Donepezil has significant efficacy in the treatment of neuropsychiatric symptoms in patients with mild to moderate AD.

SUMMARYAn irregular discharge (ID) from the A&E department is an undesirable, but relatively common occurrence. A prospective study was undertaken to quantify the size of the problem and by arranging a subsequent review of the patient, to determine the clinical outcome.Over a 3-month period, 139 patients (0.73% of attendances) took their own discharge against medical advice. A further 566 patients (3.03% of attendances) left prematurely prior to any medical assessment (DNW).Attenders irregularly discharged, often with serious untreated conditions. A high proportion were intoxicated with alcohol (65.5%). Attempted follow up proved difficult and incomplete. Patients with serious conditions appeared to return spontaneously for further care. Methods of minimizing the numbers of patients who take an ID or DNW are discussed.Taken together, the numbers of these attenders leaving prematurely, can be used as a valid performance indicator of the delivery of health care in the A&E department.

Contrary to findings in other studies, in which initial idealism has been reported to have collapsed after working with students from other professions, we achieved a positive reaction to the O&G attachment, harnessing students' initial positivity towards interprofessional learning and cementing it into real optimism. Our promising initial results suggest that more work is needed to further increase the impact of such strategies and to determine whether the improvements in attitudes translate to improved clinical behaviour and thence patient outcomes.

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