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Substance Abuse rehabilitation

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162. Assessment of the 12-Lead ECG as a Screening Test for Detection of Cardiovascular Disease in Healthy General Populations of Young People (12?25 Years of Age)

cardiovascular disease include bronchial asthma, ruptured cerebral aneurysm, use of performance-enhancing or other drugs and substances, heat stroke, and pulmonary embolus. The mechanism of death in the vast majority of these events is a ventricular tachyarrhythmia, with the major exception being Marfan syndrome and related disorders associated with aortic dilatation, in which SD usually occurs because of aortic dissection/rupture. SDs occur in a wide variety of sports, most commonly football and basketball (...) common than their actual frequency, or even the misconception that such deaths are virtually confined to athletes. Such misperceptions have legitimized screening initiatives limited to athletes, in turn perhaps diverting resources from the many other important public health issues for this age group, including but not confined to preventable accidents or other causes such as drug abuse, childhood obesity, and suicide intervention ( ). Indeed, in a 10-year study of US college athletes, Maron et al

2014 American Heart Association

163. Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association

implications be incorporated into the medical education model: (1) lifestyle risk factor assessment and management and (2) motivational interviewing for conditions such as weight management and eating disorders, tobacco use, and substance abuse. The objective for learning outcomes that students should achieve by graduation was defined as follows: “Provide patient-centered behavioral guidance and explain the appropriate theoretical model that supports the approach.” The Liaison Committee on Medical (...) expertise when appropriate The centerpiece of effective behavioral counseling is a patient-centered approach, whereby providers collaborate with patients to help them create plans to reach their own goals. Motivational interviewing is a specific form of patient-centered counseling originally developed to treat substance abuse that also has been applied successfully to foster health behavior changes. , The core counseling strategy is to avoid commanding language and instead to ask open-ended questions

2016 American Heart Association

164. Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

ventricular assist device (VAD) certification. Specifically, The Joint Commission requires involvement of palliative care specialists for patients undergoing VAD implantation as destination therapy; programs have used this as an opportunity to integrate palliative care into the care of all MCS patients. Integration of palliative care with the care of stroke patients varies, depending on the extensiveness of the stroke and the stage after stroke, from the acute phase to recovery, long-term rehabilitation (...) all portend a poor prognosis. Submaximal exercise testing also predicts mortality in ambulatory patients with HF. Additionally, cognitive impairment is a predictor of mortality in HF and may affect self-care ability. Social environmental factors such as income, disability status, Medicaid insurance, unmarried status, living alone or at a distance from hospital care, and history of alcohol or drug abuse are independent predictors of poor outcomes, including survival in advanced HF. In the REMATCH

2016 American Heart Association

167. Supporting Adults Who Anticipate or Live with an Ostomy

, and policy across a range of health service organizations, practice areas, and sectors. These experts shared their insights on supporting and caring for adults who anticipate or live with an ostomy across the continuum of care (e.g., acute care, rehabilitation, community, and primary care). A systematic and comprehensive analysis was completed by the RNAO Best Practice Guideline Development and Research Team and the RNAO expert panel to determine the scope of this BPG and to prioritize recommendation (...) settings where adults who anticipate or live with an ostomy are accessing services (such as, but not limited to, acute care, long-term care, community settings, and rehabilitation settings). In this BPG, no recommendation questions were identified that addressed the core education and training strategies required for curricula, ongoing education, and professional development of nurses or the interprofessional team in order to support adults living with or anticipating an ostomy. Please refer

2019 Registered Nurses' Association of Ontario

168. Delirium, Dementia, and Depression in Older Adults: Assessment and Care, Second Edition

) Regional Clinical Nurse Specialist, Rehabilitation & Geriatrics Programme, Winnipeg Health Region Adjunct Professor, College of Nursing, Faculty of Health Sciences, University of Manitoba Research Associate, Manitoba Centre for Nursing and Health Research Winnipeg, Manitoba Registered Nurses’ Association of Ontario Expert PanelBACKGROUND Delirium, Dementia, and Depression in Older Adults: Assessment and Care, Second Edition Registered Nurses’ Association of Ontario Expert Panel ...con’t Philippe Voyer

2016 Registered Nurses' Association of Ontario

169. Psychosis and schizophrenia

Psychosis and schizophrenia Psychosis and schizophrenia - NICE CKS Share Psychosis and schizophrenia: Summary Psychosis is a disordered mental state characterized principally by positive symptoms such as hallucinations, delusions, and thought disorder. Psychotic symptoms are cardinal features of psychotic disorders such as schizophrenia, but may be caused by medicines and substance misuse, and by medical conditions such as sepsis in the elderly. Psychotic disorders, including schizophrenia (...) in social functioning. Substance misuse. A prodromal period of emotional disturbance, typically called the ‘at risk mental state’ may precede the development of a first episode of psychosis. It is characterized by a change in mood, anxiety, or more subtle psychotic symptoms, lasting from a few days to around 18 months. A person is at risk if they are distressed, have a deterioration in social functioning, and have: Transient (short duration — less than one week) or attenuated (lower intensity) psychotic

2016 NICE Clinical Knowledge Summaries

170. Depression

of adaptive mechanisms to stressors. Chronic comorbidities such as diabetes, chronic obstructive pulmonary disease, cardiovascular disease and especially people with chronic pain syndromes. A past head injury, including hypopituitarism following trauma [ ; ]. People at high risk of depression Who is at high risk of depression? People who are at high-risk of depression include anyone with [ ; ]: A history of depression, suicide attempt, or any form of abuse (sexual, physical, or substance). Significant (...) problems. Neglect of dependants [ ]. Family problems and relationship break-ups. Increases the risk of substance abuse. [ ; ] Prognosis What is the prognosis? The average length of an episode of depression is 6–8 months. The prognosis is worse for people with [ ]: Psychotic features. Prominent anxiety. Personality disorders. Severe symptoms. The risk of recurrence is: At least 50% after a first episode of depression, 70% after a second episode and 90% after a third episode [ ]. Increased in people less

2015 NICE Clinical Knowledge Summaries

171. Preventing and Mitigating Nurse Fatigue in Health Care

DIETRICH RPN, cRTWc , cDMP , McVP , MHS Rehabilitation Consultant Cascade Disability Management Inc., Waterloo, Ontario ROSE GASS RN, ENc(c), BA, MHST Director, Emergency and Respiratory Norfolk General Hospital, Simcoe, Ontario JULIE GREGG MADED, RN Policy Consultant College of Registered Nurses of Nova Scotia, Halifax, Nova Scotia LINDA HASLAM-STROUD RN President Ontario Nurses’ Association, T oronto, OntarioPreventing and Mitigating Nurse Fatigue in Health Care BACKGROUND 13 BEST PRACTICE GUIDELINES (...) and shifts, heavy lifting, exposure to hazardous and infectious substances, and threats to personal safety. ¦ At the organizational level, the Organizational/Physical Factors include the physical characteristics and the physical environment of the organization, as well as the organizational structures and processes created to respond to the physical demands of the work. Included among these factors are staffing practices, flexible-scheduling and self- scheduling, access to functioning lifting equipment

2011 Registered Nurses' Association of Ontario

172. Developing and Sustaining Nursing Leadership

and infectious substances, and threats to personal safety. ¦ At the organizational level, the Organizational Physical Factors include the physical characteristics and the physical environment of the organization and also the organizational structures and processes created to respond to the physical demands of the work. Included among these factors are staffing practices, flexible, and self-scheduling, access to functioning lifting equipment, occupational health and safety policies, and security personnel

2013 Registered Nurses' Association of Ontario

173. Developing and Sustaining Interprofessional Health Care: Optimizing patients/clients, organizational, and system outcomes

Factors Social Work Demand Factors Cognitive/Psycho/ Figure 1B. Cognitive/Psycho/Socio-Cultural Components Nurse/ Patient/Client Organizational Societal Outcomes ¦ At the individual level, the Physical Work Demand Factors include the requirements of the work which necessitate physical capabilities and effort on the part of the individual. schedules and shifts, heavy lifting, exposure to hazardous and infectious substances, and threats to personal safety. ¦ At the organizational level

2013 Registered Nurses' Association of Ontario

174. Self-harm

Self-harm Self-harm - NICE CKS Share Self-harm: Summary Self-harm refers to an intentional act of self-poisoning or self-injury, irrespective of the motivation or apparent purpose of the act, and is an expression of emotional distress. The majority of self-poisoning episodes involve prescribed or over-the-counter medication, and a minority involve illicit drugs, other household substances, or plant material. The majority of self-injury episodes involve cutting, while less common methods include (...) -poisoning episodes involve prescribed or over-the-counter medication, and a minority involve illicit drugs, other household substances, or plant material [ ; ]. The majority of self-injury episodes involve cutting, while less common methods include burning, hanging, stabbing, swallowing objects, insertion, shooting, and jumping from heights or in front of vehicles [ ]. Self-harm includes suicide attempts as well as acts where little or no suicidal intent is involved (for example, where people harm

2014 NICE Clinical Knowledge Summaries

175. Person-and Family-Centred Care

work produced by RNAO is editorially independent from its funding source. Contact Information Registered Nurses’ Association of Ontario 158 Pearl Street, T oronto, Ontario M5H 1L3 Website: www.RNAO.ca/bestpracticesEngaging Clients Who Use Substances Person- and Family-Centred CarePerson- and Family-Centred Care 2 REGISTERED NURSES’ ASSOCIATION OF ONTARIO Greetings from Doris Grinspun, Chief Executive Officer, Registered Nurses’ Association of Ontario The Registered Nurses’ Association of Ontario

2015 Registered Nurses' Association of Ontario

176. Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition

“Pathogenesis and general management of foot lesions in the diabetic patient,” by M. E. Levin, 2001, in J. H. Bowker & M. A. Pfeifer (eds.), Levin and O’Neals The Diabetic Foot (6th ed.), p. 222. St. Louis, MO: Mosby, Inc. Copyright Elsevier (2001). Ulcers and amputations result in enormous societal costs, including lost wages, job loss, prolonged hospitalization, lengthy rehabilitation and an increased need for home care and social services. Given the data on the burden of illness and the significant long

2013 Registered Nurses' Association of Ontario

177. Promoting Safety: Alternative Approaches to the Use of Restraints

Geriatric Health Care System T oronto, Ontario Assistant Professor New Y ork University College of Nursing Hartford Institute for Geriatric Nursing New Y ork, NY, USA Athina Perivolaris RN, BScN, MN T eam Leader Advanced Practice Nurse Mental Health/Gerontology, Centre for Addiction and Mental Health T oronto, Ontario Nancy Boaro RN, BScN, MN, CNN(C), CRN(C) Advanced Practice Leader, Neuro Program T oronto Rehabilitation Institute T oronto, Ontario Lisa Casselman BSc, BSW, MSW, RSW Mental Health (...) Ottawa Mental Health Centre Professional Development, Crisis Prevention Instructor Ottawa, Ontario Kathy Culhane RN Nurse Educator Lady Dunn Health Centre Wawa, Ontario Michelle DaGloria RN, BScN Clinical Educator, Professional Practice Lead Medicine Guelph General Hospital Guelph, Ontario Sylvia Davidson MSc, DipGer, OT Reg.(Ont.) Advanced Practice Leader – Geriatrics T oronto Rehabilitation Institute – University Centre T oronto, Ontario Nicole Didyk MD, FRCP(C) Geriatrician St. Mary’s Hospital

2012 Registered Nurses' Association of Ontario

178. Assessment and Management of Pain (Third Edition)

were interprofessional, made up of people who held clinical, administrative and academic roles in a variety of health-care organizations. They work with clients of all ages in different types of care – acute, long-term and home health care, mental health and addictions G , rehabilitation and community services. The participants of the focus groups outlined outstanding resources including books, guidelines, position papers, and care pathways developed to meet the needs of specific populations (...) Darlene Davis, RN, MN Health Services Manager, Pain Services Capital District Health Authority Halifax, Nova Scotia Céline Gélinas, RN, PhD Assistant Professor Ingram School of Nursing McGill University Researcher and Nurse Scientist Centre for Nursing Research and Lady Davis Institute Jewish General Hospital Montreal, Quebec Nicholas Joachimides, RN, BScN, CRN(c), MCISC Clinical Educator Holland Bloorview Kids Rehabilitation Hospital T oronto, Ontario Salima S. J. Ladak, RN(EC), MN Nurse Practitioner

2013 Registered Nurses' Association of Ontario

179. Managing and Mitigating Conflict in Health-care Teams

, RN, BScN, MN Nursing Unit Administrator, Mount Sinai Hospital, T oronto, Ontario DEBORA COWiE, RPN Staff Nurse, Ontario Shores Centre for Mental Health Sciences, Whitby, OntarioB A CKGROUND Managing and Mitigating Conflict in Health-care T eams 18 REGISTERED NURSES’ ASSOCIATION OF ONTARIO MiCHELLE DAGLORiA, RN, BScN Clinical Educator Medicine, Guelph General Hospital, Guelph, Ontario SyLViA DAViDSON , MSC, BSc, DiP Advanced Practice Leader – Geriatrics, T oronto GER, OT REG. (ONT.) Rehabilitation

2012 Registered Nurses' Association of Ontario

180. PEER Simplified Guideline: Medical Cannabinoids

syndrome (cyclic vomiting) and amotivational syndrome, are still being defined. 22,23 Cannabis use disorder (CUD), replacing previous cannabis abuse and cannabis dependence, may be as common as one fifth of regular cannabis users. 6 Risk of CUD is higher in those who use more frequently, are male, and begin earlier. 6,24 However, in another study of those meeting criteria for having CUD, 67% remitted (no longer met criteria) at three years, with 64% of them no longer using cannabis. 25 Whether regular (...) , Bunnell RE, Promoff G, McAfee TA. Toking, vaping, and eating for health or fun: marijuana use patterns in adults, U.S., 2014. Am J Prev Med. 2016 Jan;50(1):1-8. 3. Park JY, Wu LT. Prevalence, reasons, perceived effects, and correlates of medical marijuana use: A review. Drug Alcohol Depend. 2017;177:1-13. 4. Fischer B, Ialomiteanu A, Aeby S, Rudzinski K, Kurdyak P, Rehm J. Substance use, health, and functioning characteristics of medical marijuana program participants compared to the general adult

2018 Toward Optimized Practice

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