difficile in Britain can be matched by the rise in incidence of a true superbug, methicillin resistant Staphylococcus aureus (MRSA) While C. difficile has soared from fewer than 1,000 cases in 1990 to 43,672 cases in 2004, MRSA has grown from virtually nothing to more than 5,000 cases over the same period of time. The latest figures show that the two bugs each killed more than 900 people in 2003.Unfortunately, these sorts of statistics will only confirm many people's fears about staying in hospital. These risks will increase as the population gets older because elderly patients are more vulnerable to hospital-acquired infections. The average age of the patients who died at Stoke Mandeville was 85.So what needs to be done? Cleaner hospitals should be a priority, even though some microbiologists say that dirty floors and walls are not necessarily the real problem. They argue that infections are spread more by dirty hands than by dirty wards. This seems to be the case with MRSA bacteria which are known to be passed more easily during physical contact between staff and patients than by contact with inanimate objects.But the issue of C.

difficile, whose spores can linger on dirty walls, floors and toilets for longer than other bugs, shows that meeting the target for cleaner hospitals must be more than a public relations exercise It must be an absolute imperative. There is no point in the NHS curing people of one malady, only to have them fall ill or die from a hospital infection.

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If managers believe this can only be done by taking privatised hospital cleaning back in-house, as Stoke Mandeville has done (but only after their problems became public), they must be free to take that decision. The system - public or private - is secondary; the priority must be cleanliness, rigorously observed and monitored Anything else is a false economy..

The period since the ninth congress in 2000 has witnessed important political events that has put tremendous pressure on Arab citizens and forced them to an unprecedented re-examination of their convictions and ideas. They have had to revisit their basic beliefs, which have been shaken by the storm of dramatic developments that struck our world and our region, which have led to uncertainty of vision, conceptual confusion, to the blurring of the meaning of terminology, and a conflict in values and frames of reference. They turned on their leaders and staged revolutions, enraged that they had been misled into such a disaster. The story is startlingly simple: the human settlers on the island - living in perfect isolation from the rest of the world - systematically destroyed their own habitat. The result? At first, the island was plunged into war as different groups scrambled to seize the remaining natural resources for themselves. In a burst of over-development, they cut down their forests much faster than they could grow back.