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During the past decade, a distinct body of research has started to investigate the dynamics between nursing and place. However, despite attention being paid to a wide-range of nursing subjects, few studies have engaged with the important topic of labour force recruitment. In this context, this study uses a combined questionnaire (n = 650), interview (n = 30) and focus group (n = 7) survey of London-based students, and investigates the complex mix of experiences and perceptions that result in hospitals having varying degrees of popularity as potential workplaces. The findings suggest experiences and perceptions of institutions often gained on clinical placements--to be important, particularly relating to feeling valued, the quality of patient care, clinical and educational opportunities and team cohesion. These are often combined with experiences and perceptions of locality, relating to factors such as cost of living, travel considerations and sense of personnel safety. The study demonstrates that place is relevant to employment decision-making on multiple scales from wards to regions. Furthermore, that perceptions of potential workplaces result from engagements with complex mixes of cultural, economic and physical features, many of which are the consequences of management. It is argued that in order to effectively unpack workplaces, geographical research of nursing labour may benefit from researching simultaneously both 'inside' institutions, focusing on their dominant cultures of production and subcultures, and 'outside', focusing on their local urban or rural contexts. Keywords: Nurse recruitment; Nursing research; Health geography; Medical geography

Loneliness and isolation can be a major cause of unhappiness and can contribute towards depression and mental illness in older age. These associations are recognised by academics, policy makers and older people's representative organisations alike in several countries, and many corrective ad hoc and country-specific initiatives have been supported. This study examines the opinions of the users of a local home-visiting befriending service in the United Kingdom. The befrienders are volunteers, and most users were introduced to the service by female relatives or health service professionals. Positive opinions of the service predominated, and users placed a high value on the reliability of their befrienders. The service provided the users with an opportunity to develop a new bond, and many reported friendly reciprocity, which they recognised as an ingredient of 'real' friendship. These friendships sometimes developed beyond the agreed rules and remits of the 'formal' service, and incorporated various forms of supplementary assistance and social activities. The paper demonstrates the value of befriending services and examines carefully the aspects of their implementation that required exceptional sensitivity. KEY WORDS--volunteering, voluntary sector, friendship, loneliness, isolation, home-visiting.

The association between dental erosion and oral hygiene practices on bulimic patients was determined through assessment of dental history, oral hygiene practices, measurement of tooth wear index (TWI) and nutritional intake in thirty-three vomiting bulimics. Results obtained have shown that there is no significant association between oral hygiene practices, TWI, and nutritional intake and dental erosions among bulimics.

A panel of surgeons has rated laparoscopic herniorrhaphy investigational and most would not want the procedure if they had a hernia. Herniorrhaphy is the surgical treatment of hernia, which is traditionally done as open surgery. However, several studies have evaluated the use of laparoscopic surgery for hernias. A bibliography of these studies and a questionnaire was mailed to 75 surgeons who specialized in laparoscopic surgery or herniorrhaphies and 47 responded. They rated laparoscopic herniorrhaphy as safe but of unproven effectiveness for repairing primary and bilateral hernias. But they believed the procedure was safe and effective for reducing postoperative pain and hospital stays. Ninety-one percent said they would prefer to receive open surgery if they had a hernia., Objective.--To provide clinicians with a technology assessment of the safety and effectiveness of laparoscopic herniorrhaphy for the surgical repair of inguinal hernias. Participants.--A literature review and a Diagnostic and Therapeutic Technology Assessment (DATTA) survey questionnaire were mailed to 75 physicians with expertise in surgical repair of inguinal hernias. These panelists had been nominated to the DATTA panel by the appropriate specialty societies and medical schools. A total of 55 panelists (73%) responded. Evidence.--Assessment was based on the expert opinion of the panelists, as well as on published literature (available as of February 8,1996). Published studies were identified by a MEDLINE search using the terms laparoscopic surgery, inguinal hernia, and laparoscopic herniorrhaphy and by review of the references cited in these primary sources. Consensus Process.--The respondents completed a DATTA survey questionnaire; the survey results were tabulated, analyzed, and interpreted by American Medical Association staff. Conclusions.--The DATTA panelists rated the use of laparoscopic herniorrhaphy as promising for safety and investigational for effectiveness for two indications: the repair of primary inguinal hernias and the repair of bilateral inguinal hernias. The use of laparoscopic herniorrhaphy to repair recurrent inguinal hernias was rated as investigational for both safety and effectiveness by the panel. This technique was rated as promising for safety and effectiveness as a method for decreasing postoperative tenderness and time until return to full activity. JAMA 1996;276:1076-10