Clin Med
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Comparative Study
Are we dressed to impress? A descriptive survey assessing patients' preference of doctors' attire in the hospital setting.
This study investigated patients' attitudes to doctors in different attires in a hospital setting. A cross-sectional descriptive survey asked 586 adult patients to rate and rank photographs of a doctor in each of the following attires: scrubs, professional informal, professional formal, smart casual, casual and white coat. They were also asked to choose the single most important feature of a doctor's appearance out of six predetermined choices. ⋯ Varying demographic groups within the hospital rated and ranked some attire differently. Daily laundered clothing was considered to be the most important feature. With patients' clear preference for white coats, its reintroduction should be given consideration and education regarding the cleanliness of scrubs may increase patient confidence.
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The primary antibody deficiency syndromes are a rare group of immunodeficiencies where diagnostic delay remains common due to limited awareness of the existence and heterogeneity of their presenting features. Referral for specialist assessment leads to earlier diagnosis and appropriate therapy to prevent or limit structural organ and tissue damage. Greater education of healthcare professionals is required to ensure prompt recognition and referral to specialists with expertise in the care of primary immunodeficiencies, especially since study of these rare conditions is a minor part of undergraduate and general postgraduate training. Greater awareness would lead to reduced morbidity, improved quality of life and survival outcomes in this patient group.
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There is little evidence to support tube feeding in advanced dementia although it is still frequently used in acute hospital settings. Patients present with complex problems and are often unable to make decisions about their healthcare needs. ⋯ This paper guides decision making in the management of patients with dementia and dysphagia in the acute hospital setting. A structured approach to information gathering, assessment and management is outlined with practical application of recent published guidelines and research evidence, which ensures appropriate individualised care.
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Plain radiographs remain useful in the acute setting. Barium studies continue to be the mainstay investigation of the GI tract but are gradually being superseded by newer techniques for example CTC and small bowel MRI. Further studies are underway to establish the clinical utility of MR and clarify its place in the repertoire of GI imaging studies.
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Attitudes to death are non-rational and culturally determined. This is relevant to concerns about shortages of organs for transplantation. ⋯ Consent is the fundamental principle of the Human Tissue Act 2004 in considering use of organs after death. These legal and ethical concerns create difficulties to be explored in a subsequent paper.