Enrolled nurses' experiences of conversion to first level

The study focuses on enrolled nurses' experiences of conversion and altered perceptions of self and others as they progress through a conversion course to first level. The experience involves a cultural transition that requires questioning of traditionally held values and adoption of a critical stance to professional practice. The transition mirrors current tensions within nursing as the prevalent direction of professionalisation in recent years has influenced the need for individual accountability that has implications for the self-regulation of practice. Thirty enrolled nurses participated in the study and were interviewed on three occasions as they progressed through specific parts of a conversion course. A grounded theory approach was utilised and important findings emerged in relation to the nature of learning from practice, the influence of gender and class on perceptions of academic ability and occupational standing and the development of self-agency through critical reflection. The findings challenge predominant scientific values within professional nurse education and support the validity of a situated learning approach for this group of experienced nurses. It is contended that, if opportunities for professional development and education are to be genuinely accessible, the diverse needs influencing learner participation must be considered. The main recommendations include the provision of accessible, experiential learning conversion courses for enrolled nurses and the development of a facilitative approach to professional development within nurse education

Shoreline Evolution: City of Virginia Beach, Virginia, Chesapeake Bay, Lynnhaven River, Broad Bay, and Atlantic Ocean Shorelines

The City of Virginia Beach is situated along both the Atlantic Ocean and Chesapeake Bay (Figure 1). Through time, the City’s shoreline has evolved, and determining the rates and patterns of shore change provides the basis to know how a particular coast has changed through time and how it might proceed in the future.Along Chesapeake Bay’s estuarine shores, winds, waves, tides and currents shape and modify coastlines by eroding, transporting and depositing sediments.The purpose of this report is to document how the shore zone of the City of Virginia Beach has evolved since 1937. Aerial imagery was taken for most of the Bay region beginning that year and can be used to assess the geomorphic nature of shore change. Aerial photos show how the coast has changed, how beaches, dunes, bars, and spits have grown or decayed, how barriers have breached, how inlets have changed course, and how one shore type has displaced another or has not changed at all. Shore change is a natural process but, quite often, the impacts of man, through shore hardening or inlet stabilization, come to dominate a given shore reach. In addition to documenting historical shorelines, the change in shore positions along the rivers and larger creeks in the City of Virginia Beach will be quantified in this report. The shore lines of very irregular coasts, small creeks around inlets, and other complicated areas will be shown but not quantified. In addition to the Atlantic Ocean and Chesapeake Bay shorelines, the Lynnhaven River and Broad Bay shorelines were analyzed for change.Back Bay was not included

Shoreline Evolution Update: 1937/38-2009 End Point Rate Calculations Counties of Accomack, Gloucester, and York Cities of Newport News, Norfolk, and Poquoson

Through time, Chesapeake Bay’s shoreline has evolved, and determining the rates and patterns of shore change provides the basis to know how a particular coast has changed through time and how it might proceed in the future. Along Chesapeake Bay’s estuarine shores, winds, waves, tides and currents shape and modify coastlines by eroding, transporting and depositing sediments. The purpose of this report is to document how the shore zone of six Virginia localities, Accomack, Gloucester, York, Newport News, Norfolk, and Poquoson, have evolved since 1937/38 (Figure 1). Aerial imagery was taken for most of the Bay region beginning then and can be used to assess the geomorphic nature of shore change. Aerial photos show how the coast has changed, how beaches, dunes, bars, and spits have grown or decayed, how barriers have breached, how inlets have changed course, and how one shore type has displaced another or has not changed at all. Shore change is a natural process but, quite often, the impacts of man, through shore hardening or inlet stabilization, come to dominate a given shore reach. In addition to documenting historical shorelines, the change in shore positions along the rivers and larger creeks will be quantified in this report. The shorelines of very irregular coasts, small creeks around inlets, and other complicated areas will be shown but not quantified

Shoreline Evolution: Prince William County, Virginia Potomac River, Occoquan Bay, and Occoquan River Shorelines

Prince William County is situated along the Potomac River (Figure 1). Through time, the County’s shoreline has evolved, and determining the rates and patterns of shore change provides the basis to know how a particular coast has changed through time and how it might proceed in the future. Along Chesapeake Bay’s estuarine shores, winds, waves, tides and currents shape and modify coastlines by eroding, transporting and depositing sediments. The purpose of this report is to document how the shore zone of Prince William County has evolved since 1937. Aerial imagery was taken for most of the Bay region beginning that year and can be used to assess the geomorphic nature of shore change. Aerial photos show how the coast has changed, how beaches, dunes, bars, and spits have grown or decayed, how barriers have breached, how inlets have changed course, and how one shore type has displaced another or has not changed at all. Shore change is a natural process but, quite often, the impacts of man, through shore hardening or inlet stabilization, come to dominate a given shore reach. In addition to documenting historical shorelines, the change in shore positions along the rivers and larger creeks in Prince William County will be quantified in this report. The shorelines of very irregular coasts, small creeks around inlets, and other complicated areas will be shown but not quantified

Shoreline Evolution: Westmoreland County, Virginia Potomac River and Rappahannock River Shorelines

Westmoreland County is situated along the Potomac River and Rappahannock River. Through time, the County’s shoreline has evolved, and determining the rates and patterns of shore change provides the basis to know how a particular coast has changed through time and how it might proceed in the future. Along Chesapeake Bay’s estuarine shores, winds, waves, tides and currents shape and modify coastlines by eroding, transporting and depositing sediments. The purpose of this report is to document how the shore zone of Westmoreland County has evolved since 1937. Aerial imagery was taken for most of the Bay region beginning that year and can be used to assess the geomorphic nature of shore change. Aerial photos show how the coast has changed, how beaches, dunes, bars, and spits have grown or decayed, how barriers have breached, how inlets have changed course, and how one shore type has displaced another or has not changed at all. Shore change is a natural process but, quite often, the impacts of man, through shore hardening or inlet stabilization, come to dominate a given shore reach. In addition to documenting historical shorelines, the change in shore positions along the rivers and larger creeks in Westmoreland County will be quantified in this report. The shorelines of very irregular coasts, small creeks around inlets, and other complicated areas will be shown but not quantified

A Geotechnical Evaluation of Chesapeake Beach Shoal for Beach Quality Sand

Chesapeake Beach Shoal is located along the southern coast of Chesapeake Bay in Virginia Beach, Virginia (Figure 1-1). Chesapeake Beach, which is nearly adjacent, has a history of chronic beach erosion which threatens upland infrastructure. Beach nourishment occurs on Ocean Park Beach to the east from intermittent dredging of Lynnhaven Inlet (Figure 1-2), but the effects do not always translate westward to Chesapeake Beach. The general alongshore sand movement is east to west. The purpose of this project is to establish a reliable source of beach sand for Chesapeake Beach via the nearshore shoal. Many issues, including identifying the location and volume of suitable material, cost effectiveness, permitting requirements (marine habitat impacts) and impacts to the local wave climate, must be addressed before mining sand from offshore shoals. Permits for sand mining for beach nourishment in the Bay have been granted for the Buckroe and Factory Point areas, but extensive environmental assessments are required. First, the sand resource must be identified in order to develop a dredging/mining plan. A single core, taken by VIMS in 1981(Hobbs et al., 1981), showed that the first 20 feet of material in the subbottom was at least 97% sand (Figure 1-2). According to results from Hobbs et al. (1981), the surface sediments in Chesapeake Beach Shoal are mostly very fine grained silty-sands, grading to gray medium sand near the beach. The core shows a sand horizon starting at the beach which has an overburden of inorganic clays and silts that thickens to the north and west. However, a surface deposit has a thickness of between 7 and 20 ft and an estimated volume of material with an overfill ratio of less than 2.0 is about 3.0 million cubic yards (Hobbs et al., 1981). According to the Army Corps of Engineers (1990) the average mean grainsize of the beach sands along Ocean Park is 0.35 mm (medium-grained). This analysis is no doubt influenced by recent beach fill projects. Hobbs et al. (1992) found the sediments in the nearshore to be between 0.2 mm and 0.35 mm. This report focuses on the acquisition of short cores and site data in order to establish the extent of the sand resource and provide data for developing a sand-mining plan. Athena Technologies took 42 vibracores in August 2011. These were analyzed to determine grain size characteristics which would define the location and suitability of beach quality material in the nearshore off Chesapeake Beach. In addition, a selected storm wave was modeled to determine the effect of the proposed dredging in the nearshore

Shoreline Evolution: Lancaster County, Virginia Rappahannock River and Chesapeake Bay Shorelines 2012

ancaster County is situated along the Rappahannock River and Chesapeake Bay (Figure 1). The County has 330 miles of tidal shoreline (Lancaster, 2007). Through time, the County’s shoreline has evolved, and determining the rates and patterns of shore change provides the basis to know how a particular coast has changed through time and how it might proceed in the future. Along Chesapeake Bay’s estuarine shores, winds, waves, tides and currents shape and modify coastlines by eroding, transporting and depositing sediments. The purpose of this report is to document how the shore zone of Lancaster County has evolved since 1937. Aerial imagery was taken for most of the Bay region beginning that year and can be used to assess the geomorphic nature of shore change. Aerial photos show how the coast has changed, how beaches, dunes, bars, and spits have grown or decayed, how barriers have breached, how inlets have changed course, and how one shore type has displaced another or has not changed at all. Shore change is a natural process but, quite often, the impacts of man, through shore hardening or inlet stabilization, come to dominate a given shore reach. In addition to documenting historical shorelines, the change in shore positions along the rivers and larger creeks in Lancaster County will be quantified in this report. The shorelines of very irregular coasts, small creeks around inlets, and other complicated areas, will be shown but not quantified

Dying at home: a qualitative study of family carers' views of support provided by GPs community staff

Background: Dying at home is the preference of many patients with life-limiting illness. This is often not achieved and a key factor is the availability of willing and able family carers. Aim: To elicit family carers’ views about the community support that made death at home possible. Design and setting: Qualitative study in East Devon, North Lancashire, and Cumbria. Method: Participants were bereaved family carers who had provided care at the end of life for patients dying at home. Semi-structured interviews were conducted 6–24 months after the death. Results: Fifty-nine bereaved family carers were interviewed (54% response rate; 69% female). Two-thirds of the patients died from cancer with median time of home care being 5 months and for non-cancer patients the median time for home care was 30 months. An overarching theme was of continuity of care that divided into personal, organisational, and informational continuity. Large numbers and changes in care staff diluted personal continuity and failure of the GPs to visit was viewed negatively. Family carers had low expectations of informational continuity, finding information often did not transfer between secondary and primary care and other care agencies. Organisational continuity when present provided comfort and reassurance, and a sense of control. Conclusion: The requirement for continuity in delivering complex end-of-life care has long been acknowledged. Family carers in this study suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience