Tuesday, January 31, 2023

Liječenje akutne okluzije centralne retinalne arterije (obustava dotoka krvi u mrežnicu oka) Ključne poruke Nije bilo dovoljno dokaza koji podupiru predložene oblike liječenja za akutnu neartertičnu okluziju centralne retinalne arterije. Cilj Cochraneovog sustavnog pregleda Okluzija centralne retinalne arterije nastaje kada se iznenada blokira dotok krvi u unutarnji dio mrežnice (retina, sloj unutar oka osjetljiv na svjetlo). Potpuni oporavak moguć je ako se začepljenje otkloni na vrijeme i povrati dotok krvi u mrežnicu. Međutim, ako je začepljenje produljeno, stanice mrežnice umiru....

Djeluju li fizičke mjere, poput pranja ruku ili maski u sprječavanju ili usporavanju širenja respiratornih virusa? Ključne poruke Nije jasno utječe li nošenje N95/P2 respirator maski na zaustavljanje ili usporavanje širenja respiratornih virusa. Programi koji promiču higijenu ruku mogu usporiti širenje respiratornih virusa. Kako se šire respiratorni virusi? Respiratorni virusi su virusi koji inficiraju stanice u dišnim putevima: u nosu, grlu i plućima. Te infekcije mogu uzrokovati ozbiljne probleme i utjecati na normalno disanje. Mogu izazvati gripu, teški akutni respiratorni sindrom (engl....

Measures to eliminate hazards around the home, such as reducing clutter, adding railings to stairs and improving poor lighting, can reduce the risk of falls for older people by around a quarter, according to a Cochrane review recently published.

The review did not find any compelling evidence for other measures to reduce falls, such as making sure older people have the correct prescription glasses, special footwear, or education on avoiding falls.

It also found that decluttering and reducing hazards had the most benefit for older people who are at risk of falls, for example because they have recently had a fall and been hospitalised or need support with daily activities such as dressing or using stairs.

Nearly one third of people aged 65 years and older fall each year. Most falls occur in the home.

Lindy Clemson, Professor Emeritus at the University of Sydney, Australia was lead author of the review. She said: “Falls are very common among older people. They can cause serious injury or even death, but they are preventable. In this review we wanted to examine which measures could have the biggest impact on reducing falls among older people living at home.”

Professor Clemson and her colleagues analysed the results of 22 studies including data on 8,463 older people living in the community.

They found that taking measures to reduce fall hazards around the home lowers the overall rate of falls by 26%. This typically includes an assessment of fall hazards in and around the home and recommendations for lowering the risk, for instance by removing clutter and adding handrails and non-slip strips to steps. These measures have the biggest effect (38% fewer falls) for people who are at a higher risk of falls. Based on their analyses, the reviewers found that if 1,000 people who had previously had a fall followed these measures for about a year, the total number of falls would come down from 1,847 to 1,145.

Professor Clemson said: “Having had a fall or starting to need help with everyday activities are markers of underlying risk factors, such as being unsteady on your feet, having poor judgement or weak muscles. These risk factors make negotiating the environment more challenging and increase the risk of a trip or slip in some situations.

The research shows that, for those at risk of falls, being aware of fall hazards in and around the home, removing hazards and adapting with safe behaviours can significantly reduce the risk of falling. It appears that interventions to reduce fall hazards around the home need certain elements of assessment and support to work, not just a short check list of things to tick off. So, while everyone can take more care about their home environment and should do exercise for balance and lower limb strength, professional support from an occupational therapist is an important intervention for many people living at home."

“We encourage all people, as they age, to reduce fall hazards. These are often simple things like removing or changing slippery floor mats, improving lighting on stairs or de-cluttering the home. It seems this is not always ‘common sense’. People tend not to notice clutter around their home or realise that climbing ladders the way they always have is potentially a fall risk, particularly if their mobility or balance is not as it used to be.”

While the review showed fewer falls with hazard reduction, there was not enough data from the studies to determine if there were fewer admissions to hospital due to a fall. The authors found limited evidence for the other approaches to prevent falls that they examined – assistive technologies and education. They also found there was a lack of research on the impact on fall reduction of providing equipment or modifications to help older people carry out daily activities, such as showering or as cooking a meal.

Professor Clemson added: “Preventing falls is a really important way of helping people to remain healthy and independent as they grow older, and our review also highlights the need for more research in this area.”

• Clemson L, Stark S, Pighills AC, Fairhall NJ, Lamb SE, Ali J, Sherrington C. Environmental interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2023, Issue 1. Art. No.: CD013258. DOI: 10.1002/14651858.CD013258.pub2
• Read the Cochrane Library Editorial 'Preventing falls in older people: the evidence for environmental interventions and why history matters.' 
• Read the Evidently Cochrane blog 'Preventing falls in older people: new evidence on what helps.'

Friday, March 10, 2023

Friday, January 27, 2023

Kalcij i vitamin D za poboljšanje zdravlja kostiju zdravih žena u premenopauzi Ključne poruke Suplementacija kalcija, vitamina D ili kalcija u kombinaciji s vitaminom D nema učinka na mineralnu gustoću kostiju ni na jednom anatomskom mjestu (kuk ili kralježnica) kod zdravih žena u premenopauzi. Što je osteoporoza? Osteoporozu karakterizira niska razina kalcija i drugih minerala u kostima (niska mineralna gustoća kostiju). To uzrokuje formiranje rupa unutar kostiju te stanjivanje vanjskih stijenki kostiju, što ih čini krhkijima i može dovesti do učestalih prijeloma i lomova. Osteoporoza...

Cochrane London 2023: Forward together for trusted evidence
4-6 September 2023
Central London, UK

Cochrane UK is delighted to be hosting the  Cochrane Colloquium at the Queen Elizabeth II (QEII) Centre in London, UK from the 4 to 6 of September 2023, with satellite events and meetings on the 3rd September.

Cochrane holds an annual conference, known as a Colloquium, that brings together Cochrane researchers, clinical professionals, early career professionals, patients and carers, policymakers, and anyone interested in evidence synthesis and evidence-based healthcare. The events are a mix of keynote speakers, training opportunities, workshops, presentations, and a lively social and networking atmosphere. They are an exciting opportunity for a community of evidence synthesis enthusiasts to share, learn, and connect.  

The deadline for submissions has been extended until Monday 6 March 2023 (23:59 GMT)

The theme of the Colloquium is 'Forward together for trusted evidence', which explores the challenges for the future around the trustworthiness of healthcare information whilst also celebrating 30 years of producing trusted evidence. 

We invite abstract submissions for the following streams: producing trusted evidence; advocating for trusted evidence; informing health and care decisions; and co-production and working together. 

We recognize that everything Cochrane does is about and for patients and other health consumers. We ask that all abstract submissions consider the impact on patients and healthcare consumers. In particular, we welcome submissions that are co-produced, co-presented or co-designed with patients or other healthcare consumers.

If you are planning to submit an abstract, please see our guidance and recommendations:

• Abstract submission guidance (for posters and oral presentations)
• Workshop submission guidance 

 Catherine Spencer, Cochrane CEO said, “The Cochrane Colloquium will bring people together in one place to discuss, develop and promote Cochrane’s work. I am looking forward to a packed programme at my first Colloquium and encourage you to submit your contributions now.”

Martin Burton, Director of Cochrane UK, said: “We look forward to receiving your abstract submissions for London 2023. You can now submit abstracts for posters, oral presentations, or workshops – and we have guidance to help you.” 

We invite everyone to visit the Colloquium website for all information related to the Colloquium as it's released, including submissions for abstracts and awards/prizes, registration, stipend applications, and the event programme.

• Abstract submission guidance
• Workshop submission guidance 
• Colloquium website 
• #CochraneLondon
• Press contact: Katie Abbotts, Cochrane UK

 

Wednesday, March 1, 2023

Lijekovi za sprječavanje ugrušaka nakon krvarenja u mozgu Istraživačko pitanje Koje su dobrobiti i rizici lijekova koji se koriste za sprječavanje stvaranja ugrušaka (poznatih kao 'antitrombotici') kratkoročno i dugoročno nakon moždanog udara zbog krvarenja u mozgu (poznato kao 'moždano krvarenje')? Dosadašnje spoznaje Ljudi s moždanim udarom zbog krvarenja u mozgu imaju veću vjerojatnost za razvijanje ugrušaka u krvnim žilama nego ljudi bez krvarenja u mozgu. Nepokretnost rano nakon moždanog udara može uzrokovati ugruške u venama nogu i zdjelice. Osnovna medicinska stanja pacijenata,...

Jesu li koncentrirana protutijela od ljudi ili životinja koji su se oporavili od COVID-19 učinkovit oblik liječenja za pacijente s bolešću COVID-19? Ključne poruke • Ne znamo smanjuje li hiperimuni imunoglobulin (pripravak napravljen s protutijelima ljudi koji su preboljeli COVID-19) smrtnost ili ozbiljne neželjene učinke kod ljudi s umjerenim do teškim oblikom COVID-19. Sličan pripravak napravljen ubrizgavanjem određenih protutijela životinjama može smanjiti smrtnost i ozbiljne neželjene učinke te može spriječiti pogoršanje stanja. • Nismo pronašli nijedno ispitivanje koje je istraživalo...

Title: Head of Fundraising
Specifications: Permanent – Full Time
Salary: £60K per annum
Location: Ideally based in the UK, Germany or Denmark. Candidates from the rest of the world will be considered; however, Cochrane’s Central Executive Team is only able to offer consultancy contracts outside these countries (1-year fixed-term contracts)
Directorate: Development
Closing date: 21 Feb, 2023

Cochrane is an international charity. For 30 years we have responded to the challenge of making vast amounts of research evidence useful for informing decisions about health. We do this by synthesising research findings and our work has been recognised as the international gold standard for high quality, trusted information.

Cochrane's strength is in its collaborative, global community. We have 110,000+ members and supporters from more than 220 countries. Though we are spread out across the globe, our shared passion for health evidence unites us. Our Central Executive Team supports this work and is divided into five directorates: Evidence Production and Methods, Publishing and Technology, Development, and Finance and Corporate Services.

The Head of Fundraising will lead a small and dedicated team to provide the necessary vision, leadership, and fundraising skills which will enable the organisation to achieve its fundraising targets and organisational Development Strategy. They will have substantial international fundraising and management experience, a talent for building relationships and a proven track record in securing funds from international institutions, statutory sources, major international trusts and foundations, and major donors.

Don’t have every single qualification? We know that some people are less likely to apply for a job unless they are a perfect match. At Cochrane, we’re not looking for “perfect matches.” We’re looking to welcome people to our diverse, inclusive, and passionate workplace. So, if you’re excited about this role but don’t have every single qualification, we encourage you to apply anyway. Whether it’s this role or another one, you may be just the right candidate.

Our organization is built on four core values: Collaboration: Underpins everything we do, locally and globally. Relevant: The right evidence at the right time in the right format. Integrity: Independent and transparent. Quality: Reviewing and improving what we do, maintaining rigour and trust.

You can expect:

• An opportunity to truly impact health globally
• A flexible work environment
• A comprehensive onboarding experiences
• An environment where people feel welcome, heard, and included, regardless of their differences

Cochrane welcomes applications from a wide range of perspectives, experiences, locations and backgrounds; diversity, equity and inclusion are key to our values.

How to apply

• For further information on the role and how to apply, please click here.
• The deadline to receive your application is 21st Feb, 2023.
• The supporting statement should indicate why you are applying for the post, and how far you meet the requirements, using specific examples.
• Read our Recruitment Privacy Statement

Wednesday, January 25, 2023 Category: Jobs

Intervencije za poboljšanje sanitarnih uvjeta u cilju sprječavanja proljeva Cilj Cochraneovog sustavnog pregleda Cilj ovog Cochraneovog sustavnog pregleda bio je procijeniti mogu li sanitarne intervencije smanjiti učestalost proljevastih stolica, kako bi se omogućili i unaprijedili zahodi ili latrine ili potaknuli ljudi da ih koriste. Prikupili smo i analizirali sva relevantna istraživanja unaprijed određenog dizajna i pronašli 51 istraživanje koje je ukupno uključilo 238,535 ljudi. Ključne poruke Pronašli smo dokaze da sanitarne intervencije mogu zaštititi od proljeva. Međutim, učinci su se...

Cochrane is delighted to announce the availability of RevMan Web, its popular, web-based systematic-review production software, to the wider academic community beyond Cochrane – to support evidence synthesis development and evidence-based medicine education. Cochrane expects interest in use of the tool from those in universities and medical schools, and many other research sectors.

RevMan Web facilitates the creation of meta-analyses, forest plots, risk-of-bias tables, and other systematic review elements. It is acknowledged to be easy-to-use – and is also widely used in learning or training about systematic review production.

Cochrane is making RevMan Web available for use by institutions or individuals for their own systematic review development work. The product is presented on a Software-as-a-Service basis: Cochrane offers a hosted service, comprising the software and cloud storage of all review data uploaded. 

Laura Ingle, Cochrane’s Director of Publishing and Technology, says this is a hugely positive step forward: “Cochrane’s investment and development of RevMan Web has allowed the preparing and maintaining of Cochrane Reviews to reach our high standards and methodologies – making Cochrane reviews the gold standard in health evidence. Cochrane is committed to making RevMan Web the platform of choice for all systematic review production, and now we are enabling access to RevMan Web for the wider review community at a reasonable and affordable cost.

"In addition to reviews of studies of the effects of healthcare interventions, you can use RevMan Web to write reviews that synthesize qualitative evidence, reviews of prognosis studies, reviews of studies of methodology, diagnostic test accuracy reviews, and overviews of reviews. RevMan Web is easy to use, is a safe and central place to manage all reviews, and allows collaboration across people to work on the same project. With its included learning and training materials, it also makes it a great training tool for teaching systematic review techniques. 

"Cochrane authors have been using RevMan for 5 years and we are excited to offer this systematic review and meta-analysis software to individual researchers, those working on reviews together, and to those looking for licences for their university. It’s a great tool for those generating one-off meta-analyses and forest plots or conducting their own systematic reviews.”

Free access is available in Research4Life low and middle-income countries and to Cochrane Review authors working on Cochrane Reviews. Cochrane authors working on non-Cochrane reviews, Cochrane Members, students,  and academics are eligible for a discounted rate. 

To find out more:

• Visit the RevMan Web website
•  RMWsubscriptions@cochrane.org

Friday, March 24, 2023

Tuesday, January 24, 2023

Dr Jenny McSharry, Health Psychologist and lecturer in the School of Psychology at the University of Galway, explains what systematic reviews are and why they are a particularly trustworthy source of health evidence. 

Dr Jenny Mc Sharry was supported by an Evidence Synthesis Ireland Writing Mentorship (Grant code ESI-2021-001) and this blog post was originally posted on Evidently Cochrane.

When we are diagnosed with a new condition, experience a worrying symptom or need to make a health decision for ourselves or our loved ones, it can be hard to know where to turn. How often have we found ourselves unable to sleep, alone at 3AM, searching online for answers to questions we never thought we would have to ask?  In times of anxiety and uncertainty, how can we know what health evidence to trust when we need it most?

When looking for reliable information to help with health decisions, reviews of evidence, in particular systematic reviews, can be a good place to start.

Systematic reviews of multiple studies can be useful for health decisions

Reviews that bring together and summarise the existing evidence are more reliable than one research study, or one person’s opinion or experience. Lots of things can affect the findings of a research study and we can have more confidence in reviews that bring together lots of studies. There is more information on why Personal experiences or anecdotes (stories) are an unreliable basis for assessing the effects of most treatments on the Evidently Cochrane blog.

Systematic reviews are seen as the gold-standard of research evidence. A systematic review is a type of review that tries to find, assess, and summarise all the evidence that meets pre-specified criteria to answer a specific question. Researchers who complete systematic reviews follow a number of key steps to make their findings more trustworthy.

Systematic reviews summarise evidence related to a specific question

Systematic reviews look for evidence that might help answer a specific question, and clearly outline this question from the start. For example, a systematic review Antihistamines for motion sickness was done to find out if  medicines used for allergy symptoms (antihistamines) work and are safe in preventing travel (motion) sickness. The review summarises evidence on how antihistamines compare with dummy treatment (placebo), no treatment, and other medicines. This review is useful if you want to find evidence about medicines for travel sickness, but not if you want to know if you should avoid reading or drink ginger tea while travelling. When a review clearly states its focus, it helps us judge whether it is relevant and useful to us.

Systematic reviews aim to find all studies that meet certain criteria

Systematic reviews researchers try to find and include all studies relevant to a specific question. This is important, as we want all relevant information to be available to us when making a health decision. When using evidence from a review to decide if we should start a new treatment for example, we want to be sure that studies that found benefits, studies that found harms, and studies that found little or no difference, are just as likely to have been included.

Systematic review researchers try to find all relevant studies by clearly outlining the sources they will search, and by making a list of the criteria they will use to decide if studies should be included. For example, in our review Video calls for reducing social isolation and loneliness in older people, we wanted to find out if older people who used video calls to keep in touch with family and friends feel less lonely than those who did not. For this review, we needed to decide on what we meant by older adults, as the findings might be different for people aged 65 and older, or people aged 70 and older. For this review, we decided to include studies of people aged 65 and older and made it clear when reporting the findings that this was the group we had focused on.

Systematic review researchers clearly state the methods they will use to identify studies before starting the review. Other researchers should be able to use these methods and find the same set of studies.

Systematic reviews assess and report on the quality of evidence

When reading reviews of evidence, it is important to know how many relevant studies there are, but also to know if the studies are of good quality. Even if a number of studies find that a treatment is beneficial, we may not want to choose this treatment if we find out that the number of people included in the studies was very small, or that the way in which people were identified to take part in the studies was not clear. For a systematic review, researchers assess if the methods used in the included studies were appropriate. Researchers then make a judgement on the level of certainty we can have in the overall evidence, based on whether the included studies were done well or not.

Finding relevant systematic reviews: Where to look?

When it comes to trustworthiness, not all information we find is equal, and it is good to know that systematic reviews can be helpful in making health decisions. However, when feeling anxious about a health condition or symptom, or when trying to make an urgent health decision, it can be hard to know how to find relevant systematic reviews.

Cochrane is an independent global organisation that aims to provide high-quality evidence to inform decisions about health and care. Cochrane systematic reviews are published online in the Cochrane Library. The Cochrane Library is free to access for people in the UK and Ireland (and in many other countries). You can search by topic, and the reviews all have a Plain Language Summary. The blogs here on Evidently Cochrane aim to make health evidence easy to understand and use by providing summaries of Cochrane Reviews in context, often alongside patients’ and health professionals’ experiences. Evidently Cochrane includes an A-Z list of topics to make it easier to search for relevant evidence, and can be a good place to start when supporting family and friends or making choices about our own health.

What else can you do to work out if health information is trustworthy?

If you are interested in finding out more about health information and what we can trust, the blog, Making health decisions: things that can help, looks at some key things to consider to help us to make the right decision and to reduce the risk of regretting our choices later on. The blog also reminds us that summaries of research evidence are just one part of how we make health decisions, and our own preferences and values and the views of healthcare professionals are also very important. The blog includes lots of resources to help you think critically about health information and to support your decision-making.

• Learn more about health evidence in our free Cochrane Evidence Essentials resource
• Read more Evidently Cochrane blogs
• Join in on the conversation on Twitter with @jenmcsharry @CochraneUK or leave a comment on the blog

Tuesday, January 24, 2023

Monday, January 23, 2023

Friday, January 20, 2023

Friday, January 20, 2023

Family-centred care is a way of providing care that focuses on the needs of children while providing planned care around the whole family unit. A new Cochrane review published recently found there was a small improvement in the overall health and well-being of Indigenous children and their families when they participated in family-centred care programmes at a primary healthcare service.

‘Family centred-care is not new,’ says lead author Dr Natalie Strobel, Senior Research Fellow at Edith Cowan University’s Centre for Improving Health Services for Aboriginal and Torres Strait Islander Children and Families. ‘Aboriginal Medical Services have been doing this for years. For example, they don’t just immunise babies, they talk to mums, aunts, uncles, grandparents and everybody that’s part of that family unit – trying to ensure that everybody's getting care. That’s both health and social care, so it might be making sure there’s appropriate housing, referrals to services that they needed or for other types of support.’

‘We know that primary healthcare, particularly Indigenous-led services, are well placed to deliver services that reflect the needs of Indigenous children and their families. Of our author team of nine, four are Aboriginal and have worked in health services as nurses and midwives for a long time. Families want primary healthcare services that both support them and recognise Indigenous ways of knowing and doing business. This can be delivered through environmental, communication, educational, counselling, and family support approaches.’

A key finding of this new review was that family-centred care delivered by primary healthcare services may improve the overall health and well-being of children and their families, however, due to a range of factors, the evidence was rated as very low certainty. There was also evidence to suggest that families who participated in family-centred care increased their parenting knowledge and awareness to a small degree. However, for all other outcomes it was unclear whether family-centred care improves specific child health and well-being outcomes. Ultimately more high quality trials are needed to generate evidence to determine whether family-centred care improves the health and well-being of Indigenous children.

‘We consider family-centred care to be really promising, but we’re not confident in the evidence for a range of reasons, which are quite complex,’ Natalie says. ‘For example, people in the studies were aware of what intervention they were getting, many people did not come back to report their results, and not all the studies reported the information we were interested in. Also, some of the issues around low quality of evidence are really hard for communities that are doing this type of work to get around.’

‘For instance, in the United States you're delivering the intervention on a reservation and there's not a huge number of people to do this work. Often the person who delivers the intervention also collects the data. We know that's got a significant level of bias involved in it, but it's also very pragmatic, that's what happens and how it has to work because there's not enough people to complete the project. This highlights the challenges of conducting high quality studies, and underscores the need to build capacity and support people in communities.’

‘I think with the advent of this type of research, it will give people an idea of what's going on in the field so that they know where potentially they could identify and collect better evidence to add to this emerging evidence base. Ultimately it is quite a tricky space, and realistically when you are trying to do things that are good for your community, you have to make allowances and be pragmatic about how research is delivered.’

‘Overall, this was a huge and complex review that was really challenging to deliver but we’re so pleased we did,’ Natalie says. ‘I really have to hand it to the team though. It was their sheer persistence that delivered this review, and the reward now for us is having this really high quality piece of work that people from health services can use to show how effective their programs are. We wanted to support local services to advocate for themselves and now they can use this information as they need – either to show where they might need to make changes or to demonstrate that what they're doing is effective and benefits children, families and communities. They are really making a difference.’

Strobel NA, Chamberlain C, Campbell SK, Shields L, Bainbridge RG, Adams C, Edmond KM, Marriott R, McCalman J. Family‐centred interventions for Indigenous early childhood well‐being by primary healthcare services. Cochrane Database of Systematic Reviews 2022, Issue 12. Art. No.: CD012463. DOI: 10.1002/14651858.CD012463.pub2.

• Read the full systematic Review

Written by  Shauna Hurley, Cochrane Australia 

 

Thursday, January 19, 2023

Različiti načini liječenja ezotropije (otklon oka prema unutra) koja se javlja unutar prvih šest mjeseci života Koji je cilj ovog sustavnog pregleda? Cilj je ovog sustavnog pregleda bio ustanoviti je li jedan način liječenja (npr. kirurški ili nekirurški) bolji od drugoga za ezotropiju (otklon oka prema unutra) koja se javlja u djece unutar prvih šest mjeseci života. To se stanje zove infantilna ezotropija. Kako bismo dobili odgovor, pretražili smo baze podataka i pronašli dva relevantna istraživanja vezana uz liječenje infantilne ezotropije. Što se proučavalo u ovom sustavnom pregledu?...

Pomaže li smanjenje unosa soli u sprječavanju i liječenju kronične bolesti bubrega kod osoba s dijabetesom? Što je proučavano u ovom sustavnom pregledu? Postoje čvrsti dokazi da svi konzumiramo previše soli, što može povećati rizik za nastanak visokog krvnog tlaka. Ovo je osobito važno kod osoba oboljelih od dijabetesa jer dijabetes povećava rizik od moždanog i srčanog udara, te zatajenja bubrega. Visok krvni tlak će dodatno povećati te rizike. Smanjenje unosa soli bi moglo pomoći u snižavanju krvnog tlaka, umanjiti rizik od srčanog udara, te pogoršanja funkcije bubrega. Kako je proveden...