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Objectives: To describe a series of lymphogranuloma venereum (LGV) cases presenting as inguinal syndrome and/or genital ulceration seen among men who have sex with men (MSM) in London, UK. Methods: Collaborative retrospective case note review. Clinicians from three London genitourinary medicine (GUM) clinics accessed by large populations of MSM within the current LGV outbreak collected clinical data from confirmed cases of LGV inguinal syndrome or genital ulcer. LGV was confirmed by the detection of LGV-specific DNA from specimens such as bubo aspirates, ulcer swabs, urethral swabs, first void urine and rectal biopsy material. Results: There were 13 cases detected overall: 5 cases of urethral LGV infection with inguinal adenopathy, 3 cases of genital ulcer with LGV inguinal adenopathy, 3 cases of isolated LGV-associated inguinal buboes, 1 case of a solitary LGV penile ulcer and 1 case with a penile ulcer and bubonulus. Only 6 of the 13 were HIV positive and all tested negative for hepatitis C. The majority of cases reported few sexual contacts in the 3 months preceding their diagnosis. Conclusions: Clinical manifestations of LGV in MSM have not been confined to proctitis in the current outbreak in the UK and a small but significant number of inguinogenital cases of LGV have been observed. Epidemiologically, many of the cases described seem to have occurred at the periphery of the current MSM LGV epidemic. Clinicians need to be vigilant for these less common presentations of LGV among MSM and specific diagnostic tests should be done from the relevant lesions. [ABSTRACT FROM AUTHOR]

Focuses on the consensus made around the twelve-sixties relating to Spalding priory in England. Key features of the economic and social history of Spalding priory; Evidence on vagabonds relating to the manors of the priory; Manner of immigration from Spalding manors.

'Dementia Friends' is a programme used to raise awareness of dementia, developed by the Alzheimer's Society, which has been delivered across the UK to diverse populations, including adolescents. However, there is little evidence available with regards to adolescents' perceptions of the programme and its impact. This study aims to explore this in a group of adolescents from the south of England. Focus group discussions. Thirty adolescents aged between 11 and 16 years were recruited from two schools in East Sussex, England. All had participated in a Dementia Friends session in the past month. Focus group discussions were transcribed, coded and themes were created using inductive thematic analysis. Four themes were identified: (1) perceptions and experiences of dementia, (2) outcomes and learning from Dementia Friends session, (3) reactions to the Dementia Friends session and (4) identified future learning needs. Adolescents had generally positive opinions about Dementia Friends, particularly the interactive nature of the session. Whilst they felt participating in Dementia Friends improved their attitudes and knowledge, they were often left wanting to learn more. Future research needs to empirically evaluate the extent to which Dementia Friends may improve attitudes and knowledge of dementia. • Dementia Friends is an enjoyable initiative for adolescents. • Adolescents held positive attitudes and perceptions about people with dementia. • Adolescents felt the initiative improved their knowledge about dementia. • Future research needs to quantify the initiatives impact on attitudes and knowledge. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to articles on the number of small live births and total births in England and Wales since 1962 by Ronald R. Gordon in the November 5, 1977 issue and the trend in Cardiff, Wales by R. Newcombe and I. Chalmers in the October 8 issue.

Background: Parkinson's disease (PD) is a common neurodegenerative condition. Despite the recognised need for palliative care in PD, access to either generic or specialist palliative care (SPC) remains poor. Integrated SPC models of care have been described in other conditions. We report the experience of a novel service integrating SPC services for people with PD.Innovation: The Scarborough integrated PD SPC service is a joint venture between St Catherine's hospice and the movement disorder clinic at Scarborough General Hospital. Patients with potential palliative care needs are discussed at a monthly multi-disciplinary team meeting with representation from Elderly and palliative care teams.Evaluation: We retrospectively reviewed the case notes of all 47 patients (34 Male, Ave. Age 77 years) referred for SPC since the service started (30 months). At referral average disease duration was 85 months (range 5-321), mean L-dopa dose was 482mg and 34% of patients were in 24 hour care. Common triggers for referral included; complex symptoms (81%), future care planning (79%) and aspiration pneumonia /dysphagia (30%). Most carers had evidence of strain (88%) and most patients did not retain capacity for complex decision making (81%). 23 patients died and place of death was known for 22; with only 13% of deaths occurring in acute hospital beds (Care home 34%, Hospice 26%, Own home 13%, Hospital palliative care bed 8%).Conclusions: Access to SPC for PD is achievable in a district general setting. Experience so far indicates a dramatic reduction in death in hospital and increased deaths at home/hospice compared with previous UK data (Snell K et al. Age and Aging 2009; 38(5): 617-19). Cognitive impairment and 24 hour care were common, suggesting referral late in disease. Important triggers to consider referral for SPC include; carer support, future care planning, management of complex persistent symptoms and terminal care. [ABSTRACT FROM AUTHOR]