Getting health services right for 16-25 year-olds.

The 2019 NHS England Long Term Plan set out the ambition to work across the 0-25 age range to support children and young people as they make the transition to early adulthood. Within this broad age bracket, how do we ensure we get health services right for 16-25 year-olds including the transfer to adult services? In this paper, we explore the evidence supporting youth-friendly and developmentally appropriate healthcare approaches and what these mean in practice for young people and healthcare professionals. Examples from primary and secondary care, as well as the perspectives of a young person, illustrate the challenges and solutions.

Current practice in the diagnosis and management of sarcopenia and frailty - results from a UK-wide survey.

Objectives: Despite a rising clinical and research profile, there is limited information about how frailty and sarcopenia are diagnosed and managed in clinical practice. Our objective was to build a picture of current practice by conducting a survey of UK healthcare professionals.

Methods: We surveyed healthcare professionals in NHS organisations, using a series of four questionnaires.

Best practice guidelines for the management of frailty: a British Geriatrics Society, Age UK and Royal College of General Practitioners report.

Unlabelled: Older people are majority users of health and social care services in the UK and internationally. Many older people who access these services have frailty, which is a state of vulnerability to adverse outcomes. The existing health care response to frailty is mainly secondary care-based and reactive to the acute health crises of falls, delirium and immobility.

Changing interpretation of chromosomal microarray over time in a community cohort with intellectual disability.

Chromosomal microarray (CMA) is the first-line diagnostic test for individuals with intellectual disability, autism, or multiple congenital anomalies, with a 10-20% diagnostic yield. An ongoing challenge for the clinician and laboratory scientist is the interpretation of variants of uncertain significance (VOUS)-usually rare, unreported genetic variants. Laboratories differ in their threshold for reporting VOUS, and clinical practice varies in how this information is conveyed to the family and what follow-up is arranged.

Transition to adult services.

The lack of focus on young people as a group with particular healthcare needs in medical training and the health service underpins the difficulty that we have experienced as a profession in improving transition in the UK. This article discusses current progress towards improving training in young people's health in the UK, the evidence base for transitional care in young people with chronic conditions with interventions that focus on staffing, service delivery and young people, a practice based approach for transitional care in young people with learning difficulties and complex needs, the need for monitoring and evaluation of transitional care, and the challenge of funding.

Mutations in the guanine nucleotide exchange factor gene IQSEC2 cause nonsyndromic intellectual disability.

The first family identified as having a nonsyndromic intellectual disability was mapped in 1988. Here we show that a mutation of IQSEC2, encoding a guanine nucleotide exchange factor for the ADP-ribosylation factor family of small GTPases, caused this disorder. In addition to MRX1, IQSEC2 mutations were identified in three other families with X-linked intellectual disability.

Career choices of United Kingdom medical graduates of 2002: questionnaire survey.

Objectives: To report the specialty choices of UK medical graduates of 2002, and to compare their choices with those of qualifiers in previous years and with the profile of career grade doctors in different specialties in England.

Methods: We carried out a postal questionnaire survey in the UK and drew comparisons with official data for numbers of specialists.

Results: The response rate was 65.

Nurse-led implementation of the single assessment process in primary care: a descriptive feasibility study.

Objective: to determine the resources required to carry out the single assessment process in primary care.

Design: prospective descriptive study.

Setting: one urban primary care practice, Southampton.

Reasons why some UK medical graduates who initially choose psychiatry do not pursue it as a long-term career.

Background: Some doctors who initially choose psychiatry do not pursue it as a long-term career. The study seeks to identify reasons for leaving psychiatry.

Method: Postal questionnaire survey of UK medical graduates of 1988, 1993, 1996 and 1999 identified as having left psychiatry; for comparison, doctors who left general practice or trauma and orthopaedics.

Career choices for pathology: national surveys of graduates of 1974-2002 from UK medical schools.

In the past 10 years there has been increasing concern about recruitment of junior doctors into pathology, particularly histopathology, in the UK. In this study, we report on career choices for pathology, derived from postal questionnaire surveys of all qualifiers from all UK medical schools in nine qualification years since 1974. 74% (24,623/33,417) and 73% (20,709/28,468) of doctors responded at 1 and 3 years after qualification.

Career choices for psychiatry: national surveys of graduates of 1974-2000 from UK medical schools.

Background: Concerns continue about recruitment levels of junior doctors into psychiatry in the UK.

Aims: To report career choices for and career progression in psychiatry.

Method: Postal questionnaire surveys of qualifiers from all UK medical schools in eight qualification years since 1974.

Variation by medical school in career choices of UK graduates of 1999 and 2000.

Objective: To report on how newly qualified doctors' specialty choices, and factors that influenced them, varied by medical school.

Design: Postal questionnaires.

Setting: United Kingdom.