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NIHR Signal General hospital care for children with learning disabilities has scope for improvement
Less than half of NHS staff surveyed said they were routinely informed that a child has learning disabilities through a dedicated flagging system on admission. Many general hospital staff lack confidence and organisational support in providing care for children and young people with learning disabilities. In an NIHR national hospital staff-awareness survey, staff were uncertain or unaware of local policy and practice. Only half of the children’s hospitals had a learning disability nurse, ...
NIHR Signal People take prescribed statins more reliably after discussing their advantages and disadvantages
Patients want to know more about how statins work, the reasons for prescribing them and their possible side effects. Statins lower cholesterol and reduce the risk of recurrent stroke or heart attack. They also help prevent cardiovascular disease developing in people at high risk. At a population, level statins reduce the overall incidence of cardiovascular disease for people at moderate risk, but the benefits for an individual are less clear-cut. This review found that people are happy to take...
NIHR Signal Text messages improve diabetes self-management and blood sugar control
In adults with poorly controlled diabetes, text messages offering advice and support can improve self-management and blood sugar control. This trial included 366 adults with type 1 or type 2 diabetes in New Zealand. An automated system delivered individually tailored text messages to participants over a nine-month period to support self-management of blood sugar. The control group received usual care, comparable to that in the UK. The text message group had a small reduction in blood sugar lev...
NIHR Signal Daily low-dose antibiotics halve urinary tract infections in people who self-catheterise
People who perform clean intermittent self-catheterisation can reduce symptomatic urinary tract infections from two per year to one by taking daily low-dose antibiotics. This NIHR-funded trial randomised 404 adults in the UK who perform the procedure for a variety of reasons to either daily oral low-dose antibiotics or no prophylaxis. All had a recent history of urinary tract infection. Although prophylactic antibiotics halved infection rates, it increased antimicrobial resistance compared wit...
NIHR Signal UK-wide study reveals a pattern of delay in referrals to specialist end-of-life care
Referrals to hospice-based specialist palliative care occur closer to death in older than in younger people and in those without cancer. Existing evidence shows that some people near the end of life have a better quality of life and symptom control if they receive specialist palliative care. This research highlights the need to better understand the reasons for any delay. In this large NIHR-funded hospice study people aged under 50 years were referred to hospice specialist palliative care about...
NIHR Signal Music can reduce pain and anxiety following surgery
Recorded music played before, during or after surgery in adults reduces self-reported post-operative pain and anxiety, compared with usual care. The average effect is equivalent to a reduction in anxiety of 21 percentage points and a 10 percentage point reduction in pain within a few days of surgery. It is thought that placebo and distraction effects probably play a role, but in this review music still improved pain when used for patients under a general anaesthetic. Nearly two-thirds of patie...
NIHR Signal School-based self-regulation interventions can improve child academic, health and behavioural outcomes
Different types of interventions improve self-regulation in children and young people, which helps children to manage their behaviour and emotions. School curriculum-based interventions show the most consistently positive results. Interventions also improve longer-term academic, health and social outcomes. Self-regulation encompasses a range of skills, including controlling your own emotions, interacting positively with others, avoiding inappropriate or aggressive actions, and carrying out self...
NIHR Signal Varicose vein injections help new venous leg ulcers heal
For patients with leg ulcers caused by varicose veins, early intervention to treat the veins results in faster healing of ulcers than standard compression therapy alone. Researchers studied 450 people with open venous leg ulcers of 6 weeks to 6 months duration and varicose veins. Those assigned to have their veins treated within two weeks had healed ulcers in an average of 56 days, compared with 82 days for those who had treatment deferred for six months, or until after the ulcer had healed. I...
NIHR Signal Nurse staffing levels linked to reports of missed care in adult wards
Nurses are more likely to report omitting necessary care in acute inpatient wards when registered nurse staffing levels are low, even if there are additional healthcare assistants. Care categorised as planning and communication is reported as missed more often than clinical care. NHS hospitals are responsible for ensuring that the number and skills mix of nursing staff matches patient needs. Previous reviews have shown links between lower registered nurse staffing levels and poor patient outcom...
NIHR Signal Self-monitoring improves control of high blood pressure compared with GP monitoring alone
Allowing patients who have inadequately controlled high blood pressure to monitor their own blood pressure at home helps their GPs to optimise their management. Patients who self-monitor and visit or talk to their GP when needed for medication adjustments achieve 4mmHg lower systolic blood pressure over 12 months compared with those relying only on the measurements made by a GP without self-monitoring. Effects are similar if patients write down their measurements to send to the GP or do so via ...
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