Vision screening of school children: should it be continued?

Vision screening of all children at school entry has been a traditional practice for many years. Recently, decisions have been made to discontinue screening and to rely on parent and teacher referral methods instead. A review of the literature suggested that parent and teacher referral methods of screening were less than satisfactory, and that professional screening of all children at school entry age should be continued.

Incontinence aids for home use.

Specific knowledge of the relative merits and costs of equipment and techniques will enable individualized incontinence management for greater patient comfort.

Monitoring asthma with a Mini-Wright Peak Flow Meter.

Clinical assessments of the degree of airway obstruction in asthma are known to be unreliable. Objective measurements of pulmonary function are essential to assessing the severity of asthma. Recently, an inexpensive, portable machine, the Mini-Wright Peak Flow Meter, has become available for clinic and home use. This article describes ways the nurse practitioner can use this meter to improve diagnosis and treatment of asthma. Peak flow measurements can be used to diagnose asthma, and are especially useful in atypical and severe presentations of the disease. Treatment is enhanced by both clinic and home monitoring of response to medications. Regular home monitoring can also improve patients' abilities to provide self-care. Several examples from a case study are given which illustrate the usefulness of home monitoring in medication management, in detection of diurnal variation of the asthma and in the identification of acute illness.

Prevalence of urinary incontinence.

The prevalence of urinary incontinence was investigated by determining the number of incontinent patients under the care of various health and social service agencies in two London boroughs and by a postal survey of the 22 430 people aged 5 years and over on the practice lists of 12 general practitioners in different parts of the country. The prevalence of incontinence known to the health and social service agencies was 0.2% in women and 0.1% in men aged 15-64 and 2.5% in women and 1.3% in men aged 65 and over. The postal survey, to which 89% of the people whose correct address was known replied, showed a prevalence of urinary incontinence of 8.5% in women and 1.6% in men aged 15-64 and 11.6% in women and 6.9% in men aged 65 and over. Nulliparous women had a lower prevalence than those who had had one, two, or three babies, but within the parity range of one to three there were no differences in prevalence. The prevalence was appreciably increased in women who had had four or more babies. Incontinence was moderate or severe in a fifth of those who reported it in the postal survey, of whom less than a third were receiving health or social services for the condition. Incontinence is a common symptom, and many unrecognised cases appear to exist. There may be considerable scope for improving its management.