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Individuals labelled as having hypertension tend to report poor self-rated health (SRH), but it is unclear whether this association is independent of actual hypertension, socioeconomic status and adiposity, and extends across racial and ethnic groups. In a cross-sectional study we compared hypertensive and normotensive individuals (N=19 057) who varied in whether they had ever been labelled hypertensive. Blood pressure was measured in participants' homes and mobile examination centres in the United States as part of the Third National Health and Nutrition Examination Survey, 1988–1994. The main outcome measure was global SRH. Hypertensive labelling was associated with poorer SRH and was independent of established SRH predictors, antihypertensive medication use, body mass index, and hypertension status (adjusted odds ratio (OR)=1.79, 95% confidence interval (CI), 1.61–1.99). Hypertension was also associated with poorer SRH (OR=1.26; 95% CI 1.09–1.46) but this association was eliminated by adjustment for hypertensive labelling (OR 1.06; 95% CI 0.92–1.22). These effects were consistent across non-Hispanic white, non-Hispanic black, and Hispanic subgroups. Individuals labelled hypertensive are more likely to have lower SRH and this labelling effect predominates over that of actual hypertension. Public health efforts to increase the number of individuals screened for high blood pressure may successfully detect the presence of hypertension but may also reduce health-related quality of life as measured by global SRH.Journal of Human Hypertension (2006) 20, 117–123. doi:10.1038/sj.jhh.1001950; published online 3 November 2005 [ABSTRACT FROM AUTHOR]

Enacted in 1967 as a required component of the Medicaid program, the Early and Periodic Screening, Diagnosis and Treatment Program combines outreach, health screening, follow-up care for detected conditions, and case management. This article describes the delivery of this program's services by nurse practitioners in an academic nursing center. Detailed are the Nursing Center's activities to develop a services contract for the Early and Periodic Screening, Diagnosis and Treatment Program and to improve client access. Issues discussed include protocol development, prescriptive authority and referral to health care providers accepting Medicaid. Services are evaluated by auditors, faculty, students and clients. The article concludes with suggestions for other providers or potential providers of the program.

After reviewing the faculty practice literature of the 1980s and finding philosophical support for practice but also growing concerns about faculty role overload, the authors report a study to identify organizational factors that influence the role expectations of faculty members about practice. A survey was sent to the deans or directors of all National League for Nursing--accredited baccalaureate nursing programs (n = 462). Of the 356 respondents (78 per cent), 224 (63.3 per cent) reported that their school had practicing faculty, but only 20 schools (8.8 per cent) required practice. Written faculty practice plans were reported by 23 schools (10.2 per cent), and nursing centers by 41 schools. Thirty-six respondents (16 per cent) reported that practicing faculty generated revenue for the school. Practice was required for promotion in 15.8 per cent and for tenure in 15.3 per cent of all schools surveyed. The study showed significant direct relationships between master's and doctoral programs and practicing faculty, but there was an inverse relationship between the presence of a health science center and schools with practicing faculty. Organizational factors relating to both the number and per cent of faculty who practiced included requiring practice, having a practice plan, and having practice as a criterion for promotion and for tenure. Revenue generation and presence of formalized practice arrangements were related to the number of faculty who practiced but not the per cent of the total faculty who practiced. The study's findings have implications for nursing education in designing organizational structures and rewards that support faculty practice.