Obstructive jaundice secondary to neuroendocrine tumour in a patient with von Recklinghausen's disease

Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder, with variable clinical manifestations and unpredictable course, associated with an increased incidence of various tumours. Plexiform neurofibromas are hallmark lesions of NF1; they are slow-growing tumours, which account for substantial morbidity, including disfigurement and functional impairment, and may even be life-threatening. Neuroendocrine tumours (NETs), a rare diverse group of neoplasms, are occasionally associated with neurofibromatosis. Pancreatic NETs are tumours with an incidence of less than 1/100 000 population/year and complex patterns of behaviour, which often need complicated strategies for optimal management. We present the case of a young adult with NF1, having a unique concurrence of plexiform neurofibroma involving the liver with an ampullary NET, and we discuss step by step the management in a specialist centre.

Relationships with special needs students: exploring primary teachers' descriptions

Positive teacher-student relationships play an established role in the developmental outcomes of students. Ongoing research suggests that positive teacher-student relationships may be particularly beneficial for students with special educational needs [Baker, J. A. 2006. "Contributions of Teacher-Child Relationships to Positive School Adjustment During Elementary School."Journal of School Psychology 44 (3): 211-229]. However, particular learning and behavioural characteristics are known to pose certain challenges when developing these relationships. For instance, teachers may have difficulty in forming close relationships with students who behave in a hostile way. Likewise, they might feel stressed with students who take longer to learn material [Baker 2006; Yoon, J. S. 2002. "Teacher Characteristics as Predictors of Teacher-Student Relationships: Stress, Negative Affect and Self Efficacy." Social Behaviour and Personality 30: 485-494]. This study conducted a focus group with six mainstream teachers from a primary school in the Western Suburbs of Melbourne to investigate the following questions: (1) How do primary school teachers describe their relationships with special needs students? (2) Are these descriptions substantively different from the way in which relationships with non-special needs students are described? And (3) what, if any, are teachers' reported concerns with inclusive education practice? Thematic analysis provided three primary themes and nine secondary themes, indicating that in the context of inclusive practices, the quality of teacher-student relationships is affected by a combination of psychosocial factors. In concurrence with previous literature, the use of qualitative methodology was considered optimal for exploring teachers' descriptions.