Results of three courses of adriamycin, bleomycin, vindesine, and dacarbazine with subtotal nodal irradiation in 189 patients with nodal Hodgkin''s disease (stage I, II and IIIA)

This paper will explore the delivery of mental health nursing care within a neo-liberal model of mental health care delivery in New Zealand. Mental health nursing as a socially constructed activity occurs within a particular political context, which determines its role and function. This environment determines the nature of the nurse-patient relationship which is integral to the role of mental health nurses. Critical analysis of the New Zealand Government's neo-liberal health policies will be conducted to explore their effect on mental health care delivery and the nurse-patient relationship. Some of the ideologies and values maintained by current dominant discourses within nursing and the State are discussed. To establish therapeutic partnerships with service-users, mental health nurses are urged to critically analyse their practice and the context in which it occurs.     

Towards anti-oppressive practice in mental health nursing

Working in Partnership, the Department of Health's report on the 1994 review of mental health nursing, implies that mental health nurses should develop anti-oppressive approaches to nursing practice. There is a notable absence of articles within the nursing literature which specifically address this issue. This is possibly because the historical and ideological issues which have informed the development of mental health nursing are complex and difficult to unravel. However, an integration of the theories of David Cooper and Frantz Fanon may provide an appropriate starting point for the development of a theory of anti-oppressive practice which addresses some of the issues specific to mental health nursing.     

The discursive construction of dementia care: implications for mental health nursing

This paper sets out a new approach to dementia that may be used to underpin mental health nursing practice. The paper begins by examining the development of community care. Various models of service provision to people with dementia are then critically examined. As an alternative to these approaches a new model of dementia is developed which highlights the position of various family members in the provision of dementia care including the person with dementia and also the importance of linguistic devices such as narrative and discourse. Finally the implications of this approach upon the mental health nursing practice are examined together with various suggestions for the development of research.     

Nursing practice and ethnography: a mental health nursing response to threatened violence in ethnographic fieldwork

This paper reverses the usual argument about the relationship between research and nursing by showing how mental health nursing knowledge can be used to facilitate ethnographic research. It focuses on the use of mental health nursing in ethnographic data generation from Serbian Australian participants living in the shadow of the Balkan war 1991-96. Beginning with a fieldwork episode at the scene of property damage, it traces the main features of participants' distress, and describes a mental health nursing response to a threat of violence against the author. A background in mental health nursing facilitated a productive and safe interaction under difficult and extremely emotionally charged circumstances.     

Voluntarism: is it a useful concept for health education in the accident and emergency department?

As the year 2000 looms closer, the emphasis on health education as a means of attaining the 38 targets for 'Health for All' increases. Despite various initiatives, little, if any, progress has been made in narrowing the health divide. Currently, terms such as 'self-care', 'individual responsibility' and 'community empowerment' are often used with emphasis on individual freedom to choose. The author contends that to assume all individuals have that freedom and act voluntarily, is to deny the impact of social structure on health. Health education and the concept of voluntarism will be critically examined from the perspective of nursing in an accident and emergency department.     

Mental health promotion in high-risk groups

This article summarises a systematic review of the literature on promoting mental health in high-risk groups. The review suggests that there are a variety of effective interventions for preventing mental health problems in high-risk groups. This has implications for the scope of practice of nurses and others working in a range of services, including midwifery, health visiting, school health, mental health, terminal care, district nursing and primary health care.     

Applying a feminist analysis model to selected nursing studies of women with HIV

Women's mental health has been linked to oppression and to oppressive practices in health care. Feminist approaches to health care delivery and research have been suggested as a remedy for the subtle and overt oppression faced by women, and many nurses have used feminist principles to conduct and report their research and to critique existing studies. Though nursing authors have identified useful feminist guides for conducting and reporting research, few examples of the practice of feminist critiques of research are available in the nursing literature. This analysis synthesizes and adapts feminist principles from nursing literature and presents a feminist model to review selected nursing research reports of women with human immunodeficiency virus (HIV). A convenience sample of eight articles from nursing journals was examined for statements or implications that the author(s) (a) perceived the purposes of the study as benefiting women, (b) demonstrated an awareness of the structures and policies that oppress women, (c) were sensitive to issues of diversity, (d) were committed to social change, and (e) recognized the female participants' strengths. The selected articles were found to meet many of the feminist criteria, although these principles were not always explicitly addressed in the articles.     

The Future of Mental Health.

Examines the two sets of criteria that generally categorize mental health: those that emphasize internal events and those that deal with external events. The author discusses the future of mental health in light of many of its current trends, including greater acceptance of diversity, and he discusses the potential future role of the mental health professional. The author notes that greater numbers of mental health professionals have gotten involved with different populations, and suggests that the majority of mental health professionals will probably be experts in handling small units of behavior or experience for a limited time. The very process of making predictions changes the future course of events. Let us hope that this intricate process will result in greater satisfaction for greater numbers of people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Active and passive smoking: hazards for children

In 1995 the Sainsbury Centre for Mental Health commissioned a major review of all specialist mental health training. The current, largely uni-disciplinary approach to training was felt to be failing to equip professionals with the necessary skills for today's multi-disciplinary, integrated, community-based service, where users and their carers expect an equal partnership and sharing of information. Kevin Gournay and Susannah Strong outline the findings and recommendations of the review, and its implications for mental health nurse education, which make a case for its separation from the rest of the nursing profession.     

Madness and mayhem: the place of people with dementia in a mental health setting

Demographic predictions indicate that there will be between 174,300 and 194,200 people in Australia experiencing dementia of the Alzheimer's type by the year 2006. At present, 60% of those who make up the resident population in nursing homes and aged-care units in psychiatric hospitals suffer from dementia. To explore the place of people with dementia in a mental health setting, a comprehensive review of the literature was undertaken and the results compared with the outcomes of an ethnographic study of a unit for confused older people.     

Review of Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions.

Reviews the book, Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions by Ronald T. Brown, David O. Antonuccio, George J. Dupaul, Mary A. Fristad, Cheryl A. King, Laurel K. Leslie, Gabriele S. McCormick, William E. Pelham Jr., John C. Piacentini, and Benedetto Vitiello (see record 2007-15067-000). This volume stands as a significant contribution to the current state of affairs in child and adolescent mental health. Unassuming in size (a total of 207 pages including references and author and subject indexes), this compilation is not only of value to researchers and clinicians within the professions of psychology and psychiatry but holds significance across other professions (e.g., social work, occupational therapy, nursing) that serve and support the mental health care of children. This book consists of 13 chapters, of which 11 address common child and adolescent mental health disorders. The authors offer readers a concise summary of the status of support for psychosocial, pharmacological, and combined interventions balanced in the context of safety and potential harm. Recommendations are offered on the most appropriate first-line treatment for a particular disorder (which predominantly favours psychosocial interventions over psychoactive medications). This is a book that will be a significant resource for those seeking evidence-based guideposts to intervention with children, adolescents, and their families. It is a timely, accessible, well-organised text, giving fair consideration to pharmaceutical, psychosocial, and combined interventions. As the authors allude, this compilation represents a "snapshot in time" but sets forth a strong foundation for practise and an agenda to further clinical and research attention to children's mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Serious mental health problems: policy changes

Recent developments in services and strategies for helping people with serious mental health problems represent a watershed in mental health provision. This has implications not only for specialist mental health nursing, but also-- as increasing numbers of people with serious mental health problems live in the community-- for nurses working in all areas of health care, who will have to play a role in meeting their needs. This article describes current developments in policy and practice, and seeks to explain the basic principles of working with people in this client group.     

The variants and potentials of reconstructive surgery of the penile skin

This paper is part of a larger study examining the role of the nurse practitioner and its potential utility in mental health nursing. Two methods were employed for data collection: a focus group interview with eight RCN qualified nurse practitioners, the result of which informed the development of a postal questionnaire which was distributed to the remaining RCN qualified nurse practitioners (n = 130). Forty seven respondents did not feel adequately equipped to assess a mental health problem, despite nearly a third identifying mental health issues as a primary problem with which their patients presented. Just over 40 per cent of respondents stated that mental health needs were not met within their community and 78.7 per cent of respondents supported the development of a mental health nurse practitioner. In light of these findings the concept of a mental health nurse practitioner is discussed, alongside the need to clarify other advanced nursing roles.     

Experimental teleradiology. Novel telematics services using image processing, hypermedia and remote cooperation to improve image-based medical decision making

Various reports draw attention to the deficiency of services available for critically ill children. In December 1993 the British Paediatric Association published a report by a multidisciplinary working party on intensive care. The Minister of Health has apparently promised to act on the recommendations the working party made. In fact, purchasers are being encouraged to act and ask questions about the provision of paediatric intensive care--but no extra funding is available to provide it. However, this will all take time and until more resources are available children are still being cared for on adult intensive care units by nurses who may not be experienced in caring for sick children. One of the main areas of concern nurses have when caring for children is the physiological differences between an adult and a child. This paper is designed to assist in identifying the differences and consequent nursing implications. In an attempt to prioritize the nursing care a systems/modified model has been used over 2 papers. The review of the systems demonstrates the differences between adults and children and, where possible, highlights the nursing care and medical treatment a child requires. All aspects of care have been included as well as the psychological problems (see Part 2 which will be published in the next issue) encountered by the family of a critically ill child. Where possible easy reference tables have been included and the author hopes to introduce the package into the existing orientation programme for established staff and staff new to the unit in the hopes of decreasing the stress when a child is admitted. Paediatric resuscitation has not been covered intentionally, as the information on the physiological differences seemed to grow like 'Jack's beanstalk'. Therefore, a flow chart for basic and advanced life support is included as an appendix in Part I. It is hoped this will stimulate readers' interest for more in-depth study.     

Mental health teams in the community

This article describes how one community psychiatric nursing service established a forum to clarify the roles and professional boundaries for nurses working within a multidisciplinary team. The author describes the initiative within the context óf the wider issues surrounding mental health care in the community.     

Primary care in psychiatry residency training

The author summarizes patient perspectives and government initiatives that have fostered closer medicine-psychiatry cooperation and more comprehensive treatment of patients. Despite the growing numbers of people requiring more formal mental health care, most patients are being treated by primary health care providers. This trend will continue as long as there is a decline in the number of medical students entering psychiatry. The author summarizes several general principles that psychiatry residency program directors should consider in designing primary care experiences for their residents and for medical students rotating on their services: longitudinal primary care experiences in organized medical care settings, training in basic medical principles and techniques, and instruction in the biopsychosocial model of disease. The author also recommends there specific training experiences for psychiatry residents that would enhance their ability to provide more effective mental health services to primary care physicians and their patients: consultation psychiatry, primary mental health care, and general psychiatry. The author concludes that medical students, through their contact with primary care-oriented psychiatry residency programs, would be more attracted to psychiatry as a specialty choice and that residents, upon completion of training, would be more inclined to practice in primary care settings.     

Italian ideals

Many reports have been published in the UK about the reform movement in the Italian mental health system, but there has been a relative dearth of information on the practice of psychiatric nursing. Here the author reflects on differences and similarities with Italian colleagues and calls for greater dialogue between psychiatric nurses in the two countries.     

Developing evidence--based care in mental health nursing

For evidence-based practice to become a reality, its effects must be demonstrated clearly in the clinical situation. Practitioners must be sen to access, evaluate and apply research-based evidence in their day-to-day work. In this article, the author considers how this process could work in mental health nursing.     

Mental health nurses working purposefully with people with serious and enduring mental illness--an international perspective

There has been a world-wide refocus on people with serious and enduring mental health problems. This has provided major challenges for all those involved in mental health care, as the last two decades have produced radical changes in service delivery and a range of new interventions. Mental health nurses are playing a central role as community based clinical case managers and are beginning to use a range of psychosocial interventions. They are also revitalizing skills in the more traditional areas of medication management and residential care. In addition, there are growing problems of substance abuse and violence which needs to be addressed. Mental health nursing is responding in this new era by various training initiatives. However, these programmes need rapid expansion as mental health nurses will continue to play a key role in the services of the future and therefore need these new skills.     

Villous and tubulovillous adenomas of the colon and rectum. Results in 30 patients

Health care is increasingly driven by information, and consequently, patient care will demand effective management of information. The report of the Priority Expert Panel E: Nursing Informatics and Enhancing Clinical Care Through Nursing Informatics challenges faculty to produce baccalaureate graduates who use information technologies to improve the patient care process and change health care. The challenge is to construct an evolving nursing informatics curriculum to provide nursing professionals with the foundation for affecting health care delivery. This article discusses the design, implementation, and evaluation of an innovative nursing informatics curriculum incorporated into a baccalaureate nursing program. The basic components of the curriculum framework are information, technology, and clinical care process. The presented integrated curriculum is effective in familiarizing students with informatics and encouraging them to think critically about using informatics in practice. The two groups of students who completed the four-course sequence will be discussed.