Abstract: Evidenced Based Practice is aimed at providing safe, effective and cost-appropriate health care. The utilisation of EBP in nursing has proved to be valuable not only for patients and nurses, but also for other health professionals and the wider community. However, despite the recognised benefits of EBP, a significant gap between theory and practice exists. This paper explores some of the issues behind not implementing EBP, such as comfort with traditional practices, lack of engagement with EBP, and time constraints.

Abstract: The purpose of this research is to examine the cultural context which makes violence and abuse against women and children possible. In 2003, the public debate on prostitution law reform promised to open a space in which discourses on sexuality and violence, practices usually private or hidden, would publicly emerge. Everyday discourses relating to prostitution law reform reported in the New Zealand Herald newspaper in the year 2003 were analysed using Foucauldian and feminist post-structural methodological approaches. Foucauldian discourse analysis emphasises the ways in which power is enmeshed in discourse, enabling power relations and hegemonic practices to be made visible. The research aims were to develop a complex, comprehensive analysis of the media discourses, to examine the construction of harm in the media debate, to examine the ways in which the cultural hegemony of dominant groups was secured and contested and to consider the role of mental health nurses as agents of emancipatory political change. Mental health promotion is mainly a socio-political practice and the findings suggest that mental health nurses could reconsider their professional role, to participate politically as social activists, challenging the social order thereby reducing the human suffering which interpersonal violence and abuse carries in its wake.

Abstract: The objective of this meta-analysis was to assess the effectiveness of pentoxifylline as an adjunct to compression bandaging in the treatment of venous leg ulcers. The CENTRAL registers of the Cochrane Peripheral Vascular Diseases and Wounds Groups were searched – each register is routinely updated by extensive searches of electronic databases, handsearching of relevant journals and conference proceedings, and contact with product companies and experts in the field. The drug's manufacturer was contacted and the references of review articles and all obtained trials were scrutinised for further citations. Randomised controlled trials published in any language comparing pentoxifylline and compression with placebo in adult participants with venous ulceration were included. Trials must have reported a meaningful objective outcome (rates of healing, proportions healed, time to healing). Details from eligible trials (independently selected by two reviewers) were extracted and summarised by one reviewer. A second reviewer independently verified extracted data. Eleven clinical trials were identified. Five trials compared pentoxifylline with placebo (compression standard therapy). Six trials were excluded. Pentoxifylline and compression was more effective than placebo and compression (RR 1.30, 95% C1 1.10-1.54) and was robust to sensitivity analyses. The greater number of adverse effects (46 reports) occurred in the pentoxifylline group, although this was not significant (RR 1.12, 95% C1 0.77-1.62); 34 percent of adverse effects were gastro-intestinal. Seven of 21 reported withdrawals were for adverse effects. In conclusion, pentoxifylline appears an effective adjunct to compression bandaging in the treatment of venous ulcers. The absence of cost-effectiveness data suggests it not be employed as a routine adjunct, but it could be considered as for those patients not responding to compression therapy alone. The majority of adverse effects are likely to be tolerated by patients.

Abstract: This study explores the phenomenon of a personal exploratory field visit to HIV programmes in Malawi and how that informs the author's future plans to work cross-culturally with HIV. He uses hermeneutic phenomenology with the guidance of Heidegger and Gadamer, and draw on Ackermann, Hill, Maluleke, Moltmann, and Thielicke for theological direction. This study analyses how personal formation takes place and how the meaning of that experience can inform future cross-cultural interaction. The data of this study is drawn from a range of people interviewing 'me'. This includes a pre and post interview in relation to the author's three week exploratory visit to Malawi, and recorded daily reflections during the visit. Upon return he was interviewed about the experience by ten people from the following areas: nursing, counselling, development, theology, business, medicine, clergy, an Expatriate Malawian, and a women working from a Maori paradigm. These interviews focused on the author's experience with questions framed from the interviewer's specialty area. The transcripts become further data for this study. The findings of this thesis suggest that people wishing to work cross-culturally need to understand their motivation for their work, and understand who they are before entering a foreign land. This transformative journey also needs to continue as part of the process of working with people because we can only be effective with change if we are listening and hearing the other's perspective. It is in being open to this difference between persons that we continue to find ourselves. While perhaps we have a tendency to want to make everybody like us, we can only grow into our full potential in relationship with truly different others. Tensions experienced demonstrate that there is a complex need to understand how the context controls how HIV is perceived. This requires uncovering some of the deeper issues of HIV and culture, and knowing how to conceptualise these in both positive and informative ways. This thesis asks four key questions for the global-co-worker to work through before embarking on cross-cultural mission: 1. How do you know you should go?; 2. How are you going to make a difference?; 3. Who are you going to be?; and 4. What will sustain your involvement? The author's own experience has drawn me into a deeper awareness of the need for a vital connectedness of faith, hope and love underpinning the everydayness of such an experience.