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There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs) improve health care and outcomes. The China Medical Board (CMB) China Nursing Network (CCNN) began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities. This paper presents the discussion, recommendations and action plans developed at the inaugural planning meeting on June 26, 2015 at Fudan University in Shanghai. The recommendations are: Develop standards for advanced nursing practice; Develop Master's level curricula based on the standards; Commence pilot projects across a number of University affiliated hospitals; and Prepare clinical tutors and faculty. The strategic directions and actions are: Develop a clinical career ladder system; Expand the nursing role from hospital to community; and Build a specialty nurse accreditation system. Keywords: Advanced nursing practice, China, Nursing education, Nursing practice, Masters education, Nursing specialists

In July 2008, five nurses graduated from the first full-time doctoral program for nurses in China at Peking Union Medical College (PUMC) in Beijing. The purpose of this article is to describe the doctoral program partnership between the Schools of Nursing at PUMC and Johns Hopkins University (Hopkins) in the United States that led to this historic event. The planning, implementation, evaluation, and early outcomes of the program are described to provide a model for rapidly increasing capacity for doctoral education in nursing in countries without sufficient or any doctoral education in nursing. One of the main objectives of this doctoral program partnership was to transition the Chinese University to an independent doctoral program as rapidly as possible. Lessons learned are presented as well as the next steps for this program.

Nonadherence and poor or no persistence with taking antihypertensive medications results in uncontrolled high blood pressure, poor clinical outcomes and preventable health care costs. Factors associated with nonadherence are multilevel and relate not only to the patient, but also to the provider, health care system, health care organization, and community. National guideline committees have called for more aggressive approaches to implement strategies known to improve adherence and technologies known to enable changes at the systems level including improved communication among providers and patients. Improvements in adherence and persistence are likely to be achieved by supporting patient self-management, a team approach to patient care, technology-supported office practice systems, better methods to measure adherence, and less clinical inertia. Integrating high blood pressure control into health care policies that emphasize and improve prevention and management of chronic illness remains a challenge. Four strategies are proposed: focusing on clinical outcomes; empowering informed, activated patients; developing prepared proactive practice teams; and advocating for health care policy reform. With hypertension remaining the most common reason for office visits, the time is now.

Cardiovascular disease (CVD) is the leading cause of death and disability in most Western industrialized countries including the U.S., cutting across all ethnic, racial, and gender groups. Despite the tremendous body of research to support the efficacy and cost-effectiveness of CVD prevention

The objective of this study was to determine the prevalence of symptoms and the morbidity associated with Raynaud’s phenomenon (RP) among African Americans. A total of 2196 randomly selected residents of an inner-city community, in Baltimore, completed a health-assessment survey. Symptoms of RP consisted of cold sensitivity plus cold-induced white or blue digital color change. One third ( n = 703) reported cold sensitivity and 14% ( n = 308) reported digital color change; 84 residents with symptoms of RP were identified, yielding an overall prevalence rate of 3.8% (95% confidence interval [CI] 3.0–4.6). RP was associated with poor or fair health status (odds ratio [OR] = 1.82, CI 1.18–2.81), heart disease (OR = 2.32, CI 1.39–3.87), and stroke (OR = 2.20, CI 1.17–4.15), after adjustment for age, gender, and physician-diagnosed arthritis. The prevalence of symptoms of RP in this African-American community is comparable to published reports from other populations. These community-based data suggest that identification of RP among African Americans should raise consideration of possible comorbidity, particularly cardiovascular disease.

Purpose: Widespread prevention of cardiovascular disease (CVD) requires significant aggregate lifestyle behavior changes. Extensive resources including money, time, access, facilities, materials, and programs are needed to bring about such behavior changes on a large scale. Over the past several decades, funds for large scale public health efforts and related CVD research have become more difficult to acquire, and prevention efforts have been shifting to state and community sites. Thus, large scale behavior modification for CVD prevention requires active efforts to access resources from partnerships with multiple private sector organizations. Methods: Religious organizations (ROs) are a potentially valuable channel with many advantages for undertaking behavior change programming in partnership with public health researchers. ROs have a broad, direct “reach” with people and provide social support structures, facilities, volunteers, communication channels and access to many sub-populations as well as a compatible mission and history of interest in health. In spite of the many advantages of partnerships between CVD health researchers and ROs, very few formal research studies have been conducted. Existing reports have emphasized the feasibility and powerful benefits of implementing RO-based health programs; however, little data or formal hypothesis testing have been reported. Very few formal CVD research projects have employed scientifically acceptable research designs with random assignment of intact groups to intervention and comparison conditions. Results: In this review, conducted by the current authors, only six projects have been identified that meet these more rigorous scientific criteria. In a discussion of these projects, we classify RO-based studies into four levels of involvement of the RO: 1) use of ROs as sites for recruitment and tracking of experimental subjects; 2) use of RO facilities to conduct interventions; 3) involvement of RO members in delivering behavior change programs; and 4) the addition of significant religious components as an integral part of the intervention. This paper discusses the design, results and implications of these studies including information on what we already know about conducting research with ROs, gaps in existing research and recommendations for future studies. Conclusions: There is enormous untapped potential for RO-based CVD prevention research, but considerably more work is required to achieve the level of research that is currently conducted in other channels such as worksites and schools. Health practitioners/researchers and ROs are increasingly seizing the opportunity for partnerships to improve health. The knowledge gained from these projects and their documented successes will hopefully encourage other components of the public health system such as hospitals, managed care organizations and departments of health to continue developing ways of including ROs in health research and behavior change programming.

The authors describe historical trends in the profession and nursing education and offer a thoughtful synthesis of many complex and inter-related issues influencing the nursing workforce, nursing higher education, and the nation’s healthcare needs. Their main argument is thatmoving education of all advance practice nurses (Nurse Practitioners, Clinical Nurse Specialists, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and Advanced Practice Registered Nurses [APRNs]) from the master’s level to the doctoral level at this time is not in the best interest of the public, the national workforce, or the profession. They argue, with convincing evidence, that continuing APRN education at themaster’s level is appropriate and in the best interests of the public, the national workforce, and the profession. Interestingly, in contrast to prior public statements and writings, they do not argue that the clinical, professional practice doctorate, the Doctor of Nursing Practice (DNP), should not be added to the armamentarium of nursing degree programs.