This issue of Gastrointestinal Endoscopy Clinics provides a multidisciplinary approach to the evaluation and care of individuals with inherited gastrointestinal cancer conditions. With the many recent advances made in genomic medicine and the potential impact on medical management, the articles in this issue disseminate new knowledge on the identification and management of individuals and families with a genetic susceptibility to the development of gastrointestinal cancers, including the genetic basis and cancer risks associated with inherited cancer syndromes and integrated familial cancer risk assessment; genetic testing approaches; and incorporating genetic risk counseling into routine medical care. The goal is to improve detection of GI cancer syndromes, understand related cancer risks, and optimize strategies for the prevention and early detection of cancers to minimize morbidity and mortality. Integrating genetic assessment into gastrointestinal cancer care is highly relevant across the cancer care spectrum and gastroenterologists will come away with the most current evidence to enhance and improve their clinical practice. Provides in-depth, clinical reviews on Inherited GI Cancers: Identification, Management and the Role of Genetic Evaluation and Testing, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field; Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews. Contains 11 relevant, practice-oriented topics including Defining High-Risk Individuals for Pancreatic Cancer and the Role of Genetic Testing; Endoscopic Management and Surgical Consideration for FAP-Related Polyposis; Genetic Syndromes Associated with Gastric Cancer; Screening and Surgical Considerations in Hereditary Diffuse Gastric Cancer; and more.

Oxidative Stress and Antioxidant Protection: The Science of Free Radical Biology and< Disease provides an overview of the basic principles of free radical formation. The text delves into free radical formation in molecular biology and its effect on subcellular damage, as well as the role of antioxidant reserves as a protective mechanism. Oxidative Stress and Antioxidant Protection begins with a historical perspective of pioneers in oxidative stress with an introductory section that explains the basic principles related to oxidative stress in biochemistry and molecular biology, demonstrating both pathways and biomarkers. This section also covers diagnostic imaging and differential diagnostics. The following section covers psychological, physiologic, pharmacologic and pathologic correlates. This section addresses inheritance, gender, nutrition, obesity, family history, behavior modification, natural herbal-botanical products, and supplementation in the treatment of disease. Clinical trials are also summarized for major medical disorders and efficacy of treatment, with particular focus on inflammation, immune response, recycling, disease progression, outcomes and interventions. Each of the chapters describes what biomarker(s) and physiological functions may be relevant to a concept of specific disease and potential alternative therapy. The chapters cover medical terminology, developmental change, effects of aging, senescence, lifespan, and wound healing, and also illustrates cross-over exposure to other fields. The final chapter covers how and when to interpret appropriate data used in entry level biostatistics and epidemiology. Authored and edited by leaders in the field, Oxidative Stress and Antioxidant Protection will be an invaluable resource for students and researchers studying cell biology, molecular biology, and biochemistry, as well professionals in various health science fields.

A practical, portable handbook, newly updated with nearly 100 color images and figures, The Little GI Book: An Easily Digestible Guide to Understanding Gastroenterology, Second Edition is an invaluable resource for anyone new to the world of gastroenterology and hepatology. Featuring new information on the latest advancements in gastroenterology and hepatology and written in a friendly, conversational style, The Little GI Book will help readers learn the core concepts of digestive health and disease and absorb important information without a hiccup. Author Dr. Douglas G. Adler provides a comprehensive, soup-to-nuts guide to gastrointestinal anatomy, physiology, disease states, and treatment. With new color images throughout, The Little GI Book guides the reader through the entire gastrointestinal tract, starting at the top with the esophagus, ending at the bottom with the colon and rectum, and covering everything in between: the stomach, small intestine, liver, pancreas, bile ducts, and gallbladder. The Little GI Book is an indispensable pocket guide for residents, students, nurse practitioners, office staff, industry sales force, and anyone who works in the GI industry but isn't a gastroenterologist.

Millions of people suffer from chronic cramping, bloating, diarrhoea and gas. If you or someone you love is plagued by chronic digestive distress, you know what it's like to be held captive by your gut or spend thousands on drugs and treatments that bring only temporary relief. 'Trust Your Gut' shows you how to listen to your gut to interpret symptoms as important messages that can help correct imbalances.

Nurses must deliver up-to-date, clinically effective, evidence-based care across a range of settings and develop nursing services to meet changing demands. The thoroughly revised and restructured Oxford Handbook of Gastrointestinal Nursing 2nd edition is tailored to provide the essential knowledge nurses need; at their fingertips when they need it. This handbook will guide the reader through the care of patients with a wide range of conditions of the gastrointestinal tract. Each chapter is written in a consistent structure for ease-of-use, including symptoms, causes, investigations, and treatments. Key information is provided clearly and succinctly with tables and bullet points. Chapters cover everything from anatomy to the appropriate treatment or nursing care. It now includes new conditions including colorectal cancer, anal warts, cleft lip, and volvulus, as well as the enhanced recovery after surgery pathway. Providing key summaries of common problems and essential issues, it will provide both an invaluable reference for gastrointestinal nurses, as well as a precise, targeted guide for nurses from other specialties caring for patients with GI problems.

This issue details the latest knowledge of early diagnosis, risk factors, limited surgical treatments, and novel therapies for pancreatic diseases. Clinicians will learn the most prognostic scoring systems for acute pancreatitis, review the basics for early management of the disease, and see how current practice guidelines have evolved. Advances in radiological imaging when applied to the pancreas have resulted in enhanced staging and improved selection for surgical intervention. Endoscopy of the pancreas via both ERCP and endoscopic ultrasound has led to unprecedented access and potential for non-operative intervention. Pancreatic surgery now takes advantage of both minimally invasive approaches and techniques learned from organ transplantation. These latest advances are addressed in this issue by key opinion leaders.

Short bowel syndrome (SBS) is a pathologic condition which is characterised by reduced intestinal length and diminished intestinal absorptive capacity mainly due to extensive surgical resection, congenital defect, or pathological process affecting the small bowel. In recent decades, a better understanding of the underlying pathophysiology, new and modified surgical techniques and improvements in enteral and parenteral nutritional support improved the results of therapy of patients with SBS. This book provides research on the etiology, symptoms, surgical options and outcomes, and complications of SBS.

This book provides a comprehensive overview of the epidemiology, clinical features, radiology, classification, molecular genetics, diagnosis and treatment of gastrointestinal stromal tumors in both adults and children. Various chapters of the book summarise all the important research findings and provide an updated text for all those involved in the research and clinical management of this tumor. This book is written by experts in the field from all over the world who have considerable research, clinical interest and experience in the management of this tumor. The book is a concise review of the relevant basic and clinical research on gastrointestinal stromal tumors, and provides a summary of their current classification, diagnosis and treatment strategies in both adults and children. It intends to provide a deep insight into the current knowledge on the subject and summarises all the important relevant data. It contains numerous radiologic and pathologic images, research illustrations and data that is valuable in the overall understanding of all aspects of this important tumor. This book is intended for researchers, students, paramedical staff, patients and doctors involved in the management of patients with this tumor, including gastrointestinal physicians, pediatricians, oncologists, surgeons, radiologists and pathologists. By reading this book, patients gain insight into the management of their own tumors, students find a platform on which they can build their research projects, and nurses and doctors maintain an overall understanding of the subject.

Probiotics, a word of Greek origin composed of "pro" (promoting) and "biotic "(life), have been defined by the Food and Agriculture Organization of the United Nations (FAO) as "live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host". Over 500 different types of bacteria reside in the human digestive system. In recent years, the study of intestinal microbiota and therefore the use of probiotics have been extensively studied in promoting health, as well as in treating several diseases and not solely regarding the gastrointestinal system. This book summarises the more recent knowledge about intestinal microbiota, its pathological correlations and the use of probiotics in children for the maintenance, recovery, and strengthening of healthy strains at the expense of bad ones.

Die neu uberarbeitete und erweiterte Rontgenfibel dient dem angehenden Radiologen als Einfuhrung und Hilfestellung in den verschiedenen Disziplinen seines Fachgebiets. Sie informiert schnell und umfassend uber alles, was fur die radiologische Untersuchung wichtig ist: von der Indikation uber Instrumentarium/Apparaturen und deren praktische Anwendung bis hin zur Medikation. Die konventionellen radiologischen Verfahren werden ebenso dargestellt wie Computertomographie, Dopplersonographie, spezifische Techniken in der Neuro-und der Kinderradiologie sowie die Grundprinzipien der minimal-invasiven therapeutischen Verfahren. Dabei halten sich die einzelnen Kapitel eng an den chronologischen Ablauf der jeweiligen Untersuchung; vorangestellt sind ihnen Entscheidungshifen zur Prufung der Indikation (Rontgenverordung ) und die notigen vorbereitenden Massnahmen."

"Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition" is the first in class comprehensive multidisciplinary text to encompass the entire field of deglutition. The book is designed to serve as a treasured reference of diagnostics and therapeutics for swallowing clinicians from such diverse backgrounds as gastroenterology, speech language pathology, otolaryngology, rehabilitation medicine, radiology and others.

"Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition" brings together up-to-date information on state-of-the art diagnostic and therapeutic modalities form disciplines of gastroenterology, speech language pathology, otolaryngology and radiology through contributions of 28 innovators, and master clinicians for the benefit of patients and providers alike. It concisely organizes the wealth of knowledge that exists in each of the contributing disciplines into one comprehensive information platform. "Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition" provides a one-stop destination for members of all specialties to obtain state-of-the-knowledge information on advanced diagnostic modalities and management. It is an essential reference for all deglutologists."

Upper gastrointestinal bleeding is the leading emergency leading to hospitalization and urgent endoscopy. The field of gastrointestinal bleeding is rapidly evolving. The epidemiology is changing with more complex older patients on anticoagulant and antithrombotic agents presenting with upper gastrointestinal bleeding. The initial management has rapidly evolved with new transfusion thresholds, the use of risk stratification scores and no more nasogastric tubes. There is new data and recommendations on optimal timing of endoscopy. Medical therapies have also evolved with changes in proton pump inhibitor administration and the use of prokinetics to improve endoscopic visualization. Many modifications in endoscopic therapy have recently been advanced including the use of endoscopic ultrasound guided angiotherapy, topical sprays (i.e. Hemospray) and over-the-scope clips. In order to give optimal care to patients, it is critical that practicing gastroenterologists are aware of the many recent advances in management of patients with upper gastrointestinal bleeding.

Uncommon gastrointestinal diseases are a worrisome and challenging problem for gastroenterologists and GI Pathologists. In this book, the authors present research in the study of the epidemiology, management and prevention of uncommon gastrointestinal diseases (eg: isolated gastroduodenal Crohn's disease, primary lymphangiectasis of intestine, microscopic colitis, eosinophilic gastroenteritis, solitary rectal ulcer syndrome and primary splenic epithelial cysts). This book is definitely useful for gastroenterologists and GI pathologists for the diagnosis, treatment and prevention of these uncommon conditions.

Severe trauma represents one of the biggest issues threatening modern healthcare systems across the globe. Traumatic injury is the leading cause of lost life years worldwide, responsible for an excess of 5 million deaths every year. The role of laparoscopy in trauma has not paralleled its popularity in other areas of general surgery for several reasons including the emergent nature of many of the operations, the lack of expertise and comfort level of some surgeons and the fear of missed injuries. In this book, the possible indications and pitfalls of integrating minimally invasive surgical techniques into the management of abdominal injuries are examined. Furthermore, post-traumatic haemorrhage is likely to represent the principle cause of preventable deaths amongst patients sustaining major traumatic injuries. Management of these patients and techniques (both old and emerging) are discussed, which may be able to more accurately identify early coagulopathy and enable goal-directed, targeted therapy. The third chapter of the book describes currently accepted classifications of pelvic trauma to examine the link between mechanism of injury and factors predictive of mortality. Recent advances made in services, protocols, imaging, instrumentation and management of pelvic trauma are examined, specifically looked at to determine whether any of it has served to improve the historically poor prognosis. Lastly, pancreatic injury in childhood is rare, constituting 0.3% to 0.7% of all trauma admissions at large paediatric trauma centres. Nonetheless, they do occur. The authors explore pancreatic duct ruptures in children, the subsequent diagnosis and treatment options, which usually require surgery or other interventional therapy and carry a significant risk of morbidity.

Intussusception is the most frequent cause of bowel obstruction in infants and toddlers. In this book, the symptoms and clinical findings of intussuception are discussed. The clinical guidelines for the management of intussuceptions in children are discussed as well. Other chapters examine the diagnosis, etiology, pathophysiology and treatment modalities for both small bowel obstruction and intussusception of the small bowel, focusing on minimally invasive surgical options; the etiology of afferent loop obstruction; the treatment options for adhesive small bowel obstruction (SBO), a common complication typically caused by adhesions that form after abdominal surgery; a literature review of traditional medical treatment options and a discussion on the authors' experiences in treating gynaecological cancer patients with non-malignant bowel obstruction using manual physical therapy.

Acing the GI Board Exam: The Ultimate Crunch-Time Resource has been updated into a Second Edition. The Second Edition contains new vignettes, a discussion on Maintenance of Certification Exam (MOC), and discussion on test relevancy for residency rotations! In today's fast-paced world, gastroenterology and hepatology residents and fellows struggle to find the time to study for the board exams, prepare for the recertification exam, prepare for teaching rounds, or just plain read. What is the best way to effectively prepare and study, if reading multiple resources can't seem to fit into your daily schedule? The answer to your study questions (and study time!) can be found inside the newly updated Second Edition of Acing the GI Board Exam: The Ultimate Crunch-Time Resource! Why You Will Need to Read Acing the GI Board Exam, Second Edition: New! 41 new and carefully vetted board-style vignettes with color images New! Brief discussion on the Maintenance of Certification Exam (MOC) New! Discussion on test relevancy for residency rotations Comprehensive yet succinct answers using a high-yield format Emphasis on key clinical pearls and "board buzzwords" Answers to classic board "threshold values" questions that you need to know but always seem to forget Rapid-fire, crunch-time exam with 195 classic one-liners Dr. Brennan M. R. Spiegel has collected every pearl of wisdom, high-yield factlet, ""Board buzzword,"" micrograph, and classic imaging study he could muster, all while keeping Acing the GI Board Exam: The Ultimate Crunch-Time Resource, Second Edition a manageable size. Acing the GI Board Exam, Second Edition fills the unmet need in board review by presenting time-tested and high-yield information in a rational, useful, and contextually appropriate format suitable studying for the board exams and preparing for the recertification exam. Chapters Include: A compilation of general lessons learned from past test-takers "Tough Stuff" board review vignettes Board review "Clinical Threshold Values" "Crunch-Time" Self-Test and Answer Guide-time to get your game on! With its focus on pearl after pearl, emphasis on images, and attention to high-yield "tough stuff" vignettes you don't know the answers to (yet), Acing the GI Board Exam, Second Edition is truly the ultimate crunch-time resource for acing the GI and Hepatology examination, taking recertifying examinations, looking good on clerkship rounds, or for just challenging yourself with interesting and entertaining vignettes.

Variceal Hemorrhage provides an update of the evidence concerning several aspects of variceal hemorrhage. The book features new information on natural history, diagnosis of esophageal varices, assessment of the risk of bleeding and identification of high risk groups and patients who may benefit or be harmed from different treatments. The volume also presents a critical analysis of the different steps in the management of acute variceal bleeding. Authored by the most prominent world experts in their areas of expertise, Variceal Hemorrhage serves as a very useful reference for gastroenterologists, GI surgeons, residents in internal medicine and physicians dealing with and interested in the different aspects of this severe medical emergency.

Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.

Diet and Exercise in Cystic Fibrosis, a unique reference edited by distinguished and internationally recognized nutritionist and immunologist Ronald Ross Watson, fills the gap in the current dietary modalities aimed at controlling cystic fibrosis. Using expert evaluation on the latest studies of the role of food and exercise in lifelong management of cystic fibrosis, this valuable resource shows how to maintain intestinal, hepatic, and pulmonary high quality function for improving quality of life for those with cystic fibrosis. A helpful tool for researchers and clinicians alike, this reference helps refine research targets, and provides the beginning of a structured dietary management scheme for those with cystic fibrosis.

"Celiac Disease and Gluten: Multidisciplinary Challenges and Opportunities" is a unique reference work the first to integrate the insights of the causes and effects of celiac disease from the chemistry of reaction-causing foods to the diagnosis, pathogenesis, and symptoms that lead to proper diagnoses and treatment. With an estimated three million people in the United States alone affected by celiac disease, an autoimmune digestive disease, onlyfive percentare properly diagnosed. Drawing on the connection between foods containing gluten and the resulting symptoms, this resource offers distinctive information that directly explores and links food science, medical diagnostics, and treatment information. A helpful tool for researchers and medical practitioners alike, "Celiac Disease and Gluten: Multidisciplinary Challenges and Opportunities" helps refine research targets, and provides a comprehensive overview on the multidisciplinary approaches to all crucial aspects related to celiac disease.
Presents key information from medical and food science research, as well as provides clinical insightsProvides direct corollary insights between source and symptomWritten by experts whose detailed experiments and results have shaped our understanding of celiac disease"

"Molecular Diagnostics andTreatment of Pancreatic Cancer "describes the different emerging applications of systems biology and howit is shaping modern pancreatic cancer research. This book begins by introducing the current state of the art knowledge, trends in diagnostics, progress in disease model systems as well as new treatment and palliative care strategies in pancreatic cancer. Specific sections are dedicated to enlighten the readers to newer discoveries that have emerged from gene expression profiling, proteomics, metabolomics and systems level analyses of pancreatic cancer datasets. First of a kind and novel network strategies to understand oncogenic Kras signaling in pancreatic tumors are presented. The attempts to computationally model and prioritize microRNAs that cause pancreatic cancer resistance are alsohighlighted.

Addressing this important area, "Molecular Diagnostics and Treatment of Pancreatic Cancer" provides insights into important network evaluation methodologies related to pancreatic cancer related microRNAs targetome. There are dedicated chapters on critical aspects of the evolving yet controversial field of pancreatic cancer stems cells. The work concludes by discussing the applications of network sciences in pancreatic cancer drug discovery and clinical trial design.
Encompasses discussion of innovative tools including expression signatures in cell lines, 3D models, animal xenograft models, primary models and patient derived samples, aiding subversion of traditional biology paradigms, and enhancing comprehension across conventional length and temporal scalesCoverage includes novel applications in targeted drugs, polypharmacology, network pharmacology and other related drug development arenas - helping researchers in pancreatic cancer drug discoverySummarizes many relevant computational and clinical references from fast-evolving literatureComprehensive glossary helps newer readers understand technical terms and specialized nomenclature"

Bariatric surgery has led to improved health outcomes including significant weight loss and reduction in co-morbidities among patients with obesity. Clinical practice guidelines recommend that patients considering bariatric surgery undergo a comprehensive nutritional assessment. Nutrition and Bariatric Surgery is the first comprehensive book that uniquely addresses the dietary and nutritional care of the bariatric surgery patient. This book reviews the nutritional and physiological changes imposed by surgical revision of the gastrointestinal tract. Also discussed are nutritional assessment of the bariatric surgical patient as well as pre- and postoperative dietary management recommendations. Other clinical topics covered include nutritional anemia, metabolic bone disease, neurological disorders, and protein-calorie malnutrition. Nutrition and Bariatric Surgery examines eating behaviors before and after bariatric surgery as well as psychological issues, mood disorders, and nutritional concerns associated with weight regain. The book also addresses nutritional needs of special populations undergoing bariatric surgery including adolescents, pregnant or lactating women, and severely obese ICU patients. The book is an authoritative guide for health care professionals caring for the bariatric patient including physicians, dietitians, physician assistants, nurses, and nurse practitioners.

Diseases of the pancreas have been extremely difficult to study. Until relatively recently, the pancreas was viewed by surgeons as an organ to be avoided, given its deep retroperitoneal location and the sometimes severe consequences of manipulation. Similar difficulties have plagued careful study of the pancreas. In humans, only inf- quently have we had the opportunity to evaluate the evolution of d- eases of the pancreas; instead, we are confronted with end-stage chronic pancreatitis or acute pancreatitis with extensive necrosis of the gland. Within the past decade, revolutionary techniques in molecular biology, genetics, and animal models have begun to give us dramatic new insights into pancreatic disease. Coupled with these advances has been a slow but steady progress in the development of our clinical tools for diagnosing and treating pancreatic diseases. These advances place us on the threshold of a much more complete understanding of pancreatic diseases, opening up new opportunities for novel therapies and preventive measures. Pancreatitis and Its Complications brings together many of the world's experts in pancreatic diseases. These "pancreatologists" include basic scientists, endoscopists, gastroenterologists, and surgeons. The ch- ters have been organized to provide a comprehensive discussion of acute and chronic pancreatitis, with up-to-date discussions of pat- physiology, epidemiology, diagnostic strategies, treatment, and c- plications of disease. It is hoped that this text will serve as a useful reference for clinicians as well as provide a clinical background for scientists with an interest in pancreatic or related diseases.

Similar to the first edition, the goal of Mayo Clinic Gastrointestinal Imaging Review, 2nd Edition is to provide an atlas of common abnormalities that affect the gastrointestinal tract. This comprehensive review includes all imaging modalities used within GI radiology, as well as plain radiographs, fluoroscopy, ultrasound, CT, MR, angiography, and nuclear medicine. Focusing solely on adult conditions, the book is divided into 13 chapters covering a separate organ within the gastrointestinal system and a final exam chapter reviewing all chapter content. Each organ-focused chapter is subdivided into sections related to diseases or findings of that organ. Running headers allow the reader to rapidly identify the chapter and the section being viewed.
Large, high-quality images are presented in a format so that they can be reviewed as unknowns. A discussion of the cases is presented as if it were a consultation-- with a description of the findings, differential diagnosis, and final diagnosis. A brief discussion of the disease is included. Emphasis is placed on brevity of the text and a single-page layout for all but a few cases. Study guides at the end of each section are in the form of tables summarizing major radiographic findings into differential considerations with brief imaging clues to a specific diagnosis and case references within the book. The end of each chapter lists differential diagnoses for the chapter's specific organ. Full-color composite anatomical illustrations show the immediately obvious appearance of common conditions that correlate with major radiologic findings.

Gastroenterology and Hepatology Lecture Notes is a comprehensive yet easy-to-read overview of luminal gastroenterology and hepatology. Covering the epidemiology, causes, clinical features, investigation, treatment and prognosis of all the main gut and liver conditions, it is ideal for both exam preparation and fact finding. Key features include: A full range of new illustrations, including clinical photographs and scans, that clearly demonstrate signs and symptoms Sections on anatomy, physiology, pharmacology, and epidemiology written to enhance understanding of clinical features Essential information highlighted throughout the text Case-based self-assessment for each chapter helps retention of knowledge and puts it in its clinical context A new section of best answer MCQs New chapters on inflammatory bowel disease and different diagnosis of the upper GI tract Includes a companion website at www.lecturenoteseries.com/gastroenterology featuring 16 in-depth case studies Whether learning the basics of the gastrointestinal system, starting a general medical or gastroenterological placement, or looking for a quick-reference overview to revise key concepts, Gastroenterology and Hepatology Lecture Notes is an ideal resource for medical students, MRCP or FRACP candidates, and junior doctors.