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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 London’s Low Emission Zone has not been shown to improve children’s respiratory health
The Low Emission Zone covering much of Greater London was introduced between 2008 and 2012 to improve air quality. Some measures of air pollution have slightly reduced over that time, but measures of children’s respiratory health and lung development have not significantly improved. This NIHR funded study assessed over 2,000 primary school children during the first five years of the Low Emission Zone, during which charges were phased in for several categories of commercial diesel vehicles...
NIHR Signal Honey may help painful mouth inflammation caused by cancer treatments
Compared to usual care, honey was more likely to reduce moderate or severe pain for patients after radiotherapy and/or chemotherapy treatment. This systematic review looked at trials from around the world comparing different types of honey with other treatments such as chamomile, golden syrup or placebo. The main outcome was the onset of moderately severe oral mucositis as measured by a range of standardised assessment scales. The findings suggest that honey might be useful, although whether t...
NIHR Signal A high omega-6 fatty acid diet is unlikely to prevent cardiovascular disease or deaths
Diets or supplements that aim to increase omega-6 fatty acids have no clear effect on the risk of cardiovascular events like heart attacks or stroke, overall deaths or deaths from cardiovascular disease. Omega-6 fatty acids are poly-unsaturated oils largely derived from seeds and nuts such as sunflower oil, corn oil, soybean oil, walnuts and pumpkin seeds. The results of this Cochrane review can be looked at alongside another recent Cochrane review, which found no benefits of fish oil in omega-...
NIHR Signal A commonly-used antidepressant doesn’t improve recovery after stroke
The antidepressant fluoxetine works no better than placebo to reduce disability after a stroke, lowering hopes that had been raised by other smaller studies. After a six month trial including more than 3,000 adult stroke patients recruited at 103 UK hospitals, researchers concluded that fluoxetine should not be used to promote recovery from stroke-related disability, or routinely prescribed to prevent depression after stroke. Several smaller studies and animal trials had found promising result...
NIHR Signal Delaying pushing in labour has no benefit for women with an epidural and/or spinal for pain relief
For women having their first baby with an epidural and/or spinal anaesthetic for pain-relief, the timing of pushing after full dilatation of the cervix does not affect the numbers that achieve normal vaginal delivery. The best management for the second stage of labour is still debated. In the UK epidurals are by far the most widely used regional anaesthetic technique for pain relief in labour. In this large trial, women either pushed immediately or delayed pushing by waiting for 60 minutes. Wo...
NIHR Signal New strategies for maintaining blood supplies from donations may be cost-effective
Opening blood donation centres on weekday evenings and at weekends is a cost-effective way of increasing the blood supply used by hospitals in the UK. Allowing donors to give blood more often could increase supplies in the short term, but it isn’t clear if it would be cost-effective in the long-term. This NIHR-funded modelling study used data from a recent large randomised trial in the UK that investigated the safety of donating blood more frequently than current guidance allows. This was...
NIHR Signal No additional weight-loss reported from a lifestyle programme for people with psychosis
For adults with psychosis, such as schizophrenia, who are taking antipsychotic medication, a carefully designed 12-month group diet and exercise programme did not lead to clinically important weight loss after 12 months. The programme was compared with those receiving usual care including written lifestyle advice. Intervention and usual care groups each lost half a kilo on average, with no measurable changes in diet or physical activity. People with schizophrenia are twice as likely to be overw...
NIHR Signal Treatments for depression may help irritable bowel symptoms
Antidepressants are likely to provide more than a placebo effect for those with symptoms of irritable bowel syndrome. Antidepressants improve symptoms in about 60% of those taking them, but two-thirds of that effect may be due to placebo. Psychological therapies, such as talking therapies also appear effective in about half of those offered them but may be partly due to expectations because it is not possible to provide a placebo control. Irritable bowel syndrome is a chronic disorder of the gu...
NIHR Signal Reconfiguring neonatal services balances survival chances against increased travel for families
Centralising services so that all babies are delivered in high-volume neonatal units could more than halvethe number of units from 161 to 72, meaning that more parents would need to travel above 30 minutes. However, ensuring that all very preterm and low birthweight babies are cared for in high-volume neonatal intensive care units would reduce mortality. NHS reconfiguration plans for neonatal services include closing smaller neonatal units to concentrate care where there are resources and speci...
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