Recent advances in sonography have dramatically improved the evaluation of the female urethra and vaginal canal. Widespread use of sonography for the detection of vaginal masses presents a less expensive way to identify pathology. The author recently encountered a patient with a rare vaginal mass. The following case illustrates translabial and transurethral sonography defining a vaginal mass directly under the urethra with no urethra luminal abnormalities. In general, the identification of a vaginal mass would lead most physicians to consider magnetic resonance imaging for characterization. Sonography presents an opportunity to provide accurate information without increasing medical cost to the patient. To the author’s knowledge, this is the first report describing translabial and transurethral sonography using a 10-MHz linear transducer to determine extension of a tumor from the vaginal wall into the lumen of the urethra.

Breathlessness support services have demonstrated benefits for breathlessness mastery, quality of life and psychosocial outcomes for people living with breathlessness. However, these services have predominantly been implemented in hospital and home care contexts. This study aims to evaluate the adaptation and implementation of a hospice-based outpatient Multidisciplinary Breathlessness Support Service (MBSS) in Ireland. A sequential explanatory mixed methods design guided this study. People with chronic breathlessness participated in longitudinal questionnaires ( n = 10), medical record audit ( n = 14) and a post-discharge interview ( n = 8). Caregivers ( n = 1) and healthcare professionals involved in referral to ( n = 2) and delivery of ( n = 3) the MBSS participated in a cross-sectional interview. Quantitative and qualitative data were integrated deductively via the pillar integration process, guided by the RE-AIM framework. Integration of mixed methods data enhanced understanding of factors influencing the reach, adoption, implementation and maintenance of the MBSS, and the potential outcomes that were most meaningful for service users. Potential threats to the sustainability of the MBSS related to potential preconceptions of hospice care, the lack of standardized discharge pathways from the service and access to primary care services to sustain pharmacological interventions. This study suggests that an adapted multidisciplinary breathlessness support intervention is feasible and acceptable in a hospice context. However, to ensure optimal reach and maintenance of the intervention, activities are required to ensure that misconceptions about the setting do not influence willingness to accept referral to MBSS services and integration of services is needed to enable consistency in referral and discharge processes.

^/N THIS and the following 2 pages appear all remaining discussions sub mitted for publication, and approved by the technical committees, on papers presented at the 1937 AIEE winter convention, New York, N. Y., January 25-29. Discussions of papers presented at the sessions on general power applications, vibration and balance, communication and research, pow r er transmission, education, power generation and electrical machinery, instru ments and measurements, insulation co-ordination, and lightning protective equipment at the 1937 AIEE summer convention, Milwaukee, Wis., June 21-25, now are being reviewed by the technical committees, and will appear in ELECTRICAL ENGINEERING as they are released for publication.Members anywhere are encouraged to submit written discussion of any paper published in ELECTRICAL ENGINEERING, which discussion will be re viewed by the proper technical committee and considered for possible publi cation in a subsequent issue. Discussions of papers scheduled for presenta tion at any AIEE meeting or convention are closed 2 weeks after presentation.