KEYWORDSEmerging infections Zoonotic diseases Vector-borne diseases Candida auris Elizabethkingia anopheles Avian influenza mcr-1 KEY POINTSMost emerging infectious diseases (EID) are caused by zoonotic pathogens.Vector-borne diseases are a major public health problem in the United States.Factors contributing to EID include population growth, spread in health care facilities, aging population, global travel, and changing vector habitats related to climate change.

Our objective was to better understand the experience and impact of pain on ALS patients in the U.S., and to survey ALS physicians on their pain assessment and management practices. Individuals with ALS were invited to complete an online survey of pain in ALS. ALS specialist physicians were sent an e-mail survey about their experiences in evaluating and managing patients' pain. Nearly 75% of patients with ALS reported significant pain, and most thought that ALS was the source of at least some of this pain. Pain intensity scores (mean 3.9/10) and pain interference scores (mean 4.3/10) were moderate on average, but nearly 80% of participants were using pain medication, including 22% using opioids. Nearly 25% of patients thought they needed stronger pain medication than they were receiving. Physicians generally assess and manage pain in ALS patients, but few use standardized assessment tools. Nearly two-thirds felt that there is a need for better pain management practices and more than one-third felt better training was needed. In conclusion, pain in patients with ALS is not always well controlled. Improvement in care may be facilitated by a more standardized approach to evaluation, and by additional education and training of ALS health care professionals.

Purpose To increase understanding of national trends in nurse practitioner (NP) clinical education, the Education Committee of the American Academy of Nurse Practitioners (AANP) con‐ducted a survey at the 1999 National AANP Conference in Atlanta. Data Sources A convenience sample of preceptors (n=87) and faculty (n=42) out of the total attendance of 1,744 responded to a written questionnaire. Conclusions Preceptor respondents provided data concern‐ing the number of NP students supervised, influence of student supervision on productiv‐ity, and availability of incentives for precept‐ing. Faculty reported placement and supervi‐sion issues, the extent of precepting in their clinical practice site, and recognition and sup‐port for this role. Faculty and preceptors dis‐agreed about the types and number of incen‐tives offered for accepting students as well as the congruence of clinical teaching activities and national teaching guidelines. Precepting did not appear to strongly influence preceptor productivity. External funding did not influ‐ence opportunities for clinical education. Implications for Practice In 1998, the graduates of NP programs rose by 15.8% and over half of all nursing students enrolled in graduate nursing programs were seeking a NP education. This increase in stu‐dents may compromise the ability of schools of nursing to insure quality clinical education of NP students by increasing faculty workload and placing greater demands on expert precep‐tors in the community. Clinical education is also changing in light of changes in the health care system.

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