Emergency medicine journal : EMJ
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Urinary tract infection requires collection of a sterile urine specimen for diagnosis, which is difficult and time consuming in pre-continent children. This systematic review summarises evidence of the effectiveness of bladder stimulation techniques on urine collection in pre-continent children, compared with standard techniques. ⋯ The results suggest a positive effect of stimulation techniquesbut lack of replication in rigorous RCTs and heterogeneity of techniques and outcomes assessed prevent conclusive recommendations being made. Further RCTs are required comparing non-invasive stimulation methods and assessing time to successful collection, contamination rates, adverse effects, caregiver and clinical staff acceptability.
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A short-cut systematic review was carried out to establish if strategies to reduce greenhouse gas emissions in the ED could succeed while maintaining comparable care standards. Of 2914 papers found in the searches, 40 were selected for full-text review and none were eligible for inclusion. The main reason for exclusion was article type. Given the wide-ranging proposals for reducing greenhouse gas emissions in healthcare, there is a dramatic paucity of evidence on the pragmatic effects on patient care.