Comment: Generation X Paul Woolley pp 4-6 The term Generation X came from a fictional book of the same name written in 1991 by the Canadian author, Douglas Coupland, about three strangers who decided to distance themselves from society to get a better sense of who they are. The media saw many elements of Coupland’s strangers in the lives of the youth of the day and gave them the title of ‘Generation X’. Such a stereotypical image, while initially confined to North America, has been increasingly recognised in the UK.
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Sex and cardiovascular disease in men Mike Kirby pp 7-9 The myth that sex can be dangerous has been perpetuated throughout history by stories of public figures whose premature demise is apparently linked to sexual activity. For example, in 1979, the former US Vice-president Nelson Rockefeller died at the age of 70 in the company of his 27-year-old Personal Assistant, Megan Marshak. Although there have been cases of men expiring during the act of sexual intercourse, the odds of this happening are one sudden death per 1.51 million episodes of exertion.
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Female incontinence part 2 – surgical treatments James Balmforth and Linda D Cardozo pp 11-13 Urinary incontinence is a distressing symptom that has a major impact on a woman’s quality of life. While the prevalence of urinary incontinence has been found to vary widely depending on the definition used, a recent large-scale epidemiological study showed that 25% of women complained of urinary leakage and 7% had significant incontinence that was bothersome. Incontinence frequently leads to embarrassment, anxiety and, in some cases, social isolation.
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A fitting approach to coils Sam Hutt pp 14-15 There is at last a male contraceptive similar to the female intrauterine devices (IUDs). An intraprostatic device (IPD) is fitted via the urethra into the prostate. Fitting is simple, like passing a urinary catheter. With a Perl index of 0.4, it is 99.6% effective – as efficient as the gold standard IUDs. Some discomfort is to be expected during the fitting, minimised by the use of lignocaine gel. Vasovagal attacks are unusual and managed as in women’s IUD fittings. This approach to male contraception is tremendously exciting. It is cost-effective, long-lasting and avoids systemic hormones.
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Supplementary prescribing Rachel Webb pp 16-18 In November 2002, Health Minister Lord Philip Hunt announced new powers that would allow pharmacists and nurses to prescribe a wide range of drugs from early 2003, following a diagnosis by a doctor and within an agreed clinical management plan (CMP). This long-awaited announcement paved the way for pharmacists and nurses to take on prescribing responsibilities and further enhance their contribution to patient care.
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Resistance testing in HIV infection – an overview Suni Vitharana and Margaret Kingston pp 20-23 The first case of Acquired Immune Deficiency Syndrome (AIDS) was reported by the Center for Disease Control in 1981, after the unexplained occurrence of pneumocystis carinii pneumonia in previously healthy male homosexuals in the USA. This led to the identification of the human immunodeficiency virus (HIV) in 1983. It is now known that two types of HIV exist; HIV-1 and HIV-2, both of which lead to progressive depletion of CD4 lymphocytes over a variable amount of time, usually several years, resulting in AIDS. HIV-1 is the most prevalent strain worldwide, with HIV-2 limited mainly to Western Africa.
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Addressing the psychosexual needs of the gynaecological oncology patient Heather Pratt and Nancy Parkinson pp 25-28 The change in cancer services, following publication of the Guidance on commissioning cancer services: Improving Outcomes in Gynaecological cancers (IOG), has highlighted the need for psychosexual care for all women treated for gynaecological cancer. These guidelines also state that the clinical nurse specialist (CNS) is in an ideal position to begin to address these issues and refer patients on to counsellors and psychologists as required.
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The patter of tiny feet David Hicks pp 31-31 This is now the third on my list of weird pregnancy stories. The Daily Express of 29 June 2004 (page 30), described a mother of two from South Eastern Iran who claims to have given birth to a frog! Speculation is that frogspawn from a dirty pool entered the reproductive tract while she was swimming. The creature is then said to have grown inside her body. While genetic and anatomical tests have not been performed, the local newspaper carried quotes from a medical expert detailing the human characteristics of the animal.
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