This is a descriptive case study employing a photographic survey of the numerous objects that patients and their social networks bring to a hospice setting. Photographs were taken of all objects kept by the bedside by 31 inpatients in a hospice in the UK county of Durham. These objects ranged from assorted food and drink, greetings cards and magazines, to more specific personal items such as family photos, children's drawings, and religious icons. A total of 176 objects were analysed. There were two principle findings. First, patients appeared to bring objects to a hospice setting that reflected their desire to partially recreate their home settings or functions, however modestly. Second, despite a major diversity of objects, and the fact that most objects underlined desires for distraction, entertainment and social contact, almost every individual patient harboured at least one personally unique object. These two observations--creating some semblance of 'home' and the existence of uniqueness amid a plethora of expected patient paraphernalia--suggest important reconsideration of both hospice settings and the possibility of new ways to engage patients about meaning, illness and loss.

There is evidence from outside the United Kingdom to show that physicians’ religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers and specialist registrars and their attitudes to decisions which commonly must be taken when caring for individuals who are dying. All consultants ( N = 119), nurse key workers ( N = 36) and specialist registrars ( N = 44) working in an acute hospital in the north-east of England were asked to complete a postal questionnaire. In all, 65% of consultants, 67% of nurse key workers and 41% of specialist registrars responded. Results showed that consultants’ religion and belief systems differed from those of nurses and the population they served. Consultants and nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration and not withdraw treatment. Nurses were more sympathetic to the idea of physician-assisted suicide for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. This may have practical implications for the clinical care given and the place of care. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or physician-assisted suicide.

This NICE technology appraisal guidance on ezetimibe for primary (heterozygous-familial and non-familial) hypercholesterolaemia should be read in conjunction with the NICE technology appraisal guidance on the initiation of statin therapy (Technology Appraisal 94) and in the context of the relevant NICE clinical guidelines.The full guidance 1 was published in the NICE technology appraisal guidance in November 2007. The guidance was developed using NICE's multiple technology appraisal process. Further information is available in the Guide to the methods of technology appraisal. 2

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