Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2008
ReviewMultidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy.
Joint replacements are common procedures and treatment of choice for those with intractable joint pain and disability arising from arthropathy of the hip or knee. Multidisciplinary rehabilitation is considered integral to the outcome of joint replacement. ⋯ Based on the heterogeneity and the low quality of the included trials that precluded pooled meta-analysis, there is silver level evidence that following hip or knee joint replacement, early multidisciplinary rehabilitation can improve outcomes at the level of activity and participation. The optimal intensity, frequency and effects of rehabilitation over a longer period and associated social costs need further study. Future research should focus on improving methodological and scientific rigour of clinical trials, and use of standardised outcome measures, so that results can be pooled for statistical analysis.
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Cochrane Db Syst Rev · Apr 2008
Review Meta AnalysisInterventions for treating collagenous colitis.
Collagenous colitis is a cause of chronic diarrhea. Treatment has been based mainly on anecdotal evidence. This review was performed to identify therapies for collagenous colitis that have been proven in randomized trials. ⋯ Budesonide is effective for inducing and maintaining clinical and histological response in patients with collagenous colitis. The evidence for benefit with bismuth subsalicylate and for mesalamine with or without cholestyramine is weak. There is no evidence for the effectiveness of Boswellia serrata extract, prednisolone, or probiotics. These agents and other therapies require further study.
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Cochrane Db Syst Rev · Apr 2008
ReviewOpportunities provision for preventing youth gang involvement for children and young people (7-16).
Youth gangs have long been studied in the United States and interest elsewhere is increasing. Many studies document a robust and consistent relationship between gang membership and elevated delinquency. One theory of gang involvement, drawing on anomie and strain theories, proposes that the gang provides a means of fulfilling the economic needs of youth excluded from legitimate labour markets. Opportunities provision is a gang prevention strategy based on this theory and the principle that providing youth with educational and employment opportunities may reduce gang involvement. Common techniques within opportunities provision include tutoring, remedial education, job training, and job placement. ⋯ No evidence from randomised controlled trials or quasi-randomised controlled trials currently exists regarding the effectiveness of opportunities provision for gang prevention. Only two studies addressed opportunities provision as a gang prevention strategy, a case study and a qualitative study, both of which had such substantial methodological limitations that even speculative conclusions as to the impact of opportunities provision were impossible. Rigorous primary evaluations of gang prevention strategies are crucial to develop this research field, justify funding of existing interventions, and guide future gang prevention programmes and policies.
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Cochrane Db Syst Rev · Apr 2008
Review Meta AnalysisPalliative endobronchial brachytherapy for non-small cell lung cancer.
Non-small cell lung cancers (NSCLC) constitutes about 80% of all lung cancer cases. Although surgery is the only curative treatment of NSCLC, fewer than 20% of tumors can be radically resected. Radiotherapy is one of the main treatment modalities in lung cancer, contributing to both its cure and palliation. Endobronchial brachytherapy (EBB) has been used as one approach to improve local control either alone or in combination with other treatments. ⋯ The evidence did not provide conclusive results that EBB plus EBRT improved symptom relief over EBRT alone. We were not able to provide conclusive evidence to recommend EBB with EBRT, chemotherapy or Nd-YAG laser. For patients previously treated by EBRT who are symptomatic from recurrent endobronchial central obstruction, EBB may be considered in selected cases.
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Cochrane Db Syst Rev · Apr 2008
Review Meta AnalysisFinancial benefits for child health and well-being in low income or socially disadvantaged families in developed world countries.
A strong and consistent relationship has been observed between relative poverty and poor child health and wellbeing even among rich nations. This review set out to examine evidence that additional monies provided to poor or disadvantaged families may benefit children by reducing relative poverty and thereby improving children's health, well-being and educational attainment. ⋯ The review set out to examine the potential of financial support to poor families to improve circumstances for children. However, on the basis of current evidence we can not state unequivocally whether financial benefits delivered as an intervention are effective at improving child health or wellbeing in the short term. Our conclusions are limited by the fact that most of the studies had small effects on total household income and that while no conditions were attached to how money was spent, all studies included strict conditions for receipt of payments. We note particular concerns by some authors that sanctions and conditions (such as working hours) placed on families may increase family stress.