The 0.3 M KCl reduces Cmax in IC and DO, the effect being more pronounced in DO. Urothelial hyperpermeability is not specific to IC. Comparative cystometry using NS and 0.3 M KCl does not help to differentiate IC from DO.

Graduate education for nursing and midwifery has been debated for some years, with current opinion in favour of at least an increase in degree provision (Nursing and Midwifery Council (NMC), 1999). The professions as well as consumers and purchasers of nursing and midwifery education need to be sure, however, that they are getting "added value" with the graduate practitioner. Educationalists identify "critical thinking" as the level that distinguishes diploma from graduate preparation. This article intends to clarify whether academic achievements are restricted to the theoretical aspects of the award or whether a degree adds value to clinical practice. The study design was an experimental case-control cross-sectional survey carried out on samples of nursing and midwifery graduates and diplomates. The graduates were grouped as experimental cases, while the diplomates were controls. A measurement tool of 42 items covering a range of attributes and skills was employed in the study to provide a rating score for individual samples. Statistical analysis was carried out and showed that the scores from graduates were significantly different from the diplomates, indicating that there are genuine differences between the graduates and diplomates. Furthermore, from discriminant analysis of item scores, it appeared that the graduates' overall item scores were higher than the diplomates as indicated by the centroid of the functions being positive for the graduates and negative for the diplomats. The evidence from this study seems to support current thinking that a degree adds value to practice.

Aim: To evaluate the e¡ect of 0.3 M potassium chloride on cystometric parameters by comparing it with normal saline as a ¢lling solution in women with overactive bladder (OAB). Patients and Methods: Twenty-three women with signi¢cant OAB symptoms underwent consecutive cystometrograms (CMGs) using 0.9% normal saline (NS) and 0.3 M potassium chloride (KCl), the order of which was randomized for each patient. Individual CMGs were performed by separate investigators and both patients and investigators were blinded to the order in which each solution was given and to the results of the other CMG. Results: Regardless of the nature of the ¢lling solution, the order in which the CMGs were performed had little in£uence on either ¢rst desire to void (FDV, mean 83.5 ml vs. 117.8 ml for ¢rst and second CMGs respectively, P ¼ 0.10) or on maximum cystometric capacity (Cmax, mean 265.0 ml vs. 264.4 ml, P ¼ 0.98). KCl produced a signi¢cant (24%) reduction in mean Cmax compared to NS (mean 228.6 ml vs. 300.8 ml, P ¼ 0.001), irrespective of the order of infusion. Conclusion: This comparative study using 0.3 M KCl versus NS as ¢lling solutions suggests that intravesical potassium may not simply act on urothelial sensory nerve endings; it may also stimulate detrusor muscle contraction. These ¢ndings may in£uence the interpretation of the potassium sensitivity test in patients with OAB symptoms, particularly in those suspected of having interstitial cystitis.