Atoms
Grades of... He’d worked hard, ‘burning the candle at both ends’ as his parents described it. Poring over the set, if fusty, reference books he’d loaned, ransacking the dusty shelf of the high street library, the lady at the desk raising eyebrows as she stamped the backpack-sized pile of tomes. Still, he’d set himself a target: at least a B, a grade which would unfetter him from scholastic thoughts for the summer, a summer in which, after earning some money on the farm, he could fill with a trip to the West Country, the new loco from Paddington the ideal start point. Pressing the point: 1 Though still relatively hot off the press, the Phoenix sepsis score will by now be familiar to most. Designed to refine and enhance early detection of sepsis where previous predictive tools had performed, at best, moderately, it uses a composite...
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A small but welcome light on the child-adult transition in epilepsy
The transition, and then transfer, from child to adult neurology represents one of the most consequential and under-examined junctures in the long-term management of epilepsy. For young people with epilepsy, this handover is not just administrative. The stakes are high as this handoff represents a period of profound clinical vulnerability during which continuity of care, therapeutic relationships and seizure control can be compromised.1 Given its import, it is sobering that we still lack true consensus on what a successful transition looks like, let alone robust evidence regarding whether we are achieving it for our patients. The study by Modi and colleagues2 evaluating the rate of successful transition and transfer of young adults from the paediatric epilepsy clinic at the University College London Hospital to the National Hospital for Neurology and Neurosurgery between 2009 and 2023 sheds a small but welcome light on this knowledge gap....
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Non-therapeutic male circumcision: a clinical and legal perspective on minimum standards of practice in the UK
Introduction Male circumcision may be performed for clinical reasons or to comply with religious or cultural practice. Non-therapeutic male circumcision (NTMC) is not uniformly available in the NHS but is undertaken, generally by highly skilled circumcisionists, in non-clinical settings in children (non-competent minors) without general anaesthesia. This is authorised on the basis of a best interest decision and parental consent. There are occasions, however, where failure to adhere to minimum clinical standards of care in these settings has led to patient harm. The recent sentencing of Mohammad Siddiqui is a timely reminder of the regulatory, criminal and civil sanctions that may apply to those who perform NTMC without adequate regard to minimum standards of care. NTMC is carried out in the Jewish Community as part of the Brit Milah ceremony, an integral and enduring practice that has continued since Biblical times. The majority of mohalim (Jewish religious circumcision...
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What is in a name: the Supreme Court and anonymity
Introduction An application can be made to the Family Division of the High Court to invoke its inherent powers to withdraw life-sustaining treatment to a child. There has been an increase in the number of cases attracting national and international media attention,1 2 with a corresponding concern surrounding the impact on clinicians called as witnesses in these proceedings. While all parties seek to keep the child at the heart of the proceedings, there is also a risk to witnesses of abuse and harassment. To date, the High Court has provided wide protection of the anonymity of the child, clinicians and treating organisation through a reporting injunction. There is a precedent indicating that this protection has been granted for an indefinite duration. The issue to be determined by the Supreme Court in these aligned cases was the balancing act between a parent’s right to freedom...
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