Clin Med
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Clinical academia is not in crisis--it has a rosy future if you really celebrate and respect it as an activity, if you ensure a supply of graduates committed to research, if you get the relationship right with your key partners, if you get the best facilities for prosecuting research, and finally if you use all the possibilities to ensure that academics are properly rewarded both in morale and money.
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Severe acute respiratory syndrome (SARS) is a newly emerged disease that rapidly spread around the world. The disease originated in southern China and a novel coronavirus (SARS CoV) has been implicated as the causative organism. The path this virus took to set up human infection remains a mystery, though preliminary data point to origins in an animal reservoir. ⋯ The management principles are broadly similar to treating any community acquired pneumonia but the infection control measures take a pivotal role. There is no proven antiviral agent against SARS CoV. The most remarkable feature about the SARS epidemic was the speed with which the global community acted in a coordinated way to control it.
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Intermittent failures of healthcare delivery culminating in patient safety incidents are an international problem. Collecting information on incidents and where necessary analysing causes allows problems to be identified which, when resolved, can prevent future errors and incidents. To support incident reporting, it is vital to have an effective data collecting system and, in addition, an open and fair culture where those who report are supported and not punished. Where this has been introduced, large numbers of incidents are identified and solutions that improve patient safety can be implemented.
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The national clinical guidelines for Rehabilitation following acquired brain injury were developed by a multidisciplinary working party convened by the British Society of Rehabilitation Medicine, and are published in collaboration with the Royal College of Physicians (2003). They have been produced to complement the National Institute of Clinical Excellence head injury guidelines, and to address the medium- to longer-term needs of patients with acquired brain injury and of their families/carers. This article serves as an introduction to make physicians aware of the guidelines, and to highlight in particular the advice to doctors in the acute services regarding early discharge and referral to rehabilitation.
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As awareness grows of the palliative care needs of those diagnosed with advanced life-threatening illness other than cancer, consideration needs to be given to how to address these needs. This paper focuses on palliative care for those with such diagnoses by describing variations in illness trajectory according to diagnosis, and exploring how this may affect provision of palliative care.