Delayed post-surgical development of dural arteriovenous fistula after cervical meningocele repair

A 34-year-old female patient presented with an intracranial subarachnoid hemorrhage and was found to have a dural arteriovenous fistula at the site of previous cervical meningocele repair. Subsequent occlusion was achieved with endovascular embolization. To our knowledge, the phenomenon of the development of a spinal dural fistula at the site of a meningocele repair has not been recorded before.

Citizens as Social Work Educators in a Post-Conflict Society: Reflections from Northern Ireland

ABSTRACT This paper examines how service users and carers can contribute to social work education in a post conlict society. A small-scale study undertaken in Northern Ireland is used as a case study to show how such citizens can potentially critically contribute to social work students’ understanding of the impact of conlict on individuals, groups and communities. The need to appreciate the effects of such community division is now a core knowledge requirement of the social work curriculum in Northern Ireland. The article reports on research indings with service users, carers and agency representatives which points to ways in which social work students can achieve a critical understanding of the impact of conlict. Northern Ireland, in this way, is presented as a divided society, still in a state of adjustment and evolution, following a period of protracted community strife and violence. The author suggests that individuals who have been directly affected by conlict can contribute in an informed and critical way to social work students’ developing knowledge and experience in an important area of their professional competence and understanding of anti-oppressive practice more broadly.

Statin prescribing in Northern Ireland and England pre and post introduction of the quality and outcomes framework

Objective The objective of this research was to examine differences in patterns of statin prescribing between Northern Ireland and England both before and after the introduction of the Quality and Outcomes Framework (QOF). Setting: Primary care practices in Northern Ireland and England. Method Northern Ireland practices were matched with practices in England, statin prescribing data and QOF achievement scores (for the first year post-QOF) were obtained. Crude prescribing data from matched practices were manipulated to provide a data set of Defined Daily Doses (DDDs)/1,000 patients and cost/DDD/1,000 patients for each statin drug entity covering 1 year before and after the introduction of QOF. QOF achievements were converted into percentage scores for matched practices. Main outcome measure Cost per defined daily dose (DDD) per 1,000 patients. Results Significantly less statins (DDD/1,000 patients) were dispensed in Northern Ireland compared with the matched region in England both before and after the introduction of QOF (P