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161. BTS/SIGN British Guideline on the Management of Asthma

; or Extrapolated evidence from studies rated as 2 + Good-practice points ? Recommended best practice based on the clinical experience of the guideline development group. Healthcare Improvement Scotland (HIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual orientation. SIGN guidelines are produced using a standard methodology that has been equality impact assessed to ensure

2019 British Thoracic Society

162. Policy on Medically-Necessary Care

condition. These services are an integral part of the rehabilitative process. 26 Young children benefit from esthetic and functional restorative or surgical techniques and readily adapt to appliances that replace missing teeth and improve function, appearance, and self-image. During the period of facial and oral growth, appliances require frequent adjustment and must be remade as the individual grows. Professional care is necessary to maintain oral health, 3,4 and risk assessment is an integral element (...) developmental level and comprehension skills, affect the practitioner’s behavior guidance approaches. The success of restorations may be influenced by the child’s response to the chosen behavior guidance technique. To perform treatment safely, effectively, and efficiently, the practitioner caring for a pediatric patient may employ advanced behavior guidance techniques such as protective stabilization and/or sedation or general anesthesia. 59,60 The patient’s age, dental needs, disabilities, medical

2019 American Academy of Pediatric Dentistry

163. Policy on Acute Pediatric Dental Pain Management

with special health care needs or developmental disabilities is more challenging to assess accurately and may require utilization of scales that rely on observations such as vocalization, facial expressions, and body movements. 3-5 In addition to documenting pain severity, it is important to assess pain onset, pattern, location, and quality; aggravating and relieving factors; previous treatment and its effect; and barriers to assessment. 6 When assessing pain in a child, the patient’s psychological status (...) - gesic medications, and/or mild, moderate, or deep sedation regimens. 9,10 The extent of treatment affects post-operative pain. It has been reported that 95 percent of children undergoing full mouth dental rehabilitation, regardless of extent of treatment, report pain of moderate intensity. 8 Pain scores usually are highest immediately postoperatively while the patient is in the post-anesthesia recovery unit. 8 Due to analgesics and/or local anesthetics administered intra-operatively during dental

2017 American Academy of Pediatric Dentistry

164. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand Thoracic Society of Australia and New Zealand guidelines Full Text available with Trip Pro

. These include studies related to defining CSLD in children, , airway clearance, rehabilitation, and use of nebulised and long-term maintenance antibiotics to prevent exacerbations. These studies (obtained through systematic searches ) formed the basis for our updated recommendations. When evidence was lacking, Australian and New Zealand experts (the writing group) developed the recommendations, which were further informed by the voting group using a modified Delphi process and the GRADE (grading (...) rehabilitation. Strong Moderate 22 Regular physical activity is recommended for children and adults with CSLD or bronchiectasis. Strong Low 23 Assess and optimise nutritional status. Strong Moderate 24 Promote elimination of smoking, including second-hand smoke exposure. Strong High 25 Promote avoidance of environmental airborne pollutants. Strong Low 26 Regularly monitor and manage complications and comorbidities. When present, manage following standard guidelines. Regular review consists of at least

2015 MJA Clinical Guidelines

165. Guidelines for the Management of Absolute Cardiovascular Disease Risk

, significant weight loss).16 Cardiovascular disease (CVD), defined collectively in these guidelines as coronary heart disease (CHD), stroke and other vascular disease including peripheral arterial disease (PAD) and renovascular disease, is a leading cause of death and disability in Australia 7 and in 2003 accounted for approximately 18% of the total burden of disease in Australia. 8 In 2008, CVD accounted for over one-third (nearly 50,000) of deaths in Australia. 9 It has a strong relationship

2012 Stroke Foundation - Australia

166. The Diagnosis and Acute Management of Childhood Stroke, Clinical Guideline

diffusion coefficient; SWI, susceptibility-weighted images; FSE, fast spin echo; TSE, turbo spin echo; FLAIR, fluid-attenuated inversion recovery; TOF, time of flight; MRA, magnetic resonance angiography; PPSC, Primary Paediatric Stroke Centre; CT, computed tomography; CTA, computed tomography angiography. *time may vary between scanners. †In children with alternative diagnoses, if attaining subsequent imaging will be difficult/traumatic (e.g. young children or those with intellectual disability (...) Ability to provide acute monitoring up to 72 hours Dedicated stroke coordinator position / ? Dedicated medical lead / ? Access to ICU Rapid TIA assessment services Provision of telehealth services for acute assessment and treatment. optional optional Coordination with rehabilitation service providers Early assessment using standardised tools to determine individual rehabilitation needs and goals. Routine involvement of carers in rehabilitation process Routine use of guidelines, care plans

2017 Stroke Foundation - Australia

167. Management of Stroke in Neonates and Children Full Text available with Trip Pro

presented as neonates and 44 whose strokes were discovered later. Seventy-six children (68%) exhibited cerebral palsy, and 55 of these individuals had at least 1 additional disability; 45 (59%) experienced cognitive or speech impairment, and 36 (47%) had epilepsy. Detailed neuropsychological testing often documents cognitive dysfunction, especially related to attention and executive function. Such functional deficits are more likely to occur in individuals with a larger infarction, with comorbid (...) , neonates with cardiac disease may have a higher recurrence risk, similar to older infants and children with cardiac disease. Rehabilitation An early intervention program based on best available evidence of interventions that work in older children, Goals Activity Motor Enrichment, was evaluated in infants in a single randomized trial with promising results showing improved motor outcomes of participants compared with standard care. Another study explored the effectiveness of baby constraint-induced

2019 American Heart Association

168. Heart Disease and Stroke Statistics Full Text available with Trip Pro

as related deaths and disability-adjusted life-years lost, increased. The majority of global stroke burden is in low-income and middle-income countries. In analyses of 1 165 960 Medicare fee-for-service beneficiaries hospitalized between 2009 and 2013 for ischemic stroke, patients treated at primary stroke centers certified between 2009 and 2013 had lower in-hospital (odds ratio [OR], 0.89; 95% CI, 0.85–0.94), 30-day (hazard ratio, 0.90; 95% CI, 0.89–0.92), and 1-year (hazard ratio, 0.91; 95% CI, 0.90 (...) participation in cardiac rehabilitation after an acute MI. Between 2011 and 2015, compared with patients who did not participate in cardiac rehabilitation, those who declared such participation were less likely to be female (OR, 0.76; 95% CI, 0.65–0.90; P =0.002) or black (OR, 0.70; 95% CI, 0.53–0.93; P =0.014), were less well educated (high school versus college graduate: OR, 0.69; 95% CI, 0.59–0.81; P <0.001 and less than high school versus college graduate: OR, 0.47; 95% CI, 0.37–0.61; P <0.001

2019 American Heart Association

169. AIM Clinical Appropriateness Guidelines for Interventional Pain Management

imaging if the exam findings are clearly diagnostic of nerve root compression or spinal stenosis. Repeat Therapeutic ESI may be indicated when all of the following criteria are met: ? The prior injection produced at least a 50% reduction in pain with functional improvement of at least three (3) weeks’ duration** ? The patient has a recurrence of pain with significant functional disability ? The patient continues to receive conservative treatment between injections **Note: If the initial therapeutic (...) controlled trials. The spine journal : official journal of the North American Spine Society. 2015;15(2):348-62. 3 Chou R, Loeser JD, Owens DK, et al. Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: an evidence-based clinical practice guideline from the American Pain Society. Spine. 2009;34(10):1066-77. 4 Cohen SPH, S.; Semenov, Y et al. . Epidural steroid injections, conservative treatment, or combination treatment for cervical radicular pain: a multicenter

2019 AIM Specialty Health

170. AIM Clinical Appropriateness Guidelines for Joint Surgery

due to osteoarthritis, inflammatory disease or other chronic condition when all of the following requirements have been met: o Imaging evidence of significant joint destruction and cartilage loss, defined as Tönnis grade 3, modified Outerbridge grade III – IV, or Kellgren-Lawrence grade 3 – 4 o Limited range of motion, antalgic gait and disabling pain of at least three (3) months’ duration o Pain with passive internal or external rotation o Failure of at least three (3) months of non-surgical (...) removal of prosthesis due to infection or catastrophic failure ? Progressive and substantial bone loss ? Recurrent disabling pain or significant functional disability that persists despite at least three (3) months of conservative management in conjunction with either of the following: o Antalgic gait o Abnormal findings confirmed by plain radiography or imaging studies such as implant malposition or impingement Contraindications Total hip arthroplasty is contraindicated when any of the following

2019 AIM Specialty Health

171. Spine imaging

Rationale Neck pain is the fourth leading cause of global disability and has an annual prevalence rate exceeding 30%. 33-35 A majority (approximately 70%) of patients with neck pain improve with conservative/medical management alone. 36 Imaging of the Spine Copyright © 2019. AIM Specialty Health. All Rights Reserved. 18 Agreement exists among several high-quality guidelines that patients with progressive neurological deficits should undergo MRI, 37, 38 and that patients with major neurologic deficits (...) that neck/upper extremity strengthening exercises reduce neck pain in the near term; the average duration of the exercise programs in this review was approximately 12 weeks. 41 Several randomized controlled trials have shown that a multimodal approach to conservative management is better than a unimodal one: ? Exercise and education are better than education alone. 42 ? Multimodal exercises and cognitive behavioral therapy result in less disability from neck pain at 1 year when compared to general

2019 AIM Specialty Health

172. Risk reduction and management of delirium

likely to vary depending on a person’s values and preferences, and so the healthcare professional should spend more time discussing the options with the patient. Good-practice points ? Recommended best practice based on the clinical experience of the guideline development group. Healthcare Improvement Scotland (HIS) is committed to equality and diversity and assesses all its publications for likely impact on the six equality groups defined by age, disability, gender, race, religion/belief and sexual (...) solely to alcohol and illicit substances use. It also excludes delirium in children. 1.2.2 Common comorbidities Common comorbidities which have been considered when reviewing the evidence for this guideline are: • critical illness • dementia • depression • frailty • head injury • learning disability • Parkinson’s disease • cerebrovascular disease. 1.2.3 Definitions The International Classification of Diseases, version 10 (ICD-10) defines delirium as, “An aetiologically nonspecific organic cerebral

2019 SIGN

173. Cerebral palsy in adults

that allow adults with cerebral palsy access to a local network of care that includes: advocacy support learning disability services mental health services orthopaedic surgery (and post-surgery rehabilitation) rehabilitation engineering services rehabilitation medicine or specialist neurology services Cerebral palsy in adults (NG119) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 64secondary care expertise (...) needs (such as Gross Motor Function Classification System [GMFCS] levels IV and V) and any of the following: communication difficulties learning disabilities living in long-term care settings living in the community without sufficient practical and social support (for example, being cared for by elderly, frail parents) multiple comorbidities. 1.1.14 Discuss with the person with cerebral palsy (and their family and carers, if agreed) what information should inform the regular or annual review

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

174. Management of Venous Leg Ulcers: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum Full Text available with Trip Pro

insufficiency and leg ulcers. Angiology . 1997 ; 48 : 67–69 | | The care of VLUs can consume a significant amount of resources, so that an agreed on “best practice” algorithm can maximize the quality and effectiveness of care while minimizing cost and resource use. x 3 Passman, M.A. Non-medical initiatives to decrease venous ulcer prevalence. J Vasc Surg . 2010 ; 52 : 29S–36S | | | | | Moreover, VLUs are associated with prolonged disability, important socioeconomic impact, and significant psychosocial

2014 American Venous Forum

176. Optimal Exercise Programs for Patients With Peripheral Artery Disease: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

rehabilitation. Key words included the following: (physical* adj [active or activity or activities]); (stair* or step or steps); ([muscle or muscles or muscular] adj strengthen*); (swim* or swam or jog* or run or running or ran or walk or walking or walked); treadmill*; ([circuit* or resistance or strength* or physical or weight] adj [train or training]); exercise*; (arm* or leg*) adj2 (cycle or cycling or bicycl* or ergomet*); and rehabilitat*. Physical functioning subject headings included exp physical (...) the functional independence of patients with PAD. , However, functional impairment and functional decline are present even in people with PAD who are asymptomatic (ie, they have no exertional leg symptoms). , A limited ability to walk represents a disability when people are unable to perform their normal personal, social, and occupational activities. The major goals of treatment in people with claudication and other functional limitations resulting from PAD are to improve walking ability by relieving

2019 American Gastroenterological Association Institute

178. Distal Symmetrical Polyneuropathy: Definition for Clinical Research

not undergo the separate review process of Muscle & Nerve. This article is a joint report of the American Association of Electrodiagnostic Medicine, the American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation Abbreviations: EMG, electromyography; MDNS, Michigan diabetic neurop- athy score; MNSI, Michigan neuropathy screening instrument; NCS, nerve- conductions study/studies; NDS, neuropathy disability score; NIS-LL, neu- ropathyimpairmentscoreinthelowerlimbs;QST (...) Academy of Physical Medicine and Rehabilitation (AAPM&R) determined that there was a need for a formal case de?nition of polyneuropathy. Because of inconsistency in the literature, no consistent case de?nition exists. The use of a formal case de?nition across future research studies would ensure greater consistency of patient selection. This review de- scribes the development of such a case de?nition for “distal symmetrical polyneuropathy.” This article was prepared and reviewed by the AAEM and did

2005 American Association of Neuromuscular & Electrodiagnostic Medicine

179. Diabetic Retinopathy Guidelines

definition 6 Section 2: Epidemiology of diabetes and diabetic retinopathy 13 Section 3: Diabetic retinopathy in children and adolescents with diabetes mellitus 24 Section 4: Diabetic eye disease in people with learning disabilities 32 Section 5: The public health aspects of diabetic retinopathy 34 Section 6: Management of diabetes and retinopathy 42 Section 7: Clinical features of diabetic retinopathy 54 Section 8: Screening for diabetic retinopathy 64 Section 9: Retinal lasers 71 Section 10: Management

2012 Royal College of Ophthalmologists

180. Age-Related Macular Degeneration

rehabilitation 11.4.2 Surgical options 12. Management of Chronic/long standing vision loss 12.1 The diagnosis session in clinic – general remarks 12.2 What the patient needs to know 12.3 Rehabilitation and low vision services 12.4 Registration 12.5 Support organisations 13. Referral Pathways 13.1 Current pathways and movement through the clinic 14. Miscellaneous 14.1 Audit 14.2 Research Recommendations 14.3 Next review date 15. Glossary 6 1. Membership of the Guidelines Group Chair Professor Usha

2013 Royal College of Ophthalmologists

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