What the American Medical Association says: “Nurse Practitioners are essential members of the physician-led care team, but they are plainly not trained to practice independently.” What researchers have found: “Public safety is often used as an argument against expanding scope of practice (SOP) for nurse practitioners, despite the benefit of filling unmet health care demand…[We found] absolutely no evidence that states that expanded scope of practice performed worse than states that chose not to in terms of public safety.” Bhai & Mitchell, 2025
As documented in the last post, the AMA gives “three big reasons” for opposing independent nurse practitioners (NPs):
It won’t solve the rural access problem.
It will raise health care costs, not cut them.
It threatens patient safety.
I tackled the rural access issue in the last post. This time I will address the second reason the AMA gives for opposing independent NPs.
According to its website, the mission of the American Medical Association (AMA) is to “promote the art and science of medicine and the betterment of public health.” The AMA is also a lobbying organization that promotes the self-interest of its members: physicians and medical students. But sometimes the greater good does not mesh with the self-interest of physicians. And sometimes the AMA puts self-interest first.
Information: “Any communication or representation of knowledge such as facts, data or opinions in any medium or form”. National Institute of Standards and Technology
More to the point of this post, what is the current scientific consensus on climate change? I’m not going to depend on the version provided by Elbeyi, Jensen et al, as they seem rather biased. However, NASA has compiled over a dozen consensus statements, which are remarkably similar to each other. Here are a few of them…
“It’s when uncertainty collides with urgency that the authorities enter the fray, convene commissions, and issue findings. Those who accept the sanctioned conclusions gain official backing. Those who don’t are ruled out of bounds. No longer recognized as colleagues with legitimate hypotheses, they risk being treated as crackpots, deniers, and conspiracy theorists.” - Doctor’s Orders: It used to be progressives who distrusted the experts. What happened? By Daniel Immerwahr/The New Yorker. May 26, 2025
Human behavior is the outcome of multicausal pathways. For example, in the theory of planned behavior, beliefs, intentions and perceived behavioral control are all parts of a causal chain that lead to a behavior, whether it’s cramming for an exam or stealing a car. The outcomes of behavior provide information relevant to beliefs, intentions and perceived behavioral control and so are part of the causal chain. Intervening at any point in the chain may change the behavior.
A root cause is not fixed: its effects are not fixed. What gets the ball rolling may not keep it going. What keeps it going may change. What keeps the ball rolling may lose potency with repetition, or be worn down by contrary forces. In other words, causal pathways are subject to decay.
An open science collaboration of researchers conducted replications of 100 studies published in three top psychology journals. Of the original studies, 97% had significant results. Of the replications, just 36% had significant results. Per the study authors, “collectively these results offer a clear conclusion: A large portion of replications produced weaker evidence for the original findings” (Collaboration, O.S., 2015). Replication studies have also been done in economics, neuroscience, evolutionary biology, ecology, and organic chemistry. All arrived at the same clear conclusion.
“Property crime fell from the early-1990s onwards because of security improvements, particularly to vehicles and households. As fewer young people became involved in property crime, fewer progressed to violence (which is fortunately rarer), and fewer crimes were committed in which violence also occurs, such as robbery and aggravated burglary.” - Professor Graham Farrell, School of Law/University of Leeds. (Letter to The Economist, June 7, 2025 issue)
“News organizations increasingly use the terms “climate emergency” and “climate crisis” to convey the urgency of climate change; yet, little is known about how this terminology affects news audiences...[The results of our study] showed no effect of terminology on climate change engagement; however, “climate emergency” reduced perceived news credibility and newsworthiness compared to “climate change.” …No interactions with political ideology were found.” - Feldman & Hart (2021) Upping the ante? The effects of “emergency” and “crisis” framing in climate change news.
Grandiosity refers to a sense of specialness and self-importance that might lead you to:
boast about real or exaggerated accomplishments
consider yourself more talented or intelligent than others
dismiss or try to one-up the achievements of others
believe you’re above rules or ordinary limits
fail to recognize that your actions could harm others
lash out in anger when someone criticizes you or points out a flaw in your plans
— from “What is Grandiosity?”, PsychCentral
AI Overviews are a wonderful tool but shouldn’t be considered the final word on a topic or query. They are, however, a good place to begin an exploration.
With that in mind, I’ll start subsequent Survive and Thrive posts with an AI Overview on the topic under consideration and then proceed to whatever more I’ve found out in my own explorations.
Why does this matter? Because longitudinal studies have found that students who performed worse in PISA at age 15 are less likely to attain higher levels of education by the age of 25, and are more likely to be out of the labor market entirely, ie, not in education, employment or training. For many, a lifetime of economic hardship and reliance on public services follows.
Part of this performance gap can be explained by socio-economic and language factors, e.g., poverty and lack of fluency in the language used on the tests. I imagine age at immigration matters as well: a person who immigrates as a teenager will likely find school harder in their new country than someone who arrived as a baby. Following this logic, I’d expect second-generation immigrants - born in a country to at least one foreign-born parent - would have little difficulty adapting to a country’s education system and so their PISA scores would reflect this.
Immigrant students often do worse on PISA assessments than non-immigrant students, especially in industrialized countries. However, the performance gap between immigrants and non-immigrants varies considerably across countries. For example…
Per the above chart, American 15-year olds have been reading at roughly the same level (on average) as they were 20 years ago. Surprisingly, their reading performance held up rather well during the pandemic years, despite the challenges of extended school closures, remote learning and the high absenteeism.
This post was going to compare police response times (RTs) in the ten most dangerous US cities with the RTs of the safest cities (link). Unfortunately, none of the dangerous cities had decent RT data, except for Oakland, California. But we’re in luck! Oakland has great data, not only for RTs but also for police staffing levels, both across several years.
There is no hard-and-fast threshold for an acceptable clearance rate. That said, Oakland’s rate is abysmal. No wonder Oakland’s the most dangerous city in the US!