Psychosocial adjustment to unsuccessful IVF and GIFT treatment.

Twenty-one couples for whom in vitro fertilisation (IVF) or GIFT treatment failed were followed-up 15-30 months after treatment and compared with 20 couples for whom IVF had been successful. Current mental health status, quality of life and marital adjustment were assessed via standardised questionnaires. In addition, couples' experiences of IVF/GIFT treatment were explored via a semi-structured interview. Questionnaire results showed that unsuccessful IVF/GIFT recipients cannot be distinguished from general population norms. However, these couples reported more emotional distress relative to those whom treatment had worked and females in particular indicated a lower quality of life. Couples who had at least one child prior to IVF/GIFT treatment tended to show greater emotional distress at follow-up. Both groups gave similar accounts of the positive and negative aspects of IVF/GIFT treatment, but the unsuccessful group felt less supported by the IVF Unit staff and were less satisfied with the counseling they received. The data indicate that post-treatment counseling may be particularly important for facilitating positive reconstructions of the IVF experience when treatment is unsuccessful.

Attitudes and motives of semen donors and non-donors.

This study surveyed the views of three groups of men in relation to the situation of semen donation. In all, 97 childless student semen donors, 56 childless non-donor students and 44 mature non-donor fathers completed a questionnaire designed to explore possible motives for donating semen and preferences for involvement with recipients and offspring. Results showed the three groups could be discriminated with respect to their views about motivation and involvement in a number of ways. The major findings were: (i) relatively more donors than non-donors endorsed the importance of financial incentives for donating; (ii) non-donors, who were also fathers, favoured involvement with recipients and offspring more often than did non-fathers (donors and non-donor students); (iii) all groups expressed the importance of confidentiality and guaranteed anonymity. These results are discussed in relation to strategies for donor recruitment.

A survey of semen donor attitudes.

Semen donors have been required to register with the Human Fertilization and Embryology Authority since its formation in 1990. Since then many clinics have reported a shortage of donor semen for donor insemination treatment. Is this because potential donors are worried about the protection of their anonymity? No published studies are available concerning the attitudes to semen donation in the UK. It was against this background that an investigation of the attitudes of potential semen donors was carried out. Four dimensions were investigated: (i) motives, (ii) personal detachment and involvement, (iii) detachment and involvement with respect to recipients, and (iv) detachment and involvement with respect to offspring. A total of 55 potential semen donors completed the attitude questionnaire from semen donation programmes in three in-vitro fertilization units. The questionnaire format was found to be an effective method of data collection for this sensitive area of research, and the major findings were (i) 89% of potential donors required confidentiality and guaranteed anonymity; (ii) 82% did not mind providing non-identifying information to the recipients and offspring; (iii) 69% of potential donors expected financial reward; and (iv) 69% did not welcome counselling.

Beau's lines and pyogenic granulomas following hand trauma.

We report two cases of trauma-induced Beau's lines accompanied by pyogenic granulomas of the proximal nail folds of the affected fingers. The preceding trauma was not directly to the nail matrix but was more proximal, on the palm in one case and the arm in the other. The simultaneous occurrence of Beau's lines and pyogenic granulomas following trauma has not been reported previously in the literature.

A comparison of hospital- and community-based mental health nurses: perceptions of their work environment and psychological health.

This study compares hospital- (n = 67) and community-based (n = 55) mental health nurses in relation to their perceptions of the work environment and also their psychological health. Measures include: the General Health Questionnaire, the Maslach Burnout Inventory and the Work Environment Scale. The data, obtained from self-returned questionnaires, show that community nurses rated their work environments higher for the dimensions of Involvement, Supervisor Support, Autonomy, Innovation and Work Pressure. Hospital nurses saw their environments as being higher in (managerial) Control. There were no differences between the groups for the dimensions of Peer Cohesion, Task Orientation, Clarity or (physical) Comfort. Furthermore, there were no overall differences between the two groups in relation to psychological health, although the pattern of factors associated with emotional well-being differed. Finally, analyses of the community data revealed that those nurses with 'flexitime' arrangements evaluated their work environments less positively and showed higher levels of psychological strain than did those working 'fixed-time' schedules. The findings suggest that the hospital and community environments make different demands on nursing staff, and that this should be considered when organizing nursing services if stress is to be avoided.

Information literacy: educating for life-long learning.

Creating information-literate nurses is a challenging and complex task for nurse educators. It requires expertise on the part of the instructor, and a solid commitment to the importance of acquiring information skills and a willingness to demand quality work from the students. A librarian shares her views on information literacy.

A follow-up study of 'successful' IVF/GIFT couples: social-emotional well-being and adjustment to parenthood.

Twenty couples who conceived their babies by in vitro fertilization/gamete intrafallopian transfer (IVF/GIFT) were seen between 15 and 27 months postdelivery in order to evaluate social-emotional well-being and parental functioning. Emotional health and marital adjustment were assessed by standard questionnaires and compared with general population norms. Questionnaires measuring quality of life, parents' feelings about their babies and child-rearing attitudes were also administered. Scores from these were compared with those obtained from a group of parents who had conceived without medical assistance. Results indicated that IVF/GIFT parents were undifferentiated from the general population with respect to emotional health and marital adjustment. Also, relative to non-IVF parents, they gave higher positive ratings for their feelings about their babies and for one aspect of quality of life (feelings of freedom). Parenting attitudes for the two groups differed in only one respect, IVF/GIFT parents reported being more overprotective.

Dysplastic epidermal keratosis in a black woman.

Skin cancer is rare in black persons. When it does occur, in most cases it occurs on non-sun-exposed areas. In white persons, most skin cancer occurs in sites that have been exposed to sunlight for long periods. The decreased susceptibility of more darkly pigmented skin to the sequelae of long-term ultraviolet (UV)-energy exposure probably accounts for the low incidence of actinic keratoses, basal cell carcinomas, and squamous cell carcinomas in black persons. Multiple, dysplastic, epidermal lesions developed in a black woman, which were possibly induced by long-term UV-light or heat exposure. Her condition responded well to topical fluorouracil therapy but had an unusual delayed reaction to treatment.

Comparison between undecylenic acid and tolnaftate in the treatment of tinea pedis.

A double-blind parallel study comparing tolnaftate cream with undecylenic acid ointment and a placebo ointment in the treatment of symptomatic tinea pedis was conducted on the warm, humid Texas Gulf Coast. In one hundred and three patients studied, both the clinical and mycological effects of the two antifungal agents were indistinguishable. Both were significantly more effective than the placebo.

The generalization of new behaviours and maintenance of programme contingencies in a chronic locked ward.

The paper presents the results of a behavioural programme designed to increase social interaction and activity in the locked ward of a psychiatric hospital. The intervention used a method of information feedback to staff to encourage them to make informed choices of targets and methods of change. The rationale was that this would enhance generalization and programme maintenance. Evidence is presented to show the extent of change obtained after 6 months.