Brit J Hosp Med
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This article discusses the nutritional needs of moderate and late preterm infants (born between 32+0weeks and 36+6weeks' gestation) and makes recommendations for best practice both while these infants are in hospital and when they are discharged into the community. These recommendations were derived following a roundtable meeting of a group comprising two neonatologists, three paediatric dietitians, a health visitor/paediatric nurse and a midwife practitioner. The meeting and medical writing assistance was sponsored by Nutricia. None of the participants accepted honoraria for their contributions to the discussion.
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Most life-threatening conditions form a coherent clinical picture, with examination findings confirming the patient's history. However, pain out of proportion to examination findings can also signify an emergency - acute compartment syndrome, bowel ischaemia, necrotising fasciitis and acute aortic dissection may all present in this way. ⋯ Patients with unexplained pain risk significant morbidity and mortality, and doctors are vulnerable to litigation and reputational damage. This article addresses this danger, exploring the causes and pathology of pain that is out of proportion, and presenting an approach to mitigate risk and prevent catastrophe.
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Most international medical graduates obtain a non-training job, such as a trust grade role, when they first start work in the UK. This transition into a new healthcare system comes with many sociocultural and educational challenges. The aim of this study was to learn more about the different types of challenges and propose solutions where possible. ⋯ This study highlighted the challenges faced by international medical graduates in trust grade roles and proposed solutions where possible. Although responses varied, educational barriers were the most widely highlighted concern. To understand the full extent of these hurdles, perceptions of other healthcare professionals should be explored.