Summary. The volumes and spin‐lattice (T1) relaxation times of breast tissues and parenchymal water content were measured non‐invasively by magnetic resonance imaging (MRI) in eight healthy women during four to eight consecutive menstrual cycles. Total breast volume, and parenchymal volume, T1 relaxation time and water content were lowest between days 6 and 15. Between days 16 and 28, parenchymal volume, T1 relaxation time and water content rose sharply by 38·9%, 15·1% and 24·5%, respectively, and peaked after day 25. Within 5 days of the onset of menses, parenchymal volume fell sharply by 30·3%, while water content declined by 17·5%. Rising parenchymal volume in the second half of the menstrual cycle is not solely due to increased tissue water content and provides in vivo evidence for both growth and increased tissue fluid at this time.

PurposeThe aim of this paper is to explore the issues involved in developing and applying performance management approaches within a large UK public sector department using a multiple stakeholder perspective and an accompanying theoretical framework.Design/methodology/approachAn initial short questionnaire was used to determine perceptions about the implementation and effectiveness of the new performance management system across the organisation. In total, 700 questionnaires were distributed. Running concurrently with an ethnographic approach, and informed by the questionnaire responses, was a series of semi‐structured interviews and focus groups.FindingsStaff at all levels had an understanding of the new system and perceived it as being beneficial. However, there were concerns that the approach was not continuously managed throughout the year and was in danger of becoming an annual event, rather than an ongoing process. Furthermore, the change process seemed to have advanced without corresponding changes to appraisal and reward and recognition systems. Thus, the business objectives were not aligned with motivating factors within the organisation.Research limitations/implicationsAdditional research to test the validity and usefulness of the theoretical model, as discussed in this paper, would be beneficial.Practical implicationsThe strategic integration of the stakeholder performance measures and scorecards was found to be essential to producing an overall stakeholder‐driven strategy within the case study organisation.Originality/valueThis paper discusses in detail the approach adopted and the progress made by one large UK public sector organisation, as it attempts to develop better relationships with all of its stakeholders and hence improve its performance. This paper provides a concerted attempt to link theory with practice.

The importance of psychological support for orthognathic patients has taken an increasing precedence over recent years and is embedded in orthognathic commissioning guidelines. Furthermore, attention towards mental health-related conditions and their management is of prime importance and continues to be a key area of focus within healthcare settings. With this in mind, this paper aims to outline our experience of establishing a need for and subsequently securing funding to establish a clinical psychology service within an existing orthognathic service in the NHS. The information outlined may be of benefit to orthognathic teams seeking to secure such psychological support within their respective units.

The data obtained from this group of patients and using this measurement tool alone does not supply sufficient reason to reject the null hypothesis. However, it suggests that it is possible that no difference exists between the groups.