Group visits hold great potential for improving diabetes care and outcomes, but best practices must be developed.

A diagnosis of diabetes can require multiple changes in a person's behavior, diet, and lifestyle. Efforts to sustain these changes and manage this complex chronic disease can be difficult. Group visits, in which several patients meet together with a primary care provider and transdisciplinary team, have tremendous potential to improve health care quality, cost, and access. When group-based diabetes self-management education and a primary care visit occur within a single appointment, people with the disease can address multiple needs in one visit and take advantage of peer groups for support and motivation. A review of the literature demonstrates that the efficacy of group visits has a promising evidence base-but more needs to be learned about optimal group size and aspects of the model that should be standardized. An important first step is introducing a procedural code for group visits, so that providers and researchers can better track the efficacy of the group-visit model and develop best practices before the model is adopted systemwide.

Are regulations more consumer-friendly when boards of nursing are the sole regulators of nurse practitioners?

The widely varied regulations in the 50 states often limit consumer access to nurse practitioners (NPs). In 22 states, the Board of Nursing (BON) must share NP regulatory authority with another profession, usually physicians. This study examines the relationship between the BON as the sole authority regulating NPs or sharing that authority with another profession and the NP regulatory environment. Independent t tests compared the NP regulatory environments for consumer access and choice in states with sole BON regulation with those in states with involvement of another profession. The states' NP regulatory environments were quantified with an 11-measure tool assessing domains of consumer access to NPs, NP patients' access to service, and NP patients' access to prescription medications. BON-regulated states were less restrictive (P < .01, effect size 1.02) and supported NP professional autonomy. Entry into practice regulations did not differ in the two groups of states. Having another profession involved in regulation correlates with more restrictions on consumer access to NPs and more restrictions to the full deployment of NPs.

Opportunities in preparing global leaders in nursing.

During the past decade, there has been a large increase in the number of international nurses pursuing doctoral education in the United States. The influx of these nurses has ramifications for the institutional systems providing education as well as on international and American nursing students. To begin understanding the issues presented by international doctoral nursing education, a survey of U.S. schools of nursing as well as a focus group of currently enrolled international doctoral students was conducted. The survey revealed that both international students and nursing programs experience challenges with regard to language, communication, financing, and support systems. More specifically, information gathered from the focus group identified issues regarding (1) lack of familiarity with the U.S. health care system, (2) lack of previous experience with the seminar format used in doctoral programs, (3) restricted opportunities to participate in faculty research, and (4) stress from a heavy course load to finish the program within a very short time period. Universally, the surveys and focus group lauded the positive global perspective imbued on all students and faculties via the international connection. Nonetheless, schools of nursing need to identify more effective strategies to aid international students in their development as successful global leaders. Meleis's framework for culturally competent scholarship is offered as a guide for schools of nursing.