✓ A series of 50 fatal cases of craniospinal injury were reviewed with particular attention to the pathological findings at the craniospinal junction. There was marked tendency for the spinal cord to be damaged in the upper cervical segments, whereas disc injuries predominated in lower cervical segments. The vertebral artery was rarely involved. The lateral ligamentous structures were often damaged, while the transverse ligaments of the odontoid were spared. Rupture of muscles was rare, although hemorrhage into muscles was common.
Intimate partner violence, also known as domestic violence, is a leading health problem affecting approximately 50% of women during the course of their lifetime. A large percentage of the abusers also abuse their children and older adults. Nurses are in a key position to identify and intervene with victims of abuse. However, a major barrier to screening and referral is lack of education. Nurses indicate a lack of education in their formal undergraduate and graduate programs. Therefore, nurses should be introduced to this topic through a 2-hour continuing education program.
Roberts, while worried about many of the same issues, fears that the reforms may "depoliticise" and therefore weaken the NHS: "The fact that the government takes a position at all is exactly what makes medicine in the United Kingdom so different from that in America. The United States government avoids dealing with medical care as much as possible, recognising that whatever policies are instituted some major constituency will be offended. .. in the last presidential election neither George Bush nor Michael Dukakis offered a specific statement on health care.... The great gap is not between Americanisation and socialised medicine. It is between a system run by business versus one run by politics, by the standards of the market versus those of public discourse."6 As someone who has spent about a quarter of a century in each country, I would find it hard to disagree. GORDON BEST King's Fund College, London W2 4HS
As a user of the mental health service, Rob has first-hand experience of the marginalization that accompanies a mental health label. In seeking to validate his experience, centre and assimilate the shadow within, he has participated in teaching students within mental health programmes. Tessa in her role as an academic has sought to validate her experience of teenage pregnancy in a world that denied her experience. The chance meeting of these two people on their respective journeys highlights the voices that have not been heard and the ghosts that link them. Journeys that seek to reconcile memory and truth and entwine numinance within the narrative of mental health.
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