Cochrane Db Syst Rev
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Research has highlighted the problems for carers of people with dementia. These include the effective loss of companionship and support of a life partner, social isolation and complex financial, legal and social decision making. The burden of caring is financially, emotionally and physically significant. Studies of the effects of ways of supporting carers and reducing the burden of caring often examine a range of outcomes. Probably because of these characteristics, no formal overview of this area of service provision has been undertaken. Moreover, the term 'intervention' in relation to caregivers of people with Alzheimer's disease is open to wide variations in interpretation at the level of service provision. Interventions range from the application of 'hi-tech' computer technology for socialy isolated carers, to the formation of specialist support groups and respite services. ⋯ With the limited nature of the research evidence in mind, it is not possible to recommend either wholesale investment in caregiver support programmes or withdrawal of the same. With the addition of further studies in future updates of this review, expected in early 1999, this presently inconclusive picture may become clearer. A number of conclusions relating to future areas of research can be put forward with more conviction. Specifically, 1) Future trials need to examine interventions included in the existing knowledge base on Alzheimer's carer-supportive interventions. 2) Outcome measures used should mirror those in similar studies. 3) Outcome measures need to be clinically and 'lay' relevant. 4) Trials need to be of longer duration given the 7-10 years median life expectancy of people with Alzheimer's Disease. 5) Sample sizes need to be increased and calculated properly given the likelihood of a moderate intervention effect (if any). 7) Blinding at the outcome assessment stage needs to be a part of future basic trial designs if bias is to be avoided. 8) If reviews are to have their power increased then quality o
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Research has highlighted the problems for carers of people with dementia. These include the effective loss of companionship and support of a life partner, social isolation and complex financial, legal and social decision making. The burden of caring is financially, emotionally and physically significant. Studies of the effects of ways of supporting carers and reducing the burden of caring often examine a range of outcomes. Probably because of these characteristics, no formal overview of this area of service provision has been undertaken. Moreover, the term 'intervention' in relation to caregivers of people with Alzheimer's disease is open to wide variations in interpretation at the level of service provision. Interventions range from the application of 'hi-tech' computer technology for socialy isolated carers, to the formation of specialist support groups and respite services. ⋯ With the limited nature of the research evidence in mind, it is not possible to recommend either wholesale investment in caregiver support programmes or withdrawal of the same. With the addition of further studies in future updates of this review, expected in early 1999, this presently inconclusive picture may become clearer. A number of conclusions relating to future areas of research can be put forward with more conviction. Specifically, 1) Future trials need to examine interventions included in the existing knowledge base on Alzheimer's carer-supportive interventions. 2) Outcome measures used should mirror those in similar studies. 3) Outcome measures need to be clinically and 'lay' relevant. 4) Trials need to be of longer duration given the 7-10 years median life expectancy of people with Alzheimer's Disease. 5) Sample sizes need to be increased and calculated properly given the likelihood of a moderate intervention effect (if any). 7) Blinding at the outcome assessment stage needs to be a part of future basic trial designs if bias is to be avoided. 8) If reviews are to have their power increased then quality o
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Low back pain is one of the most common and costly musculoskeletal problems in modern societies. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. ⋯ Based on the studies reviewed, there is insufficient evidence to recommend massage as a stand-alone treatment for non-specific low back pain. There is a need for high quality controlled trials to further evaluate the effects of massage for this condition.
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Low back pain is one of the most common and costly musculoskeletal problems in modern societies. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. ⋯ Based on the studies reviewed, there is insufficient evidence to recommend massage as a stand-alone treatment for non-specific low back pain. There is a need for high quality controlled trials to further evaluate the effects of massage for this condition.
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Cochrane Db Syst Rev · Jan 2000
ReviewAntiplatelet agents for preventing and treating pre-eclampsia.
Pre-eclampsia is associated with deficient intravascular production of prostacyclin, a vasodilator, and excessive production of thromboxane, a platelet-derived vasoconstrictor and stimulant of platelet aggregation. These observations led to the hypotheses that antiplatelet agents, and low dose aspirin in particular, might prevent or delay the development of pre-eclampsia. ⋯ Antiplatelet agents, in this review largely low dose aspirin, have small-moderate benefits when used for prevention of pre-eclampsia. Further information is required to assess which women are most likely to benefit, when treatment should be started, and at what dose.