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NIHR Signal Two commonly used pressure redistributing mattresses are similar for preventing pressure ulcers but differ on price
The choice of mattress used in hospital makes no difference to whether adults develop pressure ulcers, or how quickly, but differ on price. This large NIHR-funded trial included 2,029 participants at high risk of developing pressure ulcers and found fewer pressure ulcers overall than expected (7.9%). Half of about 2,000 participants in this large NIHR-funded trial were given high-specification foam mattresses, the current standard of care, and half used alternating pressure mattresses. The alte...
NIHR Signal Impact of a national quality improvement programme for hospital wards is unclear
The Productive Ward quality improvement programme has shown some procedural changes on hospital wards in England in the 10 years since it was introduced. But evidence to show any sustained changes to the experiences of staff or patients is hard to find. This NIHR-funded study used quantitative and qualitative methods to evaluate the programme in six acute hospitals in England. It found some evidence of a lasting impact, such as wards continuing to display metrics and using equipment storage sys...
NIHR Signal Fewer infections with antibiotic-impregnated shunts for hydrocephalus
Antibiotic-impregnated shunt catheters led to fewer infections than standard catheters in this study, although the overall rate of shunt revision remained about the same. In hydrocephalus, a shunt is a device consisting in part of a long catheter (a tube) that relieves the raised pressure of fluid in the ventricles of the brain. It is inserted internally and works by simply draining the fluid, most commonly, to the abdomen. These shunts may need revision because of infection or mechanical failu...
NIHR Signal Computerised speech and language therapy can help people with aphasia find words following a stroke
People with aphasia caused by a stroke showimprovements in retrieving words when they useself-managed computerised speech and language therapy in addition to usual care from a speech and language therapist. No improvements are seen in patients’ conversational abilities or their quality of life. Aphasia is a complex language and communication disorder. It can affect people’s abilities to read, listen, speak, and write or type. Symptoms vary: some people may mix up a few words, while ...
NIHR Signal Group cognitive behavioural courses may reduce fatigue from rheumatoid arthritis
Fatigue can be one of the most difficult symptoms to cope with for people with rheumatoid arthritis and this study found that group cognitive behavioural courses may help. This NIHR-funded study compared six weekly group sessions plus a booster session with a single brief one-to-one meeting. Both groups also received an educational booklet. It took place in seven UK hospitals and was co-delivered by pairs of trained rheumatology nurses and occupational therapists. The group sessions caused a s...
NIHR Signal Online patient feedback is mostly positive — but is not being used effectively
People are increasingly reading online feedback from other patients to gauge service qualitybut fewer people go online to write feedback themselves. Health organisations and professionals are not currently effective at using this feedback to improve services. These findings come from an NIHR-funded study which used five research streams to provide an overview of online patient feedback in the NHS. Healthcare professionals rarely encourage online patient feedback and may be sceptical about it. ...
NIHR Signal MRI and ultrasound scans are both helpful in assessing Crohn’s disease; MRI is slightly more accurate
Two types of scan, MRI and ultrasound, work well when used for staging and monitoring Crohn’s disease. MRI is more accurate. Researchers compared a form of magnetic resonance (MR) imaging that includes an oral contrast agent, with ultrasound scans. They aimed to see which was better able to detect the presence and extent of active disease in the small bowel. The trial, carried out in eight NHS hospitals, involved 284 participants who had both MR and ultrasonography. While both tests perfo...
NIHR Signal Working in groups with ongoing support is valued by people with severe obesity trying to lose weight
People with severe obesity, a BMI of 35kg/m² or more, value the support and motivation they get from weight management programmes that include group-based interventions. However, commissioners and service managers should consider how to maintain adequate support and motivation once programmes end. Although previous studies have assessed the impact of non-surgical weight management programmes for obese adults, this is the first qualitative review to focus on the opinions of providers and ad...
NIHR Signal Voucher rewards do not reduce frequency of cannabis use or relapse in people with early psychosis
Contingency management - the use of positive reinforcement in the form of supermarket vouchers to shape behaviour - makes no difference in the frequency of cannabis use or relapse rates in those with early psychosis. Although psychotic symptoms initially decrease, these changes are not sustained over the longer term and are no better than with an optimised educational intervention. This NIHR-funded multicentre randomised controlled trial included 551 young adults who were being treated in an &l...
NIHR Signal Twenty mph speed zones reduce the danger to pedestrians and cyclists
Introducing 20mph speed zones reduces road traffic accidents, including those suffered by pedestrians and cyclists. Speed zones use physical obstacles such as road narrowing, speed bumps and chicanes, whereas speed limits only use signs and lines. The evidence was inconclusive on whether limiting speed to 20mph alone was effective, without the traffic calming. There was scant evidence on whether either speed reduction intervention was linked to increased activity such as walking or cycling. Th...
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