According to new survey data released last week by the American Association of Colleges of Nursing (AACN), enrollment in doctoral nursing programs increased by more than 20% this year, signaling strong interest among students in careers as nursing scientists, faculty, primary care providers, and specialists. Final results from AACN’s 2009 annual survey confirm that enrollments in all types of baccalaureate and higher degree programs continue to trend upward. Though nursing schools have been able to expand student capacity, the latest data show that more than 54,000 qualified applications to professional nursing programs were turned away in 2009, including more than 9,500 applications to master’s and doctoral degree programs.

“Expanding capacity in baccalaureate and graduate programs is critical to sustaining a healthy nursing workforce and providing patients with the best care possible,” said AACN President Fay Raines. “Even though these across-the-board increases in enrollments are encouraging, we simply must find ways to advance policy and programs that will enable schools to accommodate all qualified applicants in professional nursing programs. Bringing more nurses into graduate programs is urgent given the calls for more expert nurses to deliver high quality, cost-effective care in a healthcare system undergoing reform.”

AACN’s latest survey findings update the preliminary data announced in December 2009 and determine enrollment trends by comparing data from the same schools reporting in both 2008 and 2009. Final survey data show that enrollments in entry-level baccalaureate programs in nursing rose by 3.6% in 2009. See http://www.aacn.nche.edu/Media/pdf/EnrollChanges.pdf.

This increase in baccalaureate student population is welcome news given the calls by AACN, the American Organization of Nurse Executives, the American Nurses Association, and other authorities to concentrate the education of new nurses in baccalaureate programs. In a recent report by the Carnegie Foundation for the Advancement of Teaching, Dr. Patricia Benner and colleagues state that “profound changes in nursing practice call for equally profound changes in the education of nurses.” The authors found that many of today’s new nurses are “undereducated” to meet practice demands across settings and strongly support baccalaureate programs as the appropriate pathway for RNs entering the profession.

Growth in Doctoral Programs in Nursing

Given the need for more nurses to serve as Advanced Practice Registered Nurses (APRNs), faculty, and research scientists, the growth in the number of students entering both practice-focused and research-focused doctoral programs last year is particularly gratifying to nursing’s academic leaders.

In October 2004, AACN member schools voted to endorse the Position Statement on the Practice Doctorate in Nursing, which called for moving the level of preparation for advanced nursing practice from master’s to doctoral by 2015. Nursing schools have made great strides in the past six years toward realizing this vision by planning and launching Doctor of Nursing Practice (DNP) programs, now available in 35 states. AACN’s survey found that 28 new DNP programs were opened in 2009, bringing the total number of programs to 120. AACN survey data found that an additional 161 DNP programs are in the planning stages. At present, 71.9% of schools with APRN programs (388 schools) are either offering or planning a DNP program.

“The stunning growth in the number of DNP programs is truly impressive, as we are only at the midway point in realizing the 2015 vision for advanced nursing education,” said Dr. Raines. “A change of this magnitude is enormous, and we realize that schools in many states are facing great economic, resource, and regulatory challenges in their efforts to move to the DNP. AACN stands ready to focus its efforts on influencing policymakers, advocating for resources, and developing tools to support schools committed to making this transition.”

The number of research-focused doctoral programs (e.g., PhD, DNSc, DNS) is climbing with 120 programs currently enrolling students and another 8 programs in development. See http://www.aacn.nche.edu/Media/pdf/Docprograms.pdf.

Other key findings from AACN’s 2009 survey include the following; trends in applications, acceptance rates, and total enrollment in nursing programs (including accelerated programs, degree completion programs, clinical nurse leader programs, baccalaureate-to-doctoral programs, and doctoral nursing programs), survey response rates and student diversity data (including men in nursing). For details, see http://www.aacn.nche.edu/Media/NewsReleases/2010/enrollchanges.html.

The National Retail Federation today urged Congress to reject calls to use fast-track budget reconciliation rules to push flawed health care reform legislation through the House and Senate.

“We strongly oppose efforts to ram health care reform into law,” NRF Senior Vice President for Government Relations Steve Pfister said. “Health care represents one-sixth of the U.S. economy. Good health care policy should easily command an overwhelming majority in Congress and widespread support among the public.”

NRF strongly opposed separate health care reform bills passed by the House and Senate late last year because both included controversial employer mandates and other provisions that would drive up costs for employers while not doing enough to make health care more affordable. With the current economy making it difficult for retailers to absorb new costs, NRF believes employer mandates and penalties would force many retailers to lay off workers.

“Mandated coverage requirements are hazardous to a job-starved economy and are especially dangerous for small employers,” Pfister said. “We remain adamantly opposed to legislation that will drive up unemployment through higher labor costs.”

Pfister said NRF would support health care reform legislation that reduces immediate and long-term costs for employers, individuals and government payers; reforms the health insurance market to ease access to coverage and mitigate rate increases; and provides help to small businesses and individuals to access coverage. Legislation should build on the existing employer-based system without including employer mandates, taxes on coverage or extensive benefit requirements that fail to provide flexibility for high-turnover industries like retail, he said. Legislation also needs to preserve ERISA, which allows national companies to provide uniform health insurance benefits across state lines.

Pfister’s comments came in a letter to leadership and members of the House.

Pfister said legislation outlined by President Obama over the past two weeks “fails to solve our concerns.”

Obama on Wednesday urged Congress to use “the same kind of up or down vote” that was previously used by Republicans to pass Bush Administration tax cuts and other measures opposed by Democrats. The so-called “reconciliation” process allows a limited bill addressing revenue and spending items to pass the Senate with a simple majority of 51 votes rather than the 60 normally needed to cut off a filibuster. Democrats control only 59 votes and all 41 Senate Republicans are expected to oppose the Obama bill.

The Biggest story in healthcare isn’t the reform bill, it’s that already-below-market physician reimbursement rates are being cut 21%. Due to Congressional inaction, Medicare’s reimbursement rates to doctors for their care of our nation’s elderly population will be cut a staggering 21 percent today. This is a result of an unwillingness or inability – pick your poison – to permanently secure the Medicare payment formula system or to even temporarily extend the patchwork fix already in place (the Sustainable Growth Rate formula or SGR). The Coalition to Protect Patients’ Rights supports a strong Medicare and a fair formula that will provide physicians with the resources they need to treat America’s seniors and also allow patients and physicians to negotiate any differences in cost to ensure patients get the care they need.

Former president of the American Medical Association and current spokesman for the Coalition to Protect Patients’ Rights, Dr. Donald Palmisano, made the following statement on the Medicare payment cuts:

“What are physicians to do? What are senior citizens to do?

“As Congress debates, seniors are at peril of losing the medical care they desperately need. Doctors are already providing care to the nation’s seniors at a reduced rate, but this latest cut makes treating those on Medicare financially impossible for doctors, nurses, and hospitals.

“And a one-time patch isn’t going to fix the problem for long. Although more than 40 million Americans rely on Medicare for their well-being and as enrollment is expected to explode as baby-boomers age and retire, Congress has recently proposed gutting Medicare – to the tune of $500 billion. There’s no way Medicare can be cut and still provide the medical service our most vulnerable populations need. Congress must fund Medicare so that it becomes solvent, pays physicians for the work and treatments they provide, and give seniors the peace of mind they deserve.

“Unfortunately, when medicine is subject to the limits of government-control and price-fixing, patients suffer. This isn’t just the case for Medicare, but also for Medicaid, or any other government controlled healthcare system – no matter what it’s called. Congress must do what it can to empower patients and physicians in healthcare, while limiting the role of bureaucrats.”

Over the past several years Americans have seen numerous food recalls related to our nation’s food supply. Spinach, peanut butter and even pet food are just some of the food items that have been subject to massive recalls. While the safety of our food supply is mission critical for our food manufacturers and suppliers, fully four in ten (42%) Americans indicate they have become sick or ill over the past two years from what they attribute (at least in part) to something they ate.

These are some of the results of The Harris Poll of 2,010 adults surveyed online between January 13 and 15, 2010 by Harris Interactive.

While some who attribute an illness to a food item may have contracted their illness elsewhere, the perception of a food-attributed illness poses a major problem for our nation’s food manufacturers and suppliers. In fact, seven in ten (69%) of those who attribute an illness to a food item think they know what made them sick.

As a result, one-quarter (26%) of those who indicate they became sick from something they ate have eliminated that food from their diet entirely. Moreover, another 15% indicate that they advised family, friends and colleagues not to eat that food item, increasing the impact of their individual experience.

Americans give Food Manufacturers and Suppliers the Benefit of the Doubt

While many people will stop a behavior such as eating a food item that they believe made them sick, most Americans do not have large levels of concern regarding the safety of eating different foods. However, among four types of foods (fresh, canned, frozen and other packaged foods), two in ten adults are either extremely or very concerned that fresh foods are safe to eat (21%), followed by canned foods (15%), other packaged foods such as boxes, jars, bags, etc. (14%) and frozen foods (13%).

When we cast our net broader and include those who are at least somewhat concerned we see that at least three quarters to one half of Americans are concerned to some extent that these foods are safe to eat: fresh foods (73%), other packaged foods such as boxes, jars, bags, etc. (64%), canned foods (59%), and frozen foods (53%). Those who are at least somewhat concerned that fresh foods are safe to eat are most concerned about fresh meats (31%), fresh poultry (23%), fresh fish (20%), vegetables (16%) and fruit (8%).

For our nation’s food manufacturers and suppliers these findings show the importance of ensuring food safety. While Americans generally trust that our foods are safe to eat, the result of a food related illness can be a severe consumer backlash in the form of a permanent de-selection and grass roots advocacy against consumption of a food product that can extend well after a bad experience. At its worst, food illnesses can lead to heightened media scrutiny and more legislative and regulatory efforts at the local, state and national level.

General Knowledge about the Health and Nutritional Value of Foods is Low

Apart from issues related to the safety of our foods, concerns about obesity are already influencing public policy decisions, including a recent Executive Order from the President, and the types of foods available to Americans in restaurants and grocery stores across the country. While some Americans are opting for organic and other healthier foods, most Americans do not feel particularly knowledgeable about health and nutritional value of the foods their family eats on a regular basis. In fact, only one quarter (27%) of Americans feel either extremely or very knowledgeable about the health and nutritional value of the foods their family eats.

Why are Americans Gaining Weight?

Recent studies, including the annual Harris Polls on the subject, indicate that roughly two-thirds of Americans are officially classified as either overweight or obese based on their Body Mass Index (BMI). While a variety of factors are influencing this trend, between sedentary lifestyles or food choices a majority of Americans (57%) feel sedentary lifestyles and a lack of physical activity play a larger role than individual food choices and eating habits (43%). This does lead to the question, can Americans just exercise their way to better health?

So What?

A great deal of progress has been made with respect to food quality, safety, nutritional content and affordability. Moreover, food labeling provides Americans with information they need to make good decisions about their health. Yet, with the publicity surrounding several recent food recalls as well as growing concerns about the problem of obesity in America, it is very likely that issues related to the safety and overall health and nutritional value of our nations foods supply will come under increasing pressure from the media, special interest groups and local, state and federal government.

According to Chris McAllister, Senior Research Director, Public Affairs and Policy Research, Harris Interactive, “The reality is that no one benefits when problems with our nation’s food supply emerges. Consumers deselect food products, food manufacturers and suppliers suffer from the backlash in the form of reduced sales and government feels the pressure to act.”

President Clinton’s stent surgery brought new focus to America’s number-one killer, but it did little to expose the bias that is often present when women seek treatment for a heart attack.

“Despite the fact that more women than men die from cardiovascular disease in the United States, and despite the established benefits of PCI (percutaneous coronary intervention or coronary angioplasty) in reducing fatal and nonfatal ischemic complications in patients with acute myocardial infarction and high-risk acute coronary syndromes (ACS), only an estimated 33 percent of annual PCIs are performed in women,” says an American Heart Association (AHA) Scientific Statement.

FACTS About Florida and Heart Disease:

• Heart disease, stroke, and other cardiovascular diseases are the No. 1 killer of women in Florida.
• Heart disease and stroke account for 33.4% of all female deaths in Florida.
• On average, nearly 76 females die from heart disease and stroke in Florida each day.
• Hispanic women generally have higher rates of certain cardiovascular risk factors – including physical inactivity, diabetes, obesity and metabolic syndrome – than white women, and are less likely to have detected or treated them.

Source: Centers for Disease Control and Prevention. Mortality data based on WISQARS Leading Cause of Death Reports, 2005; Risk factor data from the BRFSS, 2007.

On a frigid, historically cold morning on January 9, 2010, in Houston, Texas, Life Time Fitness held the “Ride of a Lifetime,” a two-hour long, high-energy outdoor stationary cycle ride. Participants won’t soon forget the day, which saw a low of 20-degrees Fahrenheit and topped out at just 43-degrees. Nor will they forget their role in setting the new World Record for the largest static cycling class in history, as was confirmed by Guinness World Records on February 12, 2010.

Complemented by the sounds of Life Time’s own renowned DJ, Roberto Costa, Life Time Fitness Chairman, Chief Executive Officer and President, Bahram Akradi, led the record-setting 600 participants to secure their place in Guinness World Record history. The Ride of a Lifetime took place at Houston CityCentre, a new 37-acre, self-contained pedestrian community, which serves as home to the state-of-the-art sports, fitness, recreation and spa destination, Life Time Athletic, the Hotel Sorella and a range of retail, dining, office and residential spaces.

Life Time previously held the same record when, on March 23, 2009, 418 participants took part in an outdoor cycle ride at the Life Time Fitness center in Plano, Texas. That record was broken on September 18, 2009, when 450 cyclists participated in a static cycle class in Galway, Ireland.

Bogus health plans are spreading rapidly around the U.S., defrauding vulnerable consumers anxious for affordable health coverage in a downturned economy, according to the Coalition Against Insurance Fraud.

Bogus health plans likely are the largest and fastest-spreading insurance fraud against consumers to emerge from the troubled economy. Most states have been forced to issue emergency cease-and-desist orders, lawsuits or other actions.

Some consumers have faced tens of thousands of dollars in medical bills when their fraudulent health plans wouldn’t pay up. At least 12,000 consumers have been victimized nationally. The damage ranges from stolen premiums to large, unpaid medical bills.

Typically, bogus health plans promise full health benefits but deliver lesser products such as:

• Fake coverage that’s worthless;
• Limited-benefit policies that can be nearly useless;
• Medical discount cards that merely offer price breaks on medical services for which buyers pay themselves.

Fraudulent plans exploit a perfect storm of consumer vulnerability: As many as 50 million Americans have no health insurance, and unemployment runs at least 10 percent. With health premiums rising and layoffs continuing, many consumers and small businesses are struggling to find affordable health coverage. Many people thus believe scam sales pitches promising appealing insurance deals, the Coalition warns.

Individual consumers, families, small businesses, seniors and recent immigrants are targeted.

Typically, bogus plans promise full health coverage, affordable premiums, and easy signup despite preexisting conditions.

Victims often must join a fake trade association or union, which reinforces the illusion of affordable and legitimate group health coverage.

The scams pitch with telemarketing, blast faxes, insurance agents, TV ads, emails and event crudely printed signs stapled to telephone poles. Websites encourage easy online signup and enhance the appearance of legitimacy.

Consumers can take action to avoid being scammed:

Back off and do your homework before signing up, especially when pressured;

• Contact your state insurance department to see if the plan is licensed and how many complaints may have been filed against it;
• Insist on receiving the entire policy, not a summary, and understand it thoroughly before signing up;
• Be certain the plan is exactly as advertised: Full health coverage, limited-benefit or medical discount card.

For more information, visit www.InsuranceFraud.org.

As Americans look to keep their fitness resolutions and increase their physical activity, Dr. Bing Liem, cardiologist and electrophysiologist at El Camino Hospital in Mountain View, Calif., is hoping to raise awareness of a critical but rare heart condition: congenital malformations of the heart or vascular system, which is to blame for the majority of sudden cardiac deaths in athletes under the age of 40.

“It’s always heart-wrenching to hear news of a young athlete, at the zenith of fitness, dying suddenly on the sports field,” said Dr. Liem, who estimates that up to one in 500 people have inherited heart disease that may predispose them to sudden death. “The fact that many athletes and their parents aren’t cognizant of potential warning signs speaks to the importance of raising awareness of this condition.”

Raise Awareness, Save a Life

According to Dr. Liem, there are seven top warning signs that indicate a patient may be at risk for sudden death from cardiac arrest and should see a doctor for screening:

1. Family history of sudden premature death: Patients with a family member or relative who died suddenly of cardiac arrest under the age of 40 have an increased chance of also carrying the defective genes that cause congenital malformations of the heart.

2. History of heart murmur: Frequent heart murmurs may indicate a possible heart muscle abnormality or damaged and overworked heart valve.

3. History of fainting or near-fainting: Fainting (syncope) or nearly fainting (pre-syncope) at any time could be due to the heart’s impaired ability to pump blood.

4. History of palpitations: The patient experiences noticeable heartbeats that are fast or irregular.

5. Feeling of discomfort in the chest during exertion: When active, the patient feels pressure, pain or discomfort in the chest, indicating a less than healthy heart.

6. Shortness of breath with exertion: The patient is unduly winded by physical activities, indicating also a less than healthy heart.

7. Light-headedness with or without exertion: The patient feels dizzy or faint during physical activity, which can be caused by structural or electrical abnormality in the heart.

Screening Options

If at risk, Dr. Liem recommends a simple screening process to determine risk. The screening involves discussing family history of cardiac arrest, having a cardiologist administer a focused cardiac examination and obtaining an EKG.

“These basic steps can provide a good insight into the young athlete’s heart condition. If any of these assessments raises concern, further tests for the heart will be recommended,” said Dr. Liem, who noted that he is also using newly available genetic tests offered at El Camino Hospital’s Genomic Medicine Institute to determine if patients are carriers of the defective genes that cause congenital malformations of the heart. If diagnosed, patients can use defibrillators and curtail their athleticism to manage the disease, according to Dr. Liem.

Cardiac screening tests are not a mandatory requirement in routine physical exams. In an effort to raise awareness of the condition and provide a potentially lifesaving service, El Camino Hospital has offered a series of free cardiac screening tests to young athletes in the communities of Los Gatos and Mountain View. For more information about Dr. Liem’s next free screening session, click here or go to El Camino Hospital’s Heart and Vascular Institute event page to see a full list of activities throughout the month.

A new Harris Interactive/HealthDay poll finds that reducing unemployment and creating new jobs are clearly considered the top immediate priorities for President Obama and Congress, but healthcare reform is still important. Half of U.S. adults say it will be a “bad thing” if there is no major reform of the healthcare system in the next two years.

These are some of the results a Harris Interactive/HealthDay poll of 2,075 adults surveyed online February 3-5, 2010 by Harris Interactive.

This survey was conducted on the heels of Scott Brown’s election into the Massachusetts Senate –which some say sent a loud message against the current healthcare reform efforts, followed by the President’s State of the Union address, where he reiterated the importance of this initiative.

Although a substantial 50% to 27% plurality want to see health reform in the next two years, the public is split on whether the reform proposed by the President and the Democrats should be passed.

The Republicans in Congress and the healthcare industry are seen as mainly to blame for failure to pass a healthcare reform bill now – not President Obama. Obviously, this is less true for Republicans, who blame the Democrats in Congress. There are very large differences between Republicans and Democrats on all these issues, with Democrats much more strongly in favor of pushing hard for major reforms.

“The public is clearly split, with Republicans on one side and Democrats on the other, as to how hard the president should push for health care reform,” said Humphrey Taylor, chairman of The Harris Poll. “The president’s stated intention to push ahead is likely to be popular with most Democrats, but will probably remain so only if he and Congress can deliver significant legislation. Failure to do so could be very damaging.”

Overall, and specifically for Independents, controlling the out-of-pocket costs of healthcare and health insurance is now seen as the most important aspect of healthcare reform. Results vary for Democrats and Republicans individually:

For Democrats, the most important is to ensure more people have health insurance.

For Republicans, the most important is not increasing taxes to pay for health reform.

Independents have become the swing votes in America, and how they feel could be an important indicator of where things will go. “But, if the debate drags on without a clear outcome,” said Taylor, “the more ‘health reform fatigue’ will increase, which is likely to help Republican candidates in the November elections.”

The U.S. Department of Health and Human Services (HHS) awarded more than $119 million to states and U.S. territories to support public health efforts to reduce obesity, increase physical activity, improve nutrition, and decrease smoking-the four most important actions for combating chronic diseases and promoting health. This money supports the one of several components in the Department’s comprehensive prevention and wellness initiative, Communities Putting Prevention to Work, which is funded under the American Recovery and Reinvestment Act of 2009.

“Our goal through these statewide projects is to help make healthy choices the easier choices for all Americans, no matter where they live,” said HHS Secretary Kathleen Sebelius. “When we improve obesity-related and tobacco policies, we make it that much easier for people to eat right, to get more physical activity, and to avoid or stop smoking.”

The more than $119 million in funding — provided to 50 states, the District of Columbia, Puerto Rico and six Pacific territories — will focus on efforts to help communities and schools support healthy choices through a variety of methods including using media to support healthy food and beverage choices and increased physical activity, and increasing access to healthy choices and safe places to be active.

Awards will also support efforts to increase tobacco cessation through quit-lines and media campaigns and additional funding was provided to 13 states to support special initiatives.

Awards to states and territories are in three major categories:

1. Statewide policy and environmental change. All 58 applicants will receive funding for efforts in nutrition, physical activity, and tobacco control. The state, Washington, D.C. and Puerto Rico award amounts range from $335,801 to $2.2 million. Territory award amounts range from $99,980 to $100,000.

2. Competitive special policy and environmental change. Thirteen states were funded to implement 15 projects. The award amounts range from $1 million to $3 million per state.

3. Tobacco cessation through quitlines and media. CDC received applications-from all 50 states, Washington, D.C., Puerto Rico and Guam. 53 applicants will receive funding to expand tobacco quit-lines in concert with expanded cessation media campaigns. The award amounts range from $50,000 to $2.5 million. 53 applicants will receive funding to expand tobacco quit-lines in concert with expanded cessation media campaigns. The award amounts range from $50,000 to $2.5 million.

Awards for other Communities Putting Prevention to Work initiatives, including community-based health promotion initiatives, will be announced in the coming weeks.

To learn more about Communities Putting Prevention to Work, visit http://www.cdc.gov/chronicdisease/recovery.