Sources of stress and satisfaction in crown health enterprise senior medical staff.

Aim: To report the sources of stress and satisfaction in the specialist workforce of three crown health enterprises (CHEs).

Method: Ninety eight specialists in Northland Health, Waitemata Health and Southern Health completed a questionnaire rating 39 factors for causing stress and satisfaction in their daily work.

Results: The commonest sources of stress for specialists were keeping up to date, carrying a heavy clinical workload and time pressure generally.

Ileal infarction: a rare cause of tetanus in the elderly.

We report the case of a 70 year-old woman who presented with clinical tetanus following a four day history of abdominal pain and vomiting. The source of Clostridium tetani was an infarcted loop of ileum resulting from pelvic adhesions. The treatment of tetanus and the incidence of endogenous sources of Clostridium tetani are reviewed.