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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 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”.

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 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

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.

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 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.
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

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).

Niniejszy dokument przedstawia Narzędzie samooceny (SAT), którego celem jest wspieranie jednostek samorządu terytorialnego (JST) w Polsce w zakresie wzmacniania praktyk zarządzania publicznego na etapie opracowywania i wdrażania strategii rozwoju lokalnego. Narzędzie ma pomóc lokalnym podmiotom w ocenie standardów i praktyk stosowanych w kluczowych obszarach zarządzania, które mogą mieć wpływ na efektywność inwestycji i strategii rozwoju lokalnego podejmowanych przez władze samorządowe oraz na jakość świadczonych przez nie usług. Narzędzie samooceny zapewnia kluczowe wskaźniki, które umożliwiają powiatom i gminom ocenę mocnych stron i luk w zarządzaniu publicznym i praktykach rozwoju lokalnego, a w konsekwencji opracowanie i realizację działań mających na celu poprawę jakości usług świadczonych na rzecz obywateli oraz skuteczniejsze zaangażowanie interesariuszy w budowanie wspólnej wizji i programu rozwoju lokalnego.

English

Este documento presenta evidencia nueva sobre cómo las Tecnologías de la Información (TIC) están cambiando la demanda de habilidades en el trabajo. Mientras que el uso de las TIC se ha incrementado en la mayoría de los países entre 2011 y 2014, un número significativo de trabajadores no tiene las habilidades suficientes para usarlas de forma efectiva. La difusión de las TIC está cambiando también la forma en que se lleva a cabo el trabajo, incrementando la demanda de habilidades complementarias como la comunicación, la autodirección y la resolución de problemas. Aunque los resultados antes mencionados ofrecen perspectivas nuevas e interesantes, el documento abre otras vías para ulteriores análisis.

English
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