The beneficial attributes of visual art-making in cancer care: An integrative review.

We seek to understand what is known about the use of visual art-making for people who have a cancer diagnosis, and to explore how art-making may help address fatigue in the cancer care context. Art-making involves creating art or craft alone or in a group and does not require an art-therapist as the emphasis is on creativity rather than an overt therapeutic intention. An integrative review was undertaken of qualitative, quantitative and mixed-method studies on art-making for people who have cancer, at any stage of treatment or recovery. An adapted version of Kaplan's Attention Restoration Theory (ART) was used to interpret the themes found in the literature. Fifteen studies were reviewed. Nine concerned art-making programmes and six were focused on individual, non-facilitated art-making. Review results suggested that programme-based art-making may provide participants with opportunities for learning about self, support, enjoyment and distraction. Individual art-making can provides learning about self, diversion and pleasure, self-management of pain, a sense of control, and enhanced social relationships. When viewed through the lens of ART, art-making can be understood as an energy-restoring activity that has the potential to enhance the lives of people with a diagnosis of cancer.

Enabling professional development in mental health nursing: the role of clinical leadership.

Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing.

Immunoreactive growth hormone receptor/binding protein is present on fibroblasts and in serum of Laron-type dwarfs.

Laron-type dwarfism is an autosomal recessive disorder characterised by extreme growth retardation and growth hormone (GH) resistance and has been shown in some cases to be associated with mutations in the GH receptor gene. Limited data suggest that in this condition specific liver GH binding is absent. In the majority of reported cases specific GH binding is also absent in serum. However it is not known whether the GH receptor and/or the serum GH binding protein are expressed in this condition. Using the techniques of immunohistochemistry and Northern blotting we have demonstrated that in cultured skin fibroblasts derived from four patients with Laron-type dwarfism the GH receptor gene is transcribed and the GH receptor protein is expressed on the cell surface. Further study of one of these patients, who has not previously been reported, has also revealed low but detectable levels of GH binding protein in serum using a two-site immunradiometric assay which does not depend on GH binding. These results indicate that the growth hormone receptor/binding protein is expressed in Laron-type dwarfism.

Aneuploid islet cell tumor with late metastasis.

An unusual case of insulin producing islet cell tumor is reported which recurred after a 16 yr interval. In most instances malignancy of islet cell tumors is impossible to assess morphologically or functionally but depends on the recognition of metastases. Nuclear DNA analysis provides significant prognostic and biological information in a number of solid human tumors. Retrospective computerized nuclear image analysis of the primary tumor in the present case showed an aneuploid DNA profile similar to that seen in the metastasis. It appears that ploidy studies may be useful in predicting malignant potential of islet cell tumors.

Accuracy of blood glucose measurements using a reflectance meter.

The performance of a stock reflectance meter for measuring blood glucose levels with glucose oxidase test strips has been assessed. Glucose values obtained were spuriously high, and the response of the instrument was non-linear. The instrument could not be recommended as an accurate means of determining glucose levels, but may be useful for detecting hyperglycaemia and hypoglycaemia.

Circulating gonadotrophins and urinary oestrogens in postmenopausal diabetic women.

Serum FSH and LH and total urinary oestrogens were measured in 20 mature onset postmenopausal diabetic women and compared to 20 nondiabetic women matched for age, years since menopause, surface area and per cent ideal weight. Significantly higher levels of urinary oestrone, oestradiol and oestriol and significantly lower levels of FSH and LH were found in the diabetic women. Closer analysis of these findings showed that the differences were maintained for the diabetics who required insulin for adequate control, whereas diabetics controlled on diet alone or diet and oral hypoglycaemic drugs were not significantly different from control subjects except in urinary oestrone excretion.

Dysgerminoma--gonadoblastoma and familial 46XY pure gonadal dysgenesis: case report and review of the genetics and pathophysiology of gonadal dysgenesis and H-Y antigen.

46XY gonadal dysgenesis is a rare condition of intersexuality first described in detail by Swyer in 1955. It is characterized by a phenotypic female who is tall, eunuchoid with normal female external genitalia, hypoplastic uterus and Fallopian tubes, streak ovaries and primary amenorrhoea. The patients exhibit none of the associated congenital defects such as webbing of the neck and genu valgum seen in Turner's syndrome. Although rare, this clinical entity is important to recognize because of the high incidence of gonadoblastomas and subsequent development of dysgerminoma. The condition may be familial and therefore siblings need to be screened. To the geneticists and scientists researching in the area of intersexuality, hermaphroditism and sexual determination, it has helped to unveil the mechanisms of gonadal and genital sexual development.

Acid production in diabetic acidosis; a more rational approach to alkali replacement.

The production of organic acids in severe diabetic acidosis was studied to determine the contribution of various acids and to reassess alkali requirements. In 11 patients the mean total concentration of determined organic acids was 16 mEq/l., while the mean estimated base deficit was 24 mEq/l. Acetoacetic and beta-hydroxybutyric acids accounted for 75% of measured organic acid. In 10 patients the mean amount of sodium bicarbonate administered for correction of the acidosis was 185 mEq, while the mean requirement was 394 mEq.These findings imply that the methods commonly used to determine the base deficit and the alkali requirements in patients with diabetic acidosis may be invalid. The prompt administration of alkali should be limited, and we suggest that the blood pH should be restored only to 7.25.

Luteinizing hormone-releasing hormone analogue (Buserelin) treatment for central precocious puberty: a multi-centre trial.

A multi-centre open trial of Buserelin, a luteinizing hormone-releasing hormone (LHRH) analogue, was conducted in 13 children with central precocious puberty. Eleven children (eight girls and three boys), aged 3.4-10.2 years at commencement, completed the required 12 month period of treatment. Initially all patients received the drug by intranasal spray in a dose of 1200 micrograms/day, but by the end of the 12 month period two were having daily subcutaneous injections and three were receiving an increased dose intranasally. The first month of treatment was associated in one boy with increased aggression and masturbation, and in the girls with an increase in the prevalence of vaginal bleeding. Thereafter, however, both behavioural abnormalities and menstruation were suppressed. Median bone age increased significantly during the study, but without any significant change in the ratio of height age to bone age. The median predicted adult height for the group therefore did not alter significantly over the twelve months of the study. Buserelin treatment caused a reduction in the peak luteinizing hormone and follicle-stimulating hormone (FSH) responses to LHRH, mostly to prepubertal levels, and also suppressed basal FSH. In the first weeks of treatment, the girls' serum oestradiol levels rose significantly and then fell to prepubertal or early pubertal levels. A similar pattern was seen for serum testosterone levels. Serum somatomedin-C levels, however, showed little fluctuation over the course of the study. Buserelin treatment was safe and well accepted, and offers the promise of improved linear growth potential in precocious puberty.