Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Apr 2007
ReviewRoutine hospital admission versus out-patient or home care in children at diagnosis of type 1 diabetes mellitus.
In many places, children newly diagnosed with type 1 diabetes mellitus are admitted to hospital for metabolic stabilisation and training, even if they are not acutely ill. Out-patient or home based management of these children could avoid the stress associated with a hospital stay, could provide a more natural learning environment for the child and its family, and might reduce costs for both the health care system and the families. ⋯ Due to the generally low quality or limited applicability of the studies identified, the results of this review are inconclusive. On the whole, the data seem to suggest that where adequate out-patient/home management of type 1 diabetes in children at diagnosis can be provided, this does not lead to any disadvantages in terms of metabolic control, acute diabetic complications and hospitalisations, psychosocial variables and behaviour, or total costs.
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Many treatments are available for whiplash patients but there is little scientific evidence for their accepted use. Patients with whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms from Grade 0 (no complaints or physical signs) to Grade 4 (fracture or dislocation). ⋯ The current literature is of poor methodological quality and is insufficiently homogeneous to allow the pooling of results. Therefore, clearly effective treatments are not supported at this time for the treatment of acute, subacute or chronic symptoms of whiplash-associated disorders.
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The severe and long-lasting symptoms of schizophrenia are often the cause of severe disability. Environmental stress such as life events and the practical problems people face in their daily can worsen the symptoms of schizophrenia. Deficits in problem solving skills in people with schizophrenia affect their independent and interpersonal functioning and impair their quality of life. As a result, therapies such as problem solving therapy have been developed to improve problem solving skills for people with schizophrenia. ⋯ We found insufficient evidence to confirm or refute the benefits of problem solving therapy as an additional treatment for those with schizophrenia. The small number of participants, the quality of reporting of methods and results were of concern. More trials with adequate reporting of methods to minimize bias, adequately powered, with validated, reliable and clinically meaningful outcomes are needed to provide robust evidence to guide policy and practice.
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Cochrane Db Syst Rev · Apr 2007
ReviewIncentives and disincentives to participation by clinicians in randomised controlled trials.
Patients and clinicians need reliable, up-to-date information from randomised controlled trials (RCTs) on the costs and benefits of treatments. Recruitment difficulties arise when clinicians do not invite patients to participate in trials. ⋯ The impact of factors varied across studies. Researchers need to be aware that aspects of the design and conduct of trials can affect clinicians' willingness to invite patients to participate. Further research is needed.
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Vascular dementia (VD) is a syndrome or diagnosis that has different causes and clinical manifestations relating to several different vascular mechanisms and changes in the brain. Some traditional Chinese herbal medicines were developed for treating VD. DH: Yizhi capsule is one such herbal concoction which is reported to improve clinical symptoms significantly. The efficacy and adverse effects of Yizhi capsule need to be reviewed systematically and assessed critically to inform clinical practice and guide the continued search for new treatment regimens. ⋯ There is no evidence from randomised controlled trials to support or proscribe against the use of 'Yizhi capsule' as a treatment for vascular dementia.