British journal of hospital medicine
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The use of opioids for chronic pain of non-malignant origin remains controversial. However, problems anticipated from experience with animal experiments and pain-free abusers seldom cause difficulties when opioids are used appropriately to treat pain. With sensible guidelines, and in the context of a multidisciplinary pain clinic, opioids may provide the only hope of relief to many sufferers of chronic pain.
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Paediatric intensive care has developed into a highly specialized and labour-intensive clinical activity. The provision of adequate numbers of properly staffed children's intensive care beds within the UK, and the lack of national planning and coordination are both problematic. This article examines these problems and discusses current thinking on the provision of paediatric intensive care services.
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Adults and children have cardiac arrests for very different reasons. The commonest reason for an adult cardiac arrest is a primary arrhythmia in association with ischaemic heart disease, i.e. ventricular fibrillation. Children have cardiac arrests because of respiratory failure, hypovolaemia (due to trauma and dehydration) and sepsis.
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This paper proposes a new way of managing the provision of flexible training opportunities by job-sharing. It shows how the difficulties of implementing job-sharing can be overcome, and gives an example of implementation of job-sharing in the context of flexible training.