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Analysis of the efficacy of hypertonic nasal spray with algae in rhinosinusitis.
Full text linkNo abastract availablehttps://link.springer.com/article/10.1007/s00405-025-09403-
Parents' experiences of care for premature infants in the community
No full textThe rates of premature infants born in the UK at 22 weeks' gestation and given life support have increased three-fold in England and Wales following changes to NHS guidance for the treatment of extreme prematurity. These infants can have life-long disabilities and long-standing health or developmental issues; consequently, there is an increasing demand for community professionals to support this vulnerable and growing population. The aim of this literature review was to explore parents' experiences of community care after their premature infant is discharged home. After thematic analysis, three superordinate themes emerged: there is a lack of effective service provision for preterm infants and their parents in the community; there is a gap in the knowledge base of community professionals relating to preterm infants and; parents commend a multidisciplinary approach to their preterm infant and ongoing health needs. The review concludes that there is a need for enhanced community support and strengthening of community services for premature infants and their parents following discharge home. This is the first of a two-part article, the second of which will be published in a forthcoming issue.https://www.magonlinelibrary.com/doi/abs/10.12968/jfch.2025.2.1.3
Pre-Emptive Acetaminophen for Postoperative Pain (PAPP): An Updated Meta-Analysis.
Full text linkPURPOSE: Postoperative pain is a common consequence of surgery. Pre-emptive analgesia involves the initiation of analgesics prior to surgical incision. This has been proposed as a simple method to help reduce postoperative pain, which may be more effective in higher-risk populations such as cervical spine surgery. A previous meta-analysis has demonstrated that pre-emptive acetaminophen may be effective in reducing postoperative pain although the certainty of evidence was limited. This present paper is an updated meta-analysis comparing pre-emptive acetaminophen versus postincision acetaminophen in adult patients undergoing surgery. DESIGN: Systematic review and meta-analysis with the inclusion of an unpublished randomized, placebo-controlled, double-blind trial. METHODS: An updated meta-analysis was conducted which searched electronic databases to identify randomized controlled trials with the same interventions. FINDINGS: We included 845 participants and 12 studies in the updated meta-analysis. The meta-analysis (including our trial) found reduced 24-hour morphine consumption in the pre-emptive group (mean difference -2.42 mg; 95% confidence interval -4.26 to -0.59 mg), as well as reduced postoperative vomiting (risk ratio 0.56; 95% confidence interval 0.36 to 0.88). There was no difference between pre-emptive acetaminophen and control groups for time to analgesic request, pain scores at 6 and 24 hours or pruritis. For all outcomes assessed, there was very low certainty of evidence. CONCLUSIONS: This meta-analysis found pre-emptive acetaminophen reduced 24-hour opioid consumption and postoperative vomiting
Benign Vomiting-Induced Hepatic Portal Venous Gas: A Case Report.
Full text linkHepatic portal venous gas (HPVG) is a rare but significant radiological finding traditionally associated with severe abdominal pathology, particularly bowel ischaemia. However, advances in imaging have led to the recognition of benign and self-limiting causes. We report the case of a 34-year-old female with longstanding type 1 diabetes mellitus, autonomic dysfunction, and stage 4 chronic kidney disease (CKD), who presented with severe vomiting, abdominal pain, and malaise. CT revealed HPVG without any evidence of bowel compromise or ischaemia. The patient was successfully managed with conservative treatment, including intravenous fluids, antiemetics, and insulin therapy, resulting in rapid clinical improvement and resolution of the HPVG on follow-up imaging. This report underscores the importance of recognising vomiting-induced HPVG as a benign phenomenon and highlights the essential role of careful clinical assessment in avoiding unnecessary surgical interventions
Review article : the acceptability and effectiveness of standardised diagnostic assessment approaches in children and young people's mental health services – an updated systematic review
Full text link2025 The Author(s). Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and
Adolescent Mental Health.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and
reproduction in any medium, provided the original work is properly citedBackground Standardised diagnostic assessment (SDA) tools are designed to comprehensively evaluate various mental health disorders and support accurate diagnoses. While evidence for their routine use in child and adolescent mental health services (CAMHS) remains limited, increasing service demands underscore the need for efficient clinical assessments. This updated review examines the acceptability and clinical utility of SDA tools in CAMHS. Method A systematic review of 464 studies published between January 2013 and February 2025 was conducted (PROSPERO: CRD42024494051). Ten studies met the inclusion criteria, comprising eight cross-sectional studies and two randomised controlled trials. Results SDA tools reviewed included Development and Wellbeing Assessment (DAWBA), Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS). DAWBA improved referral decision accuracy, while both DAWBA and MINI-KID had acceptable agreements with expert consensus diagnoses. MINI-KID and KSADS were able to identify more cases than routine clinical assessments. However, DAWBA did not show effectiveness in changing diagnostic practice. Clinicians were favourable of SDA tools' psychometric properties but less favourable of diagnostic labels and feasibility in practice. Psychiatrists and psychologists were more likely than other healthcare professionals to use these tools in practice. Conclusions This review highlights that while SDA tools may aid referral decisions, evidence supporting their overall effectiveness in CAMHS is lacking. Clinician concerns pose barriers to routine use, requiring further research before implementation.https://acamh.onlinelibrary.wiley.com/doi/10.1111/camh.7000
Mannitol for cerebral oedema after acute intracerebral haemorrhage (MACE-ICH): protocol for a prospective, randomised, open-label, blinded-endpoint phase IIb trial.
Full text linkBACKGROUND: Acute intracerebral haemorrhage (ICH) is devastating with a 1 month mortality rate of ~40%. Cerebral oedema can complicate acute ICH and is associated with poor outcome. In patients with large ICH, the accompanying swelling increases mass effect and causes brain herniation. Mannitol, an osmotic diuretic, is used to treat cerebral oedema after traumatic brain injury, but its safety and efficacy in ICH is unclear. We aim to assess the feasibility of a phase II randomised, controlled trial of mannitol in patients with ICH with, or at risk of, cerebral oedema to inform a definitive trial. METHODS: The mannitol for cerebral oedema after acute intracerebral haemorrhage trial (MACE-ICH) aims to include 45 ICH participants from 10 UK sites with estimated largest diameter of haematoma volume >2 cm, presenting within 72 hours of onset with, or at risk of, cerebral oedema (limited Glasgow Coma Scale (GCS)8) with or without mass effect. Participants will be randomised (1:1:1) to 1 g/kg 10% single-dose intravenous mannitol, 1 g/kg 10% mannitol followed by a second dose at 24 hours, or standard care alone. Outcome assessors will be masked to treatment allocation. Feasibility outcomes include proportion of patients approached being randomised, participants receiving allocated treatment, recruitment rate, treatment adherence and follow-up. Secondary outcomes include serum electrolytes and osmolality at days 1-2; change in ICH and oedema volume at day 5; number of participants who developed urinary tract infection, GCS and National Institutes of Health Stroke Scale at day 5±2; length of hospital stay, discharge destination and death up to day 28; death and death or dependency by day 180 and disability (Barthel Index), quality of life (EuroQol, 5-D) and cognition (telephone mini-mental state examination) at day 180. ETHICS AND DISSEMINATION: MACE-ICH received ethics approval from the East Midlands-Leicester Central research ethics committee (22/EM/0242). The trial is funded by a National Institute for Health and Care Research RfPB grant (203080). The results will be published in an academic journal and disseminated through academic conferences and patient support groups. Reporting will be in line with Consolidated Standards of Reporting Trials recommendations. TRIAL REGISTRATION NUMBERS: ISRCTN15383301; EUDRACT 2022-000283-22
Feasibility, reach, and acceptability of social prescribing in the emergency department.
No full textBACKGROUND: Social prescribing (SP) connects individuals with community resources to address practical, social and emotional needs affecting health. While predominantly located in primary care, SP models have been introduced in some Emergency Departments (EDs). This study evaluated the feasibility, reach and acceptability of an ED-based SP pilot in the United Kingdom. METHODS: Feasibility and reach were assessed through a retrospective review of anonymised patient trackers and clinical records. Acceptability was evaluated via a staff survey exploring knowledge, attitudes and referral practices. RESULTS: Over 14 months Social Prescribers supported 1,057 ED patients, with mental wellbeing being the most common referral reason. Patients were signposted or referred to over 200 different community organisations. The programme was valued by ED staff, who recognised its potential to improve patient health and wellbeing. Reported barriers included limited awareness of the out-of-hours referral pathway. DISCUSSION: This is the first published evaluation of an ED-based SP programme, building upon existing conceptual models and qualitative studies that have explored its potential. The findings demonstrate that the model is both feasible and acceptable to staff, while effectively reaching patients with a broad range of health and social needs. Further research is needed to explore long-term impacts on patient outcomes and broader system-wide benefits
Academic psychiatry is everyone’s business : commentary, Morriss
No full textNo abstract availablehttps://www.cambridge.org/core/product/DD4B47B5355087FFF3B669603784FF7
Assessing change and establishing empirical cutoffs : the Brief INSPIRE-O measure for personal recovery in mental health services
Full text linkThe Author(s) 2025. This article is licensed under a Creative Commons
Attribution 4.0 International License, which permits use, sharing,
adaptation, distribution and reproduction in any medium or format,
as long as you give appropriate credit to the original author(s) and the
source, provide a link to the Creative Commons licence, and indicate
if changes were made. The images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not
included in the article’s Creative Commons licence and your intended
use is not permitted by statutory regulation or exceeds the permitted
use, you will need to obtain permission directly from the copyright
holder. To view a copy of this licence, visit http://creativecommons.o
rg/licenses/by/4.0/INTRODUCTION: Personal recovery in mental health services, encouraged by the World Health Organization, has gained significance in research and clinical settings. However, measuring personal recovery remains challenging due to the lack of universally accepted instruments. This study assessed Brief INSPIRE-O's ability to map personal recovery by determining cut-off scores and its ability to detect change in the process of personal recovery. METHOD: Data was from the internet-based monitoring system (IMS) at the Mental Health Service, Capital Region of Denmark. Between 2018 and 2020, 8,192 patients with baseline data on Brief INSPIRE-O were included to assess its role in measuring personal recovery. Additionally, for analyses focusing on Brief-INSPIRE-O as a measure of change in personal recovery, we included 2,714 patients with pre- and post-treatment data. MATERIALS: Brief INSPIRE-O was examined along with well-being (WHO-5) and measures of symptom distress (SCL-10), and functioning (SDS-M). RESULTS: Scores on all measures improved from pre- to post-treatment, except for functional impairment (SDS-M). Convergent validity was established with symptom distress (SCL-10; r = -0.63) and functioning (SDS-M; r = -0.55). A 10-point change in WHO-5 corresponded to an 18.9-point increase in Brief INSPIRE-O. ROC analysis identified an empirical cutoff of 50 for personal recovery and 8 points for clinically relevant change. DISCUSSION: The Brief INSPIRE-O demonstrated strong validity and sensitivity to change, supporting its use as a reliable tool for assessing personal recovery and treatment quality in clinical practice. It can be considered a relevant brief patient reported outcome measure to be used in international standards of quality and outcome monitoring.https://link.springer.com/article/10.1007/s00127-025-02948-
Effects of social support interventions on depressive symptoms and quality of life among older adults : a systematic review and meta-analysis
Full text link© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use,
sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and
the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included
in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.BACKGROUND: Interventions that include participation in social or group connections as measures to prevent or reduce depression have received little attention. This systematic review and meta-analysis aimed to determine the effects of social support interventions on depressive symptoms and Quality of life (QoL) among older adults. METHODS: A detailed search of six databases comprising Medline, CINAHL, PubMed, Cochrane Library, African Journals Online and Web of Science Core Collections was conducted until January 2025. A review protocol was developed and registered with the PROSPERO database (ID-CRD42021283342). A meta-analysis was used to synthesize the findings of the included studies based on subgroups of social support interventions. Of the 1524 articles found from the six databases, only 16 randomised controlled trials (14 parallel and 2 cluster) were eligible for inclusion. CONCLUSION: Social support interventions included emotional support, social engagement, instrumental, instrumental and appraisal, and social engagement and appraisal support. Meta-analysis findings indicated that social support interventions had non-significant effects on depression and QoL among older adults. Social support interventions have the potential to reduce depressive symptoms and improve QoL. However, current evidence is insufficient to determine the impact of social support interventions on depression and QoL in older adults.https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-025-06146-