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The purpose of this study was to audit the outcome in terms of change in practice of the published research from one volume of the British Medical Journal. All original papers and short reports from one Volume 296 of the British Medical Journal (BMJ) 1988 were read and classified into theoretical only, practical and theoretical and practical. Those papers with any practical message were reviewed by one of a panel of specialists in the subject of the paper to assess if the recommendation made by the paper had become common clinical practice. The results show that most papers originated from teaching centres and research institutes in the UK. Only 8% of main papers and 6% of short reports had a solely practical application, although a further 18% and 22% had practical elements. The majority of the recommendations aimed at changing practice were of relevance to hospital specialists rather than general practitioners (GPs). Of the papers with any practical implications 48% (12% of the total) of main papers and 41% (11% of the total) of short reports were considered to be current practice. The reasons why the papers failed to change practice are discussed. In conclusion, the majority of the original research papers published in the BMJ in 1988 were of a theoretical nature and only about 20% of papers made recommendations for a change in practice. About 50% of the recommendations are now current practice. [ABSTRACT FROM AUTHOR]

The article presents a paper that aims to describe the Hospital Annexe in HMP Wormwood Scrubs, a unique example of a therapeutic community within a maximum security prison in Great Britain. Furthermore, it aims to discuss the implications of the management and process of such a unit. A discussion on the evaluation by means of reconviction data will also be presented.

The article provides information on papers discussed at a meeting of the Section of Rheumatology and Rehabilitation of the Royal Society of Medicine held in Great Britain in 1984. The forum opened with a paper on primary multifocal fibrositis and chronic benzodiazepine. Doctor T. D. Kennedy presented a paper on crystal deposition in the knee and great toe joints of asymptomatic gout patients. Doctor A. N. Bamji introduced a follow-up study of the treatment of ankylosing spondylitis with radiotherapy.

During the latter half of 1990 the Royal Air Force established a medical evacuation chain in support of the British First Armoured Division during Operation Granby (known as Operation Desert Storm in the USA). Medical contingency plans, formulated prior to embarkation from the UK, foresaw the need for five aeromedical staging facilities sub-deployed throughout the east of the Arabian Peninsula. The early days of the deployment found personiel busy with the construction of tented and hardened facilities and with the establishment of local operating procedures. Many problems were initially encountered, especially with supply, communications and in co-ordinating with collaborating coalition and host nation units. Nevertheless, progress was rapid and non-combatant operations were started within days of arrival. As the ground offensive became more imminent, traning took on a sense of urgency. Advanced first aid techniques were taught to all non-medical staff, whereas doctors, nurses and paramedical personnel were taught ACLS and ATLS skills. All studied field hygiene, the hazards of nuclear, chemical and biological warfare, casualty handling, battle psychology and the intricacies of loading and unloading various types of aircraft. By the start of the ground phase of the war the British evacuation chain was fully operational and capable of treating and transferring hundreds of casualties per day. In the event, only about 850 patients were transported down the evacuation chain during the conflict, and less than 10% of these were battle casualties. This paper presents an overview of the British aeromedical evacuation system and discusses, in more detail, the establishment and operation of the busiest aeromedical staging facility at Al Jubail in the Eastern Province of Saudi Arabia. [ABSTRACT FROM AUTHOR]

The article examines pesticide residues in food in a toxicological perspective as discussed in a paper read to the Section of Comparative Medicine of the Royal Society of Medicine in Great Britain in February 1984. Defining the toxic properties of a pesticide generally involves the use of animal model that are related to man. Such chemicals are acceptable for use only if they have been demonstrated that residues will not become a toxic hazard to man, domestic animals and wildlife or environment.

The article discusses the laws governing the scientific procedures on animal experimentation and testing in Great Britain. Conventional wisdom asserts that law does not generally mix well with science, at least not if its role is to define and permit only what society considers to be acceptable scientific experiments. Laws have been in effective to regulate the nature and circumstances of experiments using animals and to control and limit any associated pain.

The article discusses the effectiveness of counseling of clients in general practice in Great Britain. There are some major problems associated with the effort to assess effectiveness and improvement. It is also difficult to conduct a cost effective analyses. The number of counsellors recruited into general practice is growing.

The article focuses on the need for reform in the selection procedure of medical students in Great Britain. Information on the selection procedure of medical students in the country is presented. Failures of medical schools in adopting a changing society and applying cumulative experience of other professions in selection techniques have been mentioned. However, some opportunities have been offered by the current alterations in the school examination system for change and experimentation.

The article discusses the cost and effectiveness of in vitro fertilization (IVF) technique in Great Britain. The development of IVF presents the providers of health care with several problems. Inequality of distribution will become a problem if the new technique would be taken up by the private sector. In the present financial climate of the country it appears that National Health Service funding will be available to meet the demand for IVF.

The article focuses on the iron restoration regulation that lead researchers to conduct a study regarding the impact of adding iron to white floor to the public health. Details related to the historical aspects of implementation of iron restoration regulation in Great Britain are included. Information on the study about the nutritional contribution of adding iron to flour are discussed. It concludes that additional iron to floor has no significant benefit to public health.

The article focuses on medical specialists. It says that patients are given an abysmally low standard of care by being given various prescriptions and by being referred to a narrow-minded specialist. It mentions that most of the costs of the British National Health Service are committed to specialist care although there are only few patients who need it.

The article examines the use of simulation models to plan Health Service resources in Great Britain. Health authorities are encouraging the introduction of systems for monitoring expenditure wherein they have recognized the importance of more informed decision-making. On the other hand, the Clinical Accountability, Service Planning and Evaluation research project have been created to help clinicians control their own budgets and resources.

The article focuses on the study regarding the use of videotex in medicine with emphasis on covering teletext and viewdata in information services in Great Britain. The author discusses the potential of videotex of becoming a major information source in medicine. Moreover, he talks about the uses of the new information-dissemination system.

The article discusses on the significance of computers to medical practitoners in Great Britain. Studies showed that although medical innovations are increasing, medical practioners are hesitant to use new technologies such as the computer. With these, campaigns to increase acceptance on the use of computers is promoted. Practitioners are given information on the advantage of computers, by showing accuracy and unique information taken from computers for diagnosis and monitoring of patients.

The article discusses severe asthma as the cause of sudden death of a number of people in Great Britain annually. According to a survey, the fatality rate of the disease remained to be constant for the period of 30 years despite the use of oral and inhaled corticosteroids, selective beta-2 adrenoceptor agonists, and sodium cromoglycate. Information regarding the patterns of fatal attacks of asthma and the factors which contributes to the death from asthma is also discussed.

The article discusses the pathogenesis and treatment of acute intermittent porphyria (AIP) in Great Britain. AIP is characterized by a partial deficiency of uroporphyrinogen 1-synthase also known as porphobilinogen deamisae. Its progression is usually gradual, but occasionally flaccid paralysis of all extremities can occur rapidly within a matter of days.

The article discusses the orientation failures in medicine and psychiatry in Great Britain. Orientation failures refers to dislocations between the subject's cognition of time, space or person, and the relevant reference systems. The described orientation failures are determined by whether the subject chooses to orientate himself in relation to public or private reference systems.

The article compares the administration of whooping cough immunization in France and Great Britain. It has been noted that the latter is not really active in the vaccination policy, while the former normally incorporates whooping cough vaccine with diphtheria and tetanus toxoids. However, administration of the vaccine had brought out various side effects in each of the country.

The article discusses the issue of in vitro fertilization (IVF) a breakthrough technique for treatment options for infertility. Robert Edwards and Patrick Steptoe have done this breakthrough. They received recognition from the general public when Louise Brown was born in Great Britain in 1978 through IVF. Despite the success of IVF, there is still uncertainty and skepticism whether it is safe and efficient enough to have an accepted place in infertility management.

The article focuses on the alteration in health care model for elderly people in Great Britain. The need for the change in treatment approach emerged due to diminishing younger workforce and rapidly growing number of elderly people. The effectiveness of all advances in care for the elderly is undermined by government policies and particularly due to the ways of spending money.

The article presents information on papers about surgery discussed at a meeting of the Royal Society of Medicine held in Great Britain on January 29, 1986. One report suggests that during repeat biopsies of patients with prostate cancer, aneuploid tumours remain aneuploid while diploid tumours remain diploid even when progressive. Another study cites that people who smoke tend to be at risk to duodenal ulcer. A paper cites that platelets could be accumulated in endarterectomized artery five days after carotid surgery.

The article focuses on the pitfalls of current health care screening programs in Great Britain. The history of audits of cervical screening programs in the country is being reviewed. The procedures of designing an audit and setting standards for it are discussed. It is emphasized that the shortcomings should be identified and accordingly the improvement plans should be implemented.

The article focuses on the management of drug addiction in general practice in Great Britain. A report published by the British government titled "Guidelines of Good Clinical Practice in the Treatment of Drug Misuse" has shown that drug abusers came from a heterogeneous group which ranges from adolescents to people who have been dependent for many years. It is claimed that most general practitioners who manage drug misuse have no ready access to the support of a drug dependency unit.

The article focuses on the factors that contribute to the rise of ischaemic heart disease (IHD) aside from butter in Great Britain. From 1959 to 1972, consumption of polyunsaturated fats increased by 25% when the incident of IHD has the greatest increase. IHD may also attributed to lifestyle changes such as increase in consumption of meat, decline of fish consumption, smoking and internal migration. The emergence of new type of food processing that forms atherogenic oxysterols also contributed to the rise of IHD epidemic.

This article discusses the development of mental hospitals in Great Britain. Mental hospitals in Britain were mainly built in the second half of the last century. Often the guiding principle of the construction of mental hospitals is providing an alternative family atmosphere, perceptible in features of many of the original buildings where they have not been affected.

The article presents opinion on the access control and management of medical records in Great Britain. It emphasizes the importance of making, maintaining and reading of records. One of the arguments raised against offering unrestricted access to medical records is the fact that it is not feasible for psychiatric patients. The refusal to offer unrestricted access to records is attributed to the presence of paternalism in the bureaucracy.

The article examines the judgment on a case concerning the detention of a psychiatric patient in Great Britain. This case involved a psychosis patient who was recalled after a medical officer certified that he should be detained for further treatment. The patient argued that this recall contravened his human rights based on the Convention for the Protection of Human Rights and Fundamental Freedoms. Circumstances held by the European Court of Human Rights are discussed.

The article presents information on several papers discussed at a meeting of the Section of General Practice of the Royal Society of Medicine held in Great Britain on March 21, 1984. Doctor David Ryde tackled his own practice of recognizing patients who consult him. Doctor Gus Plaut highlighted his effort to remove cervical smears from all women in his practice to eliminate cervical cancer. Another paper outlined medical practice in East London.

The article focuses on a paper about the interrelation between the status and work of surgeons, limitation of resources and the impact of the introduction of general management in the British National Health Service (NHS). The author mentions that it is illusory to expect the separation of the NHS from the elements of politics.

The article presents a discussion on the use of registers in eye diseases. A register can be defined as an epidemiological investigation resembling that of a cohort study. The most familiar registers to the ophthalmologists of Great Britain are the national Blind and Partial Sight registers. By examining subjects from existing registers, much useful eye research can be undertaken.

The article discusses various papers on myxoedema, written by British authors between 1871 and 1898. During this period, the term myxoedema was used for a specific malady. Today, it is referred to describe one feature of the florid cases of hypothyroidism. The Clinical Society of London's meeting in 1883 was focused on myxoedema. In 1871, C.H. Fagge released the paper "On Sporadic cretinism, occurring in England." He discussed four cases including a case of juvenile myxoedema.

The author reflects on the dilemmas of general practitioners (GPs) in taking decisions for patient care in view of a new health care policy of the British National Health Service. The policy emphasizes both effectiveness and cost of patient care. However, it becomes difficult for GPs to decide what is best for patients and what is cost effective for the government. Physician Lord Horder's view on the training of general practitioners has also been considered as a solution to the problem.

The article provides information about the papers presented during the meeting of the "Journal of the Royal Society of Medicine" concerning colorectal surgery in Great Britain. The first paper describes the end-to side technique for colorectal anastomosis. The second paper talks about preoperative weight loss and its impact on the postoperative outcome in inflammatory bowel disease. Another speaker provides a paper on the histology, pathology and clinical aspects of the anal transitional zone.

In this article, the author proposes a potential major change to the medical research peer review process in Great Britain in 2006. Central to his argument is that what matters most about any scientific paper are the conclusions drawn from it. The author asserts that the main aim of the review process should be to ensure that the published conclusions are reasonable and supported by what goes before them. Moreover, he cites the biggest potential drawback of such a process.

The article highlights the outing of the Section of the History of Medicine of the Royal Society of Medicine held June 18, 1994. The author discusses the key factors contributing to the success of the outing. Mr. Douglas Johnson discussed Sir John Floyer's "Book of Country Receipts." Professor Isoble Grundy presented a paper entitled "Medical Advance? Medical History: Small innoculation and its after-effects."

The article focuses on issues related to the British government's policy regarding chronic somatization. The process of seeking medical help by persons without any serious disease has been called "somatization." Unlike the U.S., there are few prevalence data on this disorder in Great Britain. The model of illness implicit in the White Paper emphasizes on diagnostic technology.

The article presents information on papers related to viral infections cited at the meeting of the British Society of Immunology held in November 1985. One report suggests that the role of virologists in immunology is to discover ways in which a virus becomes persistent while an immunologist investigates why the immune system failed. Rubella virus can be detected in animals through their organs and secretions. In feline leukaemia virus, the provirus is incorporated into the host's DNA and is retained in new cell progeny.

The article reports on the highlights of the proceedings in the inaugural meeting of the Royal Society of Medicine's Section of the History of Medicine that relate to the Renaissance and early periods of the history of medicine, which was held on October 11, 1912. A description of the history and achievements of the section is presented. T. Wilson Parry discussed the prehistoric and medical trephined skulls in Great Britain.

The article presents the opinion of the author on the law and legislation involved with research related to human fertilization and embryology in Great Britain. According to the author a white paper on human fertilization and embryology was published by the government of the country in 1987. The author discusses about the licensing authorities and the nature of the research that would be prohibited by the law.

Information on the papers discussed during the meeting held by the Sections of Oncology, Proctology and Surgery of the Royal Society of Medicine on March 24, 1982 in Great Britain is presented. Clair Chilvers from the Institute of Can Research presented her paper "The epidemiology of colorectal cancer." Dr. Michael Hill spoke about the dietary factors in cancer of the colon, while Dr. Michael Moore presented the study on the aspects of cell-mediated immunity in colonic cancer.

The article examines child abuse studies and certain aspects which have bearing on medical practice in Great Britain. In 1946, a paper reported the appearance of unexplained fractures shortly after the patient had arrived home after discharge from hospital. It was established that certain skeletal injuries in children were due to non-accidental injury by aggressive adults. The unwillingness of the profession to accept and diagnose the condition and to take necessary action was also emphasized.

The article profiles James Simpson who is known for his introduction of chlorofom into surgery as a general anaesthetic in 1847. His 1841 study, entitled "Antiquarian notices of leprosy and leprosy hospitals in Scotland and England" formed three papers in the "Edinburgh Medical and Surgical Journal" between 1841 and 1842. In his paper "Antiquarian notices of syphilis in Scotland," Simpson noted that syphilis first broke out in Europe after the capture of Naples by the French Army in spring 1495.

Up to June 2001, 3000 British veterans of the Gulf War had sought advice from a special medical assessment programme established because of an alleged Gulf War syndrome. After assessment those attending were classified as completely well, well with symptoms, well with incidental diagnoses treated or controlled, or unwell (physically or mentally). Mental illness was confirmed by a psychiatrist. The first 2000 attenders have been reported previously. The present paper summarizes findings in all 3000. 2252 (75%) of those attending were judged 'well', of whom 303 were symptom-free. Medical diagnoses were those to be expected in such an age-group (mean age 34 years, range 21-63). No novel or unusual condition was found. In 604 of the 748 unwell veterans, a substantial element of the illness was psychiatric, the most common condition being post-traumatic stress disorder. The healthcare requirements of the Gulf veterans seen in this programme can therefore be met by standard National Health Service provision. [ABSTRACT FROM AUTHOR]

In a previous paper we reported that 10.8% of patients admitted to two large hospitals in Greater London experienced one or more adverse events, of which half were deemed preventable. Here we examine the underlying causes of errors in clinical practice. Rather than identifying specific errors made by individuals, we have looked at possible faults in the organization of care. Adverse events were grouped according to stages in the care process: diagnosis, preoperative assessment and care, operative or invasive procedure (including anaesthesia), ward management, use of drugs and intravenous fluids and discharge from hospital. Less than 20% of preventable adverse events were directly related to surgical operations or invasive procedures ad less than 10% to misdiagnoses. 53% of preventable adverse events occurred in general ward care (including initial assessment and the use of drugs and intravenous fluids) and 18% in care at the time of discharge. Probable contributory factors in these errors included dependence on diagnoses made by inexperienced clinicians, poor records, poor communication between professional carers, inadequate input by consultants into day-to-day care, and lack of detailed assessment of patients before discharge. [ABSTRACT FROM AUTHOR]

With the advent of multicentre research committees in the UK, local research ethics committees (LRECs) are required to advise only on issues relating to the local acceptability of a project. We looked at the handling of two commercially sponsored studies, one initiated before the change and one after, confining the analysis to 21 LRECs approached in both. As judged by the amount of paper per application, the new system for LRECs is simpler and should be less costly. However, there was an increasing tendency for LRECs to charge for their services (30% study 1,47% study 2) and these charges varied by more than 400%. If such fees must be levied, a common scale is desirable. [ABSTRACT FROM AUTHOR]

The article highlights the meeting of the Forum on Lipids in Clinical Medicine that was held in Great Britain. Speaker D. N. Brindley presented a paper on hepatic lipid and lipoprotein metabolism. T. J. Peters of MRC Clinical Research Centre and his group provided an insight into the causes of fatty liver. J. Owen of Royal Free Hospital School discussed the surface composition of plasma lipoproteins.

The article provides information on the meeting entitled "Perspectives in Cancer Chemotherapy" in Great Britain. One of the speakers in the meeting was Dr. Margaret Fox of Christie Hospital & Holt Radium Institute. Fox introduced the topic of cell kinetics and drug action. Another speaker was Dr. John Smyth of Royal Marsden Hospital. He discussed the problem of designing drugs in the laboratory for future use in the clinic.

The article profiles Benjamin Collins Brodie, a founder of modern orthopedics surgery in Great Britain. Brodie was educated at home and studied medicine in 1801 in London. At the age of 25, he started to create several accomplishments in his career. One of his accomplishments is a scientific paper entitled "Dissection of a foetus with no heart" which he presented to the Royal Society of Medicine Press Ltd. in 1810.

The article focuses on issues discussed at a meeting held by the Section of Paediatrics of the Royal Society of Medicine in Great Britain on June 27-28, 1986. Doctor A. W. Chung described the development of child health care in China. The clinical and pathological features of Keshan disease, a form of cardiomyopathy endemic in certain parts of China, was discussed by Doctor X. Meng. Some salient facts about iron supplementation was presented by professor P. C. Elwood.