Development and Validation of the Postsex Experience (P-SES) Scale.

Introduction: There is little systematized research on the postsex phase of the sexual cycle, due in part to the absence of literature on the period immediately following sexual activity.

Aim: The paper describes the development and validation of the Postsex Experience Scale (P-SES), an instrument designed to measure the psychological dimensions of the postsex period of the human sexual response cycle.

Methods: Scale development involved (a) item construction, selection, and subsequent validation through item analysis, and (b) a factor analysis of the item intercorrelations of the P-SES and the establishment of its factorial validity, based upon an online survey of 4,217 respondents.

British Thoracic Society Guideline for the initial outpatient management of pulmonary embolism.

The following is a summary of the recommendations and good practice points for the BTS Guideline for the initial outpatient management of pulmonary embolism. Please refer to the full guideline for full information about each section.

An Immortalized Genetic Mapping Population for Perennial Ryegrass: A Resource for Phenotyping and Complex Trait Mapping.

To address the lack of a truly portable, universal reference mapping population for perennial ryegrass, we have been developing a recombinant inbred line (RIL) mapping population of perennial ryegrass derived via single seed descent from a well-characterized F2 mapping population based on genetically distinct inbred parents in which the natural self-incompatibility (SI) system of perennial ryegrass has been overcome. We examined whether it is possible to create a genotyping by sequencing (GBS) based genetic linkage map in a small population of the F6 generation of this population. We used 41 F6 genotypes for GBS with -based libraries.

Ambulatory emergency care - improvement by design.

Ambulatory emergency care (AEC) has been developed by clinicians as a means of providing emergency care without the traditional bed base of a hospital. Given that AEC is provided in a clinic-style setting, it can continue to operate during periods of high bed occupancy, alleviating bed pressures and continuing to provide timely care for selected patients. Although different models of AEC have developed according to local context, there are common principles that apply to AEC services, including early access to senior decision-makers, opening hours matching demand, access to diagnostics, close collaboration with other clinical services, a mixed workforce and patient selection processes.

Feasibility randomised controlled trial of a self-help acceptance and commitment therapy intervention for grief and psychological distress in carers of palliative care patients.

We tested the feasibility and preliminary effectiveness of an acceptance and commitment therapy self-help intervention for grief and psychological distress in carers of patients in palliative care. Carers were randomised to the control group, which received treatment as usual, or the intervention group, which received treatment as usual plus an acceptance and commitment therapy-based self-help booklet and telephone support call. Questionnaires were completed at baseline, 1-month post-allocation and 6 months post-loss.

Attitudes of palliative care clinical staff toward prolonged grief disorder diagnosis and grief interventions.

Unlabelled: ABSTRACTObjective:The provision of psychological support to caregivers is an important part of the role of the clinical staff working in palliative care. Staff knowledge and attitudes may determine their openness to referring caregivers to a psychological intervention. We recently developed a self-help intervention for grief and psychological distress among caregivers and were interested in exploring the extent to which staff knowledge and attitudes might affect future implementation.

Can ambulatory emergency care help to streamline services?

This article discusses four models of ambulatory emergency care (AEC), a form of clinical care that allows practitioners to assess, diagnose, treat and discharge patients on the same days that they present to emergency departments. The article recommends one model in particular, the process model, and sets out four questions practitioners who want to deliver AEC should ask of patients at the point of referral.

Patient experience. Quick decisions mean a quick exit.

Patients admitted to A&E in the evening can stay in hospital up to four days longer than morning admissions. Trusts can take targeted action during the assessment phase to reduce patient stays, explain Seamus McGirr and colleagues

Relationship between non-alcoholic fatty liver disease and kidney function: a communication between two organs that needs further exploration.

Non-alcoholic fatty liver disease (NAFLD) is now regarded as hepatic component of the metabolic syndrome. In addition, NAFLD has emerged as a growing public health problem worldwide and an important challenge for health authorities. NAFLD is associated with insulin resistance and hyperlipidaemia and this appears as the potential pathogenic role of NAFLD in the development and progression of chronic kidney disease (CKD).

Statins as potential treatment for cholesterol gallstones: an attempt to understand the underlying mechanism of actions.

Introduction: Statin therapy is widely used across the globe for the treatment and prevention of cardiovascular disease (CVD). It is well established that statin therapy is associated with significant decreases in low-density lipoprotein cholesterol (LDL-C) and plasma cholesterol levels. Cholesterol gallstones are a common problem, resulting in hospital admission and surgery, throughout western healthcare systems.

Does impaired gallbladder function contribute to the development of Barrett's esophagus and esophageal adenocarcinoma?

Introduction: Esophageal adenocarcinoma is aetiologically associated with gastro-esophageal reflux, but the mechanisms responsible for the metaplasia-dysplasia sequence are unknown. Bile components are implicated. Impaired gallbladder function may contribute to duodenogastric reflux (DGR) and harmful GERD.

Radiologic follow-up of non-functioning pituitary adenomas: rationale and cost effectiveness.

Patients with non-functioning pituitary adenomas (NFPAs) are followed-up with serial endocrine, ophthalmologic and radiological assessment. There is a lack of evidence based guidance regarding the frequency and duration of radiological assessment during follow-up. We retrospectively analysed the details of follow-up radiological scanning in a cohort of patients diagnosed with NFPAs in an attempt to devise a rational and cost effective scanning schedule for use in routine clinical practice.

The mitochondrial genome of a cytoplasmic male sterile line of perennial ryegrass (Lolium perenne L.) contains an integrated linear plasmid-like element.

The mitochondrial genome of a cytoplasmic male sterile line of perennial ryegrass (Lolium perenne L.) was shown to contain a 9.6 kb element, LpCMSi, that is absent in the mitochondrial genome of fertile lines.

The acute medical take: an outpatient specialty.

The traditional model of acute medical care involves the admission of patients to hospital to be assessed by a consultant and facilitate access to investigation and treatment. This model has, however, led to a number of problems. Firstly, there is high bed occupancy which restricts access and increases the risk of healthcare-acquired infection.

Diabetes- and nondiabetes-related lower extremity amputation incidence before and after the introduction of better organized diabetes foot care: continuous longitudinal monitoring using a standard method.

Objective: There is a lack of continuous longitudinal population-based data on lower extremity amputation (LEA) in the U.K. We present here accurate data on trends in diabetes-related (DR) LEAs and non-DRLEAs in the South Tees area over a continuous 5-year period.

Effectiveness of a screening tool to detect injuries during Army Health Care Specialist training.

The purpose of this project was to evaluate the effectiveness of an initial screening and referral process in reducing the impact of musculosketetal injuries among soldiers attending Health Care Specialist training. Musculoskeletal injury among Army Health Care Specialist students have been reported to be approximately 24% for men and 24-30% for women. The highest student visit rate to the troop medical clinic for musculoskeletal injuries, for men and women, occurs during the first week of training.

All-cause and cardiovascular mortality in diabetic subjects increases significantly with reduced estimated glomerular filtration rate (eGFR): 10 years' data from the South Tees Diabetes Mortality study.

Aims: To investigate the association between estimated glomerular filtration rate (eGFR) and total and cardiovascular mortality in a population-based cohort of diabetic subjects.

Methods: A longitudinal study using a population-based district diabetes register comprising 3288 subjects in South Tees, UK. The eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) study equation.

The burden of mortality attributable to diabetes: realistic estimates for the year 2000.

Objective: To estimate the global number of excess deaths due to diabetes in the year 2000.

Research Design And Methods: We used a computerized generic formal disease model (DisMod II), used by the World Health Organization to assess disease burden through modeling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, age- and sex-specific estimates of diabetes prevalence, and available published estimates of relative risk of death for people with diabetes compared with people without diabetes.

Pituitary apoplexy: a review of clinical presentation, management and outcome in 45 cases.

Objective: To review clinical presentation, management and outcomes following different therapies in patients with pituitary apoplexy.

Methods: Retrospective analysis of case-records of patients with classical pituitary apoplexy treated in our hospitals between 1983-2004.

Results: Forty-five patients (28 men; mean age 49 years, range 16-72 years) were identified.

The Evolving Role of the Acute Assessment Unit - from inpatient to outpatient care.

Acute Assessment Units (AAUs) have been developed to meet the demand for emergency care. Traditionally, AAUs have been an admission route to secondary care but the role is now evolving to assessment. AAUs are complex and have many interactions both in hospitals and the community.

Four pedigrees of the cation-leaky hereditary stomatocytosis class presenting with pseudohyperkalaemia. Novel profile of temperature dependence of Na+-K+ leak in a xerocytic form.

We report four pedigrees of the group of Na(+)-K(+)-leaky red cell disorders of the 'hereditary stomatocytosis' class. Each showed pseudohyperkalaemia because of temperature-dependent loss of K(+) from red cells on storage of whole blood at room temperature. All pedigrees showed an abnormality in the temperature dependence of the 'passive leak' of the membrane to K(+).