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Six Item Cognitive Impairment Test

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221. Comprehensive Care - Older people with frailty in hospital

to the primary reason for admission rather than identifying concurrent problems. To address this finding, Study 12 is testing a rapid screening tool for delirium (4ATs) that uses a combination of observation and a few short questions. Early indications suggest that this may be useful for busy staff in acute hospital settings. Details of the 4AT can be found here: http://www.the4at. com/ Study 13 compared care of cognitively impaired older people (many of whom experienced delirium) on general wards with care (...) as a result of risk assessments. A current randomised study is exploring whether high specification foam mattresses provide the same benefits. » Medication errors in prescription and administration can cause problems and pharmacist review of medicines within 24 hours of admission has been found to reduce inappropriate medication usage. DISCHARGE PLANNING » Researchers found that hospital staff need more support and training to assess the mental capacity of older people with cognitive impairment before

2018 NIHR Dissemination Centre - Themed Reviews

222. Organisation of mental health care for adults in Belgium

216 Table 25 – Flowchart of sampling process 217 Table 26 – Stakeholders’ characteristics (n = 469) 220 Table 27 – Priority objectives of the reform in mental health care 221 Table 28 – Fixed effect tests on priority scores* 222 Table 29 – Priority objectives of the reform in mental health care, differences between regions 223 Table 30 – Priority objectives of the reform in mental health care, differences between stakeholders 223 Table 31 – Differences in priority organisational interventions (...) according to the goals of social integration and care in the community 224 Table 32 – Levels of the organisation of mental health care preferred by stakeholders according to the goal of social integration vs care in the community 225 Table 33 – Conjoint analysis on the dimensions and levels of the organisation of mental health care 227 Table 34 – Fixed effect tests on utility scores (U)* 228 Table 35 – Levels of the organisation of mental health care, differences between regions 229 Table 36 – Levels

2019 Belgian Health Care Knowledge Centre

223. Depression and anxiety programs for children and young people

psychological interventions, although the returns are lower than widely implemented health care interventions. DEPRESSION AND ANXIETY PROGRAMS FOR CHILDREN AND YOUNG PEOPLE | SAX INSTITUTE 7 Six other programs were identified as having sufficient evidence to warrant a 2 or 3 thumb rating. These were: Coping Cat ( ? ? ?); Families and Schools Together ( ? ?); Physical activity interventions ( ? ?); the Good Behaviour Game ( ? ?); Mentoring ( ? ?); and Online CBT ( ? ?). All of these programs have been (...) be partly related to differences in implementation models rather than program content. For example, a number of the Australian programs (Aussie Optimism, FRIENDS, Resourceful Adolescent Program) that were implemented by school staff had weak effects. To improve the evidence for Australian psychological interventions, future evaluations should competitively test the effects of different implementation models. For example, it may be feasible to test whether effects improve when psychologists, mental

2018 Sax Institute Evidence Check

224. Identifying Effective Approaches to Support Parents and Caregivers of Children with Fetal Alcohol Spectrum Disorder

and therapy • One recent low-quality review aimed to identify programs targeted at families of children with physical disabilities and/or intellectual impairments and found education and counselling services delivered either online and in group settings as one possible approach.(7) • Two primary studies conducted in Ontario found Acceptance and Commitment Therapy (ACT) improved depression and stress among caregivers, reported health status, and psychological flexibility, as well as reduced cognitive (...) and disabilities resulting from alcohol exposure in utero.”(1) FASD affects fetal and brain development and may result in limitations to any of an individual’s: memory; sensory integration; social communication; language processing; emotional regulation; adaptive functioning; and other executive functions that may make conforming to social, behavioural and cognitive expectations difficult.(2; 3) These effects may mean that individuals affected by FASD are unable to live independently, have difficulty securing

2018 McMaster Health Forum

225. Managing health and wellbeing in the workplace

using selected key words within the advanced search functions of Google/Google Scholar and limited to the first 200 results in keeping with evidence-based guidance. Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) protocols were used with transparent reporting of search strategy and study retrieval (details in Appendices). 8 MANAGING HEALTH AND WELLBEING IN THE WORKPLACE| SAX INSTITUTE Evidence grading The review adopted the protocol used by the US Community Preventive (...) musculoskeletal disorders and symptoms, and moderate evidence that stakeholder participation and work modification are more effective and cost effective at returning to work adults with musculoskeletal conditions than other workplace-linked interventions. Evidence on the contribution of wellness programs to productivity is patchy. The Total Worker Health™(TWH) model has been used to develop the Employer Health and Productivity RoadMap™. The Roadmap comprises six interrelated and integrated core elements: (i

2018 Sax Institute Evidence Check

226. Prevention and Control of Methecillin-Resistant Staphylcoccus Aureus (MRSA)

they are at risk of having acquired MRSA (i.e. targeted screening) include the following: • Patients known to be previously positive and who are being re-admitted to an acute hospital. Grade C • Patients admitted directly from another hospital or healthcare facility, e.g. nursing home. Grade C • Patients who have been an in-patient in another healthcare facility, i.e. in acute hospital or long term care facility, in the last six months. Grade C • Patients transferred from a hospital abroad or patients who have (...) • Additional samples to diagnose infection (e.g. blood, vascular catheter tip) should be taken as clinically indicated. Grade D e) Laboratory methods • Laboratories should continue with culture-based methods for the detection of MRSA. Grade D • Ideally, broth-enrichment should be used but this results in an additional delay in the issuing of results and the decision needs to be assessed locally. Grade B • The advent of rapid diagnostic testing for MRSA with the polymerase chain reaction (PCR) is a welcome

2019 National Clinical Guidelines (Ireland)

227. Pharmacologic and Nonpharmacologic Therapies in Adult Patients With Exacerbation of COPD

therapy increases the clinical cure rate and reduces the clinical failure rate regardless of the severity of ECOPD (moderate SOE). There is insufficient evidence to support a particular antibiotic regimen. Oral and intravenous corticosteroids improve dyspnea and reduce the clinical failure rate (low SOE). Despite the ubiquitous use of inhaled bronchodilators in ECOPD, we found only a small number of trials that assessed lung function tests, and not final health outcomes. The evidence is insufficient (...) the process of the systematic review. We followed the established methodologies of systematic reviews as outlined in the Agency for Healthcare Research and Quality (AHRQ) Methods Guide for Comparative Effectiveness Reviews. 42 The reporting complies with the Preferred Reporting Items for Systematic Reviews ES-4 and Meta-Analyses (PRISMA) statements. 43 The study protocol is registered in the international prospective register of systematic reviews (PROSPERO #: 42018111609) and published on the AHRQ

2019 Effective Health Care Program (AHRQ)

228. British Association for Sexual Health and HIV national guideline for the management of vulvovaginal candidiasis

within the guideline under the relevant sections Diagnosis: • Microscopy is the primary laboratory investigation for acute VVC; culture is no longer recommended as a primary laboratory investigation for acute VVC • Culture is still recommended for recurrent VVC with appropriate speciation and sensitivity testing depending on clinical indication • Greater emphasis has been placed on ensuring that other vulval pathologies are not missed in the setting of possible recurrent VVC • Interpretation (...) of antifungal susceptibility testing should take into account the acid pH of the vagina compared with the neutral pH at which testing is usually performed; the activity of azole antifungals is reduced in acidic environment and clinical resistance may occur despite the isolate being microbiologically susceptible. Treatment: • Oral azoles – continue to avoid in pregnancy, at risk of pregnancy and whilst breastfeeding • Ketoconazole is no longer recommended for the treatment of VVC • Non-azole therapies

2019 British Association for Sexual Health and HIV

229. Guidelines for the Economic Evaluation of Health Technologies in Ireland

). July 2019 Guidelines for the Economic Evaluation of Health Technologies in Ireland 1.3 ? Revised test discount rate. Guidelines for the Economic Evaluation of Health Technologies in Ireland Health Information and Quality Authority 11 Guidelines for the Economic Evaluation of Health Technologies in Ireland Issued: July 2019 This document is one of a set that describes the methods and processes for conducting health technology assessment in Ireland. The document is available from the HIQA website (...) of administration, and duration of use is required for pharmaceutical products. Details of associated diagnostic or prognostic tests should also be described. Important information on specific investments, tools required to use the technology, additional training and information requirements specific to the technology should be included as appropriate. The technology may form part of a treatment sequence, in which case the associated technologies in the sequence also need to be clearly defined and described

2019 Health Information and Quality Authority

230. Guidelines for the Administration of Electroconvulsive Therapy

as the clinical aspects relevant to ECT administration including electrode placement, pulse width, dosing, medication use, maintenance and continua- tion ECT, and anaesthesia. However, the overall focus and purpose remained on encouraging practice that minimises adverse effects, including the lowest cognitive impairment, while retaining efficacy. Throughout this process, the draft guidelines were regularly reviewed by the SEN Executive Committee at its bi-monthly meeting. A final draft version (...) adverse effects. ECT techniques aimed at recovery that promote the lowest cognitive impairment while retain- ing efficacy are recommended in these guidelines. In reading these guidelines, it is important to recognise that the circumstances of each individual differ greatly, and consequently, each patient should be considered separately at their time of presentation and over the course of treat- ment to ensure that the most appropriate treatment is given to meet each patient’s individual needs

2019 American Psychiatric Association

231. Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland

-associated CDI? 42 2.5 Laboratory diagnosis 43 2.5.1 Who should be tested for CDI? 43 2.5.2 What type of specimen should be tested for CDI? 45 2.5.3 When should a repeat test for CDI be performed? 45 2.5.4 What is the best testing strategy to diagnose CDI? 46 2.5.5 When should specimens be sent for susceptibility testing and molecular typing? 52 2.6 Management of patients/residents with suspected/confirmed CDI 54 2.6.1 How should patients/residents with potentially infectious diarrhoea be managed (...) of C. difficile PCR ribotypes detected in recent research studies 12 Table 2.1: Elements of a CDI control programme to ensure that patient/resident care is reliable, designed to keep patients/residents safe and of high quality 25 Table 2.2: Two-step testing algorithms in use in Irish microbiology laboratories – 2011 28 Table 2.3: SIGHT Mnemonic protocol 54 Table 2.4: Summary of international recommendations on environmental decontamination of rooms/bed spaces of patients/residents with CDI 60 Table

2019 National Clinical Guidelines (Ireland)

232. Esketamine for Treatment-Resistant Depression

= electrocardiogram; EQ-5D-5L = EuroQol 5-Dimension 5-Levels questionnaire; GAD-7 = Generalized Anxiety Disorder 7-item scale; HVLT-R = Hopkins Verbal Learning Test‒Revised; ID = identification; IDS = Inventory of Depressive Symptomatology; MADRS = Montgomery- Å sberg Depression Rating Scale; MOAAS = Modified Observer's Assessment of Alertness/Sedation scale; PHQ-9 = Patient Health Questionnaire‒9; PWC-20 = Physician Withdrawal Checklist; SDS = Sheehan Disability Scale; TEAE = treatment-emergent adverse events (...) are refractory to classical antidepressants. 7 Esketamine is the S-enantiomer of racemic ketamine — a drug that has been used traditionally as a general anesthetic. In studies, sub-anesthetic intravenous doses of ketamine have demonstrated rapid antidepressant effects, as well as lessened fatigue and suicidality in patients with TRD and with minimal negative impacts on cognitive functioning. 12,13 Due in part to these promising results and despite concerns around limited data on long-term safety and duration

2019 CADTH - Issues in Emerging Health Technologies

233. Integrated care for older people (?ICOPE)?: guidance for person-centred assessment and pathways in primary care

community health and care workers to put the ICOPE recommendations into practice t o?ers care pathways to manage priority health conditions associated with declines in intrinsic capacity – loss of mobility, malnutrition, visual impairment, hearing loss, cognitive decline, depressive symptoms. These pathways start with a screening test to identify those older people who are most likely to be experiencing some losses in intrinsic capacity already. Health and social care workers can easily carry out (...) adults in primary care settings. Lack of schooling. Almost all standard cognitive assessments used for the screening or diagnosis of cognitive impairment assume a minimal amount of school education f a person has less than ?ve or six years of schooling or has no schooling, cognitive assessment can be limited. Instead, it must rely on interview and clinical judgement. For these individuals, enrolling in an adult literacy programme (if available) is highly recommended, as it promotes cognitive health

2019 World Health Organisation Guidelines

234. Assessment and Management of Patients at Risk for Suicide

of recommendations for specific testing and/or therapeutic interventions within these guidelines does not guarantee coverage of civilian sector care. Additional information on current TRICARE benefits may be found at www.tricare.mil or by contacting your regional TRICARE Managed Care Support Contractor. Version 2.0 – 2019VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide May 2019 Page 2 of 142 Prepared by: The Assessment and Management of Suicide Risk Work Group (...) . However, there was no increase in the prevalence of suicide attempts between 2016 and 2017 for this age group. SAMHSA notes that this increase in suicide-related behavior over the past 10 years co-occurs with a similar increase in the prevalence of mental health VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide May 2019 Page 8 of 142 conditions that cause significant impairment in daily life functioning, especially the occurrence of major depressive

2019 VA/DoD Clinical Practice Guidelines

235. Antipsychotics for the Prevention and Treatment of Delirium

extrapyramidal symptoms outcomes in trials with an intensive care unit population comparing haloperidol with placebo 136 Appendixes Appendix A. Detailed Search Strategy Appendix B. Screening and Data Abstraction Forms Appendix C. Included and Excluded Articles Appendix D. Evidence Tables ES-1 Evidence Summary Introduction Background Delirium is a syndrome characterized by an abrupt impairment in cognition, with a specific deficit in attention, that is associated with an underlying medical cause or causes. 1 (...) Delirium is a common and important condition in all healthcare settings, but is particularly prevalent in older adults and patients with critical illness. Delirium is strongly associated with increased mortality and longer hospital stay, with an estimated cost of $38 to $152 billion annually for patients aged 70 years or older. 2 Additionally, delirium experienced during a hospitalization is strongly associated with new or worsening long-term cognitive impairment. 3 Preventive and therapeutic

2019 Effective Health Care Program (AHRQ)

236. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights

through which people can be empowered to prevent, test for and treat disease themselves. Many health issues can already be dealt with through self-care and the list continues to grow. A people-centred approach supports health literacy so that people can take charge of their own health with evidence- based self-care interventions. When people have agency and autonomy, they can make and enact decisions in all aspects of their lives, including in relation to sexuality and reproduction. Self-care (...) Grading of Recommendations Assessment, Development and Evaluation GRC Guidelines Review Committee GVPS Global Values and Preferences Survey HIVST HIV self-testing HPV human papillomavirus HPVSS HPV self-sampling HRP The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction IPCHS Integrated People-Centred Health Services framework MEC Medical eligibility criteria for contraceptive use (WHO publication) OCP oral contraceptive pill OPK

2019 World Health Organisation Guidelines

237. Management of Stroke Rehabilitation

/DoD Clinical Practice Guideline for the Management of Stroke Rehabilitation July 2019 Page 6 of 170 Disability from stroke can present in a myriad of ways depending on the affected area(s) of the central nervous system. The most common presentations include focal weakness and sensory disturbances, speech and swallowing impairments, vision loss or neglect, cognitive problems with inattention or memory loss, as well as emotional difficulties with mood or anxiety. The early management of stroke (...) in Patients with Stroke and Transient Ischemic Attack [23] Abbreviations: AHA: American Heart Association; ASA: American Stroke Association Sidebar 2: Assessment of Impairments and Disabilities ? Assessment of impairments • Auditory/hearing • Bowel and bladder function • Cognition • Communication • Emotion and behavior • Inattention/neglect • Motor/mobility • Swallowing and nutrition • Tactile/touch • Vision function and formal visual field ? Assessment of barriers to participation in therapy • Cognitive

2019 VA/DoD Clinical Practice Guidelines

238. Achieving Health Equity in Preventive Services

of randomized controlled trials of the overall effect of patient navigation on colorectal cancer screening rates 103 Figure 6. Meta-analysis of randomized controlled trials of the effect of patient navigation on colorectal cancer screening rates by screening test, where subgroup results include all relevant studies 104 Figure 7. Meta-analysis of randomized controlled trials of the effect of patient navigation on colorectal cancer screening rates by screening adherence at baseline 105 Figure 8. Meta-analysis (...) of randomized controlled trials of the effect of patient navigation on colorectal cancer screening rates by followup time 106 Figure 9. Meta-analysis of randomized controlled trials of the effect of patient navigation on colorectal cancer screening rates by study quality 107 Figure 10. Meta-analysis of observational studies of the effect of patient navigation on colorectal cancer screening rates by screening test 108 xi Figure 11. Meta-analysis of randomized controlled trials of the effect of patient

2019 Effective Health Care Program (AHRQ)

239. Registries for Evaluating Patient Outcomes: A User's Guide

of the Institute of Medicine in October 2009 proposed the discipline of oncology as a logical condition in which to pilot test rapid- learning principles, noting that many components of an oncology learning health system were already in place, including resources from the National Cancer Institute, state cancer registries and other databases, and a library of quality measures. 10 The American Society of Clinical Oncology (ASCO), as a professional medical society representing oncologists and other cancer (...) , the Office of the National Coordinator of Health Information Technology released “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” in 2015, in which it describes the role of interoperability in building a learning health system and the key challenges that must be addressed. 12 A full exploration of EHR interoperability is beyond the scope of this chapter. However, six key technical challenges are discussed briefly here to provide context for discussions

2019 Effective Health Care Program (AHRQ)

240. Developing a Value Framework for Genetic Diagnosis: Part I A Systematic Review of Outcomes Hierarchies and Measurement Approaches

or models that can be applied and validated for use in genetic diagnoses. KQ2: What can be learned from existing value frameworks in health care? Eighteen relevant articles/documents (six rated Good) were identified. Several sources defined ‘value’ in the health care setting, and in general these were quite consistent. All considered it a ratio of some measure of health benefit, quality or outcomes and financial resources (dollars, costs, money spent). Components of value identified also included (...) ; and the need to make the case for the value of genetic services to payer and policy-makers. KQ4: What are specific health outcomes and how does a diagnosis contribute to improved short- and long-term outcomes for a) patients, b) family members and c) health care delivery systems and/or public health programs? Sixty-seven articles/documents (32 rated Good) were considered relevant. Six outcome hierarchies were identified, but only two focused on health outcomes. Hierarchies included health outcomes

2019 American College of Medical Genetics and Genomics

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