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In the 21st century, theories of leadership have re-emerged, with a focus on the leader's value base. Copeland (2014) identified 11 leadership theories situated within the sphere of values-based leadership; however, these all pertained to a business-management focus.In conducting this review, it emerged that within nursing, three main leadership theories appear under the umbrella of the values-based leadership domain. As such, this review went beyond values-based leadership literature, to capture data related to authentic leadership, servant leadership and congruent leadership, aiming to gain a wider understanding of values-based leadership. This paper begins with an overview and definition of values-based leadership and the three leadership theories identified, before describing a literature review that explored each of the theories, supporting a wider understanding from a nursing perspective.

SummaryThe breakfast habits in adult life of 34 patients with Crohn's disease were compared with those of 68 matched controls. Cornflakes were being eaten at least weekly by 23 of the patients (67 6%) at the time that their symptoms began, compared with 17 (25%) of the controls at the corresponding time. Only one of the 34 patients had not eaten cornflakes at all, compared with half of the controls. A significant but weaker association was found between Crohn's disease and the eating of wheat cereals. However, in both patients and controls the taking of cornflakes and of wheat cereals were correlated, and the observed preponderance of wheat eating among the patients was almost entirely ascribable to this association of habits.Eating of rice cereals and of porridge was not associated with Crohn's disease, though it was correlated with eating cornflakes. There was an excess of bran eaters among the propositi, but this, too, was attributable to their being also cornflake eaters. Other breakfast foods were taken with equal frequency, and omission of breakfast was equally common. Six of the 68 controls, but none of the patients, ate cornflakes later in the day but not at breakfast.The results need confirmation. There was no evidence that bias could have caused the correlation found. The association of Crohn's disease with the eating of cornflakes is strong and unlikely to be indirect. Variable digestive secretory behaviour after waking may play a part in determining susceptibility to Crohn's disease.

benefits and limitations of ultrasonography and the potential for false-positive findings. All women should be offered aneuploidy screening before 20 weeks gestation regardless of maternal age. The option of first trimester screening for nuchal translucency measurement is available, but a complete anatomic assessment is not possible before 14 weeks gestation. Ultrasound use for maternal cervical length measurement is not currently recommended because its value in predicting risk of preterm delivery has not been confirmed. Generally, ultrasound-established dates should take preference over menstrual dates when the difference is more than 7 days in the first trimester and more than 10 days in the second trimester. Changing the gestational age in the third trimester based on ultrasound examination should be performed with caution as the femur length, the best measurement of gestational age, may be accurate only within 3 to 4 weeks during this trimesters. As a result, guidelines for determining gestational age when the menstrual and ultrasound dates differ vary among institutions. Amniotic fluid volume is determined by subjective operator assessment, measurement of the single deepest pocket, and quantifying the amniotic fluid index (AFI). Oligohydramnios is defined as an AFI less than 5 cm or a maximum deepest vertical pocket of less than 2 cm. Although relied upon in the past, AFI may be a weaker predictor of perinatal outcome than previously thought. Hydramnios is frequently idiopathic but can be linked to fetal and maternal complications; it is commonly described by an AFI Z24 cm or a maximum deepest vertical pocket of Z8 cm. Fetal growth disturbances can be detected by measuring fetal abdominal and head circumferences, biparietal diameter, and femur length. These can be converted to fetal weight estimates based on published formulas and tables or can be calculated by the ultrasound equipment. Serial ultrasonography for about every 2 to 4 weeks is useful for confirming or eliminating the diagnosis of severe growth disturbances.Whenever ultrasound is performed, the patients must be informed of the benefits and limitations of the technique and the discussion must be documented.

Leadership skills are embedded in the undergraduate nursing curriculum and are essential for post-registration nurses. One way to support the development of these skills is to use the action learning and critical action learning approaches, which can be implemented in both the academic environment and the clinical setting. The process of action learning promotes collaborative multidisciplinary working and affords time for reflection and professional development, in turn supporting the process of applying for revalidation. Developing a nursing workforce with a high level of emotional intelligence can support decision-making, resilience and build confidence. These qualities are crucial not only for delivering safe patient care and promoting innovation in quality improvement, but are essential for personal development and individual career progression.

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