Abstract: This text begins with a discourse analysis of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, 1994 – DSM -IV- to illustrate the discursive construction of mental disorder. The analysis identifies how productivity, moderation, entariness and rationality are constructed by this psychiatric discourse as the fundamental attributes of normality. It is argued that this discursive construction of normality has particular implications for the subject positions available to women.The text explores how those subject positions are constituted by analysing the narratives of women who have been diagnosed as having a mental disorder. Its object is to explore how the categories 'mental disorder' and 'women' are constituted; the effect this has on some women's experiences; and to offer a feminist interpretation of those experiences. The text explores the meaning of these women's experiences and proposes that their responses can be regarded as tactical responses to the non-recognition, or disconfirming recognition, accorded to the subject positions available to them.The women's tactical responses although taking different forms, reveal some commonalities in their responses to a lack of recognition for their performances: shame regarding the body which marks them as women; a sense of meaningless and emptiness in the available performances; a sense of themselves as objects for the use of others; passive performances as self-protective tactics; a need to suppress anger; and a tension between cultural expectations of normality and their own subjective experiences. The tactical responses that these women had employed take the form of over-conformity, withdrawal and resistance. They reflect that Sass (1992:58) describes as attempts to escape the 'form of the real'. It is the women's body which establishes her engendered subjectivity and it is through the body that the tensions related to her expected performances emerge. Each women's tactical response is imbued with multiple and sometimes contradictory meanings that may represent their ambivalence in relational to the cultural expectations for productive, moderate, unitary and rational performances. To enable the meaning of the women's distress to emerge it is necessary that it be recognised by interpretations that reflect their multiple and contradictory form.Alternative readings of these women's tactical responses position the desire for recognition as central. It proposes that it is necessary to pay attention to both the literal and figurative functions of language. The possibility of 'advancing our understanding of social life' (Gergen, women constructed as mentally disordered. These readings of the narratives require an understanding of the context and construction of the narrator's life and opens up the possibility for multiple understandings that do not necessarily privilege productivity, moderation, unitariness and rationality.By attending to the significance of the women's narratives this text proposes that the DSM-IV's (1994) construction of mental disorder of effectively marginalises women's experiences of their culturally determined subject positions. It acknowledges the need to understand how women symbolize their distress in a way that creates and communicates meaning

Abstract: In 1997, Advanced Mental Health Nursing Programmes were funded nationally by the Clinical Training Agency using the funds made available subsequent to the 1996 Mason Report. The training leads to an award of either a post graduate certificate or diploma awarded by a tertiary education provider.A review was conducted with the aim to monitor the impact on service provision of advanced mental health nurse practitioner training. This was done by obtaining feedback through using an agreed standard questionnaire from course participants and mental health service providers.In seeking to learn more about the impact of these programmes, the CTA identified the following key issues:- what effect the courses may have had on mental health workforce make-up, skills and retention.- perceptions of programme delivery and content.- the impact on service delivery.Overall findings are shared which highlight that the course was seen as well organised and participants and service providers would recommend it to their colleagues. The greatest effect of the course appeared to be in developing more understanding of clinical supervision. Participating in the course had also led to positive changes in relationships with the clients and colleagues for more than three quarters of the group.The provision of an Advanced Mental Health Nursing Programme in 1997 has had many positive effects. The funding strategy and delivery models that have evolved may provide a useful template for other nursing specialty areas

Abstract: Objective; The objective of this study is to determine if attending a nursing education session on menopause has an impact on women's management of their menopausal symptoms and consequently their quality of life for women aged 40 to 60 years. The hypothesis is that women attending education sessions will start or increase health promotion activities which will reduce menopausal symptoms and thus improve their quality of life.Design and method; Two questionaires were given to the women on the day of the education sessions and another questionnaire was sent to the participant three months later. The sample of 30 completed questionnaires includes feedback from Pacific Island women. A combination of quantitative and qualitative methods were used. The measure of quality of life has been based on the level of impact of menopausal on each women's life before the education session and three months later.Results; Initial analysis indicates that diet, exercise and time out were most commonly reported health activities utilized for relief of symptoms with HRT and herbal remedies used less often. Three months after the education session there was a significant reduction in the impact of symptoms in most categories with 140 incidences of total disappearance of symptoms, 24 incidences of reduction of symptoms, 17 incidences of symptoms increasing while 36 symptoms remained unchanged. Only one woman reported that she continued to have no control over her symptoms while the rest of the sample indicated that they had some or total control. The most common changes in health promotion activities were reduction in caffeine, exercise, relaxation and lubrication with sex. Herbal, homeopathy, dietary and hormone treatment rated low in health activities after the three months.Conclusion; Initial analysis indicates that menopausal symptoms has significantly improved for the majority of women who attended the nursing education session

Abstract: The aim of this qualitative study is to explore four clinical tutors' perceptions of their role on facilitating Bachelor of Nursing students' learning in the practice setting of the health sector in New Zealand. Participants were asked to share their personal experiences including the positive aspects and the difficulties and challenges they encountered when working with students.Contract clinical tutors, are employed because of their clinical experience and expertise to enable students to apply the knowledge learned in theory and the professional competencies learned in the laboratory into the reality of clinical practice. This requires that clinical tutors be familiar with the curriculum so that their role as supervisor, teacher, facilitator, guide ands mentor can assist the student in fulfilling their learning requirements when in clinical practice. They are not, however, involved in the development or the teaching of the theoretical component of the programme. The difficulties and challenges identified by the contract clinical tutors in this study, resulted in discussion concerning strategies that could be adapted by the faculty to support clinical tutors in their role of ensuring the students receive the best possible learning opportunities when assigned to the clinical areas.Focus groups interviews were chosen as a means of collecting data from four registered nurses currently or previously employed as contract clinical tutors to work with students from an undergraduate degree programme at a small polytechnic.A two hour focus group interview was held as a means of uncovering the shared thoughts and experiences of participants. A second focus group interview was conducted to qualify information and elaborate on some issues. From the data collected a number of recommendations were identified which if adopted by polytechnics will enhance quality teaching by contract clinical tutors.