Evidence
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Melatonin shows potential for reducing delirium among older people after surgery

Taking melatonin around the time of surgery is linked with lower odds of delirium onset in older people, compared with placebo or no treatment. In a systematic review and meta-analysis, around 15% of the melatonin group developed delirium after surgery compared with around 20% of the comparison group. Delirium is an acute state of mental ...

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People leave hospital after surgery sooner if hospitals follow ‘enhanced recovery protocols’

Strategies to improve or enhance recovery after planned surgery can reduce the amount of time people over 60 spend in hospital, compared with standard care. These strategies include minimising fasting before operations, targeted anaesthesia, getting people up and about quickly after surgery and an early return to eating. In this review, hospital stay could be ...

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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 ...

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NHS health check attendance improves with changes to the invitation letter

Invitation letters improve uptake when they address common concerns and reasons for not attending the free NHS Health Checks. People are invited to attend a check every five years between 40 and 74 years, but uptake has been low. This trial of 6,313 patients from six general practices in Northampton found that presenting reasons for non-attendance ...

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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 ...

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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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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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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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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