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Speech Language Pathology

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141. Smokeless tobacco: South Asian communities

. For further details, see NICE guidance on smoking cessation services. Brief interv Brief interventions entions Brief interventions involve verbal advice, discussion, negotiation or encouragement, with or without written or other support or follow-up. They can be delivered by a range of primary and community care professionals. These interventions are often opportunistic, typically taking no more than a few minutes for basic advice, up to around 20 minutes for a more extended, individually-focused (...) services. These data should provide information on: prevalence and incidence of smokeless tobacco use and detail on the people who use it (for example, their age, ethnicity, gender, language, religion, disability status and socioeconomic status) people who use smokeless tobacco and do not use cessation services types of smokeless tobacco used perceived level of health risk associated with these products circumstances in which these products are used locally proportion and demographics of people who

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

142. Hepatitis B and C testing: people at risk of infection

in relation to format and the language used. For example, the needs of people with low literacy level and learning disabilities, and people with little interaction with statutory services should be considered. Recommendation 2 Awareness-raising for people at increased risk of hepatitis B or C infection Who should tak Who should take action? e action? Commissioners and providers of national public health services, for example Public Health England and the NHS Commissioning Board. Local authorities (...) from patients to laboratories within 24 hours (adjusted for weekends and bank holidays as necessary) Ensure service specifications specify that laboratory services providing hepatitis B and C testing: have Clinical Pathology Accreditation (UK) can support the range of samples used for hepatitis B and C testing (for example, dried blood-spot or venepuncture samples) or can refer the sample to a laboratory which can perform these tests automatically test samples that are positive for hepatitis C

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

143. Melanoma: assessment and management

biopsy as a staging rather than a therapeutic procedure for people with stage IB–IIC melanoma with a Breslow thickness of more than 1 mm, and give them detailed verbal and written information about the possible advantages and disadvantages, using the table below. Melanoma: assessment and management (NG14) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 10 of 61P Possible advantages of sentinel lymph node ossible (...) and give them detailed verbal and written information about the possible advantages and disadvantages, using the table below. Melanoma: assessment and management (NG14) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 11 of 61P Possible advantages of completion ossible advantages of completion lymphadenectom lymphadenectomy y P Possible disadvantages of completion ossible disadvantages of completion lymphadenectom

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

144. Urinary tract infection in under 16s: diagnosis and management

Poor feeding Failure to thrive Abdominal pain Jaundice Haematuria Offensive urine Urinary tract infection in under 16s: diagnosis and management (CG54) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 5 of 23Infants and children, 3 months or older Preverbal Fever Abdominal pain Loin tenderness Vomiting Poor feeding Lethargy Irritability Haematuria Offensive urine Failure to thrive Verbal Frequency Dysuria (...) and examination on confirmed UTI xamination on confirmed UTI 1.1.7.1 The following risk factors for UTI and serious underlying pathology should be recorded: poor urine flow history suggesting previous UTI or confirmed previous UTI recurrent fever of uncertain origin antenatally diagnosed renal abnormality family history of vesicoureteric reflux (VUR) or renal disease constipation dysfunctional voiding enlarged bladder abdominal mass evidence of spinal lesion Urinary tract infection in under 16s: diagnosis

2007 National Institute for Health and Clinical Excellence - Clinical Guidelines

146. Epilepsies: diagnosis and management

and social issues (including recreational drugs, alcohol, sexual activity and sleep deprivation) family planning and pregnancy voluntary organisations, such as support groups and charitable organisations, and how to contact them. [2004] [2004] 1.3.2 The time at which this information should be given will depend on the certainty of the diagnosis, and the need for confirmatory investigations. [2004] [2004] 1.3.3 Information should be provided in formats, languages and ways that are suited to the child (...) should have the test performed soon [9] . [2004] [2004] 1.6.23 Neuroimaging should not be routinely requested when a diagnosis of idiopathic generalised epilepsy has been made. [2004] [2004] 1.6.24 CT should be used to identify underlying gross pathology if MRI is not available or is contraindicated, and for children or young people in whom a general anaesthetic or sedation would be required for MRI but not CT. [2004] [2004] 1.6.25 In an acute situation, CT may be used to determine whether a seizure

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

147. Colorectal cancer: diagnosis and management

Recommendations about medicines 4 Patient-centred care 5 Key priorities for implementation 6 1 Recommendations 8 1.1 Investigation, diagnosis and staging 8 1.2 Management of local disease 9 1.3 Management of metastatic disease 14 1.4 Ongoing care and support 17 2 Research recommendations 19 2.1 Treatment of patients with moderate-risk locally advanced rectal cancer 19 2.2 The value of prognostic factors in guiding optimal management in patients with locally excised, pathologically confirmed stage I cancer 19 (...) metastatic disease or colonic perforation. Stage I colorectal cancer Stage I colorectal cancer The colorectal multidisciplinary team (MDT) should consider further treatment for patients with locally excised, pathologically confirmed stage I cancer, taking into account pathological characteristics of the lesion, imaging results and previous treatments. Imaging hepatic metastases Imaging hepatic metastases Colorectal cancer: diagnosis and management (CG131) © NICE 2018. All rights reserved. Subject

2011 National Institute for Health and Clinical Excellence - Clinical Guidelines

148. Headaches in over 12s: diagnosis and management

or medication overuse headache for neuroimaging solely for reassurance. [2012] [2012] Information and support for people with headache disorders Information and support for people with headache disorders Include the following in discussions with the person with a headache disorder: a positive diagnosis, including an explanation of the diagnosis and reassurance that other pathology has been excluded and and Headaches in over 12s: diagnosis and management (CG150) © NICE 2019. All rights reserved. Subject (...) such as flickering lights, spots or lines and/or partial loss of vision; sensory symptoms such as numbness and/or pins and needles; and/or speech disturbance On the same side as the headache: red and/or watery eye nasal congestion and/or runny nose swollen eyelid forehead and facial sweating constricted pupil and/or drooping eyelid Duration of headache 30 minutes–continuous 4–72 hours in adults 1–72 hours in young people aged 12–17 years 15–180 minutes Headaches in over 12s: diagnosis and management (CG150) ©

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

149. Idiopathic pulmonary fibrosis in adults: diagnosis and management

. Diagnosis Diagnose idiopathic pulmonary fibrosis only with the consensus of the multidisciplinary team (listed in table 1), based on: the clinical features, lung function and radiological findings (see recommendation 1.2.1) pathology when indicated (see recommendation 1.2.4). T T able 1 Minimum composition of multidisciplinary team in able 1 Minimum composition of multidisciplinary team inv volv olved in diagnosing idiopathic ed in diagnosing idiopathic pulmonary fibrosis pulmonary fibrosis Stage (...) . Information and support The consultant respiratory physician or interstitial lung disease specialist nurse should provide accurate and clear information (verbal and written) to people with idiopathic pulmonary fibrosis, and their families and carers with the person's consent. This should include information about investigations, diagnosis and management. An interstitial lung disease specialist nurse should be available at all stages of the care pathway to provide information and support to people

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

150. Tuberculosis

into account the language, actions, customs, beliefs and values of the group they are aimed at be tailored to the target population's needs include risks and benefits of treatment, and how to access services, advice and support dispel myths Tuberculosis (NG33) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 178show that, by deciding to be tested and treated for TB, a person can be empowered to take responsibility (...) for their own health use language that encourages the person to believe that they can change their behaviour be simple and succinct. [new 2016] [new 2016] 1.1.2.4 Make the material available in a range of formats such as written, braille, text messages, electronic, audio (including podcasts), pictorial and video. Make them freely available in a variety of ways, for example, online, as print materials or on memory sticks. [new 2016] [new 2016] 1.1.2.5 Disseminate materials in ways likely to reach target

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

151. Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over

for people aged 18 years and over. [2016] [2016] Speech and language ther Speech and language therap apy interv y interventions entions 1.8.3 Consider swallowing-exercise programmes for people having radiotherapy. [2016] [2016] 1.8.4 Consider mouth-opening exercises for people having radiotherapy who are at risk of reduced mouth opening. [2016] [2016] 1.8.5 Consider voice therapy for people whose voice has changed because of their treatment. [2016] [2016] Shoulder rehabilitation Shoulder rehabilitation (...) concomitant chemotherapy, for T1–2 N0 tumours of the oropharynx if pathologically adverse risk factors have been identified. [2016] [2016] 1.4 Treatment of advanced disease Squamous cell carcinoma of the larynx Squamous cell carcinoma of the larynx 1.4.1 Offer people with T3 squamous cell carcinoma of the larynx a choice of: radiotherapy with concomitant chemotherapy or or surgery with adjuvant radiotherapy, with or without concomitant chemotherapy. [2016] [2016] 1.4.2 Discuss the following with people

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

152. Osteoarthritis: care and management

can be associated with a lot of pain, or modest structural changes to joints can occur with minimal accompanying symptoms. Contrary to popular belief, osteoarthritis is not caused by ageing and does not necessarily deteriorate. There are a number of management and treatment options (both pharmacological and non- pharmacological), which this guideline addresses and which represent effective interventions for controlling symptoms and improving function. Osteoarthritis is characterised pathologically (...) ] Education and self-management Offer accurate verbal and written information to all people with osteoarthritis to enhance understanding of the condition and its management, and to counter misconceptions, such as that it inevitably progresses and cannot be treated. Ensure that information sharing is an ongoing, integral part of the management plan rather than a single event at time of presentation. [2008] [2008] Agree individualised self-management strategies with the person with osteoarthritis. Ensure

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

153. Stroke rehabilitation in adults

also be given the information and support they need. Stroke rehabilitation in adults (CG162) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 7 of 43T T erms used in this guideline erms used in this guideline Aphasia Aphasia Loss or impairment of the ability to use and comprehend language, usually resulting from brain damage. Apr Apraxia ( axia (of speech) of speech) Difficulty in initiating and executing (...) for implementation. Stroke units People with disability after stroke should receive rehabilitation in a dedicated stroke inpatient unit and subsequently from a specialist stroke team within the community. The core multidisciplinary stroke team A core multidisciplinary stroke rehabilitation team should comprise the following professionals with expertise in stroke rehabilitation: consultant physicians nurses physiotherapists occupational therapists speech and language therapists clinical psychologists

2013 National Institute for Health and Clinical Excellence - Clinical Guidelines

154. Intrapartum care for healthy women and babies

, and be aware of the importance of tone and demeanour, and of the actual words used. Use this information to support and guide her through her labour. [2007] [2007] 1.2.2 T o establish communication with the woman: Greet the woman with a smile and a personal welcome, establish her language needs, introduce yourself and explain your role in her care. Maintain a calm and confident approach so that your demeanour reassures the woman that all is going well. Knock and wait before entering the woman's room

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

155. Improving outcomes in children and young people with cancer

, dietitians, and speech and language therapists. They support the individual’s biological, psychological and social wellbeing and health, and can have a positive impact on the individual’s potential for recovery, as well as successful maturation to adulthood. They have strong links to non-health services. Although not formally recognised as AHPs, other disciplines, such as play specialists, activity coordinators, sonographers and clinical pharmacists, have an important role in these services. 24 Improving (...) in Children and Young People with Cancer Procedures 24 Palliative care 24 Allied health services 24 Non-health services 25 References 25 2 The care pathway 27 Presentation and referral 28 Diagnosis 31 Pathology 31 Imaging 32 Treatment 37 Chemotherapy 37 Surgery 41 Neurosurgery 44 Radiotherapy 47 Supportive care 52 Febrile neutropenia 52 Central venous access 55 Blood product support 58 Pain management 59 Management of nausea, vomiting and bowel disturbance 61 Nutrition 63 Oral and dental care 65

2005 National Institute for Health and Clinical Excellence - Clinical Guidelines

156. Improving outcomes in head and neck cancers

conditions such as salivary gland and skull base tumours. • Arrangements for referral at each stage of the patient’s cancer journey should be streamlined. Diagnostic clinics should be established for patients with neck lumps. • A wide range of support services should be provided. Clinical nurse specialists, speech and language therapists, dietitians and restorative dentists play crucial roles but a variety of other therapists are also required, from the pre-treatment assessment period until (...) ; the treatment can be disfiguring and often makes normal speech and eating impossible. For health services, head and neck cancers present particular challenges because of the complexity of the anatomical structures and functions affected, the variety of professional disciplines involved in caring for patients, and the relatively sparse geographical distribution of patients requiring specialised forms of therapy or support. There are over 30 specific sites (ICD10 codes) in this group and cancer of each

2004 National Institute for Health and Clinical Excellence - Clinical Guidelines

157. Improving outcomes for people with skin tumours including melanoma

were considered as evidence. No language restrictions were applied to the search; however, foreign language papers were not requested or reviewed (unless of particular importance to the clinical question). The following databases were included in the literature search: • The Cochrane Library • Medline and Premedline • Excerpta Medica (Embase) • Cumulative Index to Nursing and Allied Health Literature (Cinahl) • Allied & Complementary Medicine (AMED) • British Nursing Index (BNI) • Psychinfo • Web

2006 National Institute for Health and Clinical Excellence - Clinical Guidelines

158. Improving supportive and palliative care for adults with cancer

to be ethnically and culturally sensitive, to take account of the needs of those whose preferred language is not English or Welsh, and to be tailored to the needs of those with disabilities and communication difficulties • the value of high quality information for patients and carers. Co-ordination of care ES16 Lack of co-ordination between sectors (for instance, hospital and community) and within individual organisations has repeatedly been viewed as a problem in studies of patients’ experience. Action (...) considers the needs for supportive and palliative care of all patients facing a diagnosis of cancer and their families and carers. It is recognised that specific groups of patients, however, will have differing levels of need. Older people, for example, are more likely to have existing illnesses and disabilities and may be living alone, and patients for whom English or Welsh is not their preferred language may have specific communication needs. Recommendations are based on the premise that if needs

2004 National Institute for Health and Clinical Excellence - Clinical Guidelines

159. Improving outcomes in urological cancers

. a Clinical staging is used in decision-making about management but this is not always clearly related to pathological staging. 70 Incidence Mortality 60 50 40 30 20 10 0 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 Rate per 100,000 men Source: Data provided on request by the Office of National Statistics, London Clinical stage a Classification Description Proportion of new cases Organ-confined T1 or T2, Cancer confined 52% (Stage I or II) N0 M0 to prostate Extra-capsular T3 (...) examination (DRE), and trans-rectal ultrasound (TRUS) guided biopsy. Tumour may also be found by pathological examination of tissue samples after trans-urethral resection of the prostrate (TURP) carried out to relieve urinary obstruction. The disease usually progresses slowly, but prognosis depends heavily on the grade of the tumour. This is assessed using the Gleason scoring system. Gleason scores range from 2 to 10; more aggressive cancers, which spread faster beyond the prostate, have higher scores

2002 National Institute for Health and Clinical Excellence - Clinical Guidelines

160. Improving outcomes for people with brain and other central nervous system tumours

. There should also be access to specialist healthcare professionals as appropriate for any other problems patients may experience, such as epilepsy, headaches, and functional loss, for example speech, language or visual problems. • Palliative care specialists should be included as members of the neuroscience brain and other CNS tumours MDT and the cancer network brain and other CNS tumours MDT. They should provide advice on palliative and supportive care, the management of symptoms, and contribute (...) 21 NHS services for patients with CNS tumours 21 Neurosurgical services 22 Oncology and radiotherapy services 23 Specialist neurorehabilitation units 24 Stereotactic radiosurgery 24 References 24 1 Improving Outcomes for People with Brain and Other CNS Tumours Contents2. Multidisciplinary teams 27 Designated lead 31 Multidisciplinary teams 32 3. Presentation and referral 45 4. Diagnosis: radiology and pathology 50 5. Treatment and follow-up: brain tumours 58 Treatment 58 Low-grade glioma (WHO

2006 National Institute for Health and Clinical Excellence - Clinical Guidelines

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