Cochrane Collaboration

About: Cochrane Collaboration is a nonprofit organization based out in Oxford, United Kingdom. It is known for research contribution in the topics: Systematic review & Randomized controlled trial. The organization has 1995 authors who have published 3928 publications receiving 382695 citations.

Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library

Abstract: Peto estimates that current cigarette smoking will cause about 450 million deaths worldwide in the next 50 years Reducing current smoking by 50% would avoid 20–30 million premature deaths in the first quarter of the century and about 150 million in the second quarter1 Preventing young people from starting smoking would cut the number of deaths related to tobacco, but not until after 2050 Quitting by current smokers is therefore the only way in which tobacco related mortality can be reduced in the medium term There is evidence that some form of treatment aids an increasing number of successful attempts to quit2 This review aims to summarise evidence for the effectiveness of the available interventions #### Summary points Advice from doctors, structured interventions from nurses, and individual and group counselling are effective interventions Generic self help materials are no better than brief advice but more effective than doing nothing; personalised materials are more effective than standard materials All forms of nicotine replacement therapy are effective The antidepressants bupropion and nortriptyline increased quit rates in a small number of trials; the usefulness of the antihypertensive drug clonidine is limited by side effects Anxiolytics and lobeline are ineffective The effectiveness of aversion therapy, mecamylamine, acupuncture, hypnotherapy, and exercise is uncertain The Cochrane Tobacco Addiction Review group identifies and summarises the evidence for interventions to reduce and prevent tobacco use; it produces and maintains systematic reviews to inform policymakers, clinicians, and individuals wishing to stop smoking Twenty systematic reviews are available in the Cochrane Library and have contributed to the evidence base for smoking cessation guidelines3 Details of the methods and results of each review are available in the Cochrane Library (abstracts at wwwupdate-softwarecom/ccweb/cochrane/revabstr/g160indexhtm) The reviews summarise results from randomised controlled trials with at least six …

The marine ecosystem of Kongsfjorden, Svalbard

Abstract: Kongsfjorden is a glacial fjord in the Arctic (Svalbard) that is influenced by both Atlantic and Arctic water masses and harbours a mixture of boreal and Arctic flora and fauna. Inputs from large tidal glaciers create steep environmental gradients in sedimentation and salinity along the length of this fjord. The glacial inputs cause reduced biomass and diversity in the benthic community in the inner fjord. Zooplankton suffers direct mortality from the glacial outflow and primary production is reduced because of limited light levels in the turbid, mixed inner waters. The magnitude of the glacial effects diminishes towards the outer fjord. Kongsfjorden is an important feeding ground for marine mammals and seabirds. Even though the fjord contains some boreal fauna, the prey consumed by upper trophic levels is mainly Arctic organisms. Marine mammals constitute the largest top-predator biomass, but seabirds have the largest energy intake and also export nutrients and energy out of the marine environment. Kongsfjorden has received a lot of research attention in the recent past. The current interest in the fjord is primarily based on the fact that Kongsfjorden is particularly suitable as a site for exploring the impacts of possible climate changes, with Atlantic water influx and melting of tidal glaciers both being linked to climate variability. The pelagic ecosystem is likely to be most sensitive to the Atlantic versus Arctic influence, whereas the benthic ecosystem is more affected by long-term changes in hydrography as well as changes in glacial runoff and sedimentation. Kongsfjorden will be an important Arctic monitoring site over the coming decades and a review of the current knowledge, and a gap analysis, are therefore warranted. Important knowledge gaps include a lack of quantitative data on production, abundance of key prey species, and the role of advection on the biological communities in the fjord.

Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review

Abstract: Objective To systematically review evidence for the effectiveness of physical interventions to interrupt or reduce the spread of respiratory viruses. Data extraction Search strategy of the Cochrane Library, Medline, OldMedline, Embase, and CINAHL, without language restriction, for any intervention to prevent transmissionofrespiratoryviruses(isolation,quarantine, social distancing, barriers, personal protection, and hygiene). Study designs were randomised trials, cohort studies, case-control studies, and controlled before and after studies. Data synthesis Of 2300 titles scanned 138 full papers were retrieved, including 49 papers of 51 studies. Study qualitywaspoorforthethreerandomisedcontrolledtrials and most of the cluster randomised controlled trials; the observational studies were of mixed quality. Heterogeneity precluded meta-analysis of most data except that from six case-control studies. The highest quality cluster randomised trials suggest that the spread of respiratory viruses into the community can be prevented by intervening with hygienic measures aimed at younger children. Meta-analysis of six case-control studies suggests that physical measures are highly effective in preventing the spread of SARS: handwashing more than 10 times daily (odds ratio 0.45, 95% confidence interval 0.36 to 0.57; number needed to treat =4, 95% confidence interval 3.65 to 5.52); wearing masks (0.32, 0.25 to 0.40; NNT=6, 4.54 to 8.03); wearing N95 masks (0.09, 0.03 to 0.30; NNT=3, 2.37 to 4.06); wearing gloves (0.43, 0.29 to 0.65; NNT=5, 4.15 to 15.41); wearing gowns (0.23, 0.14 to 0.37; NNT=5, 3.37 to 7.12); and handwashing, masks, gloves, and gowns combined (0.09, 0.02 to 0.35; NNT=3, 2.66 to 4.97). The incremental effect of adding virucidals or antiseptics to normal handwashing to decrease the spread of respiratory disease remains uncertain. The lack of proper evaluation of global measures such as screening at entry ports and social distancing prevent firm conclusions being drawn. Conclusion Routine long term implementation of some physical measures to interrupt or reduce the spread of