The Tension Between Regulation and the Pursuit of Quality in Canadian Nurse Practitioner Education Programs

Nurses in advanced practice roles have existed in Canada for over 100 years, yet only in the last two decades, have nurse practitioners (NPs) been recognized as advanced practice nurses (APNs). During this time, NP educational programs have increased and transitioned from post-baccalaureate level to graduate level. Legislation and national NP regulatory approval processes have contributed to existing barriers to NP role implementation and full scope of practice. While regulation is mandatory and focused on public safety, an emphasis towards quality has led to the introduction of a national voluntary NP program accreditation process. The purpose of this paper is to initiate a discussion between Canadian NP regulators and educators related to proposed regulatory approaches and accreditation processes that balance public safety while promoting quality and excellence in NP education. Having two separate and costly processes has led to tension during a time of provincial fiscal restraint on university budgets coupled with the COVID-19 pandemic and its impact on nursing education. An integrated pan-Canadian approach of regulation and accreditation may ensure public safety, continuity, and consistency in quality NP education, enhance mobility of the NP workforce, and systematic planning to guide successful future NP role development and practice.

Denunciations of dependence

This article focuses on workers in a South African township who enter into relationships of hierarchical dependence due to a lack of alternatives in the context of high unemployment and neoliberal fiscal restraint. The relationships are characterized by a double bind: workers seek relations of dependence in order to be recognized as persons, yet within these relations they are often denied such recognition, which reproduces experiences of infantilization, paternalism, and dehumanization associated with the past. The article explores how racialized and gendered meanings condition how men and women navigate relationships of hierarchical dependence, what they can expect to get from them and how these bonds can potentially be drawn on in efforts to escape them.

Making the Case for Counsellor Education Accreditation in Canada: A Cross-Jurisdictional Review of Emerging Trends in the Pre-Service Training of Counsellors and Related Mental Health Professionals

The Council for Accreditation of Counsellor Education Programs recognizes quality assurance of master’s-level counselling programs in Canada. Accreditation is important to the pre-service training of counsellors and psychotherapists who are preparing to enter into practice after graduation. This article identifies trends in counsellor education accreditation from a national perspective—ranging from changes in the regulatory landscape in Canada to the integration of social justice and diversity practices into programs of study while fostering innovative program design in times of fiscal restraint within Canadian post-secondary institutions. From an international perspective, this article highlights trends for counsellor education accreditation programs in the United States, Britain, and Australia. Overall, it is important to inform counsellor educators and personnel running counselling programs in Canada on counsellor education program development, with the goal of supporting quality standards for accrediting counselling programs in Canada while acknowledging professional mental health service regulations and public policy.

Institutional and Economic Determinants of Regional Public Debt in Spain

We analyze from an empirical point of view the evolution and determinants of Spanish regional public debt. Spain offers an interesting case study because of its high level of fiscal decentralization, implemented gradually during the past four decades, the parallel entry into force of a number of national fiscal rules in that period, and the heterogeneity of its regions, both in terms of economic fundamentals and some institutional features. Our main findings are the following: (i) on average, over the sample of study, regional governments’ fiscal policies reacted to public debt increase; (ii) fiscal rules played a limited role in controlling debt surges; (iii) a higher degree of regional fiscal coresponsibility tends to be linked to more subdued debt dynamics; (iv) market disciple has encouraged some fiscal restraint at the regional level; and (v) increases in public commercial debt have affected the standard debt.

Justice in a time of crisis: the role of European courts as guardians of democracy

Examining some recent examples from the Court of Justice of the European Union case law, this article intends to unravel the direction to which the European courts turn towards in times of crisis. The fiscal restraint and socioeconomic restructuring dictated by considerations of public debt reduction affect the daily lives of European citizens. However, the crisis and the austerity measures framed by Union law follow the new visibility that fundamental rights assumed in the integration process with the entry into force of the Charter of Fundamental Rights of the European Union. Therefore, in accordance to the moto proclaimed by Cunha Rodrigues, the crisis highlights the role of jurists and, in particular, the judges while guardians of democracy – understood as the safe exercise of fundamental rights. This paper therefore considers the transformative potential of the current crisis and its implications on the deepening of citizenship rights in the European Union.

Dermatologic Training and Practice in Canada: A Historical Overview

The specialty of dermatology is constantly changing to meet the medical needs of our society. The discipline is in flux because of a variety of factors such as growing population needs, technological advancements, fiscal restraint, and demographic changes. As part of an in-depth review of the specialty, the Dermatology Working Group (DWG) for the Royal College of Physicians and Surgeons of Canada sought to determine whether the current training configuration is suitably preparing graduates to meet the societal health needs of dermatology patients. In this first of a 2-part series, the authors conducted comprehensive literature and historical reviews and a jurisdictional analysis to understand the current state of dermatology practice in Canada. Herein, they explore trends in the dermatology workforce, population needs, accessibility, and wait times, as well as issues in undergraduate and postgraduate medical education. In a subsequent publication, the DWG will utilize information gained from this historical analysis and jurisdictional review, stakeholder perspectives, and a national survey to shape the future of dermatology training in Canada.

How We Got Here, Why It Matters

As discussed in Chapter 2, from the nation’s founding until about 1980, debt as a share of the economy rose only during wars or recessions, and it fell rapidly after the war or recession ended due to lower defense spending or rapid revenue growth.Reagan’s tax cuts and defense spending changed that pattern, raising debt significantly during a time of peace and prosperity. Fiscal restraint by Presidents Bush and Clinton helped turn deficits into surpluses. But tax cuts and spending increases under the second President Bush, Obama, and Trump, along with the Great Recession of 2007 to 2009, boosted debt. The main lesson from the nation’s history is that the old solutions will not work this time around. The source of the country’s rising debt isn’t a war or recession but, instead, a built-in and growing imbalance between taxes and spending. The debt buildup cannot be stopped by cutting defense or boosting growth. Consequently, tough choices must be made about which programs to cut and which taxes to raise.

Stay or Leave?

This chapter reports on results of a study conducted with 1,622 young adults between the ages of 17 and 20, comparing the profiles of youth who either opt out or do not have access to extended services beyond the age of 18 to those who benefit from these services. Young adult protection in France, also known as Young Adult Contract, is a welfare contract between a young adult and a Child Welfare Officer that “commits” the young person to either continue their education or actively seek a job and accommodations, continue medical treatment, update administrative documentation, and learn to manage a budget. Opportunities and the limitations of extended care contracts are reviewed and the perverse effects of this measure are reviewed in a context of fiscal restraint when youth have difficulties acquiring vital skills essential for a successful transition to adulthood.

Sustainable Level Debt, Expansionary Austerity, and Fiscal Consolidation Theories: A Critical Analysis

This commentary critically analyzes the debate between ‘deficit financing’ and ‘deficit-reduction financing’ in contemporary economics. Reading through the paper by Ann Pettifor (2019), one gets the impression that deficits don’t matter and that fiscal consolidation has not improved the public finances, at least for the advanced economies. Although Pettifor manages to pinpoint some of the fundamental errors in contemporary economic discussions on deficit financing, her paper puts undue emphasis on Keynes’s approach to public spending. Keynes’s argument was that increases in government spending will improve growth by boosting purchasing power into the economy. However, she fails to notice the basic problem with debt, that it keeps countries from investing in future growth. A more fundamental question to this debate should be to address the issues surrounding the sustainability of debt and the most effective means to reduce debt to sustainable levels. Therefore, fiscal restraint should be taken as an opportunity to make an economic virtue out of fiscal necessity, not to be politicized by politicians and policymakers to increase unnecessary and wasteful government spending that would expose countries to a higher degree of economic vulnerability.

New Zealand budget will help government for now

Significance The coalition has been in office since October 2017 under Prime Minister Jacinda Ardern. This budget combines fiscal restraint with increased social, foreign affairs and aid spending and infrastructure investment. The government will produce two further budgets before its current term ends. Impacts The budget will support Wellington’s efforts to increase its diplomatic presence in and aid to South Pacific island states. In increasing its diplomatic presence in the South Pacific, New Zealand will vie with China for influence, and try to combat climate change. Effective fiscal management will reinforce New Zealand’s financial capacity to manage environmental and economic difficulties.