Organizing Engineering Work - A Comparative-Analysis

This article analyzes the organization of engineering work in six industrial capitalist countries. It identifies four major models for the organization of engineering work; the engineering profession did not succeed in achieving professional “closure” in any of the six countries under review. A review of the historical evolution of the organization of engineering work in each of the six countries reveals that engineering has been shaped by a complex interaction among the profession itself, employers, the state, labor, and preindustrial forces. However, none of the national variations on the four models for organizing engineering labor is stable or without internal contradiction because of the ambiguous “intermediate” position of engineers

The neurogenic bladder: medical treatment

Neurogenic bladder sphincter dysfunction (NBSD) can cause severe and irreversible renal damage and bladder-wall destruction years before incontinence becomes an issue. Therefore, the first step in adequate management is to recognize early the bladder at risk for upper- and lower-tract deterioration and to start adequate medical treatment proactively. Clean intermittent catheterization combined with anticholinergics (oral or intravesical) is the standard therapy for NBSD. Early institution of such treatment can prevent both renal damage and secondary bladder-wall changes, thereby potentially improving long-term outcomes. In children with severe side effects or with insufficient suppression of detrusor overactivity despite maximal dosage of oral oxybutynin, intravesical instillation is an effective alternative. Intravesical instillation eliminates systemic side effects by reducing the first-pass metabolism and, compared with oral oxybutynin, intravesical oxybutynin is a more potent and long-acting detrusor suppressor. There is growing evidence that with early adequate treatment, kidneys are saved and normal bladder growth can be achieved in children so they will no longer need surgical bladder augmentation to achieve safe urinary continence in adolescence and adulthood