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Speech Language Pathology

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121. Organizational Guidance for the Care of Patients with Head and Neck Cancer in Ontario

specific oncology expertise [4,6,7]. Medical Imaging Physician ? Has completed a degree in medicine or equivalent and is a member of the RCPS of Ontario, as well as having completed the RCPSC five-year residency program and received a Certificate of Special Competence in Diagnostic Radiology. ? The residency should be followed by one or more years of fellowship training in a subspecialty discipline. Speech-Language Pathologist ? Has a Master’s degree or equivalent in speech pathology (...) be found in these settings. Program Recommendations for infrastructure requirements Multidisciplinary Ambulatory Care Clinic (2019 new) ? Timely access to allied health professionals (speech language pathology, audiology, social work, nutrition, oncology nursing) ? Access to audiology services and assessment of middle and inner ear function Peri-operative ? Infrastructure for micro-vascular, laser, and minimally invasive surgery ? Rapid access to neurosurgery, thoracic surgery, and vascular surgery

2019 Cancer Care Ontario

122. Iron Deficiency – Diagnosis and Management

cancer Gastric/small bowel cancer Hemorrhoids Peptic ulcer disease Inflammatory bowel disease Angiodysplasia Esophagitis Regular blood donation Post-operative patients with significant blood loss Hematuria (gross or microscopic) Intravascular hemolysis Endurance athletes Upper GI pathology: Chronic gastritis (incl. H pylori gastritis, atrophic gastritis/pernicious anemia) Celiac disease Crohn’s disease Gastric lymphoma Medications that decrease gastric acidity or bind iron, e.g. antacids/PPIs (...) -intakes-tables-2005.html Dipchand, A., Friedman, J., Bismilla, Z., Gupta, S., Lam, C. The Hospital for Sick Children - Handbook of Pediatrics. 11th ed. Toronto: Elsevier Canada; 2009. Diagnostic code: 280 Appendices Associated Documents The following printable patient handouts are available in eight languages : (recommended daily dietary allowance by age, sex, pregnancy and breastfeeding status; vegetarian diets; advice on how to get the most iron from foods) (list of foods high in heme and non-heme

2019 Clinical Practice Guidelines and Protocols in British Columbia

123. ACR–ASNR–SIR–SNIS Practice Parameter for the Performance of Endovascular Embolectomy and Revascularization in Acute Stroke

the usefulness/effectiveness is considered uncertain or less well established by evidence or opinion. A Class 3 recommendation represents a course of action for which there is evidence and/or general agreement that the procedure or treatment is not useful/effective, and in some cases may be harmful [15,16]. CNS infarction – CNS infarction is brain, spinal cord, or retinal cell death attributable to ischemia, based on pathological, imaging, other objective evidence of cerebral, spinal cord, or retinal focal (...) or symptoms 1 = Grade 1: No significant disability; able to carry out all the usual activities of daily living without assistance. NOTE: This does not preclude the presence of weakness, sensory loss, language disturbance, etc, but implies that these are mild and do not or have not caused patient to limit his/her activities (eg, if employed before, is still employed at the same job). 2 = Grade 2: Slight disability; unable to carry out some previous activities but able to look after own affairs without much

2019 American Society of Neuroradiology

124. A Case Management Tool for TB Prevention, Care and Control in the UK

co-morbidities and multi-drug resistant disease • negative pressure facilities appropriate for prolonged isolation • skilled outreach and advocacy workers able to draw effectively on the services of allied agencies to address a patient’s language, advocacy, housing, addiction, welfare benefits and other social care needs • flexible clinic opening hours, appointment systems and community DOT options. A hub and spoke model, with all TB services providing SCM and onward referral to specialist (...) : • housing needs and living situation • mental capacity, emotional capacity and cognitive status (via referral to a mental health team and social worker as necessary) • stigma associated with TB • language and literacy barriers • cultural and religious beliefs that may impact on acceptance of diagnosis and adherence • substance misuse • access, mobility and transportation • employment and income source, including entitlement to benefits • family/social support and dynamics • legal or immigration issues

2019 Royal College of Nursing

125. Adjuvant and Salvage Radiotherapy after Prostatectomy: ASTRO/AUA Guideline

information. In April 2018, the guideline underwent its first amendment, which incorporated evidence from three randomized controlled trials into the evidence base. A new evidence-based statement was also developed to discuss the use of hormone therapy in the salvage radiotherapy setting. Guideline Statements Guideline Statement 1. Patients who are being considered for management of localized prostate cancer with radical prostatectomy should be informed of the potential for adverse pathologic findings (...) that portend a higher risk of cancer recurrence and that these findings may suggest a potential benefit of additional therapy after surgery. (Clinical Principle) Guideline Statement 2. Patients with adverse pathologic findings including seminal vesicle invasion, positive surgical margins, and extraprostatic extension should be informed that adjuvant radiotherapy, compared to radical prostatectomy only, reduces the risk of biochemical recurrence, local recurrence, and clinical progression of cancer

2019 American Urological Association

126. Role of Treatment Deintensification in the Management of p16+ Oropharyngeal Cancer

: ASCO Provisional Clinical Opinion Research Question Have deintensified treatment approaches become an acceptable treatment standard in patients with p16+ oropharyngeal cancer (OPC)? Target Population Patients with p16+ OPC Target Audience Medical oncologists, radiation oncologists, surgeons, primary care physicians, dentists, nurses, speech pathologists, oncology pharmacists, and patients Methods An Expert Panel was convened to develop provisional clinical opinions based on a systematic review (...) , targeted therapy, and immunotherapy Study designs: systematic reviews, meta-analyses, randomized controlled trials, prospective cohort reports, retrospective observational studies, and relevant meeting abstracts Articles were excluded from the systematic review if they were editorials, commentaries, letters, news articles, case reports, or narrative reviews and if they were published in a non-English language. Guideline Disclaimer The clinical practice guidelines and other guidance published herein

2019 American Society of Clinical Oncology Guidelines

127. ACR–ASNR Practice Parameter for Brain PET/CT Imaging Dementia Res. 17 – 2015 - 2019

bodies (DLB) [3]. Alzheimer disease is the most common form of dementia, accounting for approximately 60%–80% of all cases [4]. The most prominent clinical feature of AD is an early impairment of episodic memory [5], which manifests as memory impairment for recent events, unusual repeated omissions, and difficulty learning new information. As the disease progresses, the symptoms often manifest in more persistent language disturbance and difficulties completing more complex tasks of daily living (...) dementia types, and 30% to 40% of cases do not progress to dementia [7]. The original diagnostic criteria for AD rested on the notion that AD is a clinical-pathological entity. The diagnosis is classified as definite (clinical diagnosis with histologic confirmation), probable (typical clinical syndrome without histologic confirmation), or possible AD (atypical clinical features but no alternative diagnosis apparent; no histologic confirmation). Note that possible AD may be identified by unusual

2019 American Society of Neuroradiology

128. Human Papillomavirus (HPV), Cervical Screening and Cervical Cancer

understands her right to withdraw consent at any time and request the procedure be stopped. 10. Record verbal consent and, if local policy requires, obtain written consent. 11. Reconsider the need for a chaperone and, if the woman declines, record this. 12. Apply correct procedures for your local method of liquid-based cytology (LBC). When explaining the examination procedure, ensure the language used is easily understood and avoid unnecessary jargon. If there are communication difficulties, it may (...) ) • the cohort to be offered screening would regard themselves as not necessarily having symptoms of the disease or to be at risk of the disease (apparently healthy people) • there should be an effective means of identifying and contacting the whole cohort to be offered screening • the population should be proactively approached (by written invitation, verbal invitation at the time of the contact with the health service, encouraging attendance for screening) to ensure that those offered screening would

2018 Royal College of Nursing

129. Managing the disposal of pregnancy remains Full Text available with Trip Pro

Authority guidance (HTA, 2015), should be articulated in writing or verbally. This recommendation needs to take account of local languages and cultural and/or religious expectations. This edition also takes into consideration guidance available from Sands, the stillbirth and neonatal death charity, the Institute of Cemetery and Crematorium Management (ICCM), and the Miscarriage Association, all of which provide operational details for those working in this area of practice. Appendix 1 provides (...) and that if no decision has been expressed within that time, the remains will be disposed of. Ideally, this information should be provided verbally and in writing.ROYAL COLLEGE OF NURSING 9 Sometimes women/parents do not recognise their loss at the time, but may return months or years later to enquire about disposal arrangements. It is therefore important that any discussions and information provided are well-documented, along with the details of the disposal. 5.5 Returning the pregnancy remains to the woman Some

2018 Royal College of Nursing

130. Older people in care homes: Sex, Sexuality and Intimate Relationships

in later life confers benefits on general health and quality of life. It is important to recognise the diversity in older populations in terms of age, experiences, expectations, priorities, preferences and desires. Older people, like those in younger age groups, are diverse in their desire for sexual intimacy. We do recognise that, as people age, there are changes both as part of normal ageing and pathological changes that can impact on sexual functioning. A key message is that older people can find (...) incontinence and some couples report sleeping in separate bedrooms, although they do not necessarily attribute this to incontinence. In some couples incontinence does not affect sexual intimacy but does affect sexual intercourse. Ultimately, it is important to remember that, although some age-related and pathological physical changes that occur in later life may affect sexual functioning so that usual patterns of sexual activity cannot be maintained, this in no way prevents older individuals and couples

2018 Royal College of Nursing

131. Yield of additional genetic testing after chromosomal microarray for diagnosis of neurodevelopmental disability and congenital anomalies

March 2018; accepted: 4 April 2018 1 Department of Human Genetics, University of Chicago, Chicago, Illinois, USA; 2 Autism & Developmental Medicine Institute, Geisinger Health System, Danville, Pennsylvania, USA; 3 Department of Pathology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA; 4 Department of Pathology and Laboratory Medicine, Perelman School of Medicine, Philadelphia, Pennsylvania, USA; 5 Department of Pediatrics, The Ohio State University College (...) of Medicine, Columbus, Ohio, USA; 6 Department of Pathology, ARUP Laboratories, University of Utah School of Medicine, Salt Lake City, Utah, USA; 7 Department of Obstetrics and Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Broad Institute of MIT and Harvard, Harvard Medical School, Boston, Massachusetts, USA; 8 Division of Evolution and Genomics Science, School of BiologicalSciences,ManchesterAcademicHealthScienceCenter,Manchester,UK; 9 DepartmentofMedicalGenetics,MarshfieldClinic

2018 American College of Medical Genetics and Genomics

132. Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies Full Text available with Trip Pro

in situ significantly longer than temporary tracheostomies in adult practice, especially if the child has a degree of neurological impairment . Similarly, tracheostomies are much more likely to be required permanently in children, with significant lifestyle changes for the child and their parents or carers - . Children with reversible, treatable or acquired pathologies, such as vocal cord palsies or subglottic stenoses, are more likely to get decannulated and the number of associated comorbidities (...) (Google and Google Scholar) and NHS Evidence bases ( ). Scientific papers and existing national or institutional guidelines with English language abstracts were retrieved and reviewed, along with any resources known to the Working Party members. Appropriate consideration was given to ‘UK’ and ‘US’ spellings of key words. Two authors (BM and CD) filtered publications, resources, websites, expert opinion and communications, with further articles retrieved from relevant references. The majority

2018 Association of Paediatric Anaesthetists of Great Britain and Ireland

133. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome

. INTERVENTIONS – THERAPEUTIC EXERCISE C Clinicians may use a combined orthotic/ stretching pro- gram in individuals with mild to moderate CTS who do not have thenar atrophy and have normal 2-point discrimination. Cli- nicians should monitor those undergoing treatment for clinically significant improvement. tion on pathology, risk identification, symptom self-management, and postures/ activities that aggravate symptoms. C Clinicians should recommend an orthosis for women experi- encing CTS during pregnancy (...) individuals with other upper extremity pathologies, leading to clinically rel- evant differential diagnosis. While diagnostic accuracy values for some aforementioned tests may be acceptable, there is no evidence to support an isolated test or measure that can con- firm the presence of CTS. The greatest likelihood ratios were found when subjective and/or objective data were combined with anthropometric measurements 97,157,283 ; however, these data need further validation in separate and larger samples

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

134. Clinical Practice Guidelines for Surveillance Colonoscopy

to be considered b,c Surveillance colonoscopy not recommended >80 Surveillance colonoscopy not recommended a Charlson for colonoscopy benefit can be simplified as per Table 18; b colonoscopy should be considered an option dependent on a clear conversation about the low risk of significant colorectal pathology, taking the patient ’s wishes into consideration; c consent for colonoscopy should include age appropriate statistics on risk. Table 18 . Charlson score for colonoscopy benefit Age Medical conditions 75 (...) by means of educational material, video and clinical explanation can assist in improving the patient experience with the procedure, and in reducing decreasing anxiety and abdominal pain during the procedure. Practice point Endoscopists should aim to control pain and discomfort during a colonoscopy procedure in order to reduce patient anxiety. Practice point The use of neutral language around colonoscopy may be useful in order to break down the stigma and taboo surrounding the procedure and bowel health

2019 Cancer Council Australia

135. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management

of strok Prompt recognition of symptoms of stroke and tr e and transient ischaemic attack ansient ischaemic attack 1.1.1 Use a validated tool, such as FAST (Face Arm Speech T est), outside hospital to screen people with sudden onset of neurological symptoms for a diagnosis of stroke or transient ischaemic attack (TIA). [2008] [2008] 1.1.2 Exclude hypoglycaemia in people with sudden onset of neurological symptoms as the cause of these symptoms. [2008] [2008] 1.1.3 For people who are admitted (...) for people who have had a suspected TIA or acute non-disabling stroke Suspected TIA Suspected TIA 1.2.1 Do not offer CT brain scanning to people with a suspected TIA unless there is clinical suspicion of an alternative diagnosis that CT could detect. [2019] [2019] 1.2.2 After specialist assessment in the TIA clinic, consider MRI (including diffusion- weighted and blood-sensitive sequences) to determine the territory of ischaemia, or to detect haemorrhage or alternative pathologies. If MRI is done

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

136. Suspected neurological conditions: recognition and referral

or taste problems 20 1.13 Speech, swallowing and language problems in adults 21 1.14 Tics and involuntary movements in adults 22 1.15 Tremor in adults 23 1.16 Information and support 24 Recommendations for children aged under 16 25 1.17 Attention, concentration and memory problems 25 1.18 Blackouts and other paroxysmal events 25 1.19 Confusion, acute 26 1.20 Dizziness and vertigo in children 27 1.21 Headaches in children 28 1.22 Head shape or size abnormalities 30 1.23 Hypotonia ('floppiness') 32 (...) deterioration 47 Posture distortion in adults 48 Sensory symptoms including tingling or numbness in adults 49 Sleep disorders in adults 51 Suspected neurological conditions: recognition and referral (NG127) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 4 of 73Smell or taste problems 52 Speech, swallowing and language problems in adults 53 Tics and involuntary movements in adults 54 Tremor in adults 55 Information

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

137. Jaundice in newborn babies under 28 days

verbal discussion backed up by written information. Care should be taken to avoid causing unnecessary anxiety to parents or carers. Information should include: factors that influence the development of significant hyperbilirubinaemia how to check the baby for jaundice what to do if they suspect jaundice the importance of recognising jaundice in the first 24 hours and of seeking urgent medical advice the importance of checking the baby's nappies for dark urine or pale chalky stools the fact (...) that an urgent medical review is conducted (as soon as possible and within 6 hours) for babies with suspected or obvious jaundice in the first 24 hours of life to exclude pathological causes of jaundice. [2010] [2010] 1.2.13 Interpret bilirubin levels according to the baby's postnatal age in hours and manage hyperbilirubinaemia according to the threshold table and the treatment threshold graphs. [2010] [2010] Care for babies more than 24 Care for babies more than 24 hours old hours old 1.2.14 Measure

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

138. Donor milk banks: service operation

-technical language when communicating the use of donor milk and the process of donor milk banking in any written information and activities. Screening and selecting donors The following strategy of screening and selection is part of the whole process of donor milk handling and therefore is intrinsically linked with the recommendations on testing and treating the donor breast milk. 1.11 Follow the stepped screening process detailed in recommendations 1.12 to 1.21 when recruiting donors. 1.12 Advise (...) screening tests at the time of enrolling for donor milk banking; do not rely on antenatal test results. 1.19 All tests should be undertaken in laboratories with clinical pathology accreditation (CPA). 1.20 Ensure that laboratories communicate the results of serological testing clearly and that they provide appropriate interpretive comments. Donor milk banks: service operation (CG93) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

139. Barrett's oesophagus: ablative therapy

rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 21endoscopic mucosal resection with further pathological assessment or or ablative therapy (radiofrequency ablation or photodynamic therapy) or or endoscopic mucosal resection and ablative therapy (radiofrequency ablation, argon plasma coagulation or photodynamic therapy). Ablativ Ablative ther e therapies apies 1.1.6 Consider using radiofrequency ablation alone or photodynamic (...) following with an additional ablative therapy (radiofrequency ablation, argon plasma coagulation or photodynamic therapy) to completely remove residual flat dysplasia, taking into consideration the side-effect profiles [1] . P Patient and carer support and information atient and carer support and information 1.1.9 Give patients verbal and written information about their diagnosis, available treatments, patient support groups and the uncertainty of the long-term outcomes of ablative therapies. Give

2010 National Institute for Health and Clinical Excellence - Clinical Guidelines

140. Fertility problems: assessment and treatment

via access to evidence-based information. These choices should be recognised as an integral part of the decision-making process. Verbal information should be supplemented with written information or audio-visual media. [2004] [2004] 1.1.1.3 Information regarding care and treatment options should be provided in a form that is accessible to people who have additional needs, such as people with physical, cognitive or sensory disabilities, and people who do not speak or read English. [2004] [2004 (...) appropriate expertise is available, screening for tubal occlusion using hysterosalpingo-contrast-ultrasonography should be considered because it is an effective alternative to hysterosalpingography for women who are not known to have comorbidities. [2004] [2004] 1.3.8.3 Women who are thought to have comorbidities should be offered laparoscopy and dye so that tubal and other pelvic pathology can be assessed at the same time. [2004] [2004] 1.3.8.4 Women should not be offered hysteroscopy on its own as part

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

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