Nursing and Nursing Education


Book Description

Results are presented of a study of nursing and nursing education that focused on the need for continued federal support of nursing education, ways to attract nurses to medically underserved areas, and approaches to encourage nurses to stay in the profession. Findings are presented on whether the aggregate supply of generalist nurses will be sufficient to meet future demand, and how changes that could occur in the health care system might affect demand. Attention is also directed to: how the current and future supply of nurses may be influenced by the costs of nursing education and the sources of education financing; and education for generalist positions in nursing. In addition, the supply and demand situation for nurses educationally prepared for advanced professional positions in nursing is examined. The influence of employer policies and practices in utilization of nursing resources on demand and supply is also addressed. Finally, areas in which further data and studies are needed to better monitor nursing supply and demand are identified. In addition to 21 recommendations, appendices include information on Nursing Training Act appropriations, state reports on nursing issues, certificates for specialist registered nurses, projections of registered nurse supply and requirements, and doctoral programs in nursing. (SW)




Legal Pathways to Deep Decarbonization in the United States


Book Description

Legal Pathways to Deep Decarbonization in the United States provides a "legal playbook" for deep decarbonization in the United States, identifying well over 1,000 legal options for enabling the United States to address one of the greatest problems facing this country and the rest of humanity. The book is based on two reports by the Deep Decarbonization Pathways Project (DDPP) that explain technical and policy pathways for reducing U.S. greenhouse gas emissions by at least 80% from 1990 levels by 2050. This 80x50 target and similarly aggressive carbon abatement goals are often referred to as deep decarbonization, distinguished because it requires systemic changes to the energy economy. Legal Pathways explains the DDPP reports and then addresses in detail 35 different topics in as many chapters. These 35 chapters cover energy efficiency, conservation, and fuel switching; electricity decarbonization; fuel decarbonization; carbon capture and negative emissions; non-carbon dioxide climate pollutants; and a variety of cross-cutting issues. The legal options involve federal, state, and local law, as well as private governance. Authors were asked to include all options, even if they do not now seem politically realistic or likely, giving Legal Pathways not just immediate value, but also value over time. While both the scale and complexity of deep decarbonization are enormous, this book has a simple message: deep decarbonization is achievable in the United States using laws that exist or could be enacted. These legal tools can be used with significant economic, social, environmental, and national security benefits. Book Reviews "A growing chorus of Americans understand that climate change is the biggest public health, economic, and national security challenge our families have ever faced and they rightly ask, ''What can anyone do?'' Well, this book makes that answer very clear: we can do a lot as individuals, businesses, communities, cities, states, and the federal government to fight climate change. The legal pathways are many and the barriers are not insurmountable. In short, the time is now to dig deep and decarbonize." --Gina McCarthy, Former U.S. Environmental Protection Agency Administrator "Legal Pathways to Deep Decarbonization in the United States sets forth over 1,000 solutions for federal, state, local, and private actors to tackle climate change. This book also makes the math for Congress clear: with hundreds of policy options and 12 years to stop the worst impacts of climate change, now is the time to find a path forward." --Sheldon Whitehouse, U.S. Senator, Rhode Island "This superb work comes at a critical time in the history of our planet. As we increasingly face the threat and reality of climate change and its inevitable impact on our most vulnerable populations, this book provides the best and most current thinking on viable options for the future to address and ameliorate a vexing, worldwide challenge of extraordinary magnitude. Michael Gerrard and John Dernbach are two of the most distinguished academicians in the country on these issues, and they have assembled leading scholars and practitioners to provide a possible path forward. With 35 chapters and over 1,000 legal options, the book is like a menu of offerings for public consumption, showing that real actions can be taken, now and in the future, to achieve deep decarbonization. I recommend the book highly." --John C. Cruden, Past Assistant Attorney General, Environment and Natural Resources Division, U.S. Department of Justice "This book proves that we already know what to do about climate change, if only we had the will to do it. The path to decarbonization depends as much on removing legal impediments and changing outdated incentive systems as it does on imposing new regulations. There are ideas here for every sector of the economy, for every level of government, and for business and nongovernmental organizations, too, all of which should be on the table for any serious country facing the most serious of challenges. By giving us a sense of the possible, Gerrard and Dernbach and their fine authors seem to be saying two things: (1) do something; and (2) it''s possible. What a timely message, and what a great collection." --Jody Freeman, Archibald Cox Professor of Law and Founding Director of the Harvard Law School Environmental and Energy Law Program




The Future of Public Health


Book Description

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.




Clinical Practice Guidelines We Can Trust


Book Description

Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.




Key Policies for Addressing the Social Determinants of Health and Health Inequities


Book Description

Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.




Basic Methods of Policy Analysis and Planning


Book Description

Updated in its 3rd edition, Basic Methods of Policy Analysis and Planning presents quickly applied methods for analyzing and resolving planning and policy issues at state, regional, and urban levels. Divided into two parts, Methods which presents quick methods in nine chapters and is organized around the steps in the policy analysis process, and Cases which presents seven policy cases, ranging in degree of complexity, the text provides readers with the resources they need for effective policy planning and analysis. Quantitative and qualitative methods are systematically combined to address policy dilemmas and urban planning problems. Readers and analysts utilizing this text gain comprehensive skills and background needed to impact public policy.




Levelling Up Left Behind Places


Book Description

EXECUTIVE SUMMARY AND KEY RECOMMENDATIONS The nature of the problem: • Geographical inequalities in the UK are a longstanding and persistent problem rooted in deepseated and cumulative processes of local and regional divergence with antecedents in the inter-war years and accelerating since the early 1980s. • This spatial divergence has been generated by the inability of some places to adapt to the emergence of the post-industrial service and knowledge-based economy whose geographies are very different from those of past heavy industries. As a consequence, the "left behind" problem has become spatially and systemically entrenched. • Challenging ideas of market-led adjustment, there is little evidence that real cost advantages in Northern areas are correcting and offsetting the geographically differentiated development of skilled labour and human capital and the quality of residential and business environments. • A variety of different types of "left behind place" exist at different scales, and these types combine common problems with distinctive economic trajectories and varied causes. These different types will need policies that are sensitive and adaptive to their specific problems and potentialities. • Contemporary economic development is marked by agglomeration in high-skilled and knowledge-intensive activities. Research-based concentrations of high-skilled activity in the UK have been limited and concentrated heavily in parts of London and cities in the Golden Triangle, especially Oxford and Cambridge. Even in London, the benefits have been unevenly spread between boroughs. • Existing analyses of the predicaments of left behind places present a stark division between rapid growth in "winning" high-skilled cities and relative decline in "losing" areas. This view is problematic because it oversimplifies the experience in the UK and other countries. A false binary distinction is presented to policymakers which offers only the possibility of growth in larger cities and derived spillovers and other compensations elsewhere. • Yet, the post-industrial economy involves strong dispersal of activity and growth to smaller cities, towns and rural areas. However, this process has been highly selective between local areas and needs to be better understood. The institutional and policy response: • Past policies in the UK have lacked recognition of the scale and importance of the left behind problem and committed insufficient resources to its resolution. The objective of achieving a less geographically unequal economy has not been incorporated into mainstream policymaking. When compared with other countries, the UK has taken an overcentralized, "top-down" approach to policy formulation and implementation, often applying "one size fits all" policy measures to different geographical situations. • Political cycles have underpinned a disruptive churn of institutions and policies. In contrast with other Organisation for Economic Co-operation and Development (OECD) countries, particularly in Europe, there has been limited long-term strategy and continuity, and inadequate development of local policymaking capacity and capabilities, especially for research, analysis, monitoring and evaluation. • Past policies have been underfunded, inconsistent, and inadequately tailored and adapted to the needs of different local economies. We estimate that, on average over the period 1961–2020, the UK government invested on average £2.9 billion per annum in direct spatial policy (2020 prices), equivalent to around 0.15% of gross national income (GNI) per annum over the period. European Union Structural and Cohesion Policy support has added around 0.12% GNI (2020 prices) per annum to this over the period from the late 1970s. • These broad estimates suggest that discretionary expenditure in the UK on urban and regional policy when both domestic and European Union spatial policy was in operation was equivalent to 0.27% per annum of UK GNI (2020 prices). This is dwarfed by mainstream spending programmes (by comparison, the UK committed £14.5 billion (0.7% of GNI) to international aid in 2019). The level of resources devoted to spatial policy has been modest given the entrenched and cumulative nature of the problem. • Policies for "levelling up" need clearly to distinguish different types of left behind places and devise a set of place-sensitive and targeted policies for these types of "clubs" of left behind areas. This shift will need a radical expansion of "place-based" policymaking in the UK which allows national and local actors to collaborate on the design of appropriate targeted programmes. • A key priority for "levelling up" is revitalizing Northern cities and boosting their contribution to the national economy. Underperformance in these urban centres has been a major contributor to persistent geographical inequality in the UK. • Addressing the UK’s geographical economic inequalities and the plight of left behind places requires substantially more decentralization of power and resources to place-based agencies. This would enable the current UK government’s "levelling up" agenda to capitalize on the many advantages of more "place-based" policymaking to diagnose problems, build on local capabilities, strengthen resilience and adapt to local changes in circumstances. • Crucially, place-based efforts need to be coordinated and aligned with place-sensitive national policies. The key challenge of a levelling up mission is to integrate "place-based" policies with greater place sensitivity in national policies and in regulation and mainstream economic spending. • It is important to develop policies that spread the benefits from agglomeration and ensure that the income effects and innovations produced by high-skill concentrations diffuse to the wider cityregional economies and their firms (especially small and medium-sized enterprises) and workers. There is a clear need for more policy thinking on how this can be achieved. • Policy for levelling-up needs to align and coordinate with the other national missions for net zero carbon and post-pandemic recovery. This suggests that a strong "place-making" agenda focused on quality of life, infrastructure and housing in many left behind places is important for post-industrial and service growth. • Genuine place-making is a long-term process involving public, private and civic participation which allows local responses to those economic, environmental, and social constraints and problems that most strongly reduce the quality of life in local areas. A truly "total place" approach is required. The quality of infrastructure, housing stock and public services is crucial for the quality of place as well as the ability to secure and attract more dispersed forms of growth. There is little hope of delivering "place-making" if public sector austerity is once again allowed to cut back public services more severely in poorer and more deprived areas. The way forward: • The scale and nature of the UK’s contemporary "left behind places" problem are such that only a transformative shift in policy model and a resource commitment of historic proportions are likely to achieve the "levelling up" ambition that is central to the current government’s political ambitions. KEY RECOMMENDATIONS In summary, our recommendations are that the UK government should: • Grasp the transformative moment for local, regional and urban development policy as the UK adjusts to a post-Covid-19 world and seeks a net zero carbon future. • Establish a clear and binding national mission for "levelling up". • Realize the potential of place in policymaking. • Decentralize and devolve towards a multilevel federal polity. • Strengthen subnational funding and financing and adopt new financing models involving the public, private sector and civic sectors to generate the resources required. • Embed geography in the national state and in national policy machinery. • Improve subnational strategic research, intelligence, monitoring and evaluation capacity. A failure to learn from the lessons of the last 70 years of spatial policy risks the UK becoming an ever more divided nation, with all the associated economic, social and political costs, risks and challenges that this presents.







Clinical Practice Guidelines


Book Description

The Alberta clinical practice guidelines program is supporting appropriate, effective and quality medical care in Alberta through promotion, development and implementation of evidence-based clinical practice guidelines.




Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies


Book Description

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.