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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 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 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 Longer duration of urinary catheter placement associated with an increase in urinary infection
The risk of urinary infection appears low with very short-term use but increases with the time that a patient has a catheter. Women and patients with paraplegia or cerebrovascular disease are at increased risk. This US-based retrospective analysis of electronic health records identified 148,361 indwelling catheterisations, of which 61,047 were for three or more days, in five hospitals - two university hospitals, two community and one children’s hospital - where the median duration of cath...
NIHR Signal A less healthy lifestyle increases the risk of dementia
The less healthy your lifestyle, the more you are at risk of developing dementia in later life, a new systematic review has shown. Researchers analysed the results of 18 studies with over 44,000 participants. Having two or more ‘modifiable risk factors’, including smoking, high blood pressure, poor diet, inactivity, obesity and excessive alcohol consumption, puts adults at greater risk of developing dementia. The included studies followed up people without signs of cognitive declin...
NIHR Signal High-flow nasal oxygen reduces reintubation after major surgery compared with conventional oxygen therapy
In adults after major surgery, high-flow nasal oxygen decreases by about two-thirds the need for reintubation compared with conventional oxygen therapy. In this study, only about four in every 100 patients needed reintubation with high-flow nasal oxygen, compared with about 11 in every 100 patients receiving conventional oxygen therapy. This review evaluated seven randomised and three non-randomised studies in 1,327 adult patients recovering from surgery under a general anaesthetic. Most of the...
NIHR Signal Reminders to assess clotting risk increase the use of preventive measures
Reminders to assess clotting risk result in more patients being given appropriate anti-clotting measures in hospital. Computer alerts, in particular, are linked to better choice of prophylaxis and fewer blood clots in veins. Clots in deep leg veins or the lungs are common when people are bedbound in hospital. This updated Cochrane review assessed interventions aiming to increase the use of appropriate preventive measures such as anti-clotting drugs or mechanical measures, including stockings, f...
NIHR Signal A new tool helps predict recovery from ankle sprain
The SPRAINED model may improve prediction of people who are at risk of delayed recovery from ankle sprain. This model was developed in the UK using clinical information from 584 adults with ankle injuries. The model was validated using observational data from 682 people with ankle sprains across 10 different UK emergency departments. Delayed recovery from ankle injury was more likely to be detected when using the SPRAINED model than by clinicians using judgment alone. Re-assessing pain levels ...
NIHR Signal Complications following hip or knee surgery are more likely for people with long-term illness, but benefits are still worthwhile
People with long-term illness are just as likely to benefit from knee or hip surgery as those without. However, they are more likely to have complications following surgery and to be readmitted within three months. This study reviewed data from 70 studies to determine the chance of short-term harms and long-term benefits linked to 11 different co-existing health conditions (such as diabetes and cancer) following hip and knee replacement. Short-term outcomes included surgical complications, infe...
NIHR Signal A total diet replacement programme helped obese people lose weight and keep weight off
A programme of weekly behavioural support with total diet replacement led to over 7kg greater weight loss than usual care in primary care. This weight loss was maintained for a year after starting the 8-12 week low calorie programme. This trial, funded by NIHR and a commercial sponsor, was carried out in ten primary care practices in Oxfordshire. Participants had BMI over 30. It referred half of the 278 participants to a commercial weight loss programme, free of charge for six months. The rest ...
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