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THE AUTHOR, WHO IS THE GOVERNOR OF WISCONSIN, DISCUSSES HOW BLOCK GRANTS WILL AFFECT THE WELFARE SYSTEM AND DESCRIBES THE SWEEPING WELFARE REFORM THAT IS UNDER WAY IN HIS STATE.

In its earliest days, photography was seen as depicting its subjects with such objectivity as to be inherently free of ideological bias. Today we are rightly more skeptical -- at least most of the time. When it comes to photography from the past, we tend to set some of our skepticism aside. But should we? In Light on Darkness? T. Jack Thompson, a leading historian of African Christianity, revisits the body of photography generated by British missionaries to sub-Saharan Africa in the nineteenth and early twentieth centuries and demonstrates that much more is going on in these images than meets the eye. This volume offers a careful reassessment of missionary photographers, their photographs, and their African and European audiences. Several dozen fascinating photographs from the period are included.

This research uses insights from field theory to explore the early moments of how entrepreneurial ecosystems form through everyday interactions. We examine the cultural-cognitive and material micro-dynamics of activities occurring in support of social impact entrepreneurs and businesses from 2000 to 2014 in the Seattle WA region using archival and interview data sources. The pattern of results about what actors do and how interactions change over time supports a two-period model of ecosystem formation where initial distributed and disparate activity undergoes a phase transition to coalesce into a more coordinated and integrated social order. The findings point to endogenous sources of structuring, including language and interaction, rather than exogenous sources such as government action or instrumental policy goals.

Subjects This study was conducted from May 2012 to January 2013. Aim To investigate the decision-making skills of secondary care nurse practitioners compared to those of medical doctors. Background A literature review was conducted, searching for articles published from 1990 to 2012. The review found that nurse practitioners are key to the modernisation of the National Health Service. Studies have shown that compared to doctors, nurse practitioners can be efficient and cost-effective in consultations. Design Qualitative research design. Methods The information processing theory and think-aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality, and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment. Results The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took three minutes longer to complete the scenarios. Conclusion This study suggests that nurse practitioner consultations are comparable to those of medical doctors within a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes. SUMMARY STATEMENT Why is this research or review needed? • The purpose of this research was to highlight the similarities in decision-making skills between nurse practitioners and doctors during consultations. • To highlight to other multi-disciplinary teams that nurse practitioners are equally as capable as doctors in making diagnoses and prescribing further studies or treatment. • To help provide clarity on the role of the nurse practitioner. What are the key findings? • Nurse practitioners and medical doctors used similar cognitive decision-making skills. However, medical doctors were able to chunk more information and used less cue acquisition (history taking) to reach a diagnosis and thus finished their consultations quicker than nurse practitioners. • The more experienced (> 2 years) nurse practitioners were comparable to medical doctors in their consultations. • The two professions showed different consultation styles; nurse practitioners were more holistic, whilst medical doctors were more paternalistic. How should the findings be used to influence policy/practice/research/education? • This study may influence government policy, as it provides more clarity regarding the nurse practitioner's role and responsibilities. • This study may affect caring practices, as multi-disciplinary teams may acknowledge the nurse practitioner's abilities, assign them a variety of patients and organize opportunities for further training. • This study contributes to the number of studies that have confirmed that consultations performed by nurse practitioners are comparable to medical doctors' consultations.

Based on the views of hundreds of managers in 10 states surveyed in 1982 and 2000, this article explores the severity of a range of human resource-related barriers to effective state management. Adequately rewarding outstanding employees, difficulty filling key staff vacancies, retaining experienced staff, disciplining low-performing employees, and—in 2000—uncompetitive pay were among the most serious impediments. Little change in the severity of various human resource-related problems occurred between 1982 and 2000, however. Despite the criticism often leveled at them, variation in civil service coverage and variation in public sector collective bargaining were typically only weakly related to the severity of particular personnel-related problems. In fact, certain problems were less serious in those states with more extensive civil service coverage or more widespread collective bargaining. There was little evidence that deregulating aspects of state human resource systems reduced the severity of personnel-related impediments.