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Nuchal Translucency Evaluation at 11 to 14 Weeks Gestational Age New 2020 ACR Appropriateness Criteria ® 1 Nuchal Translucency Evaluation American College of Radiology ACR Appropriateness Criteria ® Nuchal Translucency Evaluation at 11 to 14 Weeks Gestational Age Variant 1: Routine nuchal translucency measurement at 11 to 14 weeks of gestation for single or twin gestations. Initial imaging. Procedure Appropriateness Category Relative Radiation Level US pregnant uterus transabdominal Usually (...) at the back of the fetal neck is a normal ultrasound (US) finding at 11 to 14 weeks of gestation; above this threshold, the fetus is considered to have an increased nuchal translucency, which is a marker for fetal aneuploidy, genetic syndromes, structural anomalies, and intrauterine demise . Fetal nuchal translucency increases with crown-rump length, so gestational age must be taken into account when determining whether a given nuchal translucency thickness is increased. It is customary to quantify
PMCID: DOI: Item in Clipboard Full-text links Cite Abstract Background: Digitally enabled rehabilitation may lead to better outcomes but has not been tested in large pragmatic trials. We aimed to evaluate a tailored prescription of affordable digital devices in addition to usual care for people with mobility limitations admitted to aged care and neurological rehabilitation. Methods and findings: We conducted a pragmatic, outcome-assessor-blinded, parallel-group randomised trial in 3 Australian (...) hospitals in Sydney and Adelaide recruiting adults 18 to 101 years old with mobility limitations undertaking aged care and neurological inpatient rehabilitation. Both the intervention and control groups received usual multidisciplinary inpatient and post-hospital rehabilitation care as determined by the treating rehabilitation clinicians. In addition to usual care, the intervention group used devices to target mobility and physical activity problems, individually prescribed by a physiotherapist
or fortified foods as well continued electrolyte and micronutrient management. Following recovery, caregivers are given appropriate nutritional training to avoid similar recurrences and instructed on the importance of sensory stimulation in children for continued emotional and physical development (Ashworth, ). SAM among children under 6 months of age is increasingly being associated with higher mortality than in older infants and children (WHO, ). The WHO guideline suggests that in infants who are under 6 (...) months of age with SAM should receive the same general medical care as infants with SAM who are 6 months of age or older with increased focus on establishing, or re‐establishing, effective exclusive breastfeeding by the mother or other caregiver (WHO, ). In this review, we will assess the effectiveness of various community‐based and facility‐based strategies to identify and manage MAM and SAM; including the community‐based screening, identification management of SAM and MAM, relative effectiveness
Covid-19: Guidance for admissions into aged residential care facilities COVID-19 Guidance for admissions into aged residential care facilities 27 APRIL 2020 Aged residential care (ARC) services, excluding deferrable respite, are essential services. This means they continue to operate, accepting referrals from both the community and from hospital. It is essential to ensure that people who do not need to be in hospital do not remain there unnecessarily. Admissions from the community ARC can (...) accept admissions from the community if the person has not had contact with anyone who has been overseas in the last 14 days or been overseas themselves, has not been in contact with anyone with confirmed, suspect or probable COVID-19 and does not have any acute respiratory symptoms (cough, fever, sore throat, or running nose). All people, prior to admission, must be screened by a General Practitioner/Nurse Practitioner or Community Based Assessment service for COVID-19 to determine
Covid-19: Alert Level 3 guidance for providers of services for olderpeople, including aged care and home and community support service Alert Level 3 guidance for providers of services for olderpeople, including aged care and home and community support service 5 May 2020 The following guidance is to help support a safe transition to Alert Level 3 for providers of olderpeople services, including aged care and home and community support services. Essential and ‘safe’ services under Alert Level (...) modifications that may safely proceed at alert level 3 will commence. • Vehicle modification requests will be considered on a case by case basis. Services not seen as essential Day services and programmes will remain suspended at Alert Level 3. People are encouraged to consider alternative ways to connecting, for example virtual supports. Health promotion activities for olderpeople continue to be provided on a different non-contact basis, e.g. by phone. Guidelines for at risk staff There may be some
Covid-19: Advice for aged care providers – residents with dementia Advice for aged care providers – residents with dementia 27 APRIL 2020 This advice provides information that may help to: i. reduce transmission of COVID-19 from resident to resident in aged residential care ii. maintain care and quality of life for residents with dementia or cognitive impairment. This advice is additional to, and should be read alongside, other guidance provided for health professionals and specifically (...) for aged residential care, which can be found on health.govt.nz/covid-19. Preventing COVID-19 in residents with dementia COVID-19 is highly contagious. We recognise that social distancing for residents with dementia may be difficult to maintain, and may heighten their anxiety and agitation. Increased staffing may be needed. You and your staff are in a good position to manage the care and wellbeing of your residents with dementia. This includes thinking about, preparing and communicating with residents
your situation further. Staying in contact with whanau, family and friends During all Alert Levels, visitors to Aged Care Residential facilities will be restricted. These extra precautions are needed to ensure people in a facility are safe, particularly those who are more at risk of infection and severe illness. Contact the provider to discuss other options to maintain contact. More information For the latest advice, information and resources, go to health.govt.nz/covid-19 or covid19.govt.nz (...) COVID-19 interNASC transfers – Aged Residential Care COVID-19 interNASC transfers – Aged Residential Care Information for transferring between District Health Boards 28 April 2020 An interNASC transfer is when a person moves between District Health Boards. In Aged Residential Care this means moving from one facility to another in a different region. Transfers from one Aged Residential Care facility to another is restricted The restrictions on transfers will depend on the Alert Level. This may
Covid-19: Guidance for preventing and controlling COVID-19 outbreaks in New Zealand aged residential care Health Quality & Safety Commission | Guidance for preventing and controlling COVID-19 outbreaks in New Zealand aged residential care Rārangi matua Main Menu Mortality review committees are statutory committees that review particular deaths, or the deaths of particular people, in order to learn how to best prevent these deaths. › › › Aged Residential Care Navigation Menu Projects Guidance (...) for preventing and controlling COVID-19 outbreaks in New Zealand aged residential care 3 Apr 2020 | This guidance document and supporting resources provide practical assistance to aged residential care facilities in response to the global COVID-19 pandemic. Please note: These documents are being updated regularly and links may change. Instead of downloading the documents, please use and share the link to this page and return here to get the most recent versions. We welcome all feedback on the guide
Covid-19: Guidance for managing staff and residents with COVID-19 infection in aged residential care facilities COVID-19: Guidance for managing staff/residents with COVID-19 infection in aged residential care facilities 26 April 2020 This document outlines guidance on managing staff and residents with potential COVID-19 infection in aged residential care (ARC) facilities. District health boards (DHBs) are expected to work closely with ARC facilities to ensure there are adequate supplies (...) of personal protective equipment (PPE) to meet requirements. These guidelines are interim and may be amended as the COVID-19 outbreak evolves. Aged care facilities are residents’ homes where they are cared for by staff. There are multiple contact points between residents and staff daily, which increases the risk of transmission of COVID-19. If a staff member or resident is suspected of having COVID-19, the person has likely had contacts with multiple staff, residents and visitors. Management of staff
JAMA Intern Med Actions . 2020 Apr 20;e200440. doi: 10.1001/jamainternmed.2020.0440. Online ahead of print. Effect of a Mammography Screening Decision Aid for Women 75 Years and Older: A Cluster Randomized Clinical Trial , , , , , , , , , , , , , , Affiliations Expand Affiliations 1 Division of General Medicine, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 2 Division of Geriatric Medicine, Department of Medicine, The University (...) aid (DA) for women 75 years and older on their screening decisions. Design, setting, and participants: A cluster randomized clinical trial with clinician as the unit of randomization. All analyses were completed on an intent-to-treat basis. The setting was 11 primary care practices in Massachusetts or North Carolina. Of 1247 eligible women reached, 546 aged 75 to 89 years without breast cancer or dementia who had a mammogram within 24 months but not within 6 months and saw 1 of 137 clinicians
Institute of Evidence-Based Medicine in OldAge, Leiden, The Netherlands. PMID: 32246476 DOI: Item in Clipboard Geriatric Screening, Triage Urgency, and 30-Day Mortality in Older Emergency Department Patients Laura C Blomaard et al. J Am Geriatr Soc . 2020 . Show details J Am Geriatr Soc Actions . 2020 Apr 4. doi: 10.1111/jgs.16427. Online ahead of print. Authors , , , , , , , , , Affiliations 1 Department of Internal Medicine, Section Geriatrics, Leiden University Medical Center, Leiden (...) , in older patients, urgency triage systems could be improved by taking geriatric vulnerability into account. We investigated the association of geriatric vulnerability screening in addition to triage urgency levels with 30-day mortality in older ED patients. Design: Secondary analysis of the observational multicenter Acutely Presenting Older Patient (APOP) study. Setting: EDs within four Dutch hospitals. Participants: Consecutive patients, aged 70 years or older, who were prospectively included
Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): the randomised, open-label, non-inferiority trial. Current guidelines recommend potent platelet inhibition with ticagrelor or prasugrel in patients after an acute coronary syndrome. However, data about optimal platelet inhibition in older patients are scarce. We aimed to investigate the safety and efficacy of clopidogrel compared with ticagrelor or prasugrel (...) in older patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).We did the open-label, randomised controlled POPular AGE trial in 12 sites (ten hospitals and two university hospitals) in the Netherlands. Patients aged 70 years or older with NSTE-ACS were enrolled and randomly assigned in a 1:1 ratio using an internet-based randomisation procedure with block sizes of six to receive a loading dose of clopidogrel 300 mg or 600 mg, or ticagrelor 180 mg or prasugrel 60 mg, and then a maintenance
the efficacy and safety of levetiracetam, fosphenytoin, and valproate in established status epilepticus, and here we describe our results after extending enrolment in children to compare outcomes in three age groups.In this multicentre, double-blind, response-adaptive, randomised controlled trial, we recruited patients from 58 hospital emergency departments across the USA. Patients were eligible for inclusion if they were aged 2 years or older, had been treated for a generalised convulsive seizure (...) included: 225 children (aged <18 years), 186 adults (18-65 years), and 51 older adults (>65 years). 175 (38%) patients were randomly assigned to levetiracetam, 142 (31%) to fosphenyltoin, and 145 (31%) were to valproate. Baseline characteristics were balanced across treatments within age groups. The primary efficacy outcome was met in those treated with levetiracetam for 52% (95% credible interval 41-62) of children, 44% (33-55) of adults, and 37% (19-59) of older adults; with fosphenytoin in 49% (38
Zinc supplementation for the promotion of growth and prevention of infections in infants less than six months of age. Zinc is a vital micronutrient for humans and is essential for protein synthesis, cell growth, and differentiation. Severe zinc deficiency can lead to slower physical, cognitive and sexual growth, cause skin disorders, decrease immunity, increase incidence of acute illnesses in infants and children and contribute to childhood stunting. By estimation, 17.3% of the world population (...) is at risk of inadequate zinc intake. Such nutritional impairment increases the risk of diarrhoea and pneumonia by 20%, as well as leads to a global loss of more than 16 million disability-adjusted life years in children less than five years of age. Not only does zinc deficiency affect lives, it adds to the considerable financial burden on depleted resources in countries that are most affected. By preventing or curing this deficiency, we can improve childhood mortality, morbidity and growth.To assess
and confounding in observational data.To determine the effectiveness of the influenza vaccine in reducing hospitalizations and mortality among elderly persons by using an observational research design that reduces the possibility of bias and confounding.A regression discontinuity design was applied to the sharp change in vaccination rate at age 65 years that resulted from an age-based vaccination policy in the United Kingdom. In this design, comparisons were limited to individuals who were near the age-65 (...) reduced hospitalizations or mortality among elderly persons. The estimates were precise enough to rule out results from many previous studies.The study relied on observational data, and its focus was limited to individuals near age 65 years.Current vaccination strategies prioritizing elderly persons may be less effective than believed at reducing serious morbidity and mortality in this population, which suggests that supplementary strategies may be necessary.National Institute on Aging.
A school intervention for 13- to 15-year-olds to prevent dating and relationship violence: the Project Respect pilot cluster RCT A school intervention for 13- to 15-year-olds to prevent dating and relationship violence: the Project Respect pilot cluster RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website
care” or high care) residents had this diagnosis. The prevalence of “cognitive impairment” (which in this setting usually indicates delirium or dementia) was much higher at 54% in low care settings and 90% in high care settings. People with dementia in residential care tend to be older than those with dementia living in private households, and have more severe dementia (91% of those with moderate or severe dementia were in residential aged care) . In 2008, people living with dementia made up (...) of the nursing home population suffers from urinary incontinence .Falls, often recurrent, affect 30% of nursing home residents. . Osteoporosis is almost universal in the nursing home . Long term care residents in New Zealand have a 10.5 fold increase in risk of hip fracture compared with age-matched people living in private homes , and 38% of the 15,000 hip fractures in Australia in 1996, occurred among olderpeople living in hostels and nursing homes . Annual hip fracture risk