Evidence
Alert

ICU admission decision support tool showed promise but was rarely used

A decision support tool developed to help doctors determine whether patients should be admitted to intensive care showed promise in facilitating patient-clinician communication, but was not often used by doctors, with fewer than 30% using the forms. Intensive care can deliver lifesaving treatment. It can be invasive and distressing with no guarantee of success. At …

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Age of stored blood used for transfusions in critically ill children doesn’t affect outcomes

Using more recently-collected red blood cells for transfusions does not reduce organ dysfunction, infection or risk of death in critically ill children, compared with blood that has been stored for longer. This large, international trial included more than 1,500 children in paediatric intensive care units. The study provides robust evidence to support the continued practice …

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Surgery to fix the womb in position after prolapse is an alternative to hysterectomy

Women who have surgery that uses stitches to lift and keep their prolapsed womb in place (called hysteropexy) are less likely to have recurrent symptoms after five years than those who have their womb removed (vaginal hysterectomy). These results from a Dutch trial involving 204 women showed comparable outcomes for the two surgical options for other …

Themed Review

Better Health and Care for All

Download the PDF  Foreword The last thirty years has seen big changes in health and social care to support people with learning disabilities. This includes a move from long-stay hospitals to supporting more people to live well in the community. But it is not easy – and we still have a long way to go …

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Pedometers can help people get more active as part of an exercise programme

Pedometers and accelerometers helped people with diabetes or cardiovascular diseases to increase their physical activity by a moderate amount, though pedometers were more successful. Programmes that involved face-to-face consultations with a facilitator were more effective than those where devices were used in isolation to track progress. This NIHR-funded systematic review included 36 trials which objectively …

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Occupational therapy at home may benefit people with dementia and their carers

Multiple occupational therapy sessions, provided in a person with dementia’s own home, improve their ability to carry out daily activities, compared with usual care. Improvements are also seen in behavioural and psychological symptoms and their quality of life. In addition, carers report feeling less distress, and a better quality of life. This study was a systematic …

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Text messaging support helps smokers quit, but apps not yet shown to work

Text messaging support helps people quit smoking, more than minimal support such as self-help materials. Also, when text messaging is combined with another smoking cessation intervention, it is more effective than just that intervention alone. However, the evidence to support smartphone apps is absent or of poor quality. This review included 26 studies and builds …

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Outcomes similar for full or partial hip replacement after hip fracture

For older people with hip fracture, the choice between full or partial hip replacement does not greatly influence outcomes. In this trial, approximately 8% of patients having each operation required further surgery within a 24-month period. Mortality rates were also similar at around 13%. This multinational trial included 1,495 adults aged over 50 with a hip …

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Increasing omega-3 intake does not prevent depression or anxiety

Increasing intake of polyunsaturated fats, for example with omega-3 fatty acid supplements, has little or no effect in preventing the onset of depression or anxiety symptoms in people without these conditions, but who might be at risk. These findings support dietary advice that omega-3 supplements are not needed in healthy people. This review also highlights …

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Advance care plans improve quality of life for heart failure patients

Advance care planning (ACP) can improve the quality of life of patients with heart failure, especially if it includes follow-up, involves family members and is carried out by trained clinicians working in multidisciplinary teams. This review summarised the evidence about the effect of ACP on quality of life, compared with usual care, for 2,924 patients …

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