Room for a Specialist?

When the Associate Specialist grade shut in 2008 it left an untenable situation in which some Specialty Doctors were providing the most senior levels of care for patients without recognition of that seniority. Hence in 2021, the Specialist Grade was created as a new national grade for senior specialist and specialty (SAS) doctors. The post provides autonomous working and recognition of seniority for SAS doctors.

Characteristics of sexual assault among young people aged under 18 years of age in Hertfordshire.

Sexual Health Hertfordshire provides integrated services for young people (YP) aged under 18 years at three sites. From January 2019 to June 2020, we saw 3483 YP, 60 of whom attended as a result of a sexual assault. Half were under 16 years, 87% female and 81% of white ethnic origin.

Downregulation of ribosome biogenesis during early forebrain development.

Forebrain precursor cells are dynamic during early brain development, yet the underlying molecular changes remain elusive. We observed major differences in transcriptional signatures of precursor cells from mouse forebrain at embryonic days E8.5 vs.

Staff, associate specialist and specialty doctors' national audit on the management of gonorrhoea in the United Kingdom, 2015.

The British Association for Sexual Health and HIV (BASHH) revised United Kingdom national guideline for the management of gonorrhoea in adults, 2011, identified five auditable outcome measures, namely, that all patients should receive first-line treatment, be screened or treated for chlamydial infection, have a test of cure (TOC), be offered written information and have partner notification carried out. The UK National Guideline for Gonorrhoea Testing, Clinical Effectiveness Group, BASHH, 2012, recommended in addition that all reactive nucleic acid amplification tests (NAATs) from pharynx and rectum should be confirmed by supplementary testing, using a second NAAT which detects a different nucleic acid target, all those with a positive NAAT for gonorrhoea should have culture and antimicrobial susceptibility testing and that TOC should be done by two weeks. Staff, associate specialist and specialty doctors performed a national audit against these standards.

Comment on "Multiple repressive mechanisms in the hippocampus during memory formation".

Cho et al. (Reports, 2 October 2015, p. 82) report that gene repression after contextual fear conditioning regulates hippocampal memory formation.

Progressive Differentiation and Instructive Capacities of Amniotic Fluid and Cerebrospinal Fluid Proteomes following Neural Tube Closure.

After neural tube closure, amniotic fluid (AF) captured inside the neural tube forms the nascent cerebrospinal fluid (CSF). Neuroepithelial stem cells contact CSF-filled ventricles, proliferate, and differentiate to form the mammalian brain, while neurogenic placodes, which generate cranial sensory neurons, remain in contact with the AF. Using in vivo ultrasound imaging, we quantified the expansion of the embryonic ventricular-CSF space from its inception.

Long-range regulation by shared retinoic acid response elements modulates dynamic expression of posterior Hoxb genes in CNS development.

Retinoic acid (RA) signaling plays an important role in determining the anterior boundary of Hox gene expression in the neural tube during embryogenesis. In particular, RA signaling is implicated in a rostral expansion of the neural expression domain of 5׳ Hoxb genes (Hoxb9-Hoxb5) in mice. However, underlying mechanisms for this gene regulation have remained elusive due to the lack of RA responsive element (RARE) in the 5׳ half of the HoxB cluster.

A national audit on the management of pelvic inflammatory disease in UK genitourinary medicine clinics.

The prompt and effective treatment of pelvic inflammatory disease (PID) may reduce the risk of complications such as infertility, ectopic pregnancy and pelvic pain. We conducted a national audit to investigate the treatment of women diagnosed with PID and associated rates of partner notification in genitourinary (GU) medicine clinics during 2008 and compared our results with the British Association of Sexual Health and HIV (BASHH) 2005 national guideline. Among a total of 1,105,587 female attendees, national data showed 18,421 cases of PID diagnosed in GU medicine clinics, giving an incidence of 167 cases per 10,000 attendences.

Non-consultant career grade doctors in genitourinary medicine - are they up to the job? National survey 2007.

Non-consultant career grade doctors in genitourinary (GU) medicine have been called 'a reliable silent backbone of the specialty' and 'a spare pair of hands' [Hiscock E. Non-consultant career grade staff in GU medicine; a reliable backbone or, a spare pair of hands? Int J STD AIDS 1996;7:375-7]. But are they adequate pairs of hands? This survey, conducted in July 2007, examined the work, qualifications and experience of these doctors.

The management of first episode genital herpes in genitourinary medicine clinics: a national audit in 2006.

A national audit of the management of first episode genital herpes (GH) was undertaken by non-consultant career grade doctors working in genitourinary (GU) medicine clinics in the United Kingdom. In total, 1620 data collection forms were completed (794 men and 826 women). Virus culture is the main detection method (1150, 71%), although polymerase chain reaction (PCR) use is increasing (442, 28%).

Genitourinary medicine clinic KC60 coding for first episode genital herpes: a lesson from north of the border?

A survey of the accuracy of applying the KC60 diagnostic code for genital herpes: first attack (C10A) was undertaken by non-consultant career-grade doctors working in genitourinary (GU) medicine in England, Wales and Northern Ireland. In total, 148 forms were returned (58% response). Overall, 88/148, 59.

Non-consultant career grade doctors in genitourinary medicine: as revalidation approaches, are some jobs at risk?

The Genitourinary Medicine Non-Consultant Career Grade Group (GUM NCCG Group) was established for the purpose of looking at training and contractual issues for this heterogeneous group of doctors. In June 2003, 700 questionnaires were posted to NCCG doctors in the UK to enquire about various aspects of working conditions. A summary of the 244 replies (35% response) is presented.

The acceptability of the introduction of a type specific herpes antibody screening test into a genitourinary medicine clinic in the United Kingdom.

Objective: To determine the uptake of a type specific herpes simplex antibody test if it were offered as part of routine screening in a genitourinary medicine clinic in a district general hospital in the United Kingdom.

Methods: Stage 1. A series of 207 consecutive new attenders and 205 patients who had attended the clinic previously were given written information about the test and asked whether they would want to have the test if it were available.

Managing the very young patient: a conflict between the requirements of the Children Act and the VD regulations?

We describe the case of a 12 year old girl who presented requesting screening for sexually transmitted infections and discuss a conflict between concerns of clinicians to maintain confidentiality and concerns of social workers to investigate the possibility of sexual abuse.

Clinical uses of herpes simplex virus type-specific serology.

Type-specific serological tests to distinguish between infection with herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) have largely been used for studies which have contributed to our knowledge of the epidemiology and natural history of these infections. Such tests could be used as diagnostic tools in clinical situations provided that clinician and patient are aware of the test characteristics, which may result in false negative and false positive results. The use of serological tests in the screening of populations or sub-populations, such as pregnant women, has been advocated to attempt to halt the worldwide spread of the infection.

Encouraging HIV testing in GUM clinics--can we dispense with the pre-test discussion? Genitourinary Medicine.

In a genitourinary medicine (GUM) clinic on the periphery of the London conurbation, HIV testing was promoted during a one-month period by offering testing without preliminary pre-test discussion to patients who assessed themselves to be low risk. The testing rate rose from 5.9% to 10.

"Existential" therapists and their group therapy practices.

Existential philosophical thought insists that human behavior is indeterminate and subject only to the individual's will. It is, therefore, skeptical of all dynamic psychologies based as they are on Freudian determinism. Group therapists imbued with this philosophy stop short of its extreme.

Risk of pulmonary aspiration among patients receiving enteral nutrition support.

We investigated the prevalence, incidence, and risk factors for pulmonary aspiration in all tube-fed adult patients over 6 months. Twelve aspiration events occurred among 276 patients (prevalence, 4.4%; 95% confidence interval, 2.

Inherent moral practice in group psychotherapy.

The large amount and variety of group psychotherapy practiced today enjoins us to determine its morality, that is, its rightness or wrongness. In this essay group therapy and morality are briefly defined. Using the writings of both philosophers and psychologists, evidence of morality is sought in the intentions and actions of both the patients and therapist and in the group process itself.