Collaborative research.

Our experience of collaborative research "the process of working with others in pursuit of scientific discovery" has been a most rewarding experience. The nurses and physicians have developed mutual respect and appreciation of the value of each other's practice, and true collaboration has emerged. The relationships between the nurses and physicians have developed over time and have been supported by our visionary Associate Director for Nursing, Kathryn McKeon. Throughout this process of collaboration, we've grown to appreciate each others strengths and recognize what each discipline has to offer. We have also learned that when we work together, it is the patient who ultimately benefits most. The neurologists' holistic approach to patient care and their respect for nursing practice have greatly contributed to the establishment of truly collaborative research.

Gaucher's disease: a pilot study of the symptomatic responses to enzyme replacement therapy.

Symptomatic responses to enzyme replacement therapy were studied in 12 patients with an inherited lipid storage disorder (Type 1 Gaucher's disease) in order to determine the impact of treatment on perceptions of well being. Before each intravenous infusion of enzyme, patients were asked to comment on the presence or absence of disease-specific symptoms presented in questionnaire format. Symptoms were grouped into five major categories: bleeding abnormalities, chronic fatigue, gastrointestinal complaints, bone pain and psychosocial function. Each reported symptom was discussed in detail with the clinic nurse coordinator and documented in the medical record. After six months of enzyme replacement therapy, each patient's chart was reviewed and changes in the frequency of disease-specific symptoms over time were evaluated. The major subjective changes included a decrease in the frequency and severity of nosebleeds, reduced bruising, increased vigor and energy level, visible reduction in abdominal girth, increased self-esteem and enhanced self-image. Patients frequently described relief of their symptoms well before changes were confirmed by objective laboratory measurements. These observations may prove useful in the comprehensive management of patients with Gaucher's disease as they recover from a chronic, debilitating illness while receiving enzyme replacement therapy. The extent and ease with which these patients can achieve a state of normal, healthy function is unknown at the present time and will require further study.

Conduct disorder in childhood and adolescence: an update.

Conduct disorder is a diagnostic entity that has elicited controversy throughout the years. Classified as a psychiatric disorder of childhood and adolescence, the syndrome of conduct disorder recently was revised from four to three categories in the DSM-III-R (Revised). This article presents an overview of conduct disorders, including diagnostic criteria, epidemiology, etiology, treatment approaches and implications for nursing practice.