Abstract: This paper critically examines the literature on mammography as a breast cancer screening modality. It looks at what the New Zealand consumer is being told about the scientific uncertainties about the effectiveness of mammography and the substantial risks involved with it. This literature review raises concerns about the lack of information available for healthy women to make a fully informed decision about mammography screening.

Abstract: This article firstly describes the application of technological care practices in elder care, and then looks at the attitudes of the elderly and their families towards this care. The value of the equipment in terms of quality of care is considered, and a discussion of the continuing education needs of nurses is presented. The ethical questions around the use of technology are examined, along with possible strategies to deal with such issues.

Abstract: This article explores the incorporation of western knowledge with kaupapa Maori in the delivery of health care. It presents a fictional kaupapa Maori service, as a tool to explore the change process and influence that organisational culture and leadership styles have on a process of integrating a kaupapa Maori nursing service. The importance of continual evaluation through quality assurance measures was also conveyed.

Abstract: The author, an occupational health nurse, examines rationale for and effectiveness of the pre-employment assessment, which has become an accepted practice. Reasons for doing assessments include the reduction of risk to the employer from lower accident rates and absenteeism, compliance with legislative requirements and the provision of baseline health measures for general health surveillance. The costs of the screening process, along with the benefits are weighed up, in conjunction with international research in the area. The author found little research on the process in New Zealand. The opportunity for primary health care and health promotion practice as an aspect of this screening is highlighted as an important, though underestimated, benefit. Regular auditing is recommended to ensure that the outcomes of the process meet the criteria required.

Abstract: The author looks at demographic and statistical information to extrapolate on trends that will affect the aged through into to the next century. She reviews policy approaches to the issues of a growing aged population combined with social and economic changes that could make this group vulnerable. Effective planning for the provision of quality care is placed in the context of social changes, advances in gerontology, and social theories of ageing.

Abstract: This article describes the Nursing and Midwifery Practice Structure, which has been in place at Healthcare Hawkes Bay since 1996. It was developed to provide nurses and midwives in clinical positions with a professional development structure, and uses a framework to recognise and reward competence. It encourages clinical progression and was developed to link nursing competence with remuneration. The Practice Structure, based on the work of Patricia Benner (Benner, 1984), is made up of 4 levels: Beginner/Advance Beginner Practitioner, Competent Practitioner, Proficient Practitioner, Expert Practitioner. The Structure was reviewed in 1998, and a Steering Group was formed to collect feedback from nurses and midwives, identify areas of concern, and make recommendations for improvements. At the time of writing, these recommendations are being implemented and systems are being developed to ensure the Nursing and Midwifery Practice Structure continues to develop.

Abstract: Using nursing and associated literature, the relevance of nutrition in the care of children and families is highlighted in this article. The role of a nurse in providing nutrition advice and interventions is examined, in the context of social and economic pressures on the provision of a healthy diet. Relevant examples of the provision of such advice is provided, along with competencies required to achieve this in practice.