From:                              Canadian Cochrane Network and Centre [carratoo@uottawa.ca]

Sent:                               Tuesday, February 10, 2009 2:01 PM

To:                                   cochrane@UOTTAWA.CA

Subject:                          Relay Cochrane! - Volume 7

 

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Canadian Cochrane Network and Centre Newsletter

< Volume 7 - February 2009 >

In the News

Cochrane is growing in Quebec!

The Centre de recherche du Centre hospitalier universitaire de Québec (CRCHUQ) and Université Laval’s Cochrane network site is expanding its activities! By supporting a part-time Research Coordinator, Martine Magnan, MSc, MBA, CRCHUQ can allow researchers to carry out systematic reviews in the fields of knowledge translation and exchange, shared decision making, health policies and e-health. Moreover, they are happy to report new funding from the CIHR knowledge synthesis competition for two reviews on patient and public involvement in clinical practice guidelines and electronic health records.

Recently, two successful standard author trainings (in French) were organized with local trainers Marie-Pierre Gagnon, Karine Gravel and Merlin Njoya.

Cochrane consumer recognized

M. Jean Légaré received a doctorate honoris causa from Université Laval for his dedication as a volunteer arthritis advocate and his leadership in many patient organizations. M. Légaré has been very involved as a consumer representative with the Cochrane Musculoskeletal Review Group. He strongly believes in the power of patients to make things happen.

Dr. Peter Tugwell named Canadian Health Researcher of the Year

Dr. Peter Tugwell of the University of Ottawa (Professor, Faculty of Medicine) and Co-editor of the Cochrane Musculoskeletal Review Group and Co-convenor of the Cochrane Health Equity Field, was named Canada's 2008 Health Researcher of the Year for Health Services and Systems and Population Health Research. Dr. Tugwell receives the prestigious Canadian Institutes of Health Research (CIHR) Michael Smith Prize.

Cochrane for Practice

Canadian Prehospital Cochrane Corner - A new evidence resource for paramedics

The Canadian Prehospital Evidence Based Protocols project has joined forces with the Canadian Cochrane Network and Centre in an effort to improve the evidence available to support the care delivered by paramedics in Canada. The Canadian Prehospital Cochrane Corner lists Cochrane reviews related to emergency medical services, which are added to the Protocol project’s database.

Find out more about the Protocols project at the upcoming Canadian Cochrane Symposium, where translating evidence to paramedic practice will be discussed. For more information, email jljensen@dal.ca.

Cochrane for Policy

New tutorial walks users through Rx for Change

CADTH has launched an online tutorial to help users navigate the Rx for Change database - a unique interventions database that summarizes current research evidence about the effects of strategies to improve drug prescribing and use.

The tutorial outlines how the database is organized, the interventions that are available, and provides tips and case studies that demonstrate how to use the database in the real world.

Interventions for increasing the proportion of health professionals practising in rural and other underserved areas

The inequitable distribution of health care professionals is a concern and many educational, financial and regulatory interventions have been used to address this imbalance. However, the authors of this review were not able to find any studies in which bias and confounding are minimized in the design, to support or refute these approaches.

Interventions for promoting information and communication technologies adoption in healthcare professionals

Many healthcare professionals have yet to take advantage of information and communication technologies (ICT) in their practice. This review found limited evidence for the effectiveness of interventions promoting the adoption of ICT in the practice of healthcare professionals. These interventions included educational meetings, distribution of educational materials, and educational outreach visits teaching the use of electronic databases and digital libraries.

Cochrane Library Spotlight - Issue 1, 2009

 

Anakinra for rheumatoid arthritis
Rheumatoid arthritis reduces a person’s mobility paired with joint stiffness and pain and can be debilitating for those affected. Anakinra, a biologic, was found to be modestly effective in treating the symptoms of rheumatoid arthritis as compared to placebo and relatively safe. Although no head-to-head trials are available, when compared to the results of other biologic therapies, the absolute treatment benefit compared to placebo is less with anakinra.

Robot assistant for laparoscopic cholecystectomy
Using a robotic assistant to remove a patient’s gallbladder by key-hole surgery (laparoscopic cholecystectomy) is as safe as working with a human assistant, this review concludes. Comparisons between robot- and human-assisted surgery showed that there were no differences in terms of morbidity, the need to switch to open surgery, total operating time, or length of stay in hospital.

Alternative therapies

Acupuncture for migraine prophylaxis
Currently, those suffering from migraine headaches may take medicine to avoid the migraine. There is now consistent evidence to indicate the prophylactic effect of acupuncture. This updated review with 12 additional trials shows that acupuncture prevents migraines when added to basic care and has fewer side effects than prophylactic drug treatment. However, in other trials, sham acupuncture was also effective in reducing the migraine frequency, suggesting that needle placement is less critical than thought.

Diabetes

Individual patient education for people with type 2 diabetes mellitus
Patient education is an integral component of diabetes care; however, there is uncertainty as to the effectiveness of different educational approaches. Individual face-to-face patient education for type 2 diabetes over a 6-12 month period benefited patients with a baseline HbA1c greater than 8%. In other studies, there was no difference in the impact of individual vs group education on HbA1c levels.

Senior’s health

Orthotic devices after stroke and other non-progressive brain lesions
A recent systematic review found that a foot-drop splint can help people walk and maintain balance after stroke or non-progressive brain lesions in the short term. This therapy does not help with activities like climbing stairs. There is insufficient evidence to make conclusions about the benefits of upper limb orthosis in these patients.

Rehabilitation therapies

Rehabilitation for older people in long-term care
This review of 49 trials concludes that many different types of physical rehabilitation benefit physical and mental health and are safe for older people in long term care. Since a variety of interventions was studied, the size and duration of the effects of physical rehabilitation approaches is unclear.

Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease (COPD)
In patients with unstable COPD who have suffered from an exacerbation recently, the effects of pulmonary rehabilitation are not established. This review concludes that pulmonary rehabilitation appears to be a highly effective and safe intervention in these patients. It is likely to reduce the risk for future hospital admissions and mortality compared with no rehabilitation. Quality of life was also substantially improved.

Child Health

The Cochrane Library and long-acting beta-agonist treatment for childhood asthma: An overview of reviews
One treatment option used to control asthma symptoms is the class of medications known as the long acting 2-agonists (LABA) and they are often used in combination with inhaled corticosteroids (ICS). The use of LABA in children has been widely debated in the literature. This overview of reviews from The Cochrane Library found no clear benefit to LABA in preventing asthma exacerbations in children. Currently, ICS should remain the controller therapy of choice. The addition of LABA to ICS may result in some improvements, however there is a greater risk of adverse events as compared to ICS alone or with placebo.

Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment
Children who have suffered abuse or neglect are vulnerable and typically placed in care out of the home. A recent review of 62 studies found that kinship care- placing children with relatives - resulted in fewer behavioural and mental health problems and more stable placements than placing children in foster care. Children in traditional foster care were more likely to use mental health resources and to be adopted.

Obesity

Interventions for treating obesity in children
Obese children run a greater risk of poor health as adults. Additional studies in this updated review identifies family-based changes in a child’s diet and encouraging more physical activity can result in weight loss compared to standard care or self help approaches. Drug therapy can be used in combination with lifestyle changes, but the drugs, orlistat and sibutramine, were associated with negative side effects.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18
Increased activity during school has been one approach to reduce the growing number of obese young people in western countries. This review shows a positive impact of school-based activity programs on reducing blood cholesterol and the amount of time students watch television. However, other outcomes such as physical activity during leisure time, blood pressure or body mass index were not affected.

Public health

Interventions for preventing weight gain after smoking cessation
A low calorie diet and cognitive behavioural therapy (CBT) were most effective in long-term smoking cessation and preventing weight gain, but longer-term CBT was more effective in maintaining weight-loss. There is not enough evidence about low calorie diets to make the same claim. Replacement therapies, naltrexone and varenicline also were effective in preventing weight gain but it is unknown if weight is maintained after ending therapy. Finally, more research is needed to draw a firm conclusion on the effects of exercise.

What’s Ahead

Understanding systematic and literature reviews

March 31, 2009; 9:30 – 11:00 EST
Host: CCNC and Seniors Health Research Transfer Network
Location: Webinar, Registration
Contact: Cheryl Arratoon (carratoo@uottawa.ca) or Nancy Roberts (NRoberts@bruyere.org);

Systematic reviews and meta-analyses of diagnostic reviews workshop

May 25-26, 2009
Host: Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute and Cochrane Infectious Diseases Group
Location: McGill University Health Centre, Montreal
Contact: Dr. Madhukar Pai: madhukar.pai@mcgill.ca or Danielle Bastien: danielle.bastien@mcgill.ca

14th International Congress on Circumpolar Health

July 11-16, 2009
Yellowknife, NT

Funding

Evidence on Tap-Expedited Knowledge Synthesis – apply now!

This competition awards teams of researchers up to $110,000 to produce a knowledge synthesis on a Ministry-identified health system priority within six months and to host a KT end-of-synthesis workshop to assist decision makers in the interpretation and contextualization of the findings.
Deadline: March 16, 2009.

funding opportunity guidelines

Contact: McMahon (meghan.mcmahon@utoronto.ca or 416-978-5172)

 

 

Registration now open!
7th Annual Canadian Cochrane Symposium

Wave to the Future - Navigating the Health Connection among Systematic Reviews, Policies and Practices

March 11-12, 2009
Halifax, Nova Scotia
www.wavetothefuture.ca

March 9-10 Pre-symposium workshops

Hosted by the Nova Scotia Health Research Foundation and CCNC.

 

 

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