Aesthetic repair of meatal stricture

A more aesthetic correction of a meatal stricture that avoids the hypospadiac appearance of the glans after conventional meatoplasty procedures is presented.     

Correlation between the findings of a clinical neurological examination and the urodynamic dysfunction in children with myelodysplasia

Clinical neurological findings in 47 children with lumbosacral myelodysplasia did not correlate well with the existing dysfunction of the lower urinary tract as diagnosed by urodynamic studies. The level of intact skin sensation, and the presence or absence of bulbocavernosus and anal reflexes could not significantly predict the function of the detrusor muscle, proximal urethra and striated urethral sphincter. Therefore, one should not rely on a clinical neurological examination to outline the urological management in such patients.     

Suicide in Northern Ireland: a comparison of two quinquennia (1982–1986 and 1987–1991)

This study compares government records of death by suicide, in Northern Ireland, during two quinquennia in the decade 1982–1991. Specifically these quinquennia are 1982–1986 l 1987–1991. During the latter quinquennium there was an increse m rate for males in most age groups, except the 45–54 and the over 65 years age groups. However, females had an increased rate in the 15–24 and 35–54 years age groups, but have a decreased rate in the other age groups. There has been a decrease in the rate of suicides by poisoning with solids and liquids for both sexes. However, male suicide rates by more violent methods have increased substantially during the latter quinquennium. Three cohorts of males, those in the 15–24, 25–34, and 55–64 age groups, have shown substantial increases during the latter quinquennium. Suggestions for psychiatric intervention strategies are made.     

Protracted yet variable major pulmonary artery compression in sarcoidosis.

A case of thoracic sarcoidosis showing diffuse mediastinal lymphadenopathy was followed for a 6-month period with serial chest radiographs, perfusion lung scans, and pulmonary angiograms. Significant extrinsic pressure upon major pulmonary arteries from large lymph nodes of sarcoidosis was seen to cause marked restriction in pulmonary parenchymal perfusion on both scanning and angiography.     

Managing to care: the importance of using existing information to guide service provision for informal carers

All managerial deciions are taken on the basis of the information. It is important that managers use appropriate information to base their decisions upon about service provision to ensure erhcient use or resources. This basic premise serves as a framework for examining how quantitative and qualitative information can be of help to nurse managers in taking these decisions in the context of developing services for informal carers. The current emphasis on surveys as a means of assessing client need is questioned, and it is suggested that a wealth of evidence, relating to the experience of carers, already exists. Examples of accounts which express the needs of informal carers are presented and their utility, in terms of highlighting the carers' perspective, is discussed to reinforce the importance of utilizing this information. The paper concludes that nurse managers can use these sources as a basis for decision-making in the area of service provision and this may result in a more effective use of resources through a needs-based approach.     

Managing nurses and nursing: short courses as role development

This paper describes the development over a 3-year-period of short management courses for registered nurses offered as part of a professional development educational programme by Oxfordshire Health Authority (OHA) Clinical Education and Practice Team (OXCEPT). The courses were seen as role development for staff nurses, team leaders, sisters, charge nurses and senior sisters, and the content and length of courses were altered, extended and developed in response to evaluation of the courses by tutors and participants. The emphasis is on integrating participants' clinical, managerial and educational roles, as professional practitioners managing nurses and nursing.