Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2006
ReviewPositive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.
Chest physiotherapy is widely prescribed to assist the clearance of airway secretions in people with cystic fibrosis (CF). Positive expiratory pressure (PEP) devices provide constant back pressure to the airways during expiration. This may improve clearance by building up gas behind mucus via collateral ventilation. Given the widespread use of PEP devices, there is a need to determine the evidence for their effect. ⋯ There was no clear evidence that PEP was a more or less effective intervention overall than other forms of physiotherapy. There was limited evidence that PEP was preferred by participants compared to other techniques, but this finding is from studies of low quality.
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Cochrane Db Syst Rev · Apr 2006
ReviewRest during pregnancy for preventing pre-eclampsia and its complications in women with normal blood pressure.
Women at risk of pre-eclampsia or gestational hypertension are sometimes advised to rest. Whether this, overall, does more good than harm is unclear. ⋯ Daily rest, with or without nutrient supplementation, may reduce the risk of pre-eclampsia for women with normal blood pressure, although the reported effect may reflect bias and/or random error rather than a true effect. There is no information about outcomes such as perinatal mortality and morbidity, maternal morbidity, women's views, adverse effects, and costs. Current evidence is insufficient to support recommending rest or reduced activity to women for preventing pre-eclampsia and its complications. Whether women rest during pregnancy should therefore be a matter of personal choice.
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Cochrane Db Syst Rev · Apr 2006
ReviewStavudine, lamivudine and nevirapine combination therapy for treatment of HIV infection and AIDS in adults.
A favourable regimen for people infected with HIV/AIDS is one that provides optimal efficacy, durability of antiretroviral activity, tolerability, and has low adverse effects and drug-drug interactions. The combination of the non-nucleoside reverse transcriptase inhibitor nevirapine (NVP), and two nucleoside reverse transcriptase inhibitors, stavudine (d4T) and lamivudine (3TC), is widely used as first-line therapy, especially in low-resource countries. Analysis of the efficacy, durability and tolerability of the regimen is thus important to clinicians, consumers and policy-makers living in both rich and poor countries. ⋯ The combination of nevirapine, 3TC and d4T is as efficacious as a combination of efavirenz, 3TC and d4T. Once-daily NVP with twice-daily 3TC and d4T is as efficacious as twice-daily NVP, 3TC and d4T. However, toxicity may be increased in the once-daily NVP regime. Additional trials of sufficient duration are required to provide better evidence for the use of this combination as a first line therapy. Ideally, trials should use standardised assessment measures especially with respect to measuring viral load, so that results can be compared and combined in meta-analyses.
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Cochrane Db Syst Rev · Apr 2006
ReviewExercise or other physical activity for preventing pre-eclampsia and its complications.
The association between an increase in regular physical activity and a reduction in the risk of hypertension is well documented for non-pregnant people. It has been suggested that exercise may help prevent pre-eclampsia and its complications. Possible adverse effects of increased physical activity during pregnancy, particularly on the risk of preterm birth and fetal growth restriction, are unclear. It is, therefore, important to assess whether exercise reduces the risk of pre-eclampsia and its complications and, if so, whether these benefits outweigh the risks. ⋯ There is insufficient evidence for reliable conclusions about the effects of exercise on prevention of pre-eclampsia and its complications.
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In traditional didactic teaching, the learner has a passive role, digesting the knowledge presented by the teacher. Stimulating and active teaching processes may be better at instilling information than more pedestrian approaches. Games involving repetition, reinforcement, association and use of multiple senses have been proposed as part of experiential learning. ⋯ Current limited evidence suggests educational games could help mental health students gain more points in their tests, especially if they have left revision to the last minute. This salient study should be refined and repeated.