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NIHR Signal Better strategies are needed to reduce preventable patient harm in healthcare
About 6% of patients in healthcare settings internationally experience harm that could have been prevented. Around one in eight of these cases result in severe harm, causing permanent disability or death. Drug errors, therapeutic management incidents and incidents involving invasive clinical procedures are the most common causes of preventable patient harm. Higher rates of harm were seen in intensive care and surgical departments than in general hospital settings. This NIHR-funded review poole...
NIHR Signal Standing desks with a support package reduce time sitting at work
An office-based intervention involving a height-adjustable workstation and instruction package reduced the amount of time spent sitting. Workers sat for around 60 to 90 minutes less per day at six and 12 months compared with the control group. Sitting for long periods is a risk factor for ill health even in people meeting recommended levels of physical activity. Reducing time sitting at work could have health and economic benefits, but the evidence is limited. This trial was fairly small, invol...
NIHR Signal A school-based obesity prevention programme was ineffective
A school-based healthy lifestyle programme delivered to 6-7-year-old children and their parents made no difference to children’s weight, diet or activity levels. Around 1 in 4 remained overweight or obese. The NIHR-funded year-long programme was delivered in 54 primary schools in one region of England. Teachers were trained to provide an additional 30 minutes of physical activity a day and deliver cookery workshops with parents each term. It also included activities with a local football ...
NIHR Signal Lying on one’s side in labour with an epidural is safe and leads to more spontaneous births
Women who lie on their side in the second stage of labour after a low-dose epidural are more likely to give birth spontaneously than those who remain upright when actively contracting. Lying down on either side doesn’t appear to be harmful to mothers or babies. This means that 17 of these women would need to lie on their side instead of maintaining an upright position for one more of them to have an unassisted or “spontaneous” birth. This UK trial looked at how position in lab...
NIHR Signal Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes
People with type 1 diabetes offered insulin pumps did not achieve better blood glucose control compared with those using multiple daily injections. Education remains important. While both groups saw improvements in blood glucose levels and fewer hypoglycaemic episodes (very low blood sugar) over two years, only one in four participants met NICE blood glucose targets. Insulin pump users showed some modest improvements in satisfaction, dietary freedom and daily hassle. All participants in this N...
NIHR Signal Online cognitive behavioural therapy is no more effective than usual GP care for people with depression
Computerised cognitive behavioural therapy (CBT) in addition to usual GP care was no more effective than usual GP care alone at four months or at 24 months. It was also not a popular treatment for patients with mild to moderate depression who typically only used the programme once or twice. Indeed, more than four out of five patients did not complete the course. Depression affects large numbers of people in the UK. Other research shows that CBT is effective in treating depression, but it is exp...
NIHR Signal Occupational therapy several years after stroke does not improve function in severely ill care home residents
This trial found that a three-month individualised occupational therapy programme did not significantly improve the daily functioning (dressing, using the toilet and overall mobility) of severely physically and cognitively impaired people living in residential care who had a stroke on average three years before. About a quarter of stroke survivors in the UK cannot return home and need residential care. Occupational therapy is recommended immediately after a stroke for those likely to benefit. ...
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