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Many OECD countries have undergone reforms over the past decade to introduce advanced roles for nurses in primary care to improve access to care, quality of care and/or to reduce costs. This working paper provides an analysis of these nurse role developments and reforms in 37 OECD and EU countries. Four main trends emerge: 1) the development in several countries of specific advanced practice nursing roles at the interface between the traditional nursing and medical professions; 2) the introduction of various new, supplementary nursing roles, often focused on the management of chronic conditions; 3) the rise in educational programmes to train nurses to the required skills and competencies; and 4) the adoption of new laws and regulations in a number of countries since 2010 to allow certain categories of nurses to prescribe pharmaceuticals (including in Estonia, Finland, France, Netherlands, Poland and Spain).

Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors. It might also contain costs by delegating tasks away from more expensive doctors. This paper reviews the development of advanced practice nurses in 12 countries (Australia, Belgium, Canada, Cyprus, Czech Republic, Finland, France, Ireland, Japan, Poland, United Kingdom and United States), with a particular focus on their roles in primary care. It also reviews the evaluations of impacts on patient care and cost. The development of new nursing roles varies greatly. The United States and Canada established “nurse practitioners” in the mid-1960s. The United Kingdom and Finland also have a long experience in using different forms of collaboration between doctors and nurses. Although development in Australia and Ireland is more recent, these two countries have been very active in establishing higher education programmes and posts for advanced practice nurses in recent years. In other countries, the formal recognition of advanced practice nurses is still in its infancy, although unofficial advanced practices may already exist in reality. Evaluations show that using advanced practice nurses can improve access to services and reduce waiting times. Advanced practice nurses are able to deliver the same quality of care as doctors for a range of patients, including those with minor illnesses and those requiring routine follow-up. Most evaluations find a high patient satisfaction rate, mainly because nurses tend to spend more time with patients, and provide information and counselling. Some evaluations have tried to estimate the impact of advanced practice nursing on cost. When new roles involve substitution of tasks, the impact is either cost reducing or cost neutral. The savings on nurses’ salaries – as opposed to doctors – can be offset by longer consultation times, higher patient referrals, and sometimes the ordering of more tests. When new roles involve supplementary tasks, some studies report that the impact is cost increasing.
French
The United States has the largest professional nurse workforce in the world numbering close to 3 million but does not produce enough nurses to meet its growing demand. A shortage of close to a million professional nurses is projected to evolve by 2020. An emerging physician shortage will further exacerbate the nurse shortage as the boundaries in scope of practice necessarily overlap. Nurse immigration has been growing since 1990 and the U.S. is now the world’s major importer of nurses. While nurse immigration is expected to continue to grow, the shortage is too large to be solved by recruitment of nurses educated abroad without dramatically depleting the world’s nurse resources. Moreover, the domestic applicant pool for nursing education is very strong with tens of thousands of qualified applicants turned away annually because of faculty shortages and capacity limitations. The national shortage could be largely addressed by investments in expanding nursing school capacity to increase graduations by 25 percent annually and the domestic applicant pool appears sufficient to support such an increase. A shortage of faculty and limited capacity for expansion of baccalaureate and graduate nurse education require public policy interventions. Specifically public subsidies to increase production of baccalaureate nurses are required to enlarge the size of the pool from which nurse faculty, advanced practice nurses in clinical care roles, and managers are all recruited. Retention of nurses in the workforce is critical and will require substantial improvements in human resource policies, the development of satisfying professional work environments, and technological innovations to ease the physical burdens of caregiving. Because of the reliance of the U.S. on nurses educated abroad as well as the benefits to the U.S. of improving global health, the nation should invest in nursing education as part of its global agenda.

We assess the relationship between numeracy skills and numeracy practices among adults in everyday life and at work from the Survey of Adult Skills, a product of the Programme for the International Assessment of Adult Competencies (PIAAC), an international survey of about 250 000 adults aged 16-65 years old conducted by the OECD in 33 countries/economies. The level of proficiency and the intensity of engagement in numeracy practices are two embedded aspects of numeracy. Proficient adults use numeracy frequently and adults who regularly engage in numeracy practices improve their performance. Individual and contextual factors influence, in different ways across countries, the strength of these links. The intensity of the use of numeracy in everyday life decreases as the lapse of time since a person’s studies increases. Moreover, employed people engage in mathematical activities less in the private setting if they do not do so intensively in the workplace.

French

The German system of nuclear third party liability has always been, and arguably still is, the object of considerable interest in the international nuclear law community.

The NEA encourages governments to take advantage of the post‑COVID‑19 economic recovery to accelerate the energy transition towards meeting climate objectives. Post‑pandemic recovery plans to reconcile climate objectives with economic goals need to put system costs at the heart of energy policy. Nuclear energy projects achieve deep decarbonisation with optimal use of land and mineral resources. Moving to a carbon neutral electricity system without nuclear power would significantly increase system costs and threaten security of supply. Achieving cost‑effective decarbonisation requires structural reform of the electricity market.

French

Large nuclear installations can have a considerable impact on the environment, both in actual terms, due to the construction and operation of the plant and in potential terms, related to the risk of an accident. A considerable part of the multiple authorisation processes required to develop a large nuclear project is devoted to addressing the possible impact on the environment.

French

The third annual meeting of the Nuclear Law Association, India (NLAI) was held on 1 March 2014 in New Delhi. This year’s overarching theme was “Nuclear energy and Indian society: Public engagement, risk assessment and legal frameworks”.

At the core of the nuclear non-proliferation regime lie international agreements. These agreements include, inter alia, the Nuclear Non-proliferation Treaty, nuclear co-operation agreements and nuclear export control agreements.1 States, however, do not always comply with their obligations under these agreements. In response, commentators have proposed various enforcement mechanisms to promote compliance.2 The inconvenient truth, however, is that states are generally unwilling to consent to enforcement mechanisms concerning issues as critical to national security as nuclear non-proliferation.

The long-promised Act No. 2006-686 of 13 June 2006 on nuclear transparency and safety (hereinafter referred to as the TSN Act) is the result of a long process, begun in the 1990s, reflecting the (more or less general) desire to promulgate a comprehensive nuclear legislative framework.

French

Following the adoption of Law No. 99 of 23 July 2009, Italy is on the threshold of returning to nuclear power, even though there are many more challenges yet to overcome. It should be recalled that Law No. 99/2009 includes enabling provisions empowering the Government to issue one or more implementing decrees providing rules for the siting of new nuclear power plants, the licensing process for the construction, operation and dismantling of those plants, as well as rules for interim storage and the final disposal of nuclear waste. On 15 February 2010, upon the proposal of the Ministry of Economic Development, the Italian Council of Ministers issued Legislative Decree No. 31/20102 (hereinafter “decree”) implementing the enabling provisions.

French

This report discusses some of the basic principles and criteria that a regulatory body should consider in making decisions and describes the elements of an integrated framework for regulatory decision making. It is not, however, a handbook or guide on how to make regulatory decisions. In preparing the report, the task group reviewed and incorporated information from a wide array of documents produced by the NEA, its member countries and other international organisations, such as the International Atomic Energy Agency (IAEA) Safety Series reports.

In April 2009, 61 states and seven international organisations with a total of 808 participants and observers convened in Beijing at an international ministerial conference, organised by the International Atomic Energy Agency (IAEA) in co-sponsorship with the Nuclear Energy Agency of the Organisation for Economic Co-operation and Development (OECD/NEA), to deal with nuclear energy in the 21st century.1 In his concluding statement, the president of that conference stressed that “the conference recognizes the positive momentum towards nuclear power and the decisions by many developed and developing states to pursue the use of nuclear energy”.2 According to the Director General of the IAEA, more than 60 countries declared their interest in launching nuclear power programmes.

French

The way in which nuclear licensees’ organisations are structured and resourced clearly has a potential impact on nuclear safety. As experience has continually demonstrated, operating organisations with a strong training programme for personnel, adequate resourcing and overall effective leadership and management perform more effectively in times of crisis than those lacking in one or more of these areas. In parallel, the nuclear industry is developing new resource deployment strategies which are making increased use of contractors and leading to changes in organisational structure, which in turn create challenges for the continued safe operation of nuclear facilities. This technical opinion paper represents the consensus among human and organisational factor specialists in NEA member and associated countries on the methods, approaches and good practices to be followed in designing an organisation with a strong safety focus while meeting business needs. It also considers some of the attributes that an organisation which is effectively managing its resources and capabilities might demonstrate.

Trade in value added (TiVA) indicators are increasingly used to monitor countries’ integration into global supply chains. However, they are published with a significant lag - often two or three years - which reduces their relevance for monitoring recent economic developments. This paper aims to provide more timely insights into the international fragmentation of production by exploring new ways of nowcasting five TiVA indicators for the years 2021 and 2022 covering a panel of 41 economies at the economy-wide level and for 24 industry sectors. The analysis relies on a range of models, including Gradient boosted trees (GBM), and other machine-learning techniques, in a panel setting, uses a wide range of explanatory variables capturing domestic business cycles and global economic developments and corrects for publication lags to produce nowcasts in quasi-real time conditions. Resulting nowcasting algorithms significantly improve compared to the benchmark model and exhibit relatively low prediction errors at a one- and two-year horizon, although model performance varies across countries and sectors.

The OECD Income Distribution Database (IDD) plays a leading role in providing evidence, and in monitoring and analysing international income distribution statistics to inform policy debate. In most OECD countries, official income distribution statistics are usually delivered with time lags varying from two to three years. This paper examines the growing use by statistical offices of nowcasting techniques based on microsimulation models to produce more timely provisional estimates, and examines the advantages and challenges associated with these techniques. The paper also presents provisional estimates of income inequality in 2020 for a selection of OECD countries, based on a compilation carried out by the OECD Secretariat in collaboration with Eurostat and national statistical offices. Finally, it discusses potential future developments and applications of these techniques.

The increasing importance of services trade in the global economy contrasts with the lack of timely data to monitor recent developments. The nowcasting models developed in this paper are aimed at providing insights into current changes in total services trade, as recorded in monthly statistics of the G7 countries. Combining machine-learning techniques and dynamic factor models, the methodology exploits traditional data and Google Trends search data. No single model outperforms the others, but a weighted average of the best models combining machine-learning with dynamic factor models seems to be a promising avenue. The best models improve one-step ahead predictive performance relative to a simple benchmark by 30-35% on average across G7 countries and trade flows. Nowcasting models are estimated to have captured about 67% of the fall in services exports due to the COVID-19 shock and 60% of the fall in imports on average across G7 economies.

Indicators based on patents provide a good measure of the innovative performance and technology outputs of countries. However, because of legal rules imposed by the patent application process, information on patents is generally publicly disclosed after 18 months. Patent indicators are consequently faced with a timeliness issue, which can extend to more than five years depending on the computational method used to develop indicators. This study aims at designing simple but robust methods that would enable to "nowcast" patent indicators - forecast the present (or the recent past) - in order to mitigate the timeliness issue. The nowcasting exercise is conducted here on two separate sets of patent indicators: the number of patents applied to the European Patent Office (EPO) and the number of Triadic Patent Families (patents taken at the EPO, the Japan Patent Office (JPO) and the United States Patent and Trademarks Office (USPTO)). Portion of patent filings at the EPO were made under the Patent Cooperation Treaty (PCT). The nowcasting method developed in the present document is based on estimates of the transfer rate of patents filed under PCT into the EPO regional phase, given that information on PCT patents at international phase is disclosed before reaching the regional/national phase. This method provides robust estimates up to year t-2 (instead of year t-4), even though patenting activity of small patenting countries or emerging economies are difficult to predict, in terms of both level and growth...

This paper presents a dynamic factor model that produces nowcasts and backcasts of Irish quarterly GDP using timely data from a panel dataset of 35 indicators. We apply a recently developed methodology, whereby numerous potentially useful indicator series for Irish GDP can be availed of in a parsimonious manner and the unsynchronised nature of the release calendar for a wide range of higher frequency indicators can be handled. The nowcasts in this paper are generated by using dynamic factor analysis to extract common factors from the panel dataset. Bridge equations are then used to relate these factors to quarterly GDP estimates. We conduct an out-of-sample forecasting simulation exercise, where the results of the nowcasting exercise are compared with those of a standard benchmark model.

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