The experiences and perspectives of overseas trained speech and language therapists working in the United Kingdom

There is a growing body of research which has investigated the experience of the migrant health worker. However, only one of these studies has included speech and language therapists thus far, and then only with extremely small numbers. The aim of this study was to explore the experiences and perspectives of migrant speech and language therapists living in the UK. Twenty-three overseas qualified speech and language therapists living in the UK completed an online survey consisting of 36 questions (31 closed question, 5 open-ended questions). The majority of participants came from Australia or the USA and moved to the UK early in their careers. Participants reported a range of benefits from working in another country and more specifically working in the UK. The findings were consistent with other research on migrant health workers regarding known pull factors of travel, finance, and career. This study suggests additional advantages to working in the UK were realised once participants had started working in the UK, such as the UK job lifestyle. Finally, the migrant speech and language therapists were similar in profile to other migrant health workers in terms of age and country of origin previously reported in the literature

Understanding Class-level Testability Through Dynamic Analysis

It is generally acknowledged that software testing is both challenging and time-consuming. Understanding the factors that may positively or negatively affect testing effort will point to possibilities for reducing this effort. Consequently there is a significant body of research that has investigated relationships between static code properties and testability. The work reported in this paper complements this body of research by providing an empirical evaluation of the degree of association between runtime properties and class-level testability in object-oriented (OO) systems. The motivation for the use of dynamic code properties comes from the success of such metrics in providing a more complete insight into the multiple dimensions of software quality. In particular, we investigate the potential relationships between the runtime characteristics of production code, represented by Dynamic Coupling and Key Classes, and internal class-level testability. Testability of a class is consider ed here at the level of unit tests and two different measures are used to characterise those unit tests. The selected measures relate to test scope and structure: one is intended to measure the unit test size, represented by test lines of code, and the other is designed to reflect the intended design, represented by the number of test cases. In this research we found that Dynamic Coupling and Key Classes have significant correlations with class-level testability measures. We therefore suggest that these properties could be used as indicators of class-level testability. These results enhance our current knowledge and should help researchers in the area to build on previous results regarding factors believed to be related to testability and testing. Our results should also benefit practitioners in future class testability planning and maintenance activities

A Sailor’s Disease Presenting in Urban America with Red Spots on the Legs

Sailors were often affected by nutritional deficiencies due to the absence of fresh foods on long voyages. One example is the development of scurvy from a lack of vitamin C ingestion. In modern society in which fresh food are available this disease is infrequently recognized. The following case describes a 62-year-old male who presented with “red spots” on his legs and a large area of ecchymosis on his thigh. After initial testing failed to elicit a cause, a dietary history revealed that the patient had a peculiar diet of only ice cream with a total avoidance of fruits and vegetables. This case highlights the importance of a good history and physical examination as the basis for medical diagnosis

What are the priorities for improving cataract surgical outcomes in Africa? Results of a Delphi exercise.

PURPOSE: The quality of cataract surgery delivered in sub-Saharan Africa (SSA) is a significant constraint to achieving the elimination of avoidable blindness. No published reports from routine SSA cataract services attain the WHO benchmarks for visual outcomes; poor outcomes (<6/60) often comprise 20% in published case series. This Delphi exercise aimed to identify and prioritise potential interventions for improving the quality of cataract surgery in SSA to guide research and eye health programme development. METHODS: An initial email open-question survey created a ranked list of priorities for improving quality of surgical services. A second-round face-to-face discussion facilitated at a Vision 2020 Research Mentorship Workshop in Tanzania created a refined list for repeated ranking. RESULTS: Seventeen factors were agreed that might form target interventions to promote quality of cataract services. Improved training of surgeons was the top-ranked item, followed by utilisation of biometry, surgical equipment availability, effective monitoring of outcomes of cataract surgery by the surgeon, and well-trained support staff for the cataract pathway (including nurses seeing post-operative cases). CONCLUSION: Improving the quality of cataract surgery in SSA is a clinical, programmatic and public health priority. In the absence of other evidence, the collective expert opinion of those involved in ophthalmic services regarding the ranking of factors to promote quality improvement, refined through this Delphi exercise, provides us with candidate intervention areas to be evaluated

International flow of Zambian nurses

This commentary paper highlights changing patterns of outward migration of Zambian nurses. The aim is to discuss these pattern changes in the light of policy developments in Zambia and in receiving countries

The elements of a computational infrastructure for social simulation

Applications of simulation modelling in social science domains are varied and increasingly widespread. The effective deployment of simulation models depends on access to diverse datasets, the use of analysis capabilities, the ability to visualize model outcomes and to capture, share and re-use simulations as evidence in research and policy-making. We describe three applications of e-social science that promote social simulation modelling, data management and visualization. An example is outlined in which the three components are brought together in a transport planning context. We discuss opportunities and benefits for the combination of these and other components into an e-infrastructure for social simulation and review recent progress towards the establishment of such an infrastructure

Interrogating the language of integration: the case of internationally recruited nurses

AIMS: This paper suggested the need to interrogate the notion of 'integration' to facilitate the retention of migrant nurses. BACKGROUND: The growth in internationally recruited nurses in the UK's health system has led to a raft of policies that aim to ensure that such nurses are well 'integrated' into their 'new environment'. It is assumed that integration will improve the quality of internationally recruited nurses' experience in the UK, improve their retention rates and thus improve the quality of health delivery within the UK. However, most of the steps through which integration is sought tend to move between some version of assimilation and 'respect for difference'. CONTRIBUTIONS: This paper aimed to add to existing literature on the integration of internationally recruited nurses in the UK by suggesting three steps towards rethinking 'integration policies'. It suggests the need to recognize migration as only one of the differentiating factors within the nursing sector, to ensure that integration does actually become a two-way process and to be cognizant of the multiple shapes that racism can take. The first two steps will prevent a slip between integration and assimilation while the last will help rethink any anti-racist training that may form part of integration policies. CONCLUSIONS: There are many factors influencing the experiences of internationally recruited nurses and not all of them can be addressed within current integration policies. RELEVANCE TO CLINICAL PRACTICE: Rethinking integration can help improve the experience of internationally recruited nurses