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Objective To develop a questionnaire that is sensitive to was good, with the instrument easily differentiating clinical and non-clinical populations. Criterion val-changes in the symptomatology of the female lower urinary tract, particularly urinary incontinence, pro-idity, as tested against frequency/volume charts and pad-test data, was acceptable, with Kappa coefficients viding an instrument that can characterize symptom severity, impact on quality of life and evaluate treat-of 0.29-0.79 for frequency/volume data and Spearman rank correlations of 0.50-0.97 and ment outcome. Patients, subjects and methods Items covering as wide 0.31-0.67 for frequency/volume and pad-test data, respectively. The reliability of the instrument was a range of urinary symptoms as possible were devised after consultation with clinicians and a health scien-good; a Cronbach's alpha of 0.78 indicated that the symptom questions had high internal consistency, tist, a literature review and discussion with patients. Additional items assessed the degree of 'bother' that while stability was excellent, with 78% of symptoms and problems answered identically on two occasions, symptoms were causing. Eighty-five women with clinical symptoms attending for urodynamic assessment and Spearman rank correlations of 0.86 and 0.90, respectively. and 20 women with none were asked to self-complete the questionnaire. The instrument's validity wasConclusion The instrument has good psychometric validity and reliability. The stability demonstrated at assessed by interviewing patients and measuring levels of missing data, comparing symptom scores between baseline and the ability to differentiate clearly between community and clinical populations suggest that it clinical and non-clinical populations and comparison with frequency/volume charts and data from pad tests.should be ideal for measuring changes following therapeutic intervention. The addition of life-impact items The instrument's reliability was assessed by measuring both internal consistency and stability, using a 2-week and a 'bother' factor may provide the opportunity to identify those women who wish treatment for their test-retest analysis. Results The questionnaire was completed by the patients symptoms; this dimension requires further exploration. Keywords Lower urinary tract, incontinence, quality of with a mean of only 2% of items missing; most questions were easily understood. Construct validity life, questionnaire measurements, such as pad tests or cystometry. This

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This paper is based on a study of the experiences of people identified as ‘young carers’, commissioned by the National Assembly for Wales as part of a wider review of carers’ needs and services. Following a brief review of some of the previous research in this area, the paper reports key findings of the research, using the words of children and young people as much as possible. It then goes on to explore some of the wider implications of this and other research for the identification and support of ‘young carers’ and their families, and for the understanding of the needs and wishes of children and young people so defined. The paper concludes with an alternative definition of a ‘young carer’ and with some recommendations for professional practice, suggesting that the role of social work is crucial in this area of service.

Heterotopic pregnancy is a life-threatening condition. A recent case at our institution prompted a systematic review of the literature from 2005 to 2010. In the majority (71%) of cases reviewed, risk factors for a heterotopic pregnancy were present. However, in several instances (33%), previous sonographic reports of a normal intrauterine pregnancy gave false reassurance. These results highlight the complexity of diagnosis. In addition, our findings were compared with two previous reviews covering cases from 1971 to 2004. This comparison highlighted two important trends: first, the increasing role of ultrasound in the definitive diagnosis of a heterotopic pregnancy, and second, the development of conservative approaches to management. Medical knowledge and technology may be improving, but ultimately, even in the presence of a known intrauterine pregnancy, the simple dictum 'think ectopic' must not be forgotten.

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Research over the past 20 years has consistently shown that children in public care fall behind at school, seldom achieve good qualifications, and are much less likely than their peers to go on to further or higher education. However, a small minority of looked‐after children do well academically. This paper examines the opinions of 38 high‐achieving young people who spent at least a year in residential or foster care on what they think are the best ways to enhance the educational experience of looked‐after children. An evaluation of four key questions from a semistructured interview highlighted the importance of foster carers, residential workers, social workers and teachers in providing support and encouragement for academic achievement. On the other hand, many of these individuals emphasized their dislike of being ‘singled out’ by the teacher. A third of the participants believed that negative stereotypes and low expectations of children in care among professionals and care providers were major obstacles to their educational success. Over half the sample reported that in many children’s homes basic necessities such as books, a desk and a quiet place to do homework were lacking. In addition their opportunity to engage in outside interests and hobbies was severely limited. By contrast, for these individuals foster care had provided better opportunities. On entering higher education the majority of the participants had faced severe problems. They stressed the need for continuing financial support and adequate year‐round accommodation, because, unlike most students, these care leavers usually have no parental home to return to during university vacations. A third of participants also felt a strong desire for a ‘guardian angel’ to support and encourage them during their time at university. The paper concludes that the views of these thoughtful and resilient individuals should be taken very seriously and translated into improvements in policy and practice. Official guidance now highlights the importance of education for looked‐after children, but changing attitudes and priorities at ground level presents a major challenge.