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David M. Keepnews, PhD, JD, RN, FAAN, a CHMP Senior Fellow, is an Associate Professor at the Hunter-Bellevue School of Nursing and the City University of New York (CUNY) Graduate Center. He is Editor of Policy, Politics & Nursing Practice, a journal focusing on nursing and health policy.

Riding the subway home recently, I noticed a Spanish-language ad placed by the New York City Department of Education (DOE). The ad, part of an effort to promote the new Common Core Learning Standards and exams being given to 3rd to 8th graders, bore a headline reading (in translation) “Higher standards. Different tests. It’s a new day.”

It ended with: “Deseamos prepararlos para la unversidad y las carreras técnicas”—“We want to prepare them [students] for college and technical careers.”

A few days later, I noticed an English-language ad headlined “This Spring, we’re aiming higher.” As I read it, I saw that despite the different headline, this was the English-language version of the ad I had read before. The text was largely identical to the Spanish-language version. However, I couldn’t help but notice that the last sentence was a little different:

“We want them prepared for college and a career.” Note: Not specifically a technical career—simply a career, in general.

This seemingly small discrepancy jarred me: The ads end with two different messages to two different audiences—English-speaking and Spanish-speaking families—about the futures they can anticipate for their children.

David M. Keepnews, PhD, JD, RN, FAAN, a CHMP Senior Fellow, is an Associate Professor at the Hunter-Bellevue School of Nursing and the City University of New York (CUNY) Graduate Center. He is Editor of Policy, Politics & Nursing Practice, a journal focusing on nursing and health policy.

Riding the subway home recently, I noticed a Spanish-language ad placed by the New York City Department of Education (DOE). The ad, part of an effort to promote the new Common Core Learning Standards and exams being given to 3rd to 8th graders, bore a headline reading (in translation) “Higher standards. Different tests. It’s a new day.”

It ended with: “Deseamos prepararlos para la unversidad y las carreras técnicas”—“We want to prepare them [students] for college and technical careers.”

A few days later, I noticed an English-language ad headlined “This Spring, we’re aiming higher.” As I read it, I saw that despite the different headline, this was the English-language version of the ad I had read before. The text was largely identical to the Spanish-language version. However, I couldn’t help but notice that the last sentence was a little different:

“We want them prepared for college and a career.” Note: Not specifically a technical career—simply a career, in general.

This seemingly small discrepancy jarred me: The ads end with two different messages to two different audiences—English-speaking and Spanish-speaking families—about the futures they can anticipate for their children.

By now, you probably know of actress Angelina Jolie’s choice to undergo preventive double mastectomy, and her must-read op-ed in Monday’s New York Times.

In her specific case, the decision was a tough, but logical one given that the benefits of the procedure dramatically reduced future risk of breast cancer. It’s never an easy decision to undergo surgery. It must have been even more difficult for someone like Jolie, whose income is partly tied to her looks.English: Angelina Jolie at the Cannes film fes...

Double mastectomy isn’t the answer for everyone. Jolie was at very high risk because she is among the small percentage of women who carry the BRCA 1 and BRCA 2 gene mutation.

As Jolie points out, genetic testing is expensive, currently not covered by all insurance plans, and therefore only viable for a small segment of the population. “The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.” There are other forms of breast cancer – which may be more difficult to detect and treat.

What are the choices for those women who do not have the resources for such gene testing? Disparities along racial, education, and socioeconomic lines in both incidence and screening are well documented. Women who have other risk factors, who are without access to the top oncologists, plastic surgeons, and other care providers need to know their choices.

By now, you probably know of actress Angelina Jolie’s choice to undergo preventive double mastectomy, and her must-read op-ed in Monday’s New York Times.

In her specific case, the decision was a tough, but logical one given that the benefits of the procedure dramatically reduced future risk of breast cancer. It’s never an easy decision to undergo surgery. It must have been even more difficult for someone like Jolie, whose income is partly tied to her looks.English: Angelina Jolie at the Cannes film fes...

Double mastectomy isn’t the answer for everyone. Jolie was at very high risk because she is among the small percentage of women who carry the BRCA 1 and BRCA 2 gene mutation.

As Jolie points out, genetic testing is expensive, currently not covered by all insurance plans, and therefore only viable for a small segment of the population. “The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.” There are other forms of breast cancer – which may be more difficult to detect and treat.

What are the choices for those women who do not have the resources for such gene testing? Disparities along racial, education, and socioeconomic lines in both incidence and screening are well documented. Women who have other risk factors, who are without access to the top oncologists, plastic surgeons, and other care providers need to know their choices.

This is a repost from KevinMD.com

 | PHYSICIAN | MAY 8, 2013

As of early April, you can walk into Walgreens in 18 states (plus D.C.), and along with a gallon of skim milk, a pair of photo mugs, a six-pack of toilet paper, and a flu shot, you can meet your new primary care provider, get your cholesterol checked, pick up your statin, and schedule a return visit. That primary care provider will not be a physician but a nurse practitioner (or a physician assistant, but that’s for another article). Those states, and now Walgreens, have recognized that nurse practitioners can handle a lot more than antibiotics for urinary tract infections: They can practice primary care just fine without physician oversight. And it’s a pretty smart move.Lagging behind are the other 32 states (this map lays it out), in which nurse practitioners are supervised to varying degrees by physicians, the scope of their practice restricted by laws that vary from state to state. In some states, nurse practitioners can’t enroll a patient in hospice, order a wheelchair, or prescribe certain medicines without a doctor’s signature. This is true even when it’s impractical geographically and financially, not to mention belittling. Nurse practitioners in a number of states, including Connecticut, Nevada, and West Virginia, are currently pushing forlegislation for the right to practice independently and improve access to care.

This is a repost from KevinMD.com

 | PHYSICIAN | MAY 8, 2013

As of early April, you can walk into Walgreens in 18 states (plus D.C.), and along with a gallon of skim milk, a pair of photo mugs, a six-pack of toilet paper, and a flu shot, you can meet your new primary care provider, get your cholesterol checked, pick up your statin, and schedule a return visit. That primary care provider will not be a physician but a nurse practitioner (or a physician assistant, but that’s for another article). Those states, and now Walgreens, have recognized that nurse practitioners can handle a lot more than antibiotics for urinary tract infections: They can practice primary care just fine without physician oversight. And it’s a pretty smart move.Lagging behind are the other 32 states (this map lays it out), in which nurse practitioners are supervised to varying degrees by physicians, the scope of their practice restricted by laws that vary from state to state. In some states, nurse practitioners can’t enroll a patient in hospice, order a wheelchair, or prescribe certain medicines without a doctor’s signature. This is true even when it’s impractical geographically and financially, not to mention belittling. Nurse practitioners in a number of states, including Connecticut, Nevada, and West Virginia, are currently pushing forlegislation for the right to practice independently and improve access to care.