigated whether total vitamin D levels at the time of presentation predicted adverse outcomes (...) in older adults undergoing invasive management of NSTEACS. Of the 629 patients screened, 300 high-risk older adults with NSTEACS managed by an invasive strategy were recruited. Serum total 25-hydroxyvitamin D was measured at index presentation. The primary outcome was defined as 1-year composite of all-cause mortality, acute coronary syndrome (ACS), unplanned repeat revascularisation, significant bleeding or stroke. Mean age was 80.5±4.8 years (61.9% male). Median vitamin D level was 29.5nmol/L

2019 PLoS ONE

52. SMARThealth India: A stepped-wedge, cluster randomised controlled trial of a community health worker managed mobile health intervention for people assessed at high cardiovascular disease risk in rural India. (PubMed)

SMARThealth India: A stepped-wedge, cluster randomised controlled trial of a community health worker managed mobile health intervention for people assessed at high cardiovascular disease risk in rural India. Cardiovascular diseases (CVD) are rising in India resulting in major health system challenges.Eighteen primary health centre (PHC) clusters in rural Andhra Pradesh were randomised over three, 6-month steps to an intervention comprising: (1) household CVD risk assessments by village-based (...) community health workers (CHWs) using a mobile tablet device; (2) electronic referral and clinical decision support for PHC doctors; and (3) a tracking system for follow-up care. Independent data collectors screened people aged ≥ 40 years in 54 villages serviced by the PHCs to create a high CVD risk cohort (based on WHO risk charts and blood pressure thresholds). Randomly selected, independent samples, comprising 15% of this cohort, were reviewed at each 6-month step. The primary outcome

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2019 PLoS ONE Controlled trial quality: predicted high

53. Acupressure in Management of Postoperative Nausea and Vomiting in High-Risk Ambulatory Surgical Patients. (PubMed)

Acupressure in Management of Postoperative Nausea and Vomiting in High-Risk Ambulatory Surgical Patients. The purpose of this randomized blinded placebo-controlled research study was to investigate the effect of acupressure over 24 hours postoperatively for ambulatory surgical patients who are identified as high risk for PONV.A randomized blinded placebo-controlled study design was implemented.Study enrollment criteria included four of five risk factors as defined in 2006 by American Society (...) patients finished the study's three phases and nine were admitted postoperatively.Acupressure is an effective minimal risk and low-cost adjunctive therapy for prevention and treatment in ambulatory surgical patients at high risk for PONV. Further studies using other acupressure points should be conducted.Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

2018 Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses Controlled trial quality: uncertain

54. The BRCA1 R1699Q intermediate risk variant: breast and ovarian cancer risk estimation and recommendations for clinical management from the ENIGMA consortium

The BRCA1 R1699Q intermediate risk variant: breast and ovarian cancer risk estimation and recommendations for clinical management from the ENIGMA consortium The BRCA1 R1699Q intermediate risk variant: breast and ovarian cancer risk estimation and recommendations for clinical management from the ENIGMA consortium | JMG Contact blog by Mutations in BRCA1 confer high life-time risks for breast cancer (BC): 68% and ovarian cancer (OC): 39%. Our paper describes the cancer risks associated (...) with the missense mutation BRCA1 *R1699Q in a large group of families ascertained internationally. Results show that the risks associated with this mutation, BC 20% and OC 6%, are lower than for the average BRCA1 mutations. Based on these risks we proposed mutation-specific recommendations for clinical management. We also found that, as occurs with moderate risk genes, cancer risks in families with this intermediate risk mutation are likely to be influenced by additional genetic factors. (By Mrs. Setareh

2017 JMG Contact blog

55. Qualitative study?other: Patients are aware of risks of opioid dependence, yet note poor communication from providers about pain and pain management

Qualitative study?other: Patients are aware of risks of opioid dependence, yet note poor communication from providers about pain and pain management Patients are aware of risks of opioid dependence, yet note poor communication from providers about pain and pain management | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, 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 Patients are aware of risks of opioid dependence, yet note poor communication from providers about pain and pain

2016 Evidence-Based Nursing

56. Negative Pressure Wound Therapy For The Management Of High Risk Surgical Incisions Or High Risk Patients: Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Negative Pressure Wound Therapy For The Management Of High Risk Surgical Incisions Or High Risk Patients: Clinical Effectiveness, Cost-Effectiveness, and Guidelines TITLE: Negative Pressure Wound Therapy For The Management Of High Risk Surgical Incisions Or High Risk Patients: Clinical Effectiveness, Cost-Effectiveness, and Guidelines DATE: 07 November 2013 RESEARCH QUESTIONS 1. What is the clinical effectiveness of negative pressure wound therapy for the management of high risk surgical (...) incisions or for patients at high risk of infection or wound dehiscence? 2. What is the cost-effectiveness of negative pressure wound therapy as compared to traditional wound management for the management of high risk surgical incisions or for patients at high risk of infection or wound dehiscence? 3. What are the evidence-based guidelines regarding the use of negative pressure wound therapy for the management of high risk surgical incisions or for patients at high risk of infection or wound dehiscence

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

57. Management of Low-risk Pulmonary Embolism (LoPE) Patients without Hospitalization: The LoPE Prospective Management Study. (PubMed)

Management of Low-risk Pulmonary Embolism (LoPE) Patients without Hospitalization: The LoPE Prospective Management Study. The efficacy and safety of managing patients with low-risk pulmonary embolism (PE) without hospitalization requires objective data from US medical centers. We sought to determine the 90-day composite rate of recurrent symptomatic VTE, major bleeding events, and all-cause mortality among consecutive patients diagnosed with acute low-risk PE managed without inpatient (...) hospitalization; and to measure patient satisfaction.We performed a prospective cohort single-arm management study conducted from January 2013 to October 2016 in five EDs. We enrolled 200 consecutive adults diagnosed with objectively confirmed acute PE and assessed to have a low risk for mortality using the Pulmonary Embolism Severity Index (PESI) score (< 86), echocardiography, and whole-leg compression ultrasound (CUS). The primary intervention was observation in the ED or hospital (observation status

2018 Chest

58. Redefining diabetes and the concept of self-management from a patient’s perspective: implications for disease risk factor management (PubMed)

Redefining diabetes and the concept of self-management from a patient’s perspective: implications for disease risk factor management The colliding epidemics of non-communicable diseases including diabetes with chronic infectious diseases in Sub-Saharan Africa requires contextualized innovative disease management strategies. This qualitative study conducted in a peri-urban township near Cape Town, South Africa aimed to identify and gain in-depth understanding of contextual and environmental (...) issues pertinent to the patient that could influence Type 2-diabetes mellitus (T2DM) care and self-management. Participants included purposively sampled diabetics or pre-diabetics from the community, PURE study database, facility health club and health care providers. Data collection employed in-depth interviews, focus group discussions (FGDs) using structured interviews and FGD topic guides. Thematic data analysis was done to identify recurrent themes. Themes identified: knowledge and awareness

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2018 Health education research

59. Failure of angiographic management in cases of post renal intervention bleed: Risk factors and management approach. (PubMed)

Failure of angiographic management in cases of post renal intervention bleed: Risk factors and management approach. To evaluate the factors predicting the risk for failed angiographic management (AM), we retrospectively studied cases of digital subtraction angiography (DSA) and superselective angiography (SSA) to control severe/delayed bleeding following renal interventions, which may otherwise be life threatening and often require nephrectomy.We have retrospectively evaluated the data of 154 (...) needed inotropes (P = .008) were found to predict risk for failure. On multivariate analysis, multiple bleeding site >2 (P = .003, odds ratio 5.23, 95% confidence interval = 1.3-22.5) and patients on inotropes (P = .02, odds ratio 2.56, 95% confidence interval = 2.15-4.75) were found to independently predict the failure.Patients with multiple bleeding lesions and who are on inotropic (leading to intrarenal vasoconstriction) are at high risk for failure of AM. Most of them can be successfully managed

2018 Urology

60. Do patients actually do what we ask: patient fidelity and persistence to the Targets and Self-Management for the Control of Blood Pressure in Stroke and at Risk Groups blood pressure self-management intervention. (PubMed)

Do patients actually do what we ask: patient fidelity and persistence to the Targets and Self-Management for the Control of Blood Pressure in Stroke and at Risk Groups blood pressure self-management intervention. Self-management of hypertension can reduce and control blood pressure (BP) compared with clinic monitoring. However, self-management relies on patients following an algorithm, which may be variably adhered to. This study reports fidelity of high-risk patients to the self-management (...) patients were randomized to self-management and 225 (82%) completed the required training sessions. Of these, 166 (74%) completed self-management. A total of 11385 (89.6%) submitted readings were accurate compared with corresponding downloaded monitor readings. Mean error rate was 5.2% per patient, which increased with age but not comorbidities. Patients made 475 of 683 (69.5%) algorithm-recommended medication changes, equating to nearly three medication changes per patient. Mean SBP for patients who

2018 Journal of Hypertension Controlled trial quality: uncertain

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