Health technology assessment : HTA
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Health Technol Assess · Jul 2014
ReviewInterventions for adult Eustachian tube dysfunction: a systematic review.
Eustachian tube dysfunction (ETD) is the inability of the Eustachian tube (ET) to adequately perform at least one of its functions: to protect the middle ear from sources of disease, to ventilate the middle ear, and to help drain secretions away from the middle ear. There are a number of treatment options for ETD, but there is little consensus about management. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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Health Technol Assess · Jul 2014
Randomized Controlled TrialChanging eating behaviours to treat childhood obesity in the community using Mandolean: the Community Mandolean randomised controlled trial (ComMando)--a pilot study.
Around one in five children in England is obese when they leave primary school. Thus far, it has not been demonstrated that primary care interventions to manage childhood obesity can achieve significant weight reduction. Training obese children to eat more slowly as an adjunct to other healthy lifestyle behaviour change has been shown to increase weight reduction in a hospital setting. ⋯ This pilot trial failed to meet its objectives in terms of recruitment, treatment adherence, demonstration of a reduction in speed of eating in sufficient numbers of children, and attendance at follow-up appointments. Despite a high prevalence of childhood obesity in the geographical area and practices signing up for the trial, this study, like many others, demonstrates a failure of families to engage with and respond to primary care weight management interventions. We need to understand why the target population seems inured to the health message that childhood obesity is a significant health-care issue and identify the barriers to seeking help and then acting on positive health behaviour retraining. Only when we have fully understood the general public's perceptions of childhood obesity and have identified ways of engaging target populations can we hope to develop interventions that can work in a primary or community-based setting.
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Health Technol Assess · Jun 2014
Randomized Controlled Trial Comparative StudyUnited Kingdom Oscillation Study: long-term outcomes of a randomised trial of two modes of neonatal ventilation.
One in 200 infants in the UK is born extremely prematurely, i.e. before 29 weeks of gestation. Seventy-five per cent of such infants survive, but many have long-term respiratory and/or functional problems. ⋯ Follow-up at 11-14 years of age of extremely prematurely born infants entered into a randomised trial of HFO versus CV has demonstrated significant differences in lung function in favour of HFO. There was no evidence that this was offset by poorer functional outcomes; indeed, HFO children did better in some school subjects. It will be important to determine whether or not these differences are maintained after puberty as this is the last positive effect on lung function.
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Health Technol Assess · Jun 2014
ReviewA systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia.
Agitation is common, persistent and distressing in dementia and is linked with care breakdown. Psychotropic medication is often ineffective or harmful, but the evidence regarding non-pharmacological interventions is unclear. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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Health Technol Assess · Jun 2014
Maximising the value of combining qualitative research and randomised controlled trials in health research: the QUAlitative Research in Trials (QUART) study--a mixed methods study.
Researchers sometimes undertake qualitative research with randomised controlled trials (RCTs) of health interventions. ⋯ This project was funded by the Medical Research Council (MRC) as part of the MRC-National Institute for Health Research Methodology Research programme.