Evidence
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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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Single urine samples are just as good as 24-hour collections for diagnosing pre-eclampsia

The urine spot albumin-creatinine ratio (which is done on a single, on-the-spot sample) reliably identified 99% of pregnant women with high blood pressure who went on to develop severe pre-eclampsia. The spot protein-creatinine ratio, as currently recommended by NICE, was slightly less sensitive identifying over 90% of women. Both spot tests were good value for ...

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National tobacco control policies linked to improvements in children’s health

National smoke-free legislation in advanced economies is linked to reduced rates of preterm birth, asthma hospitalisations and serious throat and chest infections in children. Comprehensive smoke-free policies appear to be more effective than policies with only partial or selective introduction. Smoking increases health risks for the smoker and others through second-hand exposure. Although the number ...

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Staying on antidepressants may prevent a relapse of anxiety

People with anxiety disorders who continued taking antidepressants after successful treatment were less likely to experience a relapse, and relapsed later, than people who stopped taking antidepressants. About 16% of people had a relapse if they remained on antidepressants for on average 44 weeks compared with 36% who stopped after 20 weeks. Anxiety disorders are ...

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Blood test reduces mortality and shortens antibiotic use among adults with chest infection

It may be feasible to use procalcitonin blood levels to guide antibiotic treatment for adults in hospital with a suspected chest infection. By measuring procalcitonin, an indicator of bacterial infection, clinicians could review their diagnosis earlier. This reduced antibiotic exposure by 2.5 days with fewer adverse effects and also less mortality. About 14 extra people ...

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What works to support residents’ health in care homes and why

Long-term relationships and joint working between community health practitioners and care homes are the keys to improving appropriate hospital admissions and access to medications. Additional payments for GPs, jointly agreed protocols, clear role specifications and structured systems have impact only if they trigger and sustain collaborative working. This realist evaluation in 12 English care homes ...

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Two common operations to fix a broken tibia have similar outcomes

In people who had broken the lower part of their tibia (shin bone), fixation using a metal rod nailed to the inside of the bone was compared with a locking plate screwed onto the surface of the bone. There was no difference in the quality of life, disability or pain at 12 months for people who ...

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Starting antiretroviral therapy immediately after HIV diagnosis reduces transmission of the virus

Giving antiretroviral therapy to people newly diagnosed with HIV may be an effective and cost-effective way of reducing new infections. Increased HIV testing in at-risk populations may identify more people for treatment and also reduce infection rates. Using data from a number of sources including NIHR funded projects, researchers developed a computer simulation model. The ...

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Supported employment helps people with severe mental illness to obtain work

Adults with schizophrenia and other psychosis receiving supported employment were more than twice as likely to obtain a job in the competitive labour market as those receiving pre-job training, sheltered employment or psychiatric care only. Supported employment seemed most effective when augmented with other interventions such as social or cognitive skills training. Many people with ...

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Giving oxygen routinely after a stroke does not improve outcomes

There was no benefit to routinely giving oxygen to people who have had a stroke. Oxygen given continuously, or just overnight, did not reduce disability or death and it did not improve people’s ability to do everyday tasks or live independently. There were no oxygen-related adverse events reported. Strokes occur when the blood supply to ...

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