Abstract: The author uses his personal and professional experience to explore the application of Cognitive Behavioural Therapy in caring for people who experience psychosis. Psychosis can be a life-threatening illness; about one in ten young men with psychosis will take their own lives. Much of the progress in treatment has been predicated on a biological explanation of psychosis. The late 1990s have seen increasing interest in psychological approaches in the treatment of psychosis; not withstanding that this treatment does not work for all people. The first aim of this research report is to develop understanding about Cognitive Behavioural Therapy, through exploration of its origins and examining the theoretical basis and reviewing the evidence that may support its use. The second aim is to explore the evidence around mental health nurses' training and use of Cognitive Behavioural Therapy, by critically examining some of the major UK and Australian reports. The author considers that Cognitive Behavioural Therapy is theoretically and pragmatically compatible with contemporary nursing practice, and will have increasing prominence for New Zealand mental health nurses.

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.