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Pediatric sedation in the ambulatory setting by non-anesthesiologists is becoming more commonplace, and can be safely accomplished with the right information. This handbook reflects the combined insights of specialists in emergency medicine and anesthesiology, with practical guidelines that show readers the safest and most effective methods. Coverage begins with scientific foundations and continues through management strategies and finally through specific procedures.
Despite legal and social advances in the past two decades, sexual and gender minorities continue to face widespread discrimination and violence in many countries. This discrimination and violence lead to exclusion, which adversely impacts their lives, as well as the communities and economies in which they live. A major barrier to addressing this stigma and sexual orientation and gender identity(SOGI)-based exclusion is the lack of SOGI-specific data. Robust, quantitative data on di‚fferential development experiences and outcomes of sexual and gender minorities--especially those in developing countries--is extremely thin. This paucity of data jeopardizes the achievement of the Sustainable Development Goals and countries' commitment to the principle of 'leaving no one behind' in the eff‚ort to end poverty and inequality. 'Equality of Opportunity for Sexual and Gender Minorities' assesses the unique challenges that sexual and gender minorities face in six important areas: (i) Criminalization and SOGI (ii) Access to education (iii) Access to the labor market (iv) Access to public services and social protection (v) Civil and political inclusion (vi) Protection from hate crimes. This report cov‚ers numerous policy recommendations to prevent and eliminate discriminatory practices in all of the areas covered. It also seeks to inflŽuence legislative changes and support research on institutions and regulations that can ultimately lead to poverty reduction and shared prosperity. At the same time, it acknowledges that the mere existence of inclusive laws and regulations does not ensure that sexual and gender minorities are free from discrimination--the enforcement of those laws is crucial. This publication, the first in a series of studies, will be expanded from the 16 countries included here to a wider set of countries for more in-depth quantitative analysis and to identify possible correlations with socioeconomic outcomes. It will seek to deepen knowledge, facilitate peer learning of good practices, and encourage reforms to increase the inclusion of sexual and gender minorities.
Here, two of the foremost cardiothoracic surgeons have brought together many of the top cardiologists and haematologists to produce the most current reference source on all aspects of blood conservation, from an overall clinical approach to the use of erythropoietin and the benefits of post-operative blood salvage. The subject matter covers numerous areas involved in the preoperative considerations in cardiac surgery, the intraoperative decision-making in cardiac surgery, postoperative bleeding and management and a section on the algorithm for bloodless surgery used at the New York Hospital-Cornell Medical Center.
Health systems should function in such a way that the amount of inappropriate care is minimized, while at the same time stinting as little as possible on appropriate and necessary care. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" was developed in the 1980s. It has been further developed and refined in North America and, increasingly, in Europe. The rationale behind the method is that randomized clinical trials--the "gold standard" for evidence-based medicine--are generally either not available or cannot provide evidence at a level of detail sufficient to apply to the wide range of patients seen in everyday clinical practice. Although robust scientific evidence about the benefits of many procedures is lacking, physicians must nonetheless make decisions every day about when to use them. Consequently, a method was developed that combined the best available scientific evidence with the collective judgment of experts to yield a statement regarding the appropriateness of performing a procedure at the level of patient-specific symptoms, medical history, and test results. This manual presents step-by-step guidelines for conceptualising, designing, and carrying out a study of the appropriateness of medical or surgical procedures (for either diagnosis or treatment) using the RAND/UCLA Appropriateness Method. The manual distills the experience of many researchers in North America and Europe and presents current (as of the year 2000) thinking on the subject. Although the manual is self-contained and complete, the authors do not recommend that those unfamiliar with the RAND/UCLA Appropriateness Method independently conduct an appropriateness study; instead, they suggest "seeing one" before "doing one." To this end, contact information is provided to assist potential users of the method.
This Second Edition is a significant revision of the leading text and clinical reference on pediatric pain. Written by an international group of experts from all relevant disciplines, this new edition is a vital reference for all pain practitioners, and for nurses, psychologists, PTs, anesthesiologists, and pediatricians dealing with acute and chronic pediatric pain. This edition includes new and expanded information on NSAIDs, opioids, and regional anesthesia. New chapters cover sedation, pain in the ICU, multidisciplinary pain services, palliative care, and the long-term consequences of pain. User-friendly new features include many more illustrations of techniques.
This report from the Council for International Organizations of Medical Sciences (CIOMS) in collaboration with WHO covers the activities and outputs of the CIOMS/WHO Working Group on Vaccine Pharmacovigilance (2005-2010). This working group brought together experts from both industrialized and emerging countries representing regulatory agencies, vaccine industry, national and international public health bodies including WHO and CIOMS, academia and clinical care, contributing from their different perspectives. The report covers general terms and definitions for vaccine safety and discusses the application of such harmonized tools in vaccine safety surveillance and studies. As well, the report highlights case definitions for adverse events typically reported for vaccines. The report is addressed to those engaged in vaccine safety data collection and evaluation, and will also make a useful reading for others who want to familiarize themselves with vaccine safety terminology.