Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia

Daniel L. Rolnik et al. Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia  New England Journal of Medicne 28th June 2017 

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Image source: Mike Steele – Flickr // CC BY 2.0

Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia.

This multicenter, double-blind, placebo-controlled trial, randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation.

Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a significantly lower incidence of preterm preeclampsia than that with placebo.

Full article available via the New England Journal of Medicine

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Interventions that stimulate healthy sleep in school-aged children

Busch, V. et al. (2017) European Journal of Public Health. 27(1) pp. 53-65.

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Background: Healthy sleep among children has social, physical and mental health benefits. As most of today’s children do not meet the healthy sleep recommendations, effective interventions are urgently needed. This systematic review summarizes the characteristics and effectiveness of interventions aiming to stimulate healthy sleeping in a general population of school-aged children.

Conclusion: Due to few high quality studies, evidence for the effectiveness of any particular intervention strategy to stimulate healthy sleep in children is still inconclusive. However, the more effective interventions in stimulating healthy sleep duration and adherence to regular bedtimes were mostly multi-behavioral interventions that included creating daily healthy routines and combined intervention settings (e.g. home and school). In conclusion, high-quality studies evaluating systematically developed interventions are needed to move this field forward.

Read the full article here

Does increased duration of consultant presence affect length of hospital stay?

Cromb, D. et al. Archives of Disease in Childhood. Published online: 6 December 2016

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Objectives: This study aims to review whether implementation of increased duration of consultant presence is associated with reduction in length of hospital stay (LoS) in children with an unplanned admission to hospital.

 

Conclusions: Increased duration of consultant presence was not associated with significant impact on LoS, other than in admissions of brief duration and in gastroenteritis, where diagnosis is based on clinical judgement in the absence of objective diagnostic thresholds. Future studies should focus on whether these results are generalisable across other settings, and other measures of cost-effectiveness of early consultant review, given the major implications on resource and workforce planning of such policies.

Read the full article here

Health needs of looked after children

The Local Government Association has published Healthy futures: supporting and promoting the health needs of looked after children.

This report focuses on the higher health needs of looked after children and young children which are often met less successfully than their peers, leading to poorer outcomes.  The report includes seven case studies of positive initiatives in local authorities around the country.

Numbers and circumstances

  • There are over 70,000 looked after children in England.
  • Six per cent of looked after children are unaccompanied asylum seekers.
  • The majority (75 per cent) of looked after children are placed with foster carers.
  • Over 60 per cent of children in care are looked after due to abuse and neglect.

Perinatal mental health care

Best Practice for Perinatal Mental Health Care: The Economic Case | Bauer A, Knapp M, Adeleja B (2016) | Personal Social Services Research Unit

The London School of Economics Personal Social Services Research Unit has published Best practice for perinatal mental health care: the economic case

The aim of the study was to examine the potential costs and some of the potential economic benefits of early interventions that prevent or reduce perinatal mental illness and their long-term impacts on mothers and their children thereby potentially leading to savings and other positive economic consequences.

Improving the implementation of childrens healthy eating, physical activity and obesity prevention programmes

Wolfenden, L. et al. (2016) Cochrane Database of Systematic Reviews. Issue 10. DOI: 10.1002/14651858.CD011779.pub2.

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Background: Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so.

Authors’ conclusions: Current research provides weak and inconsistent evidence of the effectiveness of such strategies in improving the implementation of policies and practices, childcare service staff knowledge or attitudes, or child diet, physical activity or weight status. Further research in the field is required.

Read the full review here

Early Intervention

Briefing Paper: Early Intervention. House of Commons Library, 7 July 2016

Early intervention is a public policy approach which encourages preventative intervention in the lives of children or their parents, to prevent problems developing later in life. Interventions can either be targeted at children deemed to be at higher risk of disadvantage, or can be universal in scope.

As well as the political and social benefits of preventing poor outcomes in later life, such as mental health problems, low educational attainment and crime, advocates of early intervention also cite economic benefits to the approach. This is based on the argument that preventative policies cost less to implement than reactive policies.

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image source: researchbriefings.parliament.uk/

This paper provides information and analysis on early intervention policies aimed at parents and children from conception to age five, covering health, education, social development and financial benefits.

This paper also looks at broader arguments around early intervention as a policy approach.

 

You can view the full document here