A profile of the inactive nurse. One solution to the shortage?

The reasons why short-staffed hospitals should consider attracting inactive nurses back to practice are clear: they are an excellent potential source of staff, and there are nearly 400,000 of them. How to attract them back, however, is not as evident. A North Carolina health-education agency surveyed approximately 430 inactive nurses, asking them what made them leave and what would bring them back.     

The future of the nurse shortage: will wage increases close the gap?

In recent years the U.S. media have been reporting a shortage of registered nurses (RNs). In theory, labor-market shortages are self-correcting; wage increases will bring labor markets into equilibrium, and policy intervention is not necessary. In this paper we develop a simple forecasting model and ask the question: How high must RN wages rise in the future to end the RN shortage? We find that inflation-adjusted wages must increase 3.2-3.8 percent per year between 2002 and 2016, with wages cumulatively rising up to 69 percent, to end the shortage. Total RN expenditures would more than double by 2016.     

How can policy makers use available evidence on the cost benefits of drug treatement?

All the studies on the cost benefits of drug treatment reviewed by Cartwright in this issue suggest benefits outweigh costs by some margin. What lessons does this review of mainly American data have for European policy makers? Drug treatments are associated with a wide range of consequences outside the health sector and there are considerable differences in treatment regimes across countries. This could well influence results. There are also considerable differences in methodologies used across available studies and many lack strong study designs. An interesting feature is the lack of valuation of individual drug users benefits, does this imply that policy makers in the US do not care about drug misusers. Would the situation be the same in Europe or other parts of the world? There is a lot of research to be done and perhaps specific guidelines are required to ensure economic evaluations in this area can be used to guide policy decisions with more confidence.     

In search of the cancer candidate: can lay epidemiology help?

First published in 1991, the ideas embedded in ‘Lay epidemiology and the prevention paradox’ offered a novel and rational explanation for the lay public’s failure to fully engage with the lifestyle messages offered by health educators. During the course of a large ethnographic study in South Wales, Davison and colleagues described the emergence of what they termed the coronary candidate. Candidacy provides a ‘cultural mechanism’ that facilitates the estimation of risk for coronary heart disease. The model has rarely been applied to other major illnesses. This article presents findings from a study that sought to explore the lay epidemiology model, candidacy and cancer. In a series of in‐depth individual interviews, members of the lay public discussed their ideas about cancer, and what emerged was an explanatory hierarchy to account for cancer events. Yet the random and unpredictable nature of cancer was emphasised as well as a general reluctance to accept the idea of cancer candidacy.