A study of the skills, education and qualifications of nurses performing dermatological surgery in the United Kingdom

Background: There has been a significant expansion of the nurse’s role in thefield of dermatological surgery in recent years. Yet, how this role has developedvaries significantly from Trust to Trust, and anecdotal evidence indicates a highdegree of inconsistency in the clinical roles undertaken.Aim: This study aims to explore the skills, education, and qualifications of nurse’s performing dermatological surgery in the United Kingdom. Findings being used to determine the training and supervision needs of nurse surgeons and implications for high quality care provision.Method: Data was collected using an electronic online questionnaire, distributednationally to members of the British Dermatological Nursing Group (BDNG).Specifically, nurses identifying as nurse surgeons were targeted.Results: 56 nurses responded and the findings demonstrate significant variations in the advanced roles adopted, the levels of education undertaken and the clinical supervision provided.Conclusion: It is clear from the findings that there are unacceptable variations inthe support and education offered to nurse undertaking dermatological surgeryin the UK making it difficult to benchmark care services

Migration signatures across the decades: Net migration by age in U.S. counties, 1950−2010

Background: Migration is the primary population redistribution process in the United States. Selective migration by age, race/ethnic group, and spatial location governs population integration, affects community and economic development, contributes to land use change, and structures service needs. Objective: Delineate historical net migration patterns by age, race/ethnic, and rural-urban dimensions for United States counties. Methods: Net migration rates by age for all US counties are aggregated from 1950−2010, summarized by rural-urban location and compared to explore differential race/ethnic patterns of age-specific net migration over time. Results: We identify distinct age-specific net migration ‘signatures’ that are consistent over time within county types, but different by rural-urban location and race/ethnic group. There is evidence of moderate population deconcentration and diminished racial segregation between 1990 and 2010. This includes a net outflow of Blacks from large urban core counties to suburban and smaller metropolitan counties, continued Hispanic deconcentration, and a slowdown in White counterurbanization. Conclusions: This paper contributes to a fuller understanding of the complex patterns of migration that have redistributed the U.S. population over the past six decades. It documents the variability in county age-specific net migration patterns both temporally and spatially, as well as the longitudinal consistency in migration signatures among county types and race/ethnic groups

Moving to Diversity

In this brief, authors Richelle Winkler and Kenneth Johnson, using new data and techniques, find that net migration between U.S. counties increased racial diversity in each of the last two decades. However, migration’s influence on diversity was far from uniform: it varied by race, age group, and location, sometimes starkly. Overall, net migration of the population under age 40 increased diversity, while net migration of people over age 60 diminished diversity. Blacks and Hispanics are migrating to predominantly white counties, while white young adults are moving to urban core counties with relatively high proportions of blacks and Hispanics. The movement of older whites is not contributing to the growing diversity, because older whites tend to move to predominantly white counties. Winkler and Johnson conclude that, while migration contributed to the growing diversity of the nation, the process was complex and varied from place to place with significant social, economic, and political implications for both the more diverse and less diverse places

Age and lifecycle patterns driving U.S. migration shifts

Migration—people moving between locations—is now driving much of the demographic change occurring in the United States. In this brief, authors Kenneth Johnson, Richelle Winkler, and Luke Rogers share new research on age-related migration patterns to provide a fuller understanding of the complex patterns of demographic change in the United States. Examining four migration age groups, including emerging adults, young adults, family age, and older adults, their analysis of trends over time shows evidence that certain age groups migrate in similar ways. For example, young adult migrants are flowing to large metropolitan areas, while family age migrants are leaving large urban cores for the suburbs. Major metro areas in the Northeast and Midwest are losing older migrants, and rural farm counties continue to lose young adults. The authors explore how these migration patterns have important implications for people, institutions, and communities of both rural and urban America, as well as for the design of policies and practices that foster the development of sustainable communities

Multilevel logic as a tool in modelling; application to glycolytic reactions

AbstractThe theoretical bases of a multilevel logical dynamics are presented as a generalization of the boolen approach developed by Thomas (1973). Multilevel logical models are derived for the glycolytic reactions responsible of oscillations

Spiritual Coping and Posttraumatic Growth after Sexual Assault

The interpersonal nature of sexual assault has been theorized to negatively impact recovery. Access to supportive others is critical to positive outcomes and in particular, to posttraumatic growth. Spirituality may provide access to supportive social and spiritual relationships; however, spirituality can also be a source of increased distress when accessed in less adaptive ways. This research sought to understand how spirituality impacts posttraumatic growth after a sexual assault. The research design was an exploratory, non-probability sample. Respondents were primarily Caucasian and of young adult age. Respondents were more likely to access personal spirituality than communal spirituality. Participants were reached through word-of-mouth and online forums. An online survey was completed by respondents which provided information about demographics, spirituality prior to and after the sexual assault, and the resulting psychological change. Quantitative results were analyzed for descriptive statistics, and qualitative results were analyzed using a grounded theory method. Overall, posttraumatic growth was lower than would be expected among those who have experienced trauma. A positive style of spiritual coping was associated with positive relationships and the strongest posttraumatic growth outcomes, whereas a negative style of spiritual coping was associated with difficulty in relationships and the weakest posttraumatic growth outcomes. Clinical social workers need to consider the influence of spirituality when it is used by clients as a coping strategy after sexual assault and, where necessary, provide additional relational support and motivation to remain engaged in the recovery process

Common Core Conversations in Connecticut: Analyzing Public Testimonies

The Common Core State Standards (CCSS) is an effort to minimize the learning gap between high- and low-achieving students in the United States by providing a set of standards all students must meet by the end of each grade level. Although 46 states already adopted the CCSS, there are varied opinions on the effectiveness of this new reform. This research examined the opinions of citizens in Connecticut, using written testimonies from a public hearing that took place in Hartford on March 12, 2014. The results show that two groups express support of the CCSS: statewide organizations and suburban administrators, who believe that the CCSS will create students who are globally competitive and better prepared for college and careers because the standards are challenging. On the other hand, suburban teachers and suburban parents are opponents of the CCSS because the standards are too rigorous and focus on test-taking rather than critical thinking skills. The results of this research suggest that speakers may vary their support of the CCSS based on how they perceive the Core’s effects within or outside the school