Shortage May Reach Crisis Sooner
one of the most far-reaching studies of the current state of nursing,
a Penn researcher has discovered that newly-minted nurses are leaving
the profession at far faster rates than their predecessors, suggesting
that the current shortage of nurses may reach crisis proportions
sooner than anticipated.
additional surprising finding is that beginning male nurses are
leaving the profession at twice the rate of women. The research,
which analyzes data from the National Sample Survey of Registered
Nurses collected by the Division of Nursing in the U.S. Department
of Health and Human Services in 1992, 1996 and 2000, is reported
in the influential health care policy journal, Health Affairs.
study indicates that new nurses begin their careers with higher
levels of job satisfaction, but the workplace itself seems to be
convincing growing numbers to leave the bedside earlier in their
careers for other professions," said Dr. Julie Sochalski, associate
professor at the School of Nursing. "We know the nation is
facing a shortfall of nurses. If new RNs are leaving the profession
after only a few years, the shortage is likely to reach crisis proportions
sooner rather than later."
baby boomers age, thus increasing demands on the health care system,
the median age of nurses is rising toward retirement. The US Department
of Labor predicts a shortfall of 331,000 nurses by 2008, leading
to national recruitment efforts. However, Dr. Sochalski found that
nearly 136,000 nurses are working in other professions, suggesting
policy makers should turn their attention to nurse retention as
well as the current emphasis on recruitment.
the research found that:
the most recent nurse survey, 7.5 percent of new male nurses dropped
out of nursing within four years of graduating from nursing school,
compared to 4 percent of women;
drop-out rate for both male and female new graduates is accelerating,
rising from 2 percent of men in 1992 to 7.5 percent in 2000; and
2.7 percent of women in 1992 to 4.1 percent in 2000;
new nurses, 75 percent of women reported being satisfied with their
jobs compared to only 67 percent of men; among more established
nurses 69 percent of women and 60 percent of men were satisfied.
accelerating rate of loss in the supply of nurses, at a time of
substantially increasing demand, underscores the need to determine
the reasons for the exodus. And while men may not yet comprise a
sizable number of the total who are leaving, the growth in their
retreat from nursing is nonetheless concerning," said Dr. Sochalski.
and Exposure Linked to Alternate Tobacco Product Use Among Teens
to family and friends who smoke and elevated levels of depression
significantly affect the likelihood of alternate tobacco product
use among adolescents, a study by researchers from Penn's School
of Medicine and Georgetown University indicates. The study, titled
"Psychosocial Correlates of Alternate Tobacco Product Use during
Early Adolescence," appeared in the August issue of Preventive
research shows that alternate tobacco products, including smokeless
tobacco (chewing tobacco and moist snuff), cigars, cigarillos, pipes,
bidis (sweet flavored cigarettes from Southeast Asia), and kreteks
(clove-flavored cigarettes), are gaining in popularity among youth.
trend is dangerous because alternate tobacco products can lead to
cancers of the oral cavity and a host of other negative health consequences,"
said senior author Dr. Janet Audrain, member of the Abramson Cancer
Center and assistant professor in the Department of Psychiatry at
the School of Medicine.
previous research has shown that both exposure to other smokers
and depression increase the likelihood of cigarette use among adolescents,
this is one of the first studies to examine the influence that these
social and psychological factors have on alternate tobacco product
eight percent of the teens reported using an alternate tobacco product
(smokeless tobacco, cigars, pipes, bidis and/or kreteks) in the
last thirty days. Among the eleven percent of freshman who reported
being current cigarette smokers (smoked in the last month), 45 percent
were also current users of an alternate tobacco product.
researchers found that current alternate tobacco product users were
significantly more likely to be male, white and current cigarette
smokers. In addition, teens with higher levels of exposure to other
smokers and those with greater depressive symptoms were found to
be two to three times more likely to be current users of alternate
tobacco products, regardless of demographic factors and current
research was funded by the National Cancer Institute and the National
Institute on Drug Abuse and was conducted by the University of Pennsylvania/Georgetown
University Transdisciplinary Tobacco Use Research Center.
Immune Cells Fight Cancer,
Others Hold Them in Check
cancer patients generate immune cells capable of specifically attacking
their tumors, but the cells rarely do, in fact, target a patient's
cancer. What prevents these potentially helpful cells from taking
action? And is there anything that might be done to unleash them?
attack cells--known as cytolytic T cells--are prevented from acting
by a second set of immune cells called regulatory T cells, according
to a new study from investigators at The Wistar Institute. The research
also shows that the regulatory T cells communicate their message
of restraint to the cytolytic T cells at a distance, via a messenger
chemical called TGF-beta. A report on the study appears in the September
15 issue of Cancer Research.
work has focused on ways to stimulate the cytolytic T cells to act,
but the new study suggests that other approaches to bringing them
into the battle against cancer might be more effective. For example,
a drug that inactivates the regulatory T cells or that blocks the
TGF-beta chemical message they send might free the cytolytic T cells
to attack a patient's tumor.
known for some time that cancer patients can generate T cells able
to attack their tumors," says immunologist Dr. Dorothee Herlyn,
a professor at The Wistar Institute and senior author on Cancer
Research study. "What we discovered in this study is that those
patients also produce negatively regulating cells at the same time
that keep the attacking T cells in check. The existence of these
regulatory cells may help explain how tumors are able to evade the
immune system. They also represent a new starting point for thinking
about novel anti-cancer treatments."
current study evolved somewhat by chance. Using cells from a human
colorectal cancer patient, Herlyn's laboratory team was working
to identify T cells with cancer-fighting capabilities and isolate
them from other types of immune cells. At one point, one of her
coworkers suggested combining different groups of isolated cell
types to look for interactions between them.
put these two different types of immune cell together, one of which
killed cancer cells in culture, the other of which did not,"
Herlyn recalls. "When we did, we were stunned to see that the
one that had previously killed cancer cells no longer did so."
explaining the mechanisms underlying that observation required several
years of additional study, she says.
lead author on the Cancer Research study is Dr. Rajasekharan Somasundaram,
at The Wistar Institute. The other Wistar-based coauthors are Lutz
Jacob, Rolf Swoboda, Ph.D., Laura Caputo, Hong Song, Saroj Basak,
David Peritt, Dewei Cai, Brigitte Birebent, Jin Kim, and Klara Berencsi.
Collaborators on the study are Dimitri Monos, Ph.D., at HUP, Francesco
Marincola, M.D., at the National Cancer Institute, and Ellen Bloome
and Michael Mastrangelo, MD, a professor of medicine at Thomas Jefferson
University. The research was supported by grants from the National
Institutes of Health.
Start Provides Leg Up to Kindergartners
research shows that Philadelphia children attending Head Start programs
and other center-based child care are better prepared for kindergarten
and maintain higher skills throughout the year. They achieve higher
levels of early literacy and math skills and display work habits
and motor skills that are more advanced than their peers.
addition, these same children had higher attendance levels than
those who had no formal preschool experiences. These findings and
many others were presented at a gathering of School District of
Philadelphia Head Start education at Penn.
before had such a comprehensive set of early childhood data been
available," said Dr. John Fantuzzo, GSE professor and lead
researcher. "This convocation is evidence of the Head Start's
local and national commitment to quality information that promotes
readiness for children in the most challenging urban environments."
65 percent of Philadelphia's kindergartners have center or school-based
childcare experiences before they enroll in kindergarten.
Almanac, Vol. 49, No. 4, September 17, 2002