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NIHR Signal Outcomes similar for full or partial hip replacement after hip fracture
For older people with hip fracture, the choice between full or partial hip replacement does not greatly influence outcomes. In this trial, approximately 8% of patients having each operation required further surgery within a 24-month period. Mortality rates were also similar at around 13%. Thismultinational trial included 1,495 adults aged over 50 with a hip fracture, who were previously able to walk unassisted. It found that both hemiarthroplasty (partial replacement) and total hip replacement ...
NIHR Signal Text messaging support helps smokers quit, but apps not yet shown to work
Text messaging support helps people quit smoking, more than minimal support such as self-help materials. Also, when text messaging is combined with another smoking cessation intervention, it is more effective than just that intervention alone. However, the evidence to support smartphone apps is absent or of poor quality. This review included 26 studies and builds on the evidence from an earlier, smaller review, indicating that text messaging support is an effective way to help smokers quit. Mob...
NIHR Signal Increasing omega-3 intake does not prevent depression or anxiety
Increasing intake of polyunsaturated fats, for example with omega-3 fatty acid supplements, has little or no effect in preventing the onset of depression or anxiety symptoms in people without these conditions, but who might be at risk. These findings support dietary advice that omega-3 supplements are not needed in healthy people. This review also highlights that evidence of the effect of omega-3 in people with existing anxiety or depression is lacking or very limited. There remains not enough ...
NIHR Signal Advance care plans improve quality of life for heart failure patients
Advance care planning (ACP) can improve the quality of life of patients with heart failure, especially if it includes follow-up, involves family members and is carried out by trained clinicians working in multidisciplinary teams. This review summarised the evidence about the effect of ACP on quality of life, compared with usual care, for 2,924 patients in 14 trials. All the participants were adults diagnosed with heart failure, in community, hospital or hospice care. The study suggests that AC...
NIHR Signal Occupational therapy at home may benefit people with dementia and their carers
Multiple occupational therapy sessions, provided in a person with dementia’s own home, improve their ability to carry out daily activities, compared withusual care. Improvements are also seen in behavioural and psychological symptoms and their quality of life. In addition, carers report feeling less distress, and a better quality of life. This study was a systematic review of trials where an average of eight one-hour sessions of occupational therapy was compared with usual care or minimal...
NIHR Signal Pedometers can help people get more active as part of an exercise programme
Pedometers and accelerometers helped people with diabetes or cardiovascular diseases to increase their physical activity by a moderate amount, though pedometers were more successful. Programmes that involved face-to-face consultations with a facilitator were more effective than those where devices were used in isolation to track progress. This NIHR-funded systematic review included 36 trials which objectively measured the activity of people with cardiac or metabolic conditions, and in which wea...
NIHR Signal Impact of online or app-based assessment for urgent health problems largely unclear
Relatively little robust evidence exists on the impact of online or app-based health assessments for people seeking urgent care. The available evidence suggests that these services are not as good at making diagnoses as health professionals; though it is not clear whether this is a useful benchmark. The ‘NHS 111 Online’ service for symptom checking and triage is available in England. It aims to reduce pressure on the equivalent telephone-based service. This NIHR-funded systematic re...
NIHR Signal Measles vaccine still effective if given to infants under nine months old
A first vaccination dose against measles is a safe and somewhat effective option if given to infants earlier than usual, and before the age of nine months. However, vaccine effectiveness does increase when administered at older ages, as currently. Two doses of measles-containing vaccines are recommended as part of a childhood immunisation programme. In countries with ongoing measles transmission, the first dose (MCV1) is recommended at nine months. In the UK, the MCV1 is recommended at 12 month...
NIHR Signal Whole-school programme can have a small effect on reducing bullying in secondary schools
An anti-bullying intervention trialled at 20 UK secondary schools resulted in a reduction in bullying incidents at school. The ‘Learning Together’ initiative was funded by the NIHR and designed to modify the school environment and provide social and emotional support. The trial took place over three years and involved around 3,000 pupils who were 11 to 12 years old at the start of the study. A control group of schools which did not receive the intervention was monitored for comparis...
NIHR Signal Universal ultrasound in late pregnancy did not reduce serious harms to babies
Offering all women third trimester ultrasounds did not reduce the rate of serious illness or death in babies in the first week of life. Monitoring fetal growth is part of routine antenatal care, using regular tape measurements from the pubic bone to the top of the uterus. To date, it has been unclear whether also monitoring babies’ growth using ultrasound late in pregnancy can reduce the risks for babies. The large Dutch IRIS trial investigated whether a policy of offering third trimeste...
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