Evidence
Alert

Primary prevention and shared decision-making are the key to managing decay in baby teeth

Sealing in decay, improving tooth hygiene and using conventional fillings all work to prevent future dental pain and infection for children with decay in baby teeth. The approaches are equally acceptable to children and parents. Researchers tested three methods of managing decay in the primary molars of children aged three to seven: best practice prevention …

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Using wires to fix wrist fracture has good long-term outcome

Fixing a displaced broken wrist with wires is as effective as fixation with locking plates in the long term. Wrist function and pain continue to improve in the five years following either operation, with no evidence of a difference between the two treatments. In 2014, a trial comparing the use of Kirschner wires and locking plates …

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Plasma and blood cell injections have not shown a benefit for Achilles tendon injury

Injecting a ruptured Achilles tendon with a small sample of a person’s own plasma, without the red blood cells, has no functional or other benefit. Plasma rich in platelets and white blood cells for the acute injury was compared with placebo. The NIHR-funded trial involved 230 adults with acute Achilles tendon rupture (the tendon which …

Collection

5 ways research could save the NHS money

More than 80% of total knee replacements can last for 25 years An NIHR-funded study showed that about 82% of total knee replacements and 70% of partial (unicompartmental) knee replacements last for 25 years. In 2017 there were 106,334 knee replacement procedures carried out in England, Wales and Northern Ireland. This research suggests people could be …

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A lifestyle change programme not effective for those at risk of heart disease or stroke

A package of extra support, including motivational interviewing, did not add value in terms of boosting weight loss or physical activity in people at high risk of cardiovascular disease, a new study has found. This NIHR-funded trial recruited 1,220 people deemed at high risk of heart disease or stroke. Researchers compared the clinical and cost-effectiveness …

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Decision aids including leaflets and computer programs help patients make treatment choices

Decision aids help patients choose between treatment options in obstetrics and gynaecology, and reduce uncertainty. A systematic review of trials of decision aids used for choices of contraception, caesarean section and menopause treatment found that patients who used them felt more confident in their ability to make the decision that was right for them, and …

Collection

My Signals – Depression

In Collections, health and social care staff and service users tell us what research is important to them and why they feel others need to know about it. In this collection, we asked nine mental health practitioners and members of the public to tell us which Alerts have interested them most. Michelle Edgar A former …

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Structured nurse ward rounds support accountability and risk management but not nurse-patient communication

Scheduling regular nurse bedside ward rounds (called ‘intentional rounding’) may not improve nurse-patient communication, as most interactions occur outside of these rounds. The rounds are intended to improve accountability and provide evidence that risks are being managed when correctly documented. Intentional rounding was introduced as a UK Government policy imperative to facilitate regular interactions between …

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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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