Ultimately, our vision is for NP care to be consistently "different," yet just as essential as physician care, leading to positive outcomes in health promotion and disease management.
Trends in multiple birth rates are thought to have been substantially affected by subfertility treatments in the last 25 years, but there are few quantitative assessments of this. This paper examines trends in twin and higher multiple birth rates separately in Scotland, England and Wales and compares their course with corresponding multiple birth rates in the Oxford Record Linkage Study area, where the proportions following subfertility treatment are documented. National data on prescriptions for subfertility treatments reinforce the view that they have had a major effect on the trends, and currently perhaps 60% of triplet and higher order births and 15% of twins follow their use in Britain.
A new RN/BSN nursing program offers rural students in a western state the opportunity to address significant health care needs on a local level by developing public health leadership competencies in their home communities. The innovative program, funded by a grant from the Health Resources and Services Administration, makes it possible for RNs to complete their BSN degrees without travel, as they position themselves to provide critically needed health care leadership in their local areas. Partnerships between the university, community colleges, and local health agencies allow students in the RN-to-BSN program to benefit from a streamlined BSN admission process, onsite mentoring, and newly developed courses that lead students to reflect on health needs in their home communities. On the basis of Public Health Nursing Competencies as defined by the Nursing Quad Council (2004), the re-designed curriculum prepares students for public health leadership by encouraging application of competencies while participating in the delivery of essential public health services in their communities. Initial response to this new opportunity indicates that students can develop as leaders by developing public health competencies, and facets of the program may encourage more students to commit to completing the BSN while increasing capacity among PHNs.
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