Objectives: Many universities use peer support programmes to support students. However, there are currently no guidelines on the most effective way of facilitating emotional wellbeing in students. The aim of this paper is to review the evidence for the effectiveness of peer support to improve mental health wellbeing in university students.

Our results indicate minor advantages for using FTA over nasal packing. Unfortunately, the included studies show significant heterogeneity and risk of bias. Based on the available evidence, clinicians must balance the higher cost of FTA against the limited advantages for the patient.

imaging or treatment modalities and percentages of clinicians reporting to use modalities were extracted from the responses. Statistical comparisons were performed in Excel and SPSS, and confidence intervals were estimated using bootstrapping. RESULTS: In total 69 responses were received (Sweden (n¼20), UK (n¼16), Northern and Western Europe (n¼17), Southern Europe (n¼9) and Central Europe (n¼7). Large variation between geographical areas was seen in the way clinicians diagnose patients. For example, when presented with a theoretical 45year-old smoking female with a suspected acute coronary syndrome, 57% of UK clinicians said they used coronary CTA, compared to only 10% of Swedish clinicians (p¼0.002). Large variations were observed regarding the use of fractional flow reserve (FFR) to guide percutaneous coronary intervention (PCI) when dealing with non-culprit lesions in STEMI patients: while high rates are reported for Sweden, the UK and Northern and Western Europe (44%, 31% and 30% respectively), clinicians in Central and Southern Europe reported not using this technique at all. CONCLUSIONS: This study suggests that MI care varies widely between European countries. Larger studies or real world data are needed to verify these findings. More research is needed to compare the quality (process and outcomes) of MI care across countries and ultimately explore critical pathways to improve it. OBJECTIVES:The purpose of this study was to present the clinical, patient-reported outcome measures (PROMs) and economic outcomes associated with enhanced recovery programs (ERPs) for total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: A systematic literature review investigating THA and TKA ERPs in Europe, Middle East and Africa, published 2012-2017, was conducted in MEDLINE and other sources. RESULTS: Thirty-four publications were identified; 23 THA and 22 TKA. Of the 34 studies, 21 were prospective and 13 retrospective. Twenty-five studies were multi-arm, 20% had non-ERPs as the comparator. Three THA studies reported clinical outcomes using the Harris Hip Score; one study compared ERP to non-ERP, demonstrating significant improvements at 12 months from baseline of 41.51 and 42.8, respectively. No TKA studies reported clinical outcomes. One of 10 studies reporting PROMs, compared ERP to non-ERP with similar results for TKA and THA. Length of stay (LOS) was improved compared to non-ERPs, by 1.6-2 days for THA and 1.2 days for TKA. ERP readmission rates improved by 0.1-3.5% for THA and by 2% for TKA compared to non-ERPs. One study compared the rate of discharge on the day after surgery, with 30% more discharged in THA ERP group vs non-ERP. ERPs did not compromise patient safety compared to non-ERPs, as indicated by: 0.9% improvement in mortality rate in THA, 2.9% improvement in complication rates, and 11% improvement in transfusion rate in TKA. Patient satisfaction scores were higher in ERPs vs non-ERPs. THA and TKA ERPs were associated with total net cost savings of £401.64 and £76.67 per patient, respectiv...