Evidence
Alert

Social exclusion heightens risk of death across many health conditions

Socially excluded men have a mortality rate that is nearly eight times higher than the average for other men, and it is almost 12 times higher for excluded women. These health inequities in outcomes exist across a wide range of health conditions, particularly in infectious diseases and mental health. These findings suggest the need for ...

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Intravenous antibiotics, administered over 3 hours, are linked to lower death rates in sepsis

The risk of death in adults with sepsis was 30% lower when each dose of antibiotic was given intravenously over three hours compared to a bolus or less than 60 minutes. This systematic review included adults on intensive care units with a range of ages, severity of sepsis and other symptoms. A variety of antibiotics ...

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Study raises questions about NHS “weekend effect”

The increased mortality observed if patients are taken to hospitals at weekends also affects night admissions and can be explained in part by the severity of illness. Five linked NIHR-funded studies reviewed mortality and time and day of admission to hospital, largely using routine England-wide data. Fewer people are admitted from A&E at the weekend. ...

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Early use of tranexamic acid reduces bleeding more effectively

In people bleeding after trauma or giving birth, tranexamic acid within an hour of the start of bleeding increases the chances of survival by 72% compared with a placebo. Overall the trial data showed that at least six deaths from bleeding complications were prevented for every 1,000 people treated and potentially more if treatment is ...

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Parental training improves a child’s disruptive behaviours regardless of socio-economic disadvantage or ethnicity

Children from low-income families, or with an unemployed or single parent, benefitted as much as did economically advantaged groups from parental training. The Incredible Years programme worked better for children with more severe behaviour problems or a parent with depression. This NIHR-funded review pooled individual-level data for pre-school and primary aged children with persistent disruptive ...

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Group-based interventions may help teenagers stop smoking

There is no single clear intervention that helps young people quit smoking in the UK, but this review shows that group counselling is one that may be effective. Interventions included in this review were diverse, for example, computer or text-based, group or individual counselling. Drug treatments such as nicotine patches were included too. Although the ...

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Stopping biological drugs for rheumatoid arthritis can lead to twice the relapse rate

It seems safer to reduce the dose of biological drugs, rather than to stop them if people with rheumatoid arthritis and their doctors want to avoid relapse. Stopping these powerful drugs caused the disease to recur in 58% of people compared with 29% who continued them. Reducing the dose also led to more relapses for ...

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A primary care intervention helps older people with depression

Enhanced case management (also called collaborative care) added to primary care reduced symptoms in people with clinical depression, compared with usual primary care. The benefit was similar to other depression treatments. However, the small benefit over usual care was not sustained to 12 months. This NIHR-funded UK trial was carried out among nearly 500 adults ...

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Biological therapies for psoriasis do not increase serious infection risk

People with psoriasis who take an immune-modulating treatment are no more likely to get serious infections than people taking standard therapies. There are fears that these biological therapies raise the risk of serious infections and this has discouraged their use. They are recommended by NICE for moderate to severe psoriasis. Previous studies have reached conflicting ...

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A surgical procedure for shoulder pain is less effective than previously thought

An increasingly common surgical procedure for shoulder pain, subacromial decompression, was only slightly more effective than no treatment. In the first trial of this sort, improvements in pain and function following decompression or arthroscopy (a placebo surgery) did not reach a threshold of clinical importance compared with people allocated to no treatment at all. This ...

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