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The American Journal of Managed Care® and Exact Sciences Corporation hosted a roundtable meeting to discuss the impact of colorectal cancer (CRC) screening modalities on improving patient outcomes. The roundtable participants were a diverse panel of experts, including primary care, gastroenterology, and oncology providers; experts in health outcomes research and health policy; and managed care executives with commercial and public payer experience. Participants discussed CRC prevention and treatment strategies, screening modalities and adherence, molecular diagnostics, patient navigation, evaluation of large data sets, managed care, outcomes research, quality improvement, and reimbursement policies. They focused on developing better value-based medical policies and payment procedures, identifying knowledge, practice, and access deficits related to CRC screening. Participants also provided suggestions on how to improve care quality and patient outcomes through effective evidence-based approaches. They also discussed costeffectiveness modeling for CRC screening, specifically the advantages and the real-world limitations of these models.

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability. Using a variety of financial performance measures to inform decision making will aid ANMCs in keeping their doors open for business.

Educational preferences, impediments to obtaining an education, and the needs of occupational health nurses are not well understood. The purposes of this regional study were to determine the graduate and continuing educational preferences, impediments, and needs of occupational health nurses in the states of Texas, New Mexico, Arkansas, Louisiana, and Oklahoma. Questionnaires (1,172) were mailed to all occupational health nurses identified by the respective state boards of nursing (N = 5). Results from 256 (response rate of 21.8%) returned questionnaires show 43.8% were interested in obtaining a graduate degree in occupational health nursing while only 48.8% of employers encourage them to obtain a higher degree. Only 33.2% reported the company for which they work provides rewards for obtaining an advanced degree or certification as an occupational health nurse. The two greatest impediments to obtaining a graduate degree as an occupational health nurse were a long distance from campus (56.3%) and lack of money (37.9%).

ANCs, by definition, deliver more than clinical services to patients and communities. The unique identifier that separates ANCs from other primary care/ambulatory care centers is the educational service they offer to students and other faculty in the school of nursing to which they belong. Therefore, measuring the quality of an ANC must include a measurement of the educational properties that it possesses in addition to the usual quality measurements by such organizations as AAAHC, JCAHO, CHAP, and AAACN. Unless these properties are included and measured by an ANC, it becomes difficult to justify the existence of such a clinic within a school of nursing. ANCs are encouraged to develop quality evaluation programs aimed at evaluating the educational aspects as well as the administrative and clinical aspects of their operations.

Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

From the settlement of the earliest peoples in the Americas to the close of the seventeenth century, enormous changes took place in what was to become the continental United States. To help students understand this sweep of history, this unique resource provides detailed description and expert analysis of the ten most important events through the seventeenth century: First Encounters, c. 40, 000 BCE - 1492 AD; The Expedition of Coronado, 1540-1542; The Founding of St. Augustine, 1565; Early English Colonization Efforts, c. 1584-1630; Early European-Native American Encounters, 1607-1637; The Introduction of Slavery into America, 1619; The Surrender of New Amsterdam, 1664; King Philip's War, 1675-1676; The Glorious Revolution in America, 1688-1689; and The Salem Witch Trials, 1692. Each event is dealt with in a separate chapter. The examination goes beyond traditional textbook treatment of history by considering the immediate and far-reaching ramifications of each event. Each chapter features an introductory essay that presents the facts of the event in a clear, chronological manner that makes complex history understandable. This essay is followed by an interpretive essay, written by a recognized authority in the field in a style designed to appeal to a general readership and promote critical thinking, that places the event in a broader context and assesses it in terms of its political, economic, sociocultural, and international significance. With an illustration and an annotated bibliography for each event, a glossary of names, events, and terms of the period, a timeline of important events in American history through the seventeenth century, Events That Changed America Through the Seventeenth Century is an ideal addition to the high school, community college, and undergraduate reference shelf, as well as excellent supplementary reading in social studies and American history courses.