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This quality standard covers managing diabetes and its complications in women who are planning pregnancy or are already pregnant.

It includes care for women with pre-existing diabetes before and during pregnancy, and diagnosis and management of gestational diabetes. Everything NICE has said on diagnosing and managing type 1 diabetes in adults in an interactive flowchart.

Everything NICE has said on diagnosing and managing type 1 and 2 diabetes in children and young people in an interactive flowchart.

Everything NICE has said on managing type 2 diabetes in adults in an interactive flowchart. This guideline covers how to identify adults at high risk of type 2 diabetes.

It aims to remind practitioners that age is no barrier to being at high risk of, or developing, the condition.

It also aims to help them provide those at high risk with an effective and appropriate intensive lifestyle-change programme to prevent or delay the onset of type 2 diabetes.

Everything NICE has said on preventing and managing foot problems in children, young people and adults with type 1 or 2 diabetes in an interactive flowchart.

Everything NICE has said on preventing type 2 diabetes in an interactive flowchart. This guideline covers preventing type 2 diabetes in adult populations and communities who are at high risk.

It aims to promote a healthy diet and physical activity at community and population level, and recommends how to tailor services for people in ethnic communities and other groups who are particularly at risk of type 2 diabetes.

Type Topic page. Last updated 04 June Type Quality standard. Last updated 18 August View quality statements for QS6. Show all sections for QS6.

Sections for QS6 Overview Introduction List of quality statements Quality statement 1: Preventing type 2 diabetes Quality statement 2: Structured education programmes for adults with type 2 diabetes Quality statement 3: Structured education programmes for adults with type 1 diabetes Quality statement 4: First intensification of blood glucose lowering therapy in type 2 diabetes Quality statement 5: Referral for adults at moderate or high risk of diabetic foot problems.

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Assets 7. Source code zip. There are then two consultation periods in which stakeholder organisations are able to comment on the draft guideline.

After the second consultation period, an independent Guideline Review Panel reviews the guideline and stakeholder comments and ensures that these comments have been taken into account.

The Guideline Development Group then finalises the recommendations and the National Collaboration Centre produces the final guideline. In October Andy Burnham said that a Labour government could reduce variation in access to drugs and procedures by making it mandatory for commissioners to follow NICE clinical guidelines.

Where they have said something is effective and affordable, on what basis does a local commissioner withhold that from somebody?

NICE has a service called Clinical Knowledge Summaries CKS which provides primary care practitioners with a readily accessible summary of the current evidence base and practical guidance.

Under the Health and Social Care Act , NICE was given responsibility for developing guidance and quality standards for social care , using an evidence-based model.

NICE, along with the NCCSC, carries out a scoping exercise with a scoping group and with input from key stakeholders, at both a workshop and a public consultation, to ensure the guidance to be produced is focused and achievable.

A chairperson and members of the Guidance Development Group are appointed, and pose review questions which will enable systematic evidence reviews to take place, thus delivering the guidance and subsequent recommendations.

Service user and carer involvement takes place throughout, as well as public consultation on the draft guidance. This is submitted to NICE for formal approval and publication.

The entire process from pre-scoping to publication takes approximately 24 months. The guidance is then available to NICE standing committees to develop a quality standard on the topic.

The quality standard is developed using the guidance and other accredited sources, to produce high-level concise statements that can be used for quality improvement by social care providers and commissioners, as well as setting out what service users and carers can expect of high quality social care services.

The NCCSC is unique within NICE, in that it is the only collaborating centre to have responsibility for the adoption and dissemination support for guidance and quality standards in the social care arena.

Drawing on the expertise of SCIE and their partners within the sector, each of the guidance products and quality standards have a needs assessment carried out to determine the requirements for tools to help embed the guidance and quality standards within the sector.

These can include tailored versions of guidance for specific audiences, costing and commissioning tools and even training and learning packages. As of August , NICE and the NCCSC had scheduled guidance delivery for five topics: domiciliary care , older adults with long-term conditions, transition between health and social care settings, transition from children's to adults' services and child abuse and neglect.

As with any system financing health care, the NHS has a limited budget and a vast number of potential spending options. Choices must be made as to how this limited budget is spent.

Economic evaluations are carried out within a health technology assessment framework to compare the cost-effectiveness of alternative activities and to consider the opportunity cost associated with their decisions.

NICE attempts to assess the cost—effectiveness of potential expenditures within the NHS to assess whether or not they represent 'better value' for money than treatments that would be neglected if the expenditure took place.

It assesses the cost—effectiveness of new treatments by analysing the cost and benefit of the proposed treatment relative to the next best treatment that is currently in use.

NICE guidance supports the use of quality-adjusted life years QALY as the primary outcome for quantifying the expected health benefits associated with a given treatment regime.

When combined with the relative cost of treatment, this information can be used to estimate an incremental cost-effectiveness ratio ICER , which is considered in relation to NICE's threshold willingness-to-pay value.

Over the years, there has been great controversy as to what value this threshold should be set at. Initially, there was no fixed number.

Patients score their perceived quality of life on a scale from 0 to 1 with 0 being worst possible health and 1 being best possible health. On the standard treatment, quality of life is rated with a score of 0.

Patients on the new treatment on average live an extra 3 months, so 1. The quality of life gained is the product of life span and quality rating with the new treatment less the same calculation for the old treatment, i.

If the patient was expected to live only one month extra and instead of three then NICE would issue a recommendation not to fund.

The patient's primary care trust [ needs update ] could still decide to fund the new treatment, but if not, the patient would then have two choices.

He or she could opt to take the free NHS standard treatment, or he or she may decide to pay out of pocket to obtain the benefit of the new treatment from a different health care provider.

If the person has a private health insurance policy the person could check to see whether the private insurance provider will fund the new treatment.

Theoretically, it might be possible to draw up a table of all possible treatments sorted by increasing the cost per quality-adjusted life year gained.

Those treatments with lowest cost per quality-adjusted life year gained would appear at the top of the table and deliver the most benefit per value spent and would be easiest to justify funding for.

Those where the delivered benefit is low and the cost is high would appear at the bottom of the list. Decision makers would, theoretically, work down the table, adopting services that are the most cost effective.

The point at which the NHS budget is exhausted would reveal the shadow price , the threshold lying between the CQG gained of the last service that is funded and that of the next most cost effective service that is not funded.

In practice this exercise is not done, but an assumed shadow price has been used by NICE for many years in its assessments to determine which treatments the NHS should and should not fund.

The threshold it employs is not based on empirical research and is not directly related to the NHS budget, nor is it at the same level as that used by primary care trusts PCTs in providing treatments not assessed by NICE, which tends to be lower.

Some witnesses, including patient organisations and pharmaceutical companies, thought NICE should be more generous in the cost per QALY threshold it uses, and should approve more products.

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N.I.C.E. 2

Learn how. NiceHash will never ask or use your private keys, but we cannot guarantee the same for the 3rd party miners included in NHM now or any time in the future.

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Sign up. Releases Tags. Latest release. This commit was created on GitHub. The combination of the late destabilization of a five planet resonant chain and an extended migration of Neptune is unlikely.

Reproducing the orbital distribution of the Kuiper belt objects requires that Neptune undergo a migration of several AU, reaching 28 AU before the encounters between planets begin.

This migration of Neptune is likely if the planetesimal disk began within 2 AU of Neptune's initial orbit. However, a late destabilization of the resonance chain requires a more distant disk, at least 4 AU beyond Neptune's orbit.

An early breaking of the resonance chain followed by a slow dust-driven migration may bridge this gap.

The dust-driven is the result of collision among the planetesimals producing debris that is ground to dust in a collisional cascade.

The dust then spirals toward the orbits of the planets due to Poynting—Robertson drag. Interactions with this dust disrupts the resonance chain and drive their migration toward the planetesimal disk over a several hundred million years period.

From Wikipedia, the free encyclopedia. The Astronomical Journal. Bibcode : AJ Comptes Rendus Physique. Bibcode : CRPhy..

Jupiter-Saturn Configuration". The Astrophysical Journal. Bibcode : ApJ Monthly Notices of the Royal Astronomical Society. Bibcode : Icar..

Astronomy and Astrophysics. Categories : Solar System dynamic theories. It also aims to help them provide those at high risk with an effective and appropriate intensive lifestyle-change programme to prevent or delay the onset of type 2 diabetes.

Everything NICE has said on preventing and managing foot problems in children, young people and adults with type 1 or 2 diabetes in an interactive flowchart.

Everything NICE has said on preventing type 2 diabetes in an interactive flowchart. This guideline covers preventing type 2 diabetes in adult populations and communities who are at high risk.

It aims to promote a healthy diet and physical activity at community and population level, and recommends how to tailor services for people in ethnic communities and other groups who are particularly at risk of type 2 diabetes.

Type Topic page. Last updated 04 June Type Quality standard. Last updated 18 August View quality statements for QS6.

Show all sections for QS6. Sections for QS6 Overview Introduction List of quality statements Quality statement 1: Preventing type 2 diabetes Quality statement 2: Structured education programmes for adults with type 2 diabetes Quality statement 3: Structured education programmes for adults with type 1 diabetes Quality statement 4: First intensification of blood glucose lowering therapy in type 2 diabetes Quality statement 5: Referral for adults at moderate or high risk of diabetic foot problems.

Last updated 24 June Type NICE guideline. Last updated 28 August View recommendations for NG Show all sections for NG Last updated 26 August View recommendations for NG3.

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