Evidence
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Delaying pushing in labour has no benefit for women with an epidural and/or spinal for pain relief

For women having their first baby with an epidural and/or spinal anaesthetic for pain-relief, the timing of pushing after full dilatation of the cervix does not affect the numbers that achieve normal vaginal delivery. The best management for the second stage of labour is still debated. In the UK epidurals are by far the most …

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Treatments for depression may help irritable bowel symptoms

Antidepressants are likely to provide more than a placebo effect for those with symptoms of irritable bowel syndrome. Antidepressants improve symptoms in about 60% of those taking them, but two-thirds of that effect may be due to placebo. Psychological therapies, such as talking therapies also appear effective in about half of those offered them but …

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No additional weight-loss reported from a lifestyle programme for people with psychosis

For adults with psychosis, such as schizophrenia, who are taking antipsychotic medication, a carefully designed 12-month group diet and exercise programme did not lead to clinically important weight loss after 12 months. The programme was compared with those receiving usual care including written lifestyle advice. Intervention and usual care groups each lost half a kilo …

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Training for clinical competence and resilience reduced job strain among intensive care nurses in France

A five-day educational course showed potential to reduce work-based stress and burnout among nurses working in intensive care units in France. The study conducted in multiple adult intensive care units aimed to identify the effects of an intensive, continuing medical education program on occupational stress. The course focussed on nursing theory, role-play and debriefing sessions. …

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NHS managers need support to use tools to ensure safe nurse staffing levels

Workforce planning technologies can help NHS managers plan for safe nurse staffing levels, but only with proper support and tools that are designed with good understanding of local needs. Tools also need to give easy access to standardised information such as staff availability and costs. NHS Trusts need to be open to information sharing and …

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A reflective group activity supports healthcare staff in England

Regular participation in structured organisation-wide forums, known as Schwartz Center Rounds®, helps support healthcare staff. The forums are linked with increased empathy and compassion for colleagues and patients, and they facilitate practice change. Levels of poor psychological well-being decrease in forum attendees compared with non-attendees. Originating in the US, these forums provide the opportunity for …

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Reconfiguring neonatal services balances survival chances against increased travel for families

Centralising services so that all babies are delivered in high-volume neonatal units could more than halve the number of units from 161 to 72, meaning that more parents would need to travel above 30 minutes. However, ensuring that all very preterm and low birthweight babies are cared for in high-volume neonatal intensive care units would reduce …

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Decontamination of the mouth or digestive tract was not linked to reductions in drug-resistant bloodstream infections in the intensive care unit

Decontamination strategies to remove potentially harmful bacteria from the mouth, throat and gut of critically ill patients don’t reduce the risk of intensive care unit-acquired bloodstream infections or deaths from bacteria that were resistant to antibiotics. The study was carried out in 13 intensive care units across Europe, including the UK, with moderate to high …

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A care package to increase awareness of fetal movements does not reduce risk of stillbirth

A care package to increase awareness of fetal movements, and allow identification and delivery of high-risk babies, did not reduce the risk of stillbirth. The incidence of stillbirth varies across high-income countries suggesting that many could be preventable. The AFFIRM trial is the largest to date to assess whether interventions that increase awareness of fetal …

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Early cooling provides no benefit following traumatic brain injury

Deliberate cooling (prophylactic hypothermia) in the early management of traumatic brain injury does not improve neurological outcomes at six months. Inducing hypothermia may also increase the risk of pneumonia. Hypothermia (33-35oC) is sometimes induced to try and limit brain damage in people with severe head injuries. However, evidence for its safety and effectiveness has been …

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