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NIHR Signal Aerobic exercise moderately reduces depressive symptoms in new mothers
For women who have had a baby in the past year, doing aerobic exercise can reduce the level of depressive symptoms they experience. This NIHR funded review of 13 studies showed that involving new mothers in group exercise programmes, or advising them on an exercise of their choice, reduced depressive symptoms compared with usual care. The effect was moderate but significant. Examples of exercise were pram walks, with dietary advice from peers in some studies. The benefits were shown whether or ...
NIHR Signal Blood pressure self-monitoring works best when people are well-supported
People with high blood pressure are more likely to have their blood pressure controlled after 12 months if they self-monitor and receive counselling by telephone compared with usual monitoring in the clinic. When people were asked to self-monitor their blood pressure with no additional support, it was no better than getting their blood pressure measured in a clinic. This NIHR-funded review of 25 trials found that self-monitoring with counselling by telephone reduced systolic blood pressure by a...
NIHR Signal Exercise improves symptoms and function for people with ankylosing spondylitis
People with ankylosing spondylitis showed improvement in their symptoms and their ability to perform day-to-day tasks when they did more exercise. Symptom and function scores improved by almost one point on a 10-point scale after 3 to 12 weeks of exercise. Ankylosing spondylitis is a type of arthritis which mainly affects the spine, causing pain, stiffness and progressive fusion of the spine. There have been recent advances in pharmacological treatment, and it was uncertain whether exercise alo...
NIHR Signal Faecal transplant effectively treats recurrent or unresponsive Clostridium difficile
Using a faecal microbiota transplant cured 92% of people with Clostridium difficile that had recurred or had not responded to antibiotics. Faecal transplant also had a lower risk of treatment failure than the antibiotic vancomycin. C. difficile is a potentially serious infection of the gut that can occur after a course of antibiotics unbalances the gut bacteria. Faecal transplant uses the diluted faeces of a healthy person delivered into the guts of the person with C. difficile to rebalance the...
NIHR Signal Comprehensive assessment when older people are in hospital improves their chances of getting home and living independently
Older people who received comprehensive geriatric assessment when in hospital were slightly more likely to be living in their own homes one year later. Sixty percent were discharged to independent living compared with 56% receiving standard ward care. People who had received this proper assessment were also 20% less likely to be in a nursing home after three months or more. Older people often have multiple complex conditions combined with frailty and are more likely to lose independence after i...
NIHR Signal Checklists are no substitute for experience in spotting patients who are deteriorating
Experience was found to count in recognising and acting on patient deterioration. National guidelines recommend the use of “track and trigger” systems to monitor seriously ill patients for the signs of deterioration. Following their identification, prompt referral to critical care teams is suggested, for example, but this does not always happen reliably. This realist review explored the organisational factors within UK hospitals that influence how and why these alert systems work in ...
NIHR Signal Using a ‘telephone first’ approach may increase the total time GPs spend consulting
A system where all patients have a telephone call with their GP before an appointment decreased the number of face-to-face consultations but increased telephone consultations. There was an overall 8% increase in the time GPs spent consulting, though there was large variation across practices. This NIHR-funded study compared 147 practices in England before and after the implementation of the telephone management system and also with a sample of surgeries using a standard appointment system. Tel...
NIHR Signal Uncertain benefit of adding amisulpiride to clozapine for treatment-resistant schizophrenia
For adults with schizophrenia who continue to have symptoms despite treatment with the antipsychotic drug clozapine, adding amisulpride (another antipsychotic) was not shown to improve their chance of responding. It is not yet clear whether a larger trial would show an effect, as too few people were recruited to the NIHR-funded trial to be sure. Participants were more likely to experience side effects and the trial does provide some important information for future studies in this difficult trea...
NIHR Signal Pilocarpine improves dry mouth caused by radiotherapy
Out of several treatments tested, the drug pilocarpine gave the most significant improvement in dry mouth following radiotherapy for head and neck cancer. Less dry mouth and increased salivary flow were twice as likely after taking pilocarpine than after a dummy pill. Dry mouth from radiotherapy impairs quality of life. Although people can try simple measures at home, such as sucking ice cubes, they may wish to discuss pilocarpine treatment with their GP. Side effects from this medication are u...
NIHR Signal A commonly used treatment does not improve chronic low back pain
This trial found that destroying nerves that take pain signals to the brain using heat (radiofrequency denervation) did not improve pain, function or a sense of “recovery”. The treatment was used alongside exercise and was a variation of the technique commonly used in the UK. In this large study, it was compared to exercise alone. Low back pain is usually short-lived, but some people develop long-term back pain which can negatively impact their lives. NICE recommends exercise, pain ...
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