International journal of clinical practice
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Int. J. Clin. Pract. · Oct 2010
The effect of sporting events on emergency department attendance rates in a district general hospital in Northern Ireland.
Previous studies have reported a conflicting relationship between the effect of live and televised sporting events on attendance rates to emergency departments (ED). The objectives of this study were to investigate the relationship of major sporting events on emergency department attendance rates and to determine the potential effects of such events on service provision. ⋯ This study suggests that live or televised sporting events do not significantly affect ED attendances to a DGH. However, some events appeared to be predictors of patient admission rates. Although it may be beneficial to consider the effect of sporting events on service stratification during these periods, the overall effect is probably minimal and should not create a major concern for future service provision despite the implementation of the European Working Time Directive.
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Int. J. Clin. Pract. · Sep 2010
An audit on assessment and management of pain at the time of acute hospital admission in older people.
Pain management is fundamental to good clinical care. All patients who are admitted into hospital with any acute condition should be assessed about the presence or absence of pain and managed appropriately at the time of admission. As the prevalence of pain is high in older people, we examined how well it is assessed and managed in the older people in a typical medical emergency setting in the UK. ⋯ Our findings suggest that pain management may be sub-optimal in older people in the acute medical settings. Regular monitoring and education may have potential to improve assessment and management of pain in these vulnerable older adults.
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Int. J. Clin. Pract. · Aug 2010
Randomized Controlled TrialA pilot double-blind randomised placebo-controlled trial of the effects of fixed-dose combination therapy ('polypill') on cardiovascular risk factors.
Our objective was to investigate the effects and tolerability of fixed-dose combination therapy on blood pressure and LDL in adults without elevated blood pressure or lipid levels. ⋯ The effects of the polypill on blood pressure and lipid levels were less than anticipated, raising questions about the reliability of the reported compliance. There is a case for a fully powered trial of a polypill for the prevention of cardiovascular disease.
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Is Institutional Review Board (IRB) approval and a rigorous informed consent process enough? It is our view that this is no longer the case. Conventional research ethics emphasise the importance of weighing the risks and benefits for prospective participants as one of the key determinants of deeming a clinical trial ethical. We support the notion that ethical obligations of research should include considerations not only at the individual level, but also at the community level (1,2).