Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Nov 2012
Review Meta AnalysisNicotine replacement therapy for smoking cessation.
The aim of nicotine replacement therapy (NRT) is to temporarily replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence. ⋯ All of the commercially available forms of NRT (gum, transdermal patch, nasal spray, inhaler and sublingual tablets/lozenges) can help people who make a quit attempt to increase their chances of successfully stopping smoking. NRTs increase the rate of quitting by 50 to 70%, regardless of setting. The effectiveness of NRT appears to be largely independent of the intensity of additional support provided to the individual. Provision of more intense levels of support, although beneficial in facilitating the likelihood of quitting, is not essential to the success of NRT.
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Cochrane Db Syst Rev · Nov 2012
Review Meta AnalysisPreoperative physical therapy for elective cardiac surgery patients.
After cardiac surgery, physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications. ⋯ Evidence derived from small trials suggests that preoperative physical therapy reduces postoperative pulmonary complications (atelectasis and pneumonia) and length of hospital stay in patients undergoing elective cardiac surgery. There is a lack of evidence that preoperative physical therapy reduces postoperative pneumothorax, prolonged mechanical ventilation or all-cause deaths.
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Cochrane Db Syst Rev · Nov 2012
Review Meta AnalysisPsychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients.
A cancer diagnosis may lead to significant psychological distress in up to 75% of cases. There is a lack of clarity about the most effective ways to address this psychological distress. ⋯ The significant variation that was observed across participants, mode of delivery, discipline of 'trained helper' and intervention content makes it difficult to arrive at a firm conclusion regarding the effectiveness of psychosocial interventions for cancer patients. It can be tentatively concluded that nurse-delivered interventions comprising information combined with supportive attention may have a beneficial impact on mood in an undifferentiated population of newly diagnosed cancer patients.
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Cochrane Db Syst Rev · Nov 2012
Review Meta AnalysisInterventions for increasing fruit and vegetable consumption in children aged 5 years and under.
Insufficient consumption of fruits and vegetables in childhood increases the risk of future chronic diseases including cardiovascular disease. ⋯ Despite the importance of encouraging fruit and vegetable consumption among children aged five years and under, this review identified few randomised controlled trials investigating interventions to achieve this.
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Cochrane Db Syst Rev · Nov 2012
Review Meta AnalysisPsychological therapies for the management of chronic pain (excluding headache) in adults.
Psychological treatments are designed to treat pain, distress and disability, and are in common practice. This review updates and extends the 2009 version of this systematic review. ⋯ Benefits of CBT emerged almost entirely from comparisons with treatment as usual/waiting list, not with active controls. CBT but not behaviour therapy has weak effects in improving pain, but only immediately post-treatment and when compared with treatment as usual/waiting list. CBT but not behaviour therapy has small effects on disability associated with chronic pain, with some maintenance at six months. CBT is effective in altering mood and catastrophising outcomes, when compared with treatment as usual/waiting list, with some evidence that this is maintained at six months. Behaviour therapy has no effects on mood, but showed an effect on catastrophising immediately post-treatment. CBT is a useful approach to the management of chronic pain. There is no need for more general RCTs reporting group means: rather, different types of studies and analyses are needed to identify which components of CBT work for which type of patient on which outcome/s, and to try to understand why.