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1. Children deafness - 0 to 6 years

approach The first approach, itself divided into two, has as an essential principle the will to stimulate auditory function and thereby enable the deaf child to develop a socially useful spoken language. It is proposed that this approach be called audiophonic, aiming to stimulate hearing early in order to encourage the development of spoken language (comprehension then expression). Practical implementation of this first approach is based on data from auditory assessments, which must be obtained (...) whatever age the child is. According to the level of hearing, auditory aids, then, if indicated, cochlear implants are used to stimulate the auditory pathways of the deaf child. During the last decade, significant technological progress has been made in stimulation methods. The educational environment proposed to parents to take advantage of auditory stimulation, and to promote the development of spoken language in the deaf child uses two methods from early intervention programme implementation

2010 HAS Guidelines

2. Sudden Hearing Loss Full Text available with Trip Pro

obtain, or refer to a clinician who can obtain, audiometry as soon as possible (within 14 days of symptom onset) to confirm the diagnosis of sudden sensorineural hearing loss. (KAS 6) Clinicians should evaluate patients with sudden sensorineural hearing loss for retrocochlear pathology by obtaining magnetic resonance imaging or auditory brainstem response. (KAS 10) Clinicians should offer, or refer to a clinician who can offer, intratympanic steroid therapy when patients have incomplete recovery from (...) is emphasized. KAS 5—New studies were added to confirm the lack of benefit of nontargeted laboratory testing in sudden sensorineural hearing loss. KAS 6—Audiometric follow-up is excluded as a reasonable workup for retrocochlear pathology. Magnetic resonance imaging, computerized tomography scan if magnetic resonance imaging cannot be done, and, secondarily, auditory brainstem response evaluation are the modalities recommended. A time frame for such testing is not specified, nor is it specified which

2019 American Academy of Otolaryngology - Head and Neck Surgery

3. Hearing Loss and/or Vertigo

without IV contrast Usually Not Appropriate O MRA head without and with IV contrast Usually Not Appropriate O MRA head without IV contrast Usually Not Appropriate O ACR Appropriateness Criteria ® 3 Hearing Loss and/or Vertigo Variant 5: Congenital hearing loss or total deafness or cochlear implant candidate. Surgical planning. Procedure Appropriateness Category Relative Radiation Level CT temporal bone without IV contrast Usually Appropriate ??? MRI head and internal auditory canal without and with IV (...) and internal auditory canal without IV contrast, or without and with IV contrast, is recommended for evaluating patients with acquired sensorineural hearing loss. ? Variant 4: Mixed conductive and sensorineural hearing loss can be evaluated with either CT temporal bone without IV contrast, or MRI head and internal auditory canal without IV contrast, or without and with IV contrast. ? Variant 5: Congenital hearing loss, total deafness, or cochlear implant is best assessed with either CT temporal bone

2018 American College of Radiology

4. American College of Medical Genetics and Genomics guideline for the clinical evaluation and etiologic diagnosis of hearing loss

American College of Medical Genetics and Genomics guideline for the clinical evaluation and etiologic diagnosis of hearing loss 347 © American College of Medical Genetics and Genomics ACMG PrACtiCe Guidelines DEFINITIONS Deaf: a community with a distinct culture and language shaped by the experience of being deaf or hard of hear- ing, which may include deaf, hard-of-hearing, and hearing individuals deaf: an auditory phenotype characterized by a total or near- total loss of the ability to hear (...) hard of hearing: an auditory phenotype characterized by a par- tial loss of the ability to hear hearing loss: an auditory phenotype characterized by any degree of loss of the ability to hear; depending on cause, hearing loss can be temporary or permanent—this guideline focuses on permanent hearing loss Submitted 6 January 2014; accepted 6 January 2014; advance online publication 20 March 2014. doi:10.1038/gim.2014.2 Genet Med 00 00 2014 Genetics in Medicine 10.1038/gim.2014.2 ACMG Practice

2014 American College of Medical Genetics and Genomics

5. Hearing loss in adults: assessment and management

not to remove earwax or clean their ears by inserting small objects, such as cotton buds, into the ear canal. Explain that this could damage the ear canal and eardrum, and push the wax further down into the ear. Hearing loss in adults: assessment and management (NG98) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 8 of 201.3 Investigation using MRI 1.3.1 Offer MRI of the internal auditory meati to adults with hearing loss (...) and localising symptoms or signs (such as facial nerve weakness) that might indicate a vestibular schwannoma or CPA (cerebellopontine angle) lesion, irrespective of pure tone thresholds. 1.3.2 Consider MRI of the internal auditory meati for adults with sensorineural hearing loss and no localising signs if there is an asymmetry on pure tone audiometry of 15 dB or more at any 2 adjacent test frequencies, using test frequencies of 0.5, 1, 2, 4 and 8 kHz. 1.4 Treating idiopathic sudden sensorineural hearing loss

2018 National Institute for Health and Clinical Excellence - Clinical Guidelines

6. Peripheral venous cannulation of children

. Indications of occluded arterial supply include: loss of colour, compromised pulse and pain. Loosen and remove the tourniquet immediately if any indication of occluded arterial supply is observed. Lightly tapping the vein or instructing the child to clench or pump the fist can encourage further venous filling ( ). Palpate the intended vein by placing one or two fingers over the vein and pressing lightly ( ). Disinfect the skin at the site at which it is intended to insert the needle, with 2% chlorhexidine (...) features. Rationale 17: Many families will have had previous experiences of cannulation or how their child copes with a stressful situation. Rationale 18: Thumb sucking will be an important coping strategy during the stressful experience of hospitalisation ( ). Rationale 19: This would represent a betrayal of the child’s trust ( ). Rationale 20: Increased risk of extravasation and phlebitis ( ). Rationale 21: Sixty minutes will achieve analgesia to pin prick but not loss of sensation or touch

2017 Publication 1593

7. Recovery: care of the child/young person

needs blood loss/fluid replacement blood components used/available intravenous fluids given and future requirements antibiotics given and when the next dose is due urine output during the procedure and expected output for the next few hours patient's anxiety level and preoperative psychological problems further investigations required how much oxygen is required and how to administer it monitoring required in the recovery room and on return to the ward possible language barrier if a throat pack has (...) to recovery staff should include: ( ) care and placement of drains precautions about dressings special nursing requirements, such as positioning of the child details of pre-operative skin integrity and any visible changes post -surgery ensuring the correct charts accompany the patient noting that personal belongings such as hearing aids and comforters, toys etc are present ( any isolation precautions and reason required Surgical handover should be included if there are specific surgical instructions

2015 Publication 1593

8. Peripheral venous cannulation of children

. Indications of occluded arterial supply include: loss of colour, compromised pulse and pain. Loosen and remove the tourniquet immediately if any indication of occluded arterial supply is observed. Lightly tapping the vein or instructing the child to clench or pump the fist can encourage further venous filling ( ). Palpate the intended vein by placing one or two fingers over the vein and pressing lightly ( ). Disinfect the skin at the site at which it is intended to insert the needle, with 2% chlorhexidine (...) features. Rationale 17: Many families will have had previous experiences of cannulation or how their child copes with a stressful situation. Rationale 18: Thumb sucking will be an important coping strategy during the stressful experience of hospitalisation ( ). Rationale 19: This would represent a betrayal of the child’s trust ( ). Rationale 20: Increased risk of extravasation and phlebitis ( ). Rationale 21: Sixty minutes will achieve analgesia to pin prick but not loss of sensation or touch

2014 Publication 1593

9. Management of Mother/Fetus & Newborn Near Neonatal Viability (22-25 Completed Weeks)

, varying from 10% to 50%? 3,4,5,6,7,8,9 Among surviving infants, 20% to 30% have disabilities such as cerebral palsy, hydro- cephalus, severe cognitive deficit, blindness, deafness, or a combination? 10,11,12,13 Although most disabilities 14 in these infants are mild or moderately severe, 15,16,17,18 up to 10% are severe and necessitate significant caretaking, far beyond that usually required by infants of their age? 19 25 to 26 Completed Weeks (175 to 188 days) Survival rates are 50% to 80%? 3,4,6,8,9

2016 British Columbia Perinatal Health Program

11. Guidelines for Psychological Practice With Older Adults

(Aldwin, Park, & Spiro, 2007; Schulz & Heckhausen, 1996), and a need to integrate or come to terms with one’s personal lifetime of aspira- tions, achievements, and failures (R. N. Butler, 1969). Among the special stresses of later adulthood are a variety of losses ranging from those of persons, objects, animals, roles, belongings, independence, health, and ?nancial well-being. These losses may trigger problem- atic reactions, particularly in individuals predisposed to depression, anxiety, or other (...) mental disorders. Because these losses are often multiple, their effects can be cumulative. Nevertheless, many older adults challenged by loss ?nd unique possibilities for achieving reconcil- iation, healing, or deeper wisdom (P. B. Baltes & Staudinger, 2000; Bonanno, Wortman, & Nesse, 2004; Sternberg & Lubart, 2001). Moreover, the vast majority of older people maintain positive emotions, improve their affect regulation with age (Charles & Carstensen, 2010), and express enjoyment and high life

2014 American Psychological Association

12. Guidelines for Psychological Practice with Lesbian, Gay, and Bisexual Clients

for lesbian, gay, and bisexual people, many of whom may be tolerated only when they are “closeted” (DiPlacido, 1998). Minority stress can be experienced in the form of ongoing daily hassles (e.g., hearing antigay jokes) and more serious negative events (e.g., loss of employment, housing, custody of children, physical and sexual assault; DiPlacido, 1998). According to a probability sample study by Herek (2009), antigay victimization has been experi- enced by approximately 1 in 8 lesbian and bisexual indi (...) to be widespread in society (APA, 1998, 2009b; Haldeman, 1994) and are implicated in many client requests to change sexual orientation. Tozer and Hayes (2004) found that the internalization of negative attitudes and beliefs about homosexuality and bisexuality was a primary factor in motivating individuals who sought to change their sexual orientation. Fear of potential losses (e.g., family, friends, career, spiritual community) as well as vulnerability to harassment, discrimination, and violence may contribute

2012 American Psychological Association

14. Multimorbidity: clinical assessment and management

or schizophrenia ongoing conditions such as learning disability symptom complexes such as frailty or chronic pain sensory impairment such as sight or hearing loss alcohol and substance misuse. 1.1.2 Be aware that the management of risk factors for future disease can be a major treatment burden for people with multimorbidity and should be carefully considered when optimising care. 1.1.3 Be aware that the evidence for recommendations in NICE guidance on single health conditions is regularly drawn from people (...) for adults with social care needs.] T erms used in this guideline Multimorbidity Multimorbidity Multimorbidity refers to the presence of 2 or more long-term health conditions, which can include: defined physical and mental health conditions such as diabetes or schizophrenia ongoing conditions such as learning disability symptom complexes such as frailty or chronic pain sensory impairment such as sight or hearing loss alcohol and substance misuse. The management of risk factors for future disease can

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

15. Responding to Domestic Abuse in Sexual Health Settings

and mortality for women of childbearing age. 12,14 Table 2: Physical Health consequences of DA 13 14 15 16 17 ? Death ? Injuries ? General health problems ? chronic pain syndromes ? gastrointestinal complaints e.g. IBS ? CNS complaints (e.g. migraines, hearing loss, cognitive problems) ? Recurrent UTIs ? Reproductive and Genitourinary Medicine (GUM) problems ? increased sexual risk behaviours including earlier coitarche, increased numbers of sexual partners, sex work ? increased rates of sexually (...) . Financial cost of domestic abuse DA has been estimated to cost the UK £15.7 billion 39 which includes costs to the criminal justice system, civil legal services, health and social care, housing and loss of earnings as well as the human and emotional costs. Key point 9 40, 41 Estimated cost of DA to the UK overall: £15.7 billion. Estimated direct cost of DA to health services: £1.7 billion. NICE 2014 DA guidelines state ‘even marginally effective interventions are cost effective‘. 42 4. Identification

2016 British Association for Sexual Health and HIV

16. Diabetes Care

appropriate for use in the Canadian population, at website: . The CDA offers an interactive screening tool, at website: Diagnosis (type 1 & 2) Diabetes can be diagnosed using any of the following criteria: FPG § of ≥ 7.0 mmol/L. A1C ¶ of ≥ 6.5%. See notes for contraindications. 2hPG of ≥ 11.1 mmol/L in a 75g OGTT. In a patient with classic symptoms of hyperglycemia (e.g., polyuria, polydipsia, and unexplained weight loss), a random plasma glucose (PG) ≥ 11.1 mmol/L. ** In the absence of symptomatic (...) of Cardiology and American Heart Association (ACC/AHA) guidelines do not recommend target LDL-C levels, but they recommend specific target statin doses. , If statin therapy is decided upon, select statin based on tolerability, potential for drug interactions, and cost. For information on dosages, see - Cardiovascular Disease: Primary Prevention . Retinopathy Early recognition and treatment of retinopathy can prevent vision loss. , Ensure patient receives dilated pupil retinal examination at diagnosis

2015 Clinical Practice Guidelines and Protocols in British Columbia

17. Asthma in Children - Diagnosis and Management

1-18 years, in the primary care setting. For recommendations regarding asthma in patients aged ≥ 19 years see – Asthma in Adults – Recognition, Diagnosis and Management . Key Recommendations Send children aged ≥ 6 years for when they are symptomatic to improve accuracy. Send patients for regularly as part of the assessment of asthma control. Prescribe daily and not intermittently. with an acute loss of asthma control in children. At each visit, as these are common reasons for poor asthma control (...) not increase their dose during acute loss of asthma control (i.e., in the yellow zone of an action plan), as this has not been shown to decrease the need for oral corticosteroids. 3. Choice of ICS There is currently not enough evidence in terms of improved efficacy or safety profile to recommend one ICS molecule over another. Resources References 1 McLeod C, Bogyo T, Demers P, et al. Asthma in British Columbia. Vancouver, BC: Centre for Health Services and Policy Research; 2007. 2 British Thoracic Society

2016 Clinical Practice Guidelines and Protocols in British Columbia

18. Asthma in Adults - Recognition, Diagnosis and Management

information and services. Translation services are available in over 130 languages on request. Website : Phone : In B.C. 8-1-1. Phone : TTY (deaf and hearing-impaired) 7-1-1 Instructions on inhaler technique: Provides detailed instructions on how to use various types of asthma inhalers. Website: QuitNow : An internet-based quit smoking service, available FREE-of-charge to all British Columbia residents. Translation services are available in over 130 languages on request. Website : Phone : Toll Free in B.C (...) leads to increased health care costs it also results in productivity and work losses. , Diagnosis Due to the high prevalence of asthma, assess all patients for asthma who present with common asthma respiratory symptoms (see Figure 1). Take a history and perform a physical examination to determine if the pattern of respiratory symptoms supports the diagnosis of asthma (see . Adult clinical features to assess the probability of asthma). A diagnosis of asthma is based on documenting a pattern of common

2016 Clinical Practice Guidelines and Protocols in British Columbia

19. Clinical practice guidelines and principles of care for people with dementia

of functioning, aphasia, hearing or visual impairments, psychiatric illness or physical/neurological problems when interpreting scores. 39 EBR Low 1 The Kimberley Indigenous Cognitive Assessment (KICA-Cog) or KICA-Screen tool is recommended for use with remote living Indigenous Australians for whom the use of alternative cognitive assessment tools is not considered appropriate. 40 EBR Low The modified KICA (mKICA) is recommended as an alternative to the Mini Mental State Exam (MMSE) in urban and rural (...) assessment. Concomitant administration of medications with anticholinergic effects should be avoided. 70 EBR Moderate Medical and nurse practitioners should be aware that the acetylcholinesterase inhibitors are associated with a number of adverse reactions that have a risk of harm. These include (but are not limited to) nausea, vomiting, diarrhoea, dizziness, increased urinary incontinence and frequency, falls, muscle cramps, weight loss, anorexia, headache and insomnia. Heart block is a rare

2016 Clinical Practice Guidelines Portal

20. Assessment, diagnosis and interventions for autism spectrum disorders

, for example relatively smaller class size in primary school years, or family ‘scaffolding’ of social impairment in childhood or adolescence or, in adults, unmasking of symptoms and signs of ASD due to loss of informal carers, will also influence this dynamic. 4 Alternatively the signs and symptoms of ASD may not always have been recognised by parents, carers, the individual themselves or other professionals, 5 so may not present until adulthood, or perhaps even older adulthood. There is therefore a need (...) Interventions for social communication and interaction Updated 6.3.1 Intensive behavioural and developmental programmes Completely revised 6.3.2 Specific interventions for ASD New 6.3.3 Cognitive behavioural therapies New 6.3.4 Auditory integration training Updated 6.3.5 Occupational therapy and sensory integration therapy Completely revised 6.3.6 Music therapy Updated 6.3.7 Sleep management Updated 6.3.8 Facilitated communication No new evidence identified 6.3.9 Additional interventions to address

2016 SIGN

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