The time scales of the Paris Climate Agreement indicate urgent action is required on climate policies over the next few decades, in order to avoid the worst risks posed by climate change. On these relatively short time scales the combined effect of climate variability and change are both key drivers of extreme events, with decadal time scales also important for infrastructure planning. Hence, in order to assess climate risk on such time scales, we require climate models to be able to represent key aspects of both internally driven climate variability and the response to changing forcings. In this paper we argue that we now have the modeling capability to address these requirements—specifically with global models having horizontal resolutions considerably enhanced from those typically used in previous Intergovernmental Panel on Climate Change (IPCC) and Coupled Model Intercomparison Project (CMIP) exercises. The improved representation of weather and climate processes in such models underpins our enhanced confidence in predictions and projections, as well as providing improved forcing to regional models, which are better able to represent local-scale extremes (such as convective precipitation). We choose the global water cycle as an illustrative example because it is governed by a chain of processes for which there is growing evidence of the benefits of higher resolution. At the same time it comprises key processes involved in many of the expected future climate extremes (e.g., flooding, drought, tropical and midlatitude storms).

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The evaluation of urodynamic function by symptomatology, clinical examination, static radiography and endoscopy is considerably less reliable than is sometimes appreciated.Since the establishment of our Urodynamic Clinic we have reviewed more than 6,000 patients with dysfunctional voiding (Turner-Warwick and Whiteside, 1969) ; synchronous cine/pressure/ flow cystography has been used in the last 3,000 of these (Bates, Whiteside and Turner-Warwick, 1970). This communication is an attempt to summarise some aspects of our present thinking related to problems of bladder neck dysfunction and outflow impairment.In considering bladder outflow obstruction we must seriously question some commonly held precepts relating to the significance of various facets: symptomatology ; the absence of post-voiding residual urine; the endoscopic evaluation of the bladder neck ; trabeculation of the bladder; the actual size of the prostate; etc.

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Nineteen patients with Peyronie's disease were treated by a modification of Nesbit's operation. The deformity was completely corrected in 18 patients. Potency was restored to 4 of the 6 impotent patients and satisfactory coitus became possible for 15 patients, whereas it had been possible for only 3 before operation.