Evidence Based Clinical Practice Guidelines
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Resource Guide for Right to Know Training
A RESOURCE GUIDE FOR RIGHT TO KNOW TRAINING ~NEW~~~ IERSlY DEPARTMENT OF Division of Epidemiology, HIAI.lH Environmental and Occupational Health Services A BETIER STATE OF HEALTH Christine Todd Whitman Len Fishman Governor Commissioner of Health A RESOURCE GUIDE FOR RIGHT TO KNOW TRAINING Prepared by: Karen Miles, Ph.D., CHES Juanita Bynum, M.Ed., CHES William E. Parkin, D.V.M., Dr.P.H., Assistant Commissioner Division of Epidemiology, EnvironmenW and Occupational Health Services Kathleen O'Leary, M.S., Director Occupational Health Service Richard Willinger, J.D., M.P.H., Manager Right to Know Program JUNE 1994 ..A Resource Guide For Right to Know Training" was written by Karen Miles, Ph.D., CHES, former Coordinator of the Education and Outreach Project in the Right to Know Program, New Jersey Department of Health. This Guide was developed to assist public employees who conduct Right to Know education and training at their facility by providing background information on occupational health principles, the New Jersey Worker and Community Right to Know Act, and the Public Employees Occupational Safety and Health Act. The Resource Guide was edited by Juanita Bynum, M.Ed., CHES, Coordinator of the Education and Outreach Project of the Right to Know Program and Nancy Savage, Education and Outreach Project to reflect the August 2, 1993 and Januacy 3, 1994 amendments to the Right to Know regulations. Special thanks are extended to Richard Willinger, Program Manager, Right to Know Program, and Kathleen O'Leacy, Service Director, Occupational Health Service, who reviewed and edited the Guide, and to Eva McGovern and Cynthia McCoy for their assistance. -
Medical Ethics and Law (Questions and Answers) Prof. Mahmoud
EXAM QUESTIONS & ANSWERS LEGAL MEDICINE & MEDICAL ETHICs Prepared & Selected by Prof. Mahmoud Khraishi 1. You are a resident in the emergency department. An irate parent comes to you furious because the social worker has been asking him about striking his child. The child is a 5-year-old boy who has been in the emergency department four times this year with several episodes of trauma that did not seem related. Today, the child is brought in with a child complaint of “slipping into a hot bathtub” with a bum wound on his legs. The parent threatens to sue you and says “How dare you think that about me? I love my son!” What should you do? a. Admit the child to remove him from the possibly dangerous environment. b. Call the police. c. Ask the father yourself if there has been any abuse. d. Explain to the parents that the next time this happens you will have to call child protective services. e. Report the family to child protective services. Answer: (e) Report the family to child protective services. Comment: Although, in general, it is better to address issues directly with patients and their families, this is not the case when you strongly suspect child abuse. Reporting of child abuse is mandatory even based on suspicion alone. Although it is frightening to be confrontational with the family, the caregiver is legally protected even if there turns out to be no abuse as long as the report was made honestly and without malice. You do not have the authority to remove the child from the custody of the parents. -
New Delhi Conference Proceedings Output As at 6Aug20.Docx
Conference Proceedings (containing abstracts submitted for presentation at the postponed International Forum New Delhi July 2020) Conference Headline Sponsor New Delhi 2020 postponed until 2021, dates to be confirmed internationalforum.bmj.com/new-delhi @QualityForum #Quality2020 #Quality2021 One of the aims of the International Forum is to showcase improvement work from real and diverse healthcare settings to allow our attendees to learn and take away practical ideas that they can implement in their own organisation. This Conference Proceedings contains work submitted to us via our Call for Posters for the International Forum originally scheduled to take place in New Delhi, India, in July 2020. Due to the spread of COVID-19 around the world, including in South Asia, this International Forum is now postponed until 2021, dates to be confirmed. A big focus of the now postponed conference is to increase the awareness of the improvement work that is happening in the region. One of the key ways we do this is via the poster displays and abstract presentations available during the International Forum. We look forward to hosting these in 2021 and in the meantime we are pleased to bring to your attention a selection of projects submitted for presentation at the postponed July conference. Thank you to all those who have shared their work and have made it available in this digital format. We hope you enjoy this selection of abstracts and will join the International Forum improvement community to share your experiences, challenges, improvement successes and failures at our future events. Find out more about future International Forums at internationalforum.bmj.com. -
Public-Private Partnerships for Health Care in Punjab
- 1 - CASI WORKING PAPER SERIES Number 11-02 09/2011 PUBLIC-PRIVATE PARTNERSHIPS FOR HEALTH CARE IN PUNJAB NIRVIKAR SINGH Professor of Economics University of California, Santa Cruz CENTER FOR THE ADVANCED STUDY OF INDIA University of Pennsylvania 3600 Market Street, Suite 560 Philadelphia, PA 19104 http://casi.ssc.upenn.edu This project was made possible through the generous support of the Nand & Jeet Khemka Foundation © Copyright 2011 Nirvikar Singh and CASI CENTER FOR THE ADVANCED STUDY OF INDIA © Copyright 2011 Nirvikar Singh and the Center for the Advanced Study of India - 2 - Public-Private Partnerships for Health Care in Punjab NIRVIKAR SINGH CASI Working Paper Series No. 11-02 September 2011 This research was supported by a grant from the Nand and Jeet Khemka Foundation to the Center for Advanced Study of India at the University of Pennsylvania. I am grateful to Devesh Kapur, Nitya Mohan Khemka, Don Mohanlal, Satish Chopra, T. S. Manko, Satinder Singh Sahni and Abhijit Visaria for helpful discussions, comments and guidance. Abhijit Visaria, in particular, played a significant role by doing preliminary and follow-up interviews, some of which I have drawn on in my report, and providing insights and detailed comments on an earlier draft. None of these individuals or organizations is responsible for the opinions expressed here. I am also grateful to numerous individuals throughout India who were extraordinarily generous with their time and insights. I have listed them separately in an Appendix. While I have drawn on these discussions, the views expressed are mine, so I have generally not made individual attributions of statements, and the same disclaimer applies with respect to responsibility for opinions expressed here. -
Very Low Birth Weight Infants
Intensive Care Nursery House Staff Manual Very Low and Extremely Low Birthweight Infants INTRODUCTION and DEFINITIONS: Low birth weight infants are those born weighing less than 2500 g. These are further subdivided into: •Very Low Birth Weight (VLBW): Birth weight <1,500 g •Extremely Low Birth Weight (ELBW): Birth weight <1,000 g Obstetrical history (LMP, sonographic dating), newborn physical examination, and examination for maturational age (Ballard or Dubowitz) are critical data to differentiate premature LBW from more mature growth-retarded LBW infants. Survival statistics for ELBW infants correlate with gestational age. Morbidity statistics for growth-retarded VLBW infants correlate with the etiology and the severity of the growth-restriction. PREVALENCE: The rate of VLBW babies is increasing, due mainly to the increase in prematurely-born multiple gestations, in part related to assisted reproductive techniques. The distribution of LBW infants is shown in the Table: ________________________________________________________________________ Table. Prevalence by birth weight (BW) of LBW babies. Percentage of Percentage of Births Birth Weight (g) Total Births with BW <2,500 g <2,500 7.6% 100% 2,000-2,500 4.6% 61% 1,500-1,999 1.5% 20% 1,000-1,499 0.7% 9.5% 500-999 0.5% 7.5% <500 0.1% 2.0% ________________________________________________________________________ CAUSES: The primary causes of VLBW are premature birth (born <37 weeks gestation, and often <30 weeks) and intrauterine growth restriction (IUGR), usually due to problems with placenta, maternal health, or to birth defects. Many VLBW babies with IUGR are preterm and thus are both physically small and physiologically immature. RISK FACTORS: Any baby born prematurely is more likely to be very small. -
Determinants of Childhood Immunisation Coverage in Urban Poor Settlements of Delhi, India: a Cross-Sectional Study
Open Access Research BMJ Open: first published as 10.1136/bmjopen-2016-013015 on 26 August 2016. Downloaded from Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study Niveditha Devasenapathy,1 Suparna Ghosh Jerath,1 Saket Sharma,1 Elizabeth Allen,2 Anuraj H Shankar,3 Sanjay Zodpey1 To cite: Devasenapathy N, ABSTRACT Strengths and limitations of this study Ghosh Jerath S, Sharma S, Objectives: Aggregate data on childhood et al. Determinants of immunisation from urban settings may not reflect the ▪ childhood immunisation We report current estimates of childhood com- coverage among the urban poor. This study provides coverage in urban plete immunisation including hepatitis B vaccine poor settlements of Delhi, information on complete childhood immunisation coverage from representative urban poor com- India: a cross-sectional study. coverage among the urban poor, and explores its munities in the Southeast of Delhi. BMJ Open 2016;6:e013015. household and neighbourhood-level determinants. ▪ The sample size was large and therefore our doi:10.1136/bmjopen-2016- Setting: Urban poor community in the Southeast effect estimates for coverage and determinants 013015 district of Delhi, India. were precise. Participants: We randomly sampled 1849 children ▪ We quantify unknown neighbourhood effects on ▸ Prepublication history and aged 1–3.5 years from 13 451 households in 39 this outcome using median ORs which are more additional material is clusters (cluster defined as area covered by a intuitively understood. available. To view please visit community health worker) in 2 large urban poor ▪ Based on the data, representative of only one the journal (http://dx.doi.org/ settlements. -
Guidelines for ASHA and Mahila Arogya Samiti in the Urban Context
Guidelines for ASHA and Mahila Arogya Samiti in the Urban Context NATIONAL URBAN HEALTH MISSION National Urban Health Mission: Guidelines for ASHA and Mahila Arogya Samiti in the Urban Context 1 Keshav Desiraju Hkkjr ljdkj Secretary LokLF;~ ,oa ifjokj't't"!CI5I't dY;k.k foHkkx Tel.:e6~lCr 23061863~ Fax: 23061252 m~ LokLF;~~ qRql'<,oa't't"!CI5I't ifjokjCI5<>'l11 dY;k.k01 flt~ ea=kky; E-mail : [email protected] CI5<>'l1jOj e6~lCr~ ~ m~m~ ~fuekZ.k~qRql'< qRql,<Hkou] CI5<>'l11ubZ fnYyh01 flt~ &.q~ 110011 [email protected] ~Ol ~. Government of India ~ KESHAV DESIRAJU m~ ~ qRql,<o:nf CI5<>'l1jOj~ .q~- 110011 DepartmentGovernment of Healthof India and Family Welfare KESHAVSecretaryDESIRAJU ~Ol ~. o:nf ~ - 110011 DepartmentMinistryof ofHealth Healthand andFamily FamilyWelfare Welfare SecretaryTel. : 23061863 Fax: 23061252 Government of India E-mail: [email protected] Department Ministry ofofNirmanHealthHealth Bhawan,andand FamilyFamily New DelhiWelfareWelfare - 110011 Tel. : 23061863 Fax: 23061252 [email protected] Nirman Shawan, New Delhi- 110011 E-mail: [email protected] Ministry of Health and Family Welfare [email protected] Nirman Shawan, New Delhi- 110011 Message PREFACEMessage Message The launch of the National Urban Health Mission marks an important milestone The National Rural Health Mission (NRHM) Strives to Provide Quality Health care to all in the country’s march towards Universal Health Coverage. The underlying principle The citizenslaunch of thethe Nationalcountry Urbanin an equitableHealth Mission manner.marks The an12thimportant five yearmilestone plan has re-affirmed of the NUHM framework is that activities will be designed so that the health needs of in theThecountry'slaunchGovernmentofmarchthe Nationaltowards of India’sUrbanUniversal commitmentHealthHealthMission – “AllCoverage. -
Care of Newborn in the Community and at Home
OPEN Journal of Perinatology (2016) 36, S13–S17 www.nature.com/jp REVIEW Care of newborn in the community and at home SB Neogi1, J Sharma1, M Chauhan1, R Khanna2, M Chokshi1, R Srivastava3, PK Prabhakar3, A Khera3, R Kumar3, S Zodpey1 and VK Paul4 India has contributed immensely toward generating evidence on two key domains of newborn care: Home Based Newborn Care (HBNC) and community mobilization. In a model developed in Gadchiroli (Maharashtra) in the 1990s, a package of Interventions delivered by community health workers during home visits led to a marked decline in neonatal deaths. On the basis of this experience, the national HBNC program centered around Accredited Social Health Activists (ASHAs) was introduced in 2011, and is now the main community- level program in newborn health. Earlier in 2004, the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program was rolled out with inclusion of home visits by Anganwadi Worker as an integral component. IMNCI has been implemented in 505 districts in 27 states and 4 union territories. A mix of Anganwadi Workers, ASHAs, auxiliary nursing midwives (ANMs) was trained. The rapid roll out of IMNCI program resulted in improving quality of newborn care at the ground field. However, since 2012 the Ministry of Health and Family Welfare decided to limit the IMNCI program to ANMs only and leaving the Anganwadi component to the stewardship of the Integrated Child Development Services. ASHAs, the frontline workers for HBNC, receive four rounds of training using two modules. There are a total of over 900 000 ASHAs per link workers in the country, out of which, only 14% have completed the fourth round of training. -
December 2014 Caribbean Partnership Newsletter
December, 2014 Quarterly Newsletter Volume 5 Issue 2 Rotary International President, Gary C.K. Huang (Taiwan) Rotary International Director, Zones 33/34, Robert L. Hall (USA) Caribbean Partnership Chair, Vance Lewis (D-7020) Newsletter Editor, Kitty Bucsko (Rotary E-Club of the Caribbean, 7020) Like us on Facebook – Caribbean Partnership DISTRICTS 33 & 34 CARIBBEAN PARTNERSHIP Send your stories to the newsletter for publication. Don’t let us have to discover them accidentally! With such excellent projects and so much hard work, you all deserve so much thanks and recognition! Caribbean Partnership Newsletter, December 2014 Page 1 TABLE OF CONTENTS Page No. Message from CP Chair, Vance Lewis 3 Our geographical area 5 Why Caribbean Partnership? 6 Recognize our Rotary Partners in Service 6 I am a Tree 7 Rotary Leadership Institute (RLI) Cruise & Seminar for 2015 8 Polio Update 9 Can We, Should We, End Polio? 10 Social Media 13 Meritorious Service – Bill Pollard 15 Support TRF – John Kenny, TRF Trustee 16 GETS Training, November 17 Holiday Video – Don’t miss it! 17 New York Times Article – Super Bugs 18 Water Resources Research Institute 22 Sao Paulo Rotary Convention News 23 Successful Projects (a few…) Appeal from Grand Cayman 24 Negril, Jamaica, and CP Partners 25 Grants that Impact You 26 Article on Alzheimer’s Initiative 27 The Butterfly Storybook – Gift of Reading 28 Updates from our Caribbean Partnership Districts 30 Appendix A – List of Governors 42 Appendix B – Zones 33 & 34 information 47 Appendix C – Rotary Acronyms 48 References 49 Caribbean Partnership Newsletter, December 2014 Page 2 CARIBBEAN PARTNERSHIP Caribbean Partnership The Caribbean Partnership provides opportunities for Rotarians in the United States and throughout the countries of the Caribbean and North Atlantic to become better educated as to our respective cultural similarities and differences and to develop relationships, share knowledge, ideas, and interests that would result in partnered clubs. -
Global Challenge Formula 16 Catamaran
Global Challenge Formula 16 Catamaran MUMBLES YACHT CLUB, WALES, UK 9-12 August 2008 NOTICE OF RACE 1. Rules. 1.1 The regatta shall be governed by the rules as defined in The Racing Rules of Sailing 2005-2008. F16 Class rules and the prescriptions of the RYA sailing charter. 1.2 The organising authority being the Mumbles Yacht Club. 1.3 The Sailing Instructions will be available at registration. 2. Eligibility and Entry. 2.1 The event is open to all compliant Formula 16 Catamarans 2.2 Pre-entry forms are available on the MYC website or can be obtained at the Clubhouse at registration. 3. Advertising 3.1 This Regatta is classified as a Category C Event for advertising. 4. Fees. 4.1 Entry fee single-handed £70.00 double-handed £100. 5. Schedule. 5.1 Registration will take place from 09.00-10.30 & 17.30-21.30 on Friday 8 th August 2008 and 09.00-11.00hrs on Saturday 9 th August 2008. 5.2 Boat measuring will take place at the discretion of the F16 Governing Council. 5.3 08-08-08 Practice Race, Preparatory signal not before 11.30 09-08-08 Skippers Briefing 10.30 09-08-08 Races 1-2-3 Preparatory signal not before 11.55. Races 2-3 Preparatory signals will be as soon as possible after the completion of the previous race. 10-08-08 Races 4-5-6 Preparatory signal not before 11.25. Races 5-6 Preparatory signals will be as soon as possible after the completion of the previous race. -
Analysis of the Universal Immunization Programme and Introduction
Vaccine 32S (2014) A151–A161 Contents lists available at ScienceDirect Vaccine j ournal homepage: www.elsevier.com/locate/vaccine Analysis of the Universal Immunization Programme and introduction of a rotavirus vaccine in India with IndiaSim a a,b a c Itamar Megiddo , Abigail R. Colson , Arindam Nandi , Susmita Chatterjee , d e a,b,c,∗ Shankar Prinja , Ajay Khera , Ramanan Laxminarayan a Center for Disease Dynamics, Economics & Policy, Washington, DC, USA b Princeton Environmental Institute, Princeton University, Princeton, NJ, USA c Public Health Foundation of India, New Delhi, India d School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India e Ministry of Health and Family Welfare, Government of India, New Delhi, India a b s t r a c t Background and objectives: India has the highest under-five death toll globally, approximately 20% of which is attributed to vaccine-preventable diseases. India’s Universal Immunization Programme (UIP) is working both to increase immunization coverage and to introduce new vaccines. Here, we analyze the disease and financial burden alleviated across India’s population (by wealth quintile, rural or urban area, and state) through increasing vaccination rates and introducing a rotavirus vaccine. Methods: We use IndiaSim, a simulated agent-based model (ABM) of the Indian population (including socio-economic characteristics and immunization status) and the health system to model three interventions. In the first intervention, a rotavirus vaccine is introduced at the current DPT3 immunization coverage level in India. In the second intervention, coverage of three doses of rotavirus and DPT and one dose of the measles vaccine are increased to 90% randomly across the population. -
Maternal and Fetal Outcomes of Spontaneous Preterm Premature Rupture of Membranes
ORIGINAL CONTRIBUTION Maternal and Fetal Outcomes of Spontaneous Preterm Premature Rupture of Membranes Lee C. Yang, DO; Donald R. Taylor, DO; Howard H. Kaufman, DO; Roderick Hume, MD; Byron Calhoun, MD The authors retrospectively evaluated maternal and fetal reterm premature rupture of membranes (PROM) at outcomes of 73 consecutive singleton pregnancies com- P16 through 26 weeks of gestation complicates approxi- plicated by preterm premature rupture of amniotic mem- mately 1% of pregnancies in the United States and is associ- branes. When preterm labor occurred and fetuses were at ated with significant risk of neonatal morbidity and mor- tality.1,2 a viable gestational age, pregnant patients were managed Perinatal mortality is high if PROM occurs when fetuses aggressively with tocolytic therapy, antenatal corticos- are of previable gestational age. Moretti and Sibai 3 reported teroid injections, and antenatal fetal testing. The mean an overall survival rate of 50% to 70% after delivery at 24 to gestational age at the onset of membrane rupture and 26 weeks of gestation. delivery was 22.1 weeks and 23.8 weeks, respectively. The Although neonatal morbidity remains significant, latency from membrane rupture to delivery ranged despite improvements in neonatal care for extremely pre- from 0 to 83 days with a mean of 8.6 days. Among the mature newborns, neonatal survival has improved over 73 pregnant patients, there were 22 (30.1%) stillbirths and recent years. Fortunato et al2 reported a prolonged latent phase, low infectious morbidity, and good neonatal out- 13 (17.8%) neonatal deaths, resulting in a perinatal death comes when physicians manage these cases aggressively rate of 47.9%.