Clin Med
-
Little research has been performed to determine how a stroke unit should be staffed and what the links are between patient dependency and staffing. For this study, 140 stroke units were randomly selected--35 from each of the four quartiles of performance in the National Sentinel Audit of Stroke. A questionnaire was sent to each of the units to collect data on patient numbers and dependency, staffing numbers and therapy, and nursing contact times on a single weekday. ⋯ Of the patients, 74% received physiotherapy, 46% occupational therapy and 25% speech and language therapy during the day with median contact times being 170 minutes for nursing, 40 minutes for physiotherapy, 45 minutes for occupational therapy and 30 minutes for speech therapy. There was a weak correlation between patient dependency and contact time with nurses and therapists. Stroke patients in England receive relatively little rehabilitation from therapists and there is a wide variation in the amount of nursing time each patient receives.
-
Progress in complex disorders requires clear thinking facilitated by clear language. Clinicians and scientists occasionally become captive to inaccurate language or meaningless terminology and this generates lazy thinking and impedes progress. ⋯ Among other FGIDs, the situation is more serious; imprecision and lack of consistency in terminology continue to mar progress. This article reviews the chequered history of terminology in this area and concludes that removing the obfuscation generated by poor usage of language should be the first step towards understanding the pathogenesis and improving the management of these, and similar, disorders.
-
The 25th anniversary of the first reports of a catastrophic illness later classified as AIDS and the 10th anniversary of highly active antiretroviral therapy (HAART) both occurred in 2006. Where available, HAART has revolutionised the treatment of HIV. ⋯ These anniversaries allow us to appreciate the milestones achieved thus far and those yet to be achieved. Only a collaborative global effort will stop the epidemic from overwhelming efforts to contain it.
-
Climate change was originally expected to have its main impact on countries in temperate latitudes which, because of their relative wealth, would be best able to cope. It is now far more likely that much poorer states in the tropics and sub-tropics will experience severe impacts. ⋯ The dangerous response to the prospects of mass migration and radical social movements is to attempt to maintain control without addressing underlying problems. Instead, there is an urgent need to embrace new concepts of sustainable security.