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The overall trend in the number of publications in the newly appointed National Health Service (NHS) consultants is examined for over a period of nine years. Results indicate a downward trend in the number of publications obtained by a gastroenterology trainee at time of their appointment to an NHS consultant post.

Background: The amount of published research that has been performed by a specialist registrar (SpR) at the time of appointment to a consultant post has no set expectations. It has been suggested that research s diminishing in all specialities in the United Kingdom. Aims: To observe any publication trends in newly appointed NHS consultants over a 9 year period. In addition, we assessed whether there were differences between district general hospital (DGH) appointments versus teaching centre hospitals (TCH). Methods: All consultant appointments and location of SpR training were noted from February 1993 to April 2001 (obtained from trainees in gastroenterology). A PubMed and Embase search was performed on each individual to note the number and type of publications up to 19 months post-appointment (previously described as the median time from submission to publication). The consultant name was then matched with his/her entry in the BSG handbook and any higher degree noted (PhD, MD or MA). If no degree was documented the individual's department was contacted to ascertain whether this information had not been supplied to the BSG. It was noted whether the appointment was at a DGH or TCH. Results: During the study period there were 362 appointments: 210 were NHS consultants appointments (52 excluded: consultant transfers n = 41 and academic appointments n = 11). There was a significant year by year reduction in the number of publications. 39% of consuhants were appointed in the region where they trained. A consultant was just as likely to have a higher degree if appointed to a DGH (68%, 80/118) or TCH (72%, 66/92). Consultants appointed to TCHs had a significantly greater number of publications (mean 15.6) compared with DGH consultants (mean 10.9, Χ², p = 0.01). Conclusion: There is a year by year, significant decreasing trend in the publication rate of SpRs' at the time of their consultant appointment. This could reflect diminished research funding... [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa status influences cystic fibrosis (CF) clinical management but no 'gold standard' definition exists. The Leeds criteria are commonly used but may lack sensitivity for chronic P. aeruginosa. We compared clinicians' decision with the Leeds criteria in three adult CF centres. Two independent prospective datasets (Sheffield dataset, n = 185 adults; ACtiF pilot dataset, n = 62 adults from two different centres) were analysed. Clinicians involved in deciding P. aeruginosa status were blinded to the study objectives. Clinicians considered more adults with CF to have chronic P. aeruginosa infection compared to the Leeds criteria. This was more so for the Sheffield dataset (106/185, 57.3% with clinicians' decision vs. 80/185, 43.2% with the Leeds criteria; kappa coefficient between these two methods 0.72) compared to the ACtiF pilot dataset (34/62, 54.8% with clinicians' decision vs. 30/62, 48.4% with the Leeds criteria; kappa coefficient between these two methods 0.82). However, clinicians across different centres were relatively consistent once age and severity of lung disease, as indicated by the type of respiratory samples provided, were taken into account. Agreement in P. aeruginosa status was similar for both datasets among adults who predominantly provided sputum samples (kappa coefficient 0.78) or adults > 25 years old (kappa coefficient 0.82). Across three different centres, clinicians did not always agree with the Leeds criteria and tended to consider the Leeds criteria to lack sensitivity. Where disagreement occurred, clinicians tended to diagnose chronic P. aeruginosa infection because other relevant information was considered. These results suggest that a better definition for chronic P. aeruginosa might be developed by using consensus methods to move beyond a definition wholly dependent on standard microbiological results.

Lung infections with Mycobacterium abscessus, a species of multidrug-resistant nontuberculous mycobacteria, are emerging as an important global threat to individuals with cystic fibrosis (CF), in whom M. abscessus accelerates inflammatory lung damage, leading to increased morbidity and mortality. Previously, M. abscessus was thought to be independently acquired by susceptible individuals from the environment. However, using whole-genome analysis of a global collection of clinical isolates, we show that the majority of M. abscessus infections are acquired through transmission, potentially via fomites and aerosols, of recently emerged dominant circulating clones that have spread globally. We demonstrate that these clones are associated with worse clinical outcomes, show increased virulence in cell-based and mouse infection models, and thus represent an urgent international infection challenge., (Copyright © 2016, American Association for the Advancement of Science.)