The consistency of an archer's postural set at the moment of loose (arrow release) is commonly perceived to be an important determinant of success. The coach seeks, among other things, to provide the archer with information about postural consistency, details of which he acquires by eye or occasionally by video-recordings. The gains that might be achieved from more precise information are examined here. Nine skilled archers, classified into either skilled or elite groups according to their officially computed handicap, were continuously monitored and measured with a three-dimensional co-ordinate analyser (Charnwood Dynamics Coda-3 Scanner) while shooting two ends (series) of three arrows each. Considerable variability was observed in the precision with which the positions of head, elbow and bow at the moment of loose were replicated by archers of similar levels of skill. These results are interpreted to suggest that precise postural consistency may not be the primary feature distinguishing between the performance of archers at the higher skill levels.

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-Transient loss of consciousness (T-LOC), or blackout, is common in acute medicine. Clinical skills are not done well, with at least 74,000 patients misdiagnosed and mistreated for epilepsy in England alone. The aim of this study was to provide a rapid, structured assessment and an electrocardiogram (ECG) for patients with blackouts, aiming to identify high risk, reduce misdiagnoses, reduce hospital admission rates for low-risk patients, diagnose and treat where appropriate, and also provide onward specialist referral. The majority of patients had syncope, and very few had epilepsy. A high proportion had an abnormal ECG. A specialist-nurse-led rapid access blackouts triage clinic (RABTC) provided rapid effective triage for risk, a comprehensive assessment format, direct treatment for many patients, and otherwise a prompt appropriate onward referral. Rapid assessment through a RABTC reduced re-admissions with blackouts. Widespread use of the web-based blackouts tool could provide the NHS with a performance map. The UK has low rates of pacing compared to Western Europe, which RABTCs might help correct. The RABTC sits between first responders and specialist referral, providing clinical assessment and ECG in all cases, and referral where appropriate.

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We present two recent successfully litigated malpractice cases in which patients with cerebrovascular accidents were misdiagnosed as stroke mimics. The first was diagnosed as a hemiplegic migraine, which occurs in only 0.01% of the population. The second was diagnosed as a conversion disorder, which ultimately has a neurologic etiology in 4% of cases. In both cases, issues of poor patient communication and poor documentation were paramount in the legal outcome. We discuss caveats of stroke mimics, tissue plasminogen activator administration liability, and pitfalls in patient and family interactions.