A postal survey to identify and describe nurse led clinics in genitourinary medicine services across England

Background: Nurses in genitourinary medicine (GUM) services are progressively extending their roles to conduct "comprehensive care" nurse led clinics. In such roles the nurse coordinates the first line, comprehensive care of patients presenting with sexual health conditions and issues. Objectives: To identify and describe comprehensive care nurse led clinics in GUM services across England. Methods: A postal questionnaire consisting of 17 closed response questions was sent to 209 GUM services across England. A second questionnaire was sent to non-responders to increase the response rate. Data were single entered and analysed using SPSS. Results: Of the 190 GUM clinic respondents (91% response rate), 44 (23%) reported providing some form of comprehensive care nurse led clinic, 90% of which were initiated since 1995. Key results show staff development featured as the main reason for initiating such services and there was general consistency in the aspects of care undertaken by these nurses. There was evidence of guideline development specific to nurse led care and some patient group direction use for supplying medication. The level of support from medical staff while nurse led clinics were being conducted varied between services. Few services have conducted any audit or research to monitor/evaluate nurse led care. There was little consistency in the clinical experience and educational prerequisites to undertake comprehensive care nurse led clinics. Continuing professional development opportunities also varied between services. Conclusions: The steady growth of comprehensive care nurse led clinics indicates that the skills of GUM nurses are being recognised. Nurses working in advanced practice roles now require courses and study days reflecting these changes in practice. Locally agreed practice guidelines can define nursing practice boundaries and ensure accountability, as will the development of patient group directions to supply medication. Monitoring and evaluation of nurse led clinics also require attention

How typical is the Coma cluster?

Coma is frequently used as the archetype z~0 galaxy cluster to compare higher redshift work against. It is not clear, however, how representative the Coma cluster is for galaxy clusters of its mass or X-ray luminosity, and significantly: recent works have suggested that the galaxy population of Coma may be in some ways anomolous. In this work, we present a comparison of Coma to an X-ray selected control sample of clusters. We show that although Coma is typical against the control sample in terms of its internal kinematics (substructure and velocity dispersion profile), it has a significantly high (~3sigma) X-ray temperature set against clusters of comparable mass. By de-redshifting our control sample cluster galaxies star-formation rates using a fit to the galaxy main sequence evolution at z < 0.1, we determine that the typical star-formation rate of Coma galaxies as a function of mass is higher than for galaxies in our control sample at a confidence level of > 99 per cent. One way to alleviate this discrepency and bring Coma in-line with the control sample would be to have the distance to Coma to be slightly lower, perhaps through a non-negligible peculiar velocity with respect to the Hubble expansion, but we do not regard this as likely given precision measurements using a variety of approaches. Therefore in summary, we urge caution in using Coma as a z~0 baseline cluster in galaxy evolution studies.Comment: accepted for publication in MNRA

Living absence:the strange geographies of missing people

In this paper ‘missing people’ gain an unstable presence through their (restaged) testimonies recounting individual occupations of material urban public space during the lived practice of absence. We explore ‘missing experience’ with reference to homeless geographies, and as constituted by paradoxical spatialities in which people are both absent and present. We seek to understand such urban geographies of absence through diverse voices of missing people, who discuss their embodiment of unusual rhythmic occupations of the city. We conclude by considering how a new politics of missing people might take account of such voices in ways to think further about rights-to-be-absent in the city

Effects of student ratings feedback and a group intervention on the quality of university teaching : a randomised controlled trial

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