Triennial Review Research Articles

Cultivation of Character for Ethical Leadership: The Department of Leadership Education at Culver Academies

Since 1894, Culver Academies has aimed to develop leaders of character. Rooted in the military academy and boarding school traditions, Culver has centered leadership development around central virtues and values. In 1986, recognizing the need to provide integrated, successive leadership learning experiences for students across 4 years, Culver instituted a standalone academic Department of Leadership Education. The Department of Leadership Education, housed in the Schrage Leadership Center, is unique among secondary boarding schools in offering four successive academic leadership education classroom experiences alongside Student Life curricula. Each year’s curriculum is centered in a transformational leadership framework, utilizing evidence-based tools to guide students’ leadership and character growth at each level. Ultimately, students’ growth is assessed by faculty (and students themselves) according to core leadership and character competencies developed by the Academies. Continual improvement of the department is ensured through a comprehensive triennial review process. The aim of this article is to illustrate a successful, iterative character and leadership education experience in a 4-year secondary school context.

ANTENATAL CARE OF A WOMAN WITH PREECLAMPSIA

Between 2018 and 2020, eight women in the UK died from complications associated with pre-eclampsia. Despite a decline in maternal mortality rates, the numbers are still higher than the previous triennial review report, 2012 to 2014. Many women and babies will experience substantial morbidities impacting their long-term physical and mental health. To ensure optimal care, it is critical midwives are competent in the detection and management of women at risk of pre-eclampsia. This article will review best practice in relation to the antenatal clinical management of a woman with pre-eclampsia.

Are Reforms to Section 1201 Needed and Warranted? Testimony Before the United States Senate Committee on the Judiciary, Subcommittee on Intellectual Property

This testimony recounts: 1. The wide array of ordinary people affected by Section 1201 of the Digital Millennium Copyright Act in their efforts to engage in noninfringing activities; 2. The chilling, burdensome nature of the regulatory process with which they must engage in the triennial review; and 3. Suggested approaches to reforming Section 1201.

Lessons from the triennial analysis of serious case reviews

Abstract Serious Case Reviews (SCRs) provide an important opportunity for professional learning when children have died or suffered serious harm from abuse or neglect. The triennial SCR analysis seeks to identify themes across SCRs to inform practice and guide the development of new strategies in order to prevent future harm to children. Neglect is a key feature of most serious case reviews; it is a complex issue with multiple contributory factors accumulating over time. Neglect is linked with unfavourable outcomes at individual and societal levels. Many of the families concerned are living in poverty and difficulties are exacerbated by the limitation of resources with which to support them. This article considers key messages for paediatric practice from the 2014–17 triennial review, particularly with respect to neglect and adolescent safeguarding concerns.

Revised Scientific Review: Minimum Age for Swim Lessons

The question addressed in the original scientific review (2009) was rephrased as Does sufficient scientific evidence exist to support setting a minimum age for swimming lessons? for this triennial review. Addressing the research question is significant because strong differences of opinion about the appropriate age(s) for initiating learn-to-swim lessons have existed among the pediatric medical profession, aquatic professionals and agencies, and proprietary programs and swim schools for over four decades. The question has implications for the appropriate purposes, pedagogies, and outcomes associated with swimming experiences for infants and young children that will be addressed in a subsequent review. The revised statement now supports as a guideline that children older than 1 year of age can benefit from swim lessons with a lower risk of drowning; parents should make their decision to enroll based upon individual child considerations as proposed in this review.

Social planning and local welfare. The experience of the Italian area social plan

ABSTRACTThis article analyses the Italian experience of planning and governance in local welfare systems, after the adoption of a specific planning instrument called the ‘Piano di Zona’ (Area Social Plan), which has reached its sixth triennial review. Our goal is to explore the relationship between governance and performance by examining under which circumstances the social planning is successful, that is one Area Social Plan is preferable to another. Our research is based on the empirical observation of the nine Area Social Plans in the Province of Pavia which involves 188 municipalities. Our results demonstrate the fundamental role of public administrations and the negative effects that horizontal multi-level forms of governance may have on the planning of the Area Social Plan, almost as though there were a sort of path dependence from previous/pre-existing governance relationships.

The Second Triennial Systematic Literature Review of European Nursing Research: Impact on Patient Outcomes and Implications for Evidence‐Based Practice

European research in nursing has been criticized as overwhelmingly descriptive, wasteful and with little relevance to clinical practice. This second triennial review follows our previous review of articles published in 2010, to determine whether the situation has changed. To identify, appraise, and synthesize reports of European nursing research published during 2013 in the top 20 nursing research journals. Systematic review with descriptive results synthesis. We identified 2,220 reports, of which 254, from 19 European countries, were eligible for analysis; 215 (84.7%) were primary research, 36 (14.2%) secondary research, and three (1.2%) mixed primary and secondary. Forty-eight (18.9%) of studies were experimental: 24 (9.4%) randomized controlled trials, 11 (4.3%) experiments without randomization, and 13 (5.1%) experiments without control group. A total of 106 (41.7%) articles were observational: 85 (33.5%) qualitative research. The majority (158; 62.2%) were from outpatient and secondary care hospital settings. One hundred and sixty-five (65.0%) articles reported nursing intervention studies: 77 (30.3%) independent interventions, 77 (30.3%) interdependent, and 11 (4.3%) dependent. This represents a slight increase in experimental studies compared with our previous review (18.9% vs. 11.7%). The quality of reporting remained very poor. European research in nursing remains overwhelmingly descriptive. We call on nursing researchers globally to raise the level of evidence and, therefore, the quality of care and patient outcomes. We urge them to replicate our study in their regions, diagnose reasons for the lack of appropriate research, identify solutions, and implement a deliberate, targeted, and systematic global effort to increase the number of experimental, high quality, and relevant studies into nursing interventions. We also call on journal editors to mandate an improvement in the standards of research reporting in nursing journals.

Interprofessional development and implementation of a pharmacist professional advancement and recognition program.

The interprofessional development, implementation, and outcomes of a pharmacist professional advancement and recognition program (PARP) at an academic medical center are described. Limitations of the legacy advancement program, in combination with low rates of employee engagement in peer recognition and professional development, at the UW Health department of pharmacy led to the creation of a task force comprising pharmacists from all practice areas to develop a new pharmacist PARP. Senior leadership within the organization expanded the scope of the project to include an interprofessional work group tasked to develop guidelines and core principles that other professional staff could use to reduce variation across advancement and recognition programs. Key program design elements included a triennial review of performance against advancement standards and the use of peer review to supplement advancement decisions. The primary objective was to meaningfully improve pharmacists' engagement as measured through employee engagement surveys. Secondary outcomes of interest included the results of pharmacist and management satisfaction surveys and the program's impact on the volume and mix of pharmacist professional development activities. Of the 126 eligible pharmacists, 93 participated in the new program. The majority of pharmacists was satisfied with the program. For pharmacists who were advanced as part of the program, meaningful increases in employee engagement scores were observed, and a mean of 95 hours of professional development and quality-improvement activities was documented. Implementation of a PARP helped increase pharmacist engagement through participation in quality-improvement and professional development activities. The program also led to the creation of organizationwide interprofessional guidelines for advancement programs within various healthcare disciplines.

(Invited) From Discovery through to Commercialization: Federal Support

As a Program Director at the National Science Foundation (NSF) working in the Mathematical and Physical Sciences Directorate, most efforts deal with supporting the discovery aspects of science – creating/revealing new materials or phenomena, improving the understanding of scientific underpinnings, and/or establishing new techniques and approaches. However, many NSF programmatic funding opportunities have an option to link to industrial partners through a mechanism called Grant Opportunities for Academic Liaison with Industry (GOALI). Also, there are centers across NSF that foster partnerships with industry; some include mandates to do so. The locus on going beyond discovery to applications at NSF lies within the Engineering Directorate, particularly in the Division of Industrial Innovation and Partnerships (IIP). NSF is not alone in these undertakings; many Federal agencies have such efforts. The recently released 2016 National Academies report, Triennial Review of the National Nanotechnology Initiative (https://doi.org/10.17226/23603) summarizes many of these efforts to address technology transition. The Nanotechnology Innovation and Commercialization Ecosystem (NICE) Working Group chartered by the Nanoscale Science, Engineering, and Technology (NSET) Subcommittee (https://www.nano.gov/about-nni/working-groups) is interested in further identification of activities to improve technology exchange across the 20 Federal departments and independent agencies engaged in the National Nanotechnology Initiative (NNI). This region between discovery and commercialization is often described in some circles as the Valley of Death – however, the National Institutes of Health discusses stages from basic science research through four translational phases: humans, patients, practice, and community where each occurs in conjunction with clinical trials. The assortment of programs available reflects the different agency missions, their attention to pinpointing specific hurdles in the process, and the importance of realizing economic benefits from the research. One example, the Small Business Technology Transfer (STTR) program, fosters technology transfer through cooperative R&D between research institutions and small businesses. Participating organizations include the Department of Defense (DOD), Department of Energy (DOE), Department of Health and Human Services (HHS), National Aeronautics and Space Administration (NASA) and NSF. Another example, Innovation Corps (I-Corps), teaches grantees to identify valuable product opportunities that can emerge from academic research, and offers entrepreneurship training facilitated by domain experts. Both NSF and NIH participate. These and other model programs will be discussed.

Are the LDCs really the world’s least developed countries?

The term ‘the least developed countries’ (LDCs) is widely understood to designate, exactly as stated, the world’s least developed countries. In conjunction with the 2015 United Nations (UN) triennial review of the LDC category, this article attempts to critically evaluate the UN’s list of LDC countries in the light of various indicators – economic, social, political, military and security related, and psychological. It concludes that the official and actual lists of LDCs, despite important similarities, are not completely identical. The term ‘the LDCs’ as used by the UN is therefore not fully consistent with the reality it attempts to designate and describe.

Methodological Note on EBA-Lite

The Fund has taken important steps to enhance its external sector assessments since the launch of the External Balance Assessment (EBA) methodology and the External Sector Report (ESR) in 2012, which provides a multilaterally consistent assessment of the largest economies’ external sector positions and policies. With scope for strengthening external sector assessments of non-EBA countries, the 2014 Triennial Surveillance Review (TSR) called for the application of EBA’s conceptual innovations to a broader set of countries. Following the 2014 TSR, the Managing Director’s Action Plan proposed developing EBA-lite to extend the EBA methodology to a broader group of countries where adequate data is available. In the fall of 2014, the launch of the EBA-lite methodology for current account assessments provided the first extension of EBA approach for non-EBA countries. In summer 2015, the real exchange rate index model and the external sustainability approach were added to the EBA-lite framework. This note serves as a reference for the EBA-lite methodology. It provides: (i) motivations for developing EBA-lite and guidance for its use; (ii) technical explanations of all three EBA-lite approaches; and (iii) suggestions on how to articulate staff assessments of the external sector informed by model results.

Statement by the Managing Director on the Work Program of the Executive Board - Executive Board Meeting, November 23, 2015

The Managing Director’s Global Policy Agenda (GPA) presented to the IMFC last month highlights the challenges associated with a rapidly changing and uncertain world. The limited room for policy maneuver and the need to adapt to new realities pose difficult trade-offs between supporting demand and current activity, reducing financial risks as financial conditions tighten, and implementing needed structural reforms to revive growth. Against this backdrop the GPA called to support growth today, invest in resilience and safeguard financial stability, improve the sustainability of the public finances, implement the structural reforms needed for sustainable and inclusive medium-term growth, and secure the effectiveness of the 2010 reforms. This document translates the policy priorities and strategic directions laid out in the Fall 2015 GPA and the IMFC communiqué into an Executive Board agenda for the next twelve months. The key focus of this agenda is to continue to refine and adapt the Fund’s core activities?surveillance, lending, and capacity building?to the challenges faced by member countries. The 2015 Work Program continues the implementation of the 2014 Triennial Surveillance Review (TSR) recommendations and underpins a broader effort of the Fund to respond to the needs of the membership in an even more agile, integrated, and member-focused manner.

Structural Reforms and Macroeconomic Performance - Country Cases

As a companion piece to the Board paper on Structural Reforms and Macroeconomic Performance: Initial Considerations for the Fund, this paper presents a selection of case studies on the structural reform experiences of member countries. These papers update the Board on work since the Triennial Surveillance Review toward strengthening the Fund’s capacity to analyze and, where relevant, offer policy advice on macro-relevant structural issues. The paper builds on the already considerable analytical work underway across the Fund, setting out considerations to support a more strategic approach going forward.

Initial Steps in Implementing the Managing Director’s Action Plan for the 2014 Triennial Surveillance Review

In November 2014, the Managing Director set out a five-year Action Plan for Strengthening Surveillance in line with the goals of the 2014 Triennial Surveillance Review (TSR). In response to Executive Directors’ request for an early update, this report outlines the initial steps taken to operationalize the Action Plan. Many initiatives will take time to be fully embedded in the Fund’s surveillance products and its day-to-day dialogue with member countries. This initial phase focused on putting in place the building blocks to support teams engaging in surveillance. This includes revising guidance to staff in line with the TSR priorities, investing in tools and staff training to boost capacity, and revamping work practices. Ongoing engagement among staff will be critical, both to raise awareness and to understand the issues teams are facing. Managers will play a vital role in implementing changed work practices, and the new leadership framework will support this. While not all initiatives are equally advanced given their different starting points or varying complexity, work is moving forward in all three of the broad pillars of the TSR: Deepening risk and spillover analysis. Staff is making a concerted effort to develop new approaches to macrofinancial surveillance, including through area department led pilot cases, enhanced technical support from functional departments, and a more collaborative approach to build skills and share knowledge. More tailored and expert policy advice. To better adapt our advice to the changing needs of member countries, staff is laying the groundwork for more detailed and tailored macro-structural analysis and ensuring that our fiscal advice continues to be ‘state of the art’. Efforts to leverage cross-country experience have gained momentum. Achieving greater impact. Staff is promoting more client focused communication, including exploring ways for more effective two-way dialogue with member countries, and promoting greater clarity in its multilateral messages. Staff is also developing principles to better understand and address perceptions of evenhandedness.

Maternal death and caesarean section in South Africa: Results from the 2011-2013 Saving Mothers Report of the National Committee for Confidential Enquiries into Maternal Deaths.

In the latest (2011-2013) Saving Mothers report, the National Committee for Confidential Enquiries into Maternal Deaths in South Africa (SA) (NCCEMD) highlights the large number of maternal deaths associated with caesarean section (CS). The risk of a woman dying as a result of CS during the past triennium was almost three times that for vaginal delivery. Of all the mothers who died during or after a CS, 3.4% died during the procedure and 14.5% from haemorrhage afterwards. Including all cases of death from obstetric haemorrhage where a CS was done, there were 5.5 deaths from haemorrhage for every 10,000 CSs performed. To scrutinise the contribution or effect of the surgical procedure on the ultimate cause of death by a cross-cutting analysis of the 2011-2013 national data. Data from the 2011-2013 triennial review were entered into an Excel database and analysed on a national and provincial basis. There were 1,243 maternal deaths where a CS was the mode of delivery and 1 471 deaths after vaginal delivery. More mothers died as a result of CS in the provinces where there is a low overall CS rate. The following CS categories were identified as specific problems: bleeding during or after CS, pre-eclampsia and eclampsia, anaesthesia-related deaths, pregnancy-related sepsis and acute collapse and embolism. This is an area of concern, and a concentrated effort should be done to make CS in SA safer. Several recommendations are

Statement by the Managing Director on the Work Program of the Executive Board - Executive Board Meeting, June 3, 2015

The Managing Director’s Global Policy Agenda (GPA) presented to the IMFC in April identified a range of actions needed to bolster today’s actual and tomorrow’s potential output, diminish risks, and confront emerging global challenges. These actions included calibrating fiscal adjustment to economic conditions while establishing credible long-term fiscal frameworks and implementing growth-friendly fiscal policies, improving monetary policy effectiveness while containing excessive financial risk-taking, and accelerating structural reforms to raise growth potential and ensure inclusiveness. The GPA also outlined how the Fund would support the membership through assessments and policy advice provided in the context of multilateral and bilateral surveillance, financial support, and capacity building. This document translates the policy priorities laid out in the GPA and the IMFC communiqué into a work agenda for the Executive Board over the next 12 months. In particular, the Board will be engaged on several issues of multilateral scope, including quota reform and resources, the SDR basket review, challenges facing the international monetary system, and the post-2015 global development agenda. The work program also includes several items from the action plan of the 2014 Triennial Surveillance Review (TSR).

2014 Triennial Surveillance Review - Managing Director’s Action Plan for Strengthening Surveillance

The 2014 review of surveillance comes at a critical juncture for the Fund and its member countries. Policymakers are navigating a brittle, uneven recovery that is still marred by the lingering effects of the crisis. They are also continuing to adapt to the challenges of a highly interconnected world, shielding their economies from potential negative spillovers while also striving to harness the benefits of globalization. It is imperative that Fund surveillance is positioned to help our members best chart this course. This paper presents specific proposals in the priority areas agreed in the 2014 Triennial Surveillance Review (TSR). These actions will help ensure that surveillance meets the current and future needs of the membership, and the wider global economic community.

2014 Triennial Surveillance Review - External Commentary - Communications

2014 Triennial Surveillance Review - External Commentary - Communications

2014 Triennial Surveillance Review - Report of the External Advisory Group

2014 Triennial Surveillance Review - Report of the External Advisory Group

Reconceptualising the Welfare State: The Rise of a Selective Welfare State' in the United Kingdom?

This paper seeks to explore the emergence of a ‘selective welfare state’ in the United Kingdom under the prefecture of the current coalition government. It will be argued, that in light of fiscal austerity, the state has been compelled to reconceptualise its traditional role from a ‘full provision welfare providing body’ to a ‘selective welfare providing entity’. Examples of deviation include the Troubled Families Agenda, under the notions of ‘citizens’ empowerment’ and ‘reducing dependencies on the state’. These reforms run parallel to the thicket of mandatory governmental restructuring, evidenced through the Triennial Review and the Red Tape Challenge at the national level. It will be demonstrated that such selective welfare revolution exacerbates an acrimonious struggle between state powers and individual rights, where in turn, the citizens question the legitimacy of the selective welfare concept. Apart from using judicial review, we also seem to be witnessing the rise of non-governmental organisations as the new avenues of social consciousness, used to translate their individual interests into collective and public issues, whose relationship to rights is most precarious, with collective voices through electoral representation as a final forum. Voters decimated the ruling power of the coalition government in the United Kingdom’s local government election in May 2013, a testimony that they do not acquiesce to the selective welfare state agenda. The state is still in search of a plethora of sustainable governance, with the General Election 2015 as a final platform to determine the destiny of the selective welfare state in Britain.