Understanding NHS pensions.

How much pension will you receive from the NHS Superannulation Scheme upon retirement? Some hospital doctors do not have a clear idea of the likely benefits or indeed any appreciation of the ancillary features included in the NHSSS. It is therefore appropriate to begin this series of articles on pension options for doctors with an overview of the NHS Scheme.     

Use of an enzyme immunoassay to detect serum IgG antibodies to Haemophilus ducreyi

An experimental enzyme immunoassay (EIA) for detecting serum IgG antibody to Haemophilus ducreyi was developed using an ultrasonicated whole-cell antigen. The mean optical densities (OD) for sera from men with proven chancroid from Nairobi (47 patients) and Bangkok (72 patients) were significantly higher than those obtained from Nairobi men with genital ulcers not due to H. ducreyi, from Nairobi men with urethritis, from pregnant women in Nairobi, and from European men with sexually transmitted disease. When an OD of 0.500 was taken as the cutoff value, 89% and 55% of men with proven chancroid in Nairobi and Bangkok, respectively, were positive for H. ducreyi antibody, as compared with 2%-17% in the control groups. A rise in OD was observed in five of 18 patients with clinical chancroid. These results confirm the development of circulating antibodies in chancroid and suggest that this EIA may be useful for the diagnosis and epidemiological study of H. ducreyi infection.     

Analysis of job-share as a process of change

This paper describes the introduction of a district nursing job-share in a primary health care team. Exploring change theory and different strategies for organizational change, the implications for members of the team are considered. In addition, changes in the balance of power which resulted in conflict within the district nursing team are discussed.     

Recruiting for success--the potential for using occupational personality questionnaires for the assessment of doctors.

OBJECTIVES: to evaluate the Saville and Holdsworth Occupational Personality Questionnaire (OPQ) to assess its potential and validity as a tool in the recruitment of doctors. To determine the range of personality characteristics in a group of general practitioners. DESIGN: an administered commercially available questionnaire. SETTING: general practitioners in North and Mid. Stafftordshire. SUBJECTS: 133 general practitioners or trainees. RESULTS: 44% of general practitioners agreed to participate. The majority found it useful and recognised its potential to increase self-awareness, highlight weaknesses that might be improved and for future recruitment of others to their teams. Doctors' personality traits were similar to those of managerial/professional norms. The validity of the OPQ was supported by (a) significant associations with subjects' previously reported mental health problems and (b) 83% of respondents confirming that their reports correctly described their personalities at work. CONCLUSIONS: OPQs have a place in the recruitment of doctors by identifying appropriate people to strengthen the team.     

Review: deterioration of glucose tolerance with age: the role of insulin resistance.

Glucose tolerance is determined by the balance of insulin secretion and insulin action and deteriorates with age. Insulin secretion does not appear to be reduced with increasing age, but many recent studies have demonstrated insulin resistance in healthy elderly subjects. However, this has not been a universal finding and the reasons for the discrepant results probably include general health, physical training, changes of liver size and delays in carbohydrate absorption. When confounding factors, particularly physical activity, are taken into account there appears to be little or no change in insulin action with age. Delays in monosacharride absorption may play a role. Maintaining physical fitness throughout middle and older age and so reducing hyperinsulinaemia may have benefits on reducing vascular disease.     

The effect of cigarette smoking on ovarian function and early pregnancy outcome of in vitro fertilization treatment

A retrospective analysis of the results of the first attempt at in vitro fertilization (IVF) treatment in 447 couples was performed by chart review. In 124 couples the female partners smoked cigarettes, and in 236 couples they did not. A total of 69 pregnancies (19.2%) were achieved, 50 in nonsmokers (21.2% per cycle), and 19 in smokers (15.3% per cycle). There were no significant differences in these cycles between the two groups in peak estradiol level achieved, the number of eggs retrieved, fertilization rate, or implantation rate. The incidence of spontaneous abortion was higher in smokers (42.1%) than in nonsmokers (18.9%). Consequently, the delivery rate per cycle of IVF was significantly lower in the smoking group (11 of 124, 9.6%) than in the nonsmokers (40 of 236, 17.0%). There was no effect when only the husband was a smoker. From these data, smoking appears to significantly reduce the chances of successful pregnancy after IVF treatment.