Reviews

Workplace interventions for smoking cessation
1. We found strong evidence that some interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling, pharmacological treatment to overcome nicotine addiction, and multiple interventions targeting smoking cessation as the primary or only outcome. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.2. We failed to detect an effect of comprehensive programmes targeting multiple risk factors in reducing the prevalence of smoking, although this finding was not based on meta-analysed data. 3. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer, although one trial demonstrated a sustained effect of financial rewards for attending a smoking cessation course and for long-term quitting. Further research is needed to establish which components of this trial contributed to the improvement in success rates.4. Further research would be valuable in low-income and developing countries, where high rates of smoking prevail and smoke-free legislation is not widely accepted or enforced. Cahill K, Lancaster T. Cochrane Database Syst Rev. 2014 Feb 26;2:CD003440. [Epub ahead of print] PMID: 24570145

Probiotics for preventing gestational diabetes
One trial has shown a reduction in the rate of GDM when women are randomised to probiotics early in pregnancy but more uncertain evidence of any effect on miscarriage/IUFD/stillbirth/neonatal death. There are no data on macrosomia. At this time, there are insufficient studies to perform a quantitative meta-analysis. Further results are awaited from four ongoing studies. Barrett HL, Dekker Nitert M, Conwell LS, Callaway LK. Cochrane Database Syst Rev. 2014 Feb 27;2:CD009951. [Epub ahead of print] PMID: 24574258

Mechanical versus manual chest compressions for cardiac arrest
Evidence from RCTs in humans is insufficient to conclude that mechanical chest compressions during cardiopulmonary resuscitation for cardiac arrest are associated with benefit or harm. Widespread use of mechanical devices for chest compressions during cardiac events is not supported by this review. More RCTs that measure and account for the CPR process in both arms are needed to clarify the potential benefit to be derived from this intervention. Brooks SC, Hassan N, Bigham BL, Morrison LJ. Cochrane Database Syst Rev. 2014 Feb 27;2:CD007260. [Epub ahead of print] PMID: 24574099

Psychological therapies (Internet-delivered) for the management of chronic pain in adults
There is insufficient evidence to make conclusions regarding the efficacy of psychological therapies delivered via the Internet in participants with headache conditions. Psychological therapies reduced pain and disability post-treatment; however, no clear evidence of benefit was found for depression and anxiety. For participants with non-headache conditions, psychological therapies delivered via the Internet reduced pain, disability, depression, and anxiety post-treatment. The positive effects on disability were maintained at follow-up. These effects are promising, but considerable uncertainty remains around the estimates of effect. These results come from a small number of trials, with mostly wait-list controls, no reports of adverse events, and non-clinical recruitment methods. Due to the novel method of delivery, the satisfaction and acceptability of these therapies should be explored in this population. These results are similar to those of reviews of traditional face-to-face therapies for chronic pain. Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Cochrane Database Syst Rev. 2014 Feb 26;2:CD010152. [Epub ahead of print] PMID: 24574082

Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia
There is insufficient evidence to justify the use of bright light therapy in dementia. Further research should concentrate on replicating the suggested effect on ADLs, and establishing the biological mechanism for how light therapy improves these important outcomes. Forbes D, Blake CM, Thiessen EJ, Peacock S, Hawranik P. Cochrane Database Syst Rev. 2014 Feb 26;2:CD003946. [Epub ahead of print] PMID: 24574061