Clin Med
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Randomised controlled trials are the gold standard for testing the efficacy and safety of health interventions, especially medications, and researchers in the U. K. are required to gain approval from ethics committees, the regulatory body (Medicines and Healthcare products Regulatory Agency) and local NHS research governance departments for such trials. ⋯ K. and to the NHS's ability to deliver high-quality evidence on which doctors can base clinical decisions and improve the delivery of care. This article discusses recent experience of running large-scale clinical trials and suggests measures that could improve the current situation.
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To comply with the European Working Time Directive (EWTD), from 1 August 2009, junior doctors are required to work no more than 48 hours per week. In accordance with this, East Sussex Hospitals Trust introduced changes to working practice in August 2007. ⋯ However, there was a notable increase in episodes of sick leave among junior doctors. Implementation of the EWTD may maintain standards of patient care but may be detrimental to the welfare of doctors in training.
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Transient ischaemic attack (TIA) is the sudden onset of focal neurological dysfunction of presumed vascular origin that, by definition, resolves within 24 hours (usually much sooner). Its importance as a predictor of completed stroke has only recently been recognised. Updated guidance on the recognition and management of TIA has recently been published as part of the National Clinical Guideline for Stroke. This is a concise version of the TIA component of the full guideline that recommends an urgent response to TIA to prevent subsequent stroke.