Effective strategies for managing the dangers of global climate change are proving very difficult to design and implement. They require governments to undertake a portfolio of efforts that are politically challenging because they require large expenditures today for uncertain benefits that accrue far into the future. That portfolio includes tasks such as putting a price on carbon, fixing the tendency for firms to under-invest in the public good of new technologies and knowledge that will be needed for achieving cost-effective and deep cuts in emissions; and preparing for a changing climate through investments in adaptation and climate engineering. Many of those efforts require international coordination that has proven especially difficult to mobilize and sustain because international institutions are usually weak and thus unable to force collective action...."

Carbon capture and storage (CCS) is among the technologies with greatest potential leverage to combat climate change. According to the PRISM analysis, a technology assessment performed by the Electric Power Research Institute (EPRI), wide deployment of CCS after 2020 in the US power sector alone could reduce emissions by approximately 350 million tonnes of CO₂ per year (Mt CO₂/yr) by 2030, a conclusion echoed by the McKinsey U.S. Mid-range Greenhouse Gas Abatement Curve 2030. But building CCS into such a formidable climate change mitigation “wedge” will require more than technological feasibility; it will also require the development of policies and business models that can enable wide adoption. Such business models, and the regulatory environments to support them, have as yet been largely undemonstrated. This, among other factors, has caused the gap between the technological potential and the actual pace of CCS development to remain large.

The purpose of the present work is to quantify actual progress in developing carbon storage projects (here defined as any projects that store carbon underground at any stage of their operation or development, for example through injection into oil fields for enhanced recovery or in saline aquifers or other geological formations). In this way, the real development ramp may be compared in scale and timing against the perceived need for and potential of the technology. Some very useful lists of carbon storage projects already exist – see, for example, the IPCC CCS database, the JP Morgan CCS project list, the MIT CCS database, and the IEA list. We seek to maintain an up-to-date database of all publicly-announced current and planned projects from which we can project a trajectory of carbon stored underground as a function of time. To do this, we estimate for each project the probability of completion as well as the potential volume of CO₂ that can be stored as of a given year.

Climate change and land use change can affect multiple infectious diseases of humans, acting either independently or synergistically. Expanded efforts in empiric and future scenario-based risk assessment are required to anticipate problems. Moreover, the many health impacts of climate and land use change must be examined in the context of the myriad other environmental and behavioral determinants of disease. To optimize prevention capabilities, upstream environmental approaches must be part of any intervention, rather than assaults on single agents of disease. Clinicians must develop stronger ties, not only to public health officials and scientists, but also to earth and environmental scientists and policy makers. Without such efforts, we will inevitably benefit our current generation at the cost of generations to come.

BACKGROUND: Strengthening hospital safety culture offers promise for reducing adverse events, but efforts to improve culture may not succeed if hospital managers perceive safety differently from frontline workers.

OBJECTIVES: To determine whether frontline workers and supervisors perceive a more negative patient safety climate (ie, surface features, reflective of the underlying safety culture) than senior managers in their institutions. To ascertain patterns of variation within management levels by professional discipline.

RESEARCH DESIGN: A safety climate survey was administered from March 2004 to May 2005 in 92 US hospitals. Individual-level cross sectional comparisons related safety climate to management level. Hierarchical and hospital-fixed effects modeling tested differences in perceptions.

SUBJECTS: Random sample of hospital personnel (18,361 respondents).

MEASURES: Frequency of responses indicating absence of safety climate (percent problematic response) overall and for 8 survey dimensions.

RESULTS: Frontline workers' safety climate perceptions were 4.8 percentage points (1.4 times) more problematic than were senior managers', and supervisors' perceptions were 3.1 percentage points (1.25 times) more problematic than were senior managers'. Differences were consistent among 7 safety climate dimensions. Differences by management level depended on discipline: senior manager versus frontline worker discrepancies were less pronounced for physicians and more pronounced for nurses, than they were for other disciplines.

CONCLUSIONS: Senior managers perceived patient safety climate more positively than nonsenior managers overall and across 7 discrete safety climate domains. Patterns of variation by management level differed by professional discipline. Continuing efforts to improve patient safety should address perceptual differences, both among and within groups by management level.