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Background Most telephone quitlines provide free nicotine replacement therapy (NRT). An 8-week course is recommended, but few users complete it. Information is needed to help quitlines distribute NRT cost-effectively. Design Randomised two-group trial. Setting/participants Colorado QuitLine callers who smoked 16-20 cigarettes per day at enrolment and who were eligible for and agreed to receive free NRT. Intervention Provision of 4-week versus 8-week NRT supply; the 8-week supply was shipped in halves and required participants to request the second half (split-shipment protocol). Enrolment occurred during March 2010-February 2011, follow-up concluded in November 2011, and analysis was performed in 2012. Main outcome measures Point abstinence (7 and 30 day) and prolonged abstinence (6 month) from tobacco use. Results Overall, 1495 study participants were enrolled and 57.7% completed follow-up. Abstinence rates did not differ significantly between study conditions: 13.8% versus 12.4% in 4-week versus 8-week arms, respectively, (30-day point abstinence, non-respondents treated as smokers). NRT duration was similar in both groups, due in part to purchase of additional patches in the 4-week group. About one-third of the 8-week group requested the full 8-week supply and had higher abstinence rates. Cost per quit was lower in the 4-week (compared to 8-week) group. Conclusions A randomised trial did not find worse cessation outcomes among quitline users who received half the minimum recommended course of NRT, but offering the full recommended course using a split-shipment protocol may be reasonably cost-effective and supportive of NRT adherers. Trial registration number NCT01889771. [ABSTRACT FROM AUTHOR]

OBJECTIVE To examine the traditional diet-heart hypothesis through recovery and analysis of previously unpublished data from the Minnesota Coronary Experiment (MCE) and to put findings in the context of existing diet-heart randomized controlled trials through a systematic review and meta-analysis. DESIGN The MCE (1968-73) is a double blind randomized controlled trial designed to test whether replacement of saturated fat with vegetable oil rich in linoleic acid reduces coronary heart disease and death by lowering serum cholesterol. Recovered MCE unpublished documents and raw data were analyzed according to hypotheses prespecified by original investigators. Further, a systematic review and meta-analyses of randomized controlled trials that lowered serum cholesterol by providing vegetable oil rich in linoleic acid in place of saturated fat without confounding by concomitant interventions was conducted. SETTING One nursing home and six state mental hospitals in Minnesota, United States. PARTICIPANTS Unpublished documents with completed analyses for the randomized cohort of 9423 women and men aged 20-97; longitudinal data on serum cholesterol for the 2355 participants exposed to the study diets for a year or more; 149 completed autopsy files. INTERVENTIONS Serum cholesterol lowering diet that replaced saturated fat with linoleic acid (from corn oil and corn oil polyunsaturated margarine). Control diet was high in saturated fat from animal fats, common margarines, and shortenings. MAIN OUTCOME MEASURES Death from all causes; association between changes in serum cholesterol and death; and coronary atherosclerosis and myocardial infarcts detected at autopsy. RESULTS The intervention group had significant reduction in serum cholesterol compared with controls (mean change from baseline-13.8% y-1.0%; P<0.001). Kaplan Meier graphs showed no mortality benefit for the intervention group in the full randomized cohort or for any prespecified subgroup. There was a 22% higher risk of death for each 30 mg/dL (0.78 mmol/L) reduction in serum cholesterol in covariate adjusted Cox regression models (hazard ratio 1.22, 95% confidence interval 1.14 to 1.32; P<0.001). There was no evidence of benefit in the intervention group for coronary atherosclerosis or myocardial infarcts. Systematic review identified five randomized controlled trials for inclusion (n=10 808). In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease (1.13, 0.83 to 1.54) or all cause mortality (1.07, 0.90 to 1.27). CONCLUSIONS Available evidence from randomized controlled trials shows that replacement of saturated fat in the diet with linoleic acid effectively lowers serum cholesterol but does not support the hypothesis that this translates to a lower risk of death from coronary heart disease or all causes. Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid. [ABSTRACT FROM AUTHOR]

The article presents a study on patient controlled analgesia (PCA) in emergency department patients afflicted with non-traumatic abdominal pain. Topics include the Pain Solutions in the Emergency Setting (PASTIES), PCA's comparison to routine care, and an increased use of morphine in patients with PCA. It also features a table of the primary outcome of total pain experienced and secondary outcomes.

The article discusses research which compared effectiveness of ciclosporin and prednisolone in treating pyoderma gangrenosum. Topics explored include the speed of ulcer healing associated with these drugs, the daily drug dosage administered to research participants, and the adverse reactions recorded in both treatment groups such as acute kidney injury and infection.

The article examines the effectiveness of transcranial direct current stimulation (tDCS) preceding cognitive behavioral management for patients experiencing chronic low back pain. Topics discussed include pain intensity and disability as primary outcome measures and the staging of a double blind parallel group randomized controlled trial with a six month follow up. The inability of tDCS to pain or disability and the outcomes of a cognitive behavioral group program is mentioned.

The article discusses research which investigated effectiveness of a school-based education programme in reducing salt intake of children and their families. Topics explored include the measurement of salt intake through urinary sodium excretion measurement, the salt reduction message relayed to children and their families, and the salt intake changes recorded in both intervention and control groups studied.

The article presents a study on the effectiveness of integrated collaborative care in managing depression in people with multimorbidity. Topics covered include the reduction in depression severity at four months, the collaborative care integrative depression care in primary care, and the results of the complete case analyses.

The article presents a study on the occupational therapy intervention for residents with stroke related conditions in care homes in Great Britain. Topics covered include the Barthel index of activities of daily living, an individualized course of occupational therapy targeting stroke related disabilities, and cognitive impairment.

The article discusses research which examined the impact of financial incentives for smoking cessation in pregnancy in Great Britain. Topics covered include the cost of healthcare associated with smoking during pregnancy, the percentage of smokers in the incentives group who stopped smoking and the higher levels of nicotine dependence found in control group smokers.

The article discusses an Australian study which found that intervention families reported a greater decline in severity of attention deficit hyperactivity disorder (ADHD) symptoms and fewer moderate-severe sleep problems at three months and six months compared with the control families. It cites the involvement of 244 children aged 5-12 years with ADHD in the study. It also mentions the participation of parents and teachers in reporting the severity of ADHD symptoms.

The article discusses the clinical trials for the adult patients with a dorsally displaced fracture of the distal radius which require for surgical fixation in Great Britain. It examines the medical outcomes for the patients rated wrist evaluation (PRWE) score, the disabilities of arm, shoulder, and hand (DASH) and surgery complications. It also notes that the trials was conducted by the surgeons and specialists of the National Health Service (NHS) hospitals.

The article presents a study which examined whether individuals at high risk of cardiovascular disease can be effectively managed by non-clinical staff through the use of digital health technologies and the telephone. Based on the results, participants who received intervention registered lower blood pressure and weight but not in cholesterol level, smoking status and cardiovascular risk. The other observed benefits include improved physical activity and drug adherence.