Clinical Medicine 2010, Vol 10, No 6: 1–2 Clinical Medicine Journal of the Royal College of Physicians of London

CMJ1006-TOC.qxd 11/8/10 9:17 PM Page 1

Volume 10 Number 6 December 2010

Elke Jakubowski, José M Martin-Moreno Editorials and Martin McKee 531 ‘The unfinished business is done’ Robert Allan Clinical practice 533 The Specialty Certificate Examination in neurology 563 The impact of an early chest radiograph on outcome in Philip EM Smith and John Mucklow patients hospitalised with community-acquired 535 The role of the Association of British Clinical Diabetologists pneumonia Peter H Winocour Thomas Bewick, Sonia Greenwood and Wei Shen Lim 537 Defining quality and quality improvement Stephen Atkinson, Jane Ingham, Michael Cheshire Medical education and Susan Went 568 Competency mapping in quality management of foundation training Original papers Jennifer Ruddlesdin, Lauren Wentworth, Sarita Bhat and Paul Baker 540 Stability of plasma creatinine concentrations in acute complex long-stay admissions to a general medical service Conference reports Donna Siriwardane, Richard Woodman, Paul Hakendorf, 573 Optimising care at the cardio-renal interface Jennifer H Martin, Graham H White, David I Ben-Tovim Donah Zachariah and Campbell H Thompson 577 Acute and general medicine for the physician Max Yates and David Scott Professional issues 544 Women and medicine Jane Dacre and Susan Shepherd Conference summaries 579 Cognitive impairment in older adults: a guide to 548 Consultant physicians for the future: report from a assessment working party of the Royal College of Physicians and John M Starr the medical specialties Andrew F Goddard 582 Diabetes: a hospital perspective Rowan Hillson 555 National ambulatory emergency care survey: current level of adoption and considerations for the future Lynn McCallum, Derek Bell, Ian Sturgess and Kate Lawrence College lectures 584 Redefining disease European issues John Bell 560 The governments’ doctors: the roles and 595 Will our children be healthy adults? Applying science responsibilities of chief medical officers in the to public health policy European Union Catherine Law continued overleaf

620 Parenteral nutrition Career lifetime advances Deb Ghosh and Penny Neild 600 General practice 624 Malnutrition: causes and consequences Rodger Charlton John Saunders and Trevor Smith 628 Self-assessment questionnaire Acute medical care 629 Answers to the diabetes self-assessment 605 A confused patient with raised anti-thyroid antibodies – questionnaire an unusual case B Srivastava, W Gelson, A Griffiths and A Schrag Lesson of the month 630 Myotonic dystrophy and out-of-hospital arrest CME SECTION 633 Is that your arm or mine? Nutrition 607 Ethics and artificial nutrition towards the end of life 635 Book review Barry JM Jones 636 Letters to the Editor 611 Fluid management on hospital medical wards Richard Leach 644 Conversations with Charles 616 Enteral tube feeding BM Wireko and Tim E Bowling 646 Index 2010

Editor Subscription rates for 2010 Enquiries to: Robert Allan MD PhD FRCP Clinical Medicine is published bi-monthly. Publications Department, Annual subscription (print and online): Royal College of Physicians, Managing editor 11 St Andrews Place, Institutions Individuals Dail Maudsley Regent’s Park, UK £145 £135 London NW1 4LE Journal administrator Europe £165 £145 Holly Fenton Rest of the world £175 £165 Tel: (020) 7935 1174 [email protected] Claims for non-receipt must be made within Fax: (020) 7486 5425 90 days of publication SAQ editors www.rcplondon.ac.uk Jonathan Fox MD FRCP Clinical Medicine online A full-text version of the journal is available free online to fellows and collegiate Nandan Gautam MRCP members when they log on to the private area of the Royal College of Physicians website. Full text of issues John Scadding MD FRCP more than one year old can be viewed and downloaded free by all readers at www.ingentaconnect.com J Allister Vale MD FRCP Competing interests Unless specifically stated, authors have no known competing interests. Design & production Suzanne Fuzzey Disclaimer All articles and other material published by Clinical Medicine reflects the agreed opinions of their authors and should not be taken to represent the policy of the Royal College of Physicians unless Head of publications this is specifically stated. Orla Fee

Marketing © Clinical Medicine 2010. All rights reserved. No part of this publication may be reproduced, stored, transmitted, or disseminated, in any form, or by any means, without written permission of the copyright Jason Plysi owner. Applications for the copyright owner’s written permission to reproduce any part of this publication [email protected] should be addressed to the publisher. Please see the Royal College of Physicians website for details. Advertising ISSN 1470-2118 (print) David Cox ISSN 1473-4893 (online) 01908 526350 [email protected] Typeset by Aptara Inc, New Delhi, India

Subscriptions Printed in the United Kingdom by The Lavenham Press Ltd, Suffolk. Julie Dalton [email protected] Front cover: TEK IMAGE / SCIENCE PHOTO LIBRARY