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8,7,4","1989,7,1,50,1,82,1","199,7,3","1990,18,1,84,16","19901994,7,1","1990-1994,7,6","1990-2008,38,1,40,1,84,21","1990s,7,1,21,1","1991,84,5","19911995,7,1","1992,7,9,82,1,84,12","1993,21,1,82,1,84,30","1994,7,2,82,1,84,33","1994-2004,82,1","1995,12,1,33,1,84,43","19951999,7,1","1995-1999,7,6","1996,7,12,84,12","19962000,7,1","1997,7,1,13,1,20,2,54,2,84,33","199720012000,7,1","1998,7,2,26,3,55,3,82,2,84,19","1998-2002,82,1","1998-2008,82,5","1999,7,1,13,1,82,1,84,8","19k,1,2,2,2,3,2,4,2,6,2,74,2,75,2,72,2,76,2","19th,7,1,12,2","1a,82,1","1b,82,1","1k,1,2,2,2,3,2,4,2,6,2,74,2,75,2,68,2,70,1,72,2,76,2,93,2,94,2,126,1,128,1,129,1,130,1,90,2,91,2,141,2,142,2,143,2,144,1,145,1,146,2,148,1,149,1","1pm,11,1","1st,27,1,30,1,53,1,56,1,57,1,58,1","2.0,7,11,26,1,55,1,52,1","2.1,7,14,12,2,26,1,55,1","2.10,7,2","2.16,82,1","2.2,7,15,14,1,27,1,34,1","2.3,7,12,11,1,34,1,82,1","2.4,7,16","2.5,7,15","2.6,7,16,11,1","2.7,7,14","2.8,7,18,17,1,25,1,82,1","2.8m,1,1,2,1,3,1,4,1,6,1,74,1,75,1,72,1,76,1","2.9,7,13","20,7,58,14,1,18,1,22,1,24,1,25,1,30,1,36,1,42,1,43,1,46,1,48,1,83,1,82,1,84,4","20.0,7,5,35,1","20.1,7,3","20.2,7,2","20.3,7,1","20.4,7,5","20.6,7,4","20.7,7,6","20.8,7,4","20.9,7,3","200,7,11,28,1,41,1,50,1,84,1","2000,7,39,39,1,46,1,82,1,84,43","20002004,7,1","2000-2004,7,6","20002008,7,1","2000-2008,7,6","2001,7,76,35,1,82,1,84,23","2001­,7,1","20012004,7,1","2001-2004,7,1","2001­2004,7,24","200120052004,7,1","2001­2008,7,9","2001â€“2002,29,1","2002,22,3,82,1,84,34","2003,7,1,35,1,52,1,84,38","2003a§,84,1","2003b§,84,1","2004,7,109,46,2,82,2,84,35","2004-2008,7,10","2004â€“2005,29,1","2004--represent,7,1","2005,7,18,31,1,84,24,131,1","20052008,7,1","2005-2008,7,1","2005­2008,7,27","2006,22,4,27,1,39,2,43,1,51,2,82,2,84,27","2007,7,56,13,1,19,1,20,2,22,7,26,2,34,1,39,2,43,2,55,2,48,1,52,1,82,1,84,20,92,1","2007.1,7,1","2007-march,71,1","2008,7,592,9,1,10,1,11,2,12,1,19,1,26,7,28,2,27,2,29,1,32,2,34,1,39,5,42,2,43,4,44,1,46,1,51,3,54,2,55,7,47,4,48,4,52,7,53,1,56,1,57,1,59,1,58,1,69,2,82,2,84,23,92,1","2008--both,7,1","2009,7,4,9,10,10,10,11,2,13,7,18,5,15,7,17,8,19,7,20,8,22,11,26,1,28,9,24,11,27,3,29,7,31,8,32,10,37,8,39,3,42,1,43,8,45,8,51,6,54,1,55,1,47,2,49,8,52,3,53,10,56,10,57,10,59,1,58,10,71,1,82,6,84,11,92,1,131,9","2009.â ,42,1","200â ,22,1","201,7,5","2010,7,3,14,1,11,12,12,3,18,15,16,9,21,1,26,11,23,5,25,2,27,3,30,2,33,13,34,9,35,13,42,9,45,1,46,8,51,1,54,6,55,11,50,8,53,5,56,5,57,5,83,2,58,5,61,12,82,2","2010-2015,35,1","2011,14,7,12,13,18,1,16,1,21,10,26,2,25,10,27,14,30,11,36,9,34,2,38,7,41,14,40,9,46,1,54,2,55,2,49,1,50,5,83,1,61,9,82,11,84,2","2011-2012,23,1","2011-2014,46,1","2012,12,1,13,1,26,1,25,2,41,1,55,1","20124,26,1,55,1","2013,12,1,16,1,26,1,34,1,42,1,55,1,83,2","2014,26,1,36,1,55,1","2015,25,2","2017,48,1","2019,36,1","202,7,4,35,1","202.7,7,1","2020,33,1,54,1","202k,64,1,85,1,86,1,87,1,135,1,89,1,138,1,139,1,140,1","203,7,2","2030,14,1,42,1","204,7,2","2040,32,1","205,7,3","206,7,1,26,1,55,1","207,7,1","208,7,5","2080,7,1","209,7,4,26,1,55,1","20-jul-2010,1,1,2,1,3,1,4,1,6,1,74,1,75,1,72,1,76,1","20k,1,2,2,2,3,2,4,2,6,2,74,2,75,2,72,2,76,2","20s,7,1","20th,7,2,36,1","20th.â ,33,1","20-year,84,1","21,7,18,13,4,26,1,24,1,29,1,32,5,34,2,38,2,40,2,45,1,51,1,55,1,82,1,84,3","2-1,7,11","21.0,7,4","21.1,7,7","21.2,7,4","21.3,7,7","21.4,7,4","21.5,7,3","21.6,7,6","21.7,7,7","21.8,7,1","21.9,7,1","210,7,4,34,1","2-10,7,2","211,7,2","2-11,7,3","211-217,84,1","212,7,2,82,1","2-12,7,3","21-23,52,1","21275,59,2","213,7,2","2-13,7,3","21-33,84,1","2134,30,2","214,7,4","2-14,7,1","214-218,84,1","21482157,84,1","215,7,1","216,7,4","217,7,6","219,82,1","21-dec-2010,1,1,2,1,3,1,4,1,6,1,74,1,75,1,72,1,76,1","21k,1,4,2,4,3,4,4,4,6,4,74,4,75,4,72,4,76,4","21st,25,1,53,1,56,1,57,1,58,1,84,1","22,1,1,2,1,3,1,4,1,6,1,7,19,12,1,13,1,16,1,23,1,24,1,30,1,31,1,36,1,51,1,74,1,75,1,72,1,76,1,84,3,131,1","2-2,7,11","22.0,7,2","22.1,7,6,82,1","22.2,7,2,82,1","22.3,7,4","22.4,7,4","22.5,7,7,41,1","22.50,53,1,56,1,57,1,58,1","22.6,7,2","22.7,7,1","22.8,7,5","22.9,7,5","220,7,3,83,1","220-215,49,1","221,7,4","222,7,2","223,7,1","223-237,84,1","2235twr,42,1","224,7,2","225,7,1","226,7,2","227,7,1","228,7,1","229,7,6","22k,1,4,2,4,3,4,4,4,6,4,74,4,75,4,72,4,76,4","22nd,39,1,44,1,48,1,59,1","23,1,1,2,1,3,1,4,1,6,1,7,16,18,1,26,1,30,1,44,1,45,1,55,1,50,1,74,1,75,1,72,1,76,1,84,6","2-3,7,10","23.0,7,3","23.1,7,5,34,1","23.2,7,5","23.3,7,3","23.4,7,2","23.5,7,4,22,1,28,1","23.6,7,4","23.7,7,3","23.8,7,7","23.9,7,6,82,1","230,7,3","231,7,2","232,7,6,84,1","232.4,7,1","233,7,3","234,7,2","235,7,3","236,7,1","237,7,2","238,7,1,50,1","239,7,4","23-feb-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","23k,1,2,2,2,3,2,4,2,6,2,72,2,74,2,75,2,76,2","23-minute,37,1","23-nov-2010,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","23rd,9,1,10,1,15,1,17,1,28,1,24,1,32,1,37,1,43,1,51,2,47,1","24,1,1,2,1,3,1,4,1,6,1,7,21,20,1,22,1,25,1,34,1,72,1,74,1,75,1,76,1,82,1,84,1","2-4,7,9","24.0,7,3","24.1,7,2","24.2,7,6","24.25,14,1,21,1,27,1","24.3,7,5,9,1,10,1","24.4,7,7","24.5,7,2","24.6,7,6","24.7,7,4","24.8,7,1","24.9,7,9","240,7,3","241,7,2","242,7,5","2427-2428,84,1","243,7,1","2431,7,3","24-31,7,1","243-2443,48,2","244,7,1","245,7,3","246,7,3","247,7,1,17,1,84,1","248,7,1","249,7,2","24k,1,3,2,3,3,3,4,3,6,3,72,3,74,3,75,3,68,1,76,3,93,1,94,1,90,1,91,1,141,1,142,1,143,1,146,1","24th,11,1,18,1,33,3,34,4,35,3,41,1,42,2,46,1,53,1,56,1,57,1,58,1","25,7,36,12,1,16,1,17,1,21,3,26,1,24,1,27,1,30,2,33,1,36,1,39,1,41,1,42,2,44,1,51,1,54,1,55,1,50,1,53,1,56,1,57,1,59,1,83,1,58,1,82,2,84,3,88,1","2-5,7,9","25.0,7,5","25.00,48,1","25.1,7,10","25.2,7,7","25.3,7,9","25.4,7,2","25.5,7,3,30,1","25.6,7,4","25.7,7,3","25.8,7,8","25.9,7,5","250,7,6,29,1,47,1,82,4,84,1","2500,7,1,84,1","251,7,6","252,7,1","2529,7,4","25-29,7,1","25­29,7,1","253,7,4,42,1","253-260,84,1","254,7,2","254-261,84,1","2549,7,1","255,7,2","256,7,2","257,7,3,82,1","258,7,1","259,7,3,84,1","25-aug-2010,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","25-may-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","25th,14,3,12,3,21,2,25,1,30,3,36,1,38,2,41,1,40,2,46,1,50,3","26,7,30,14,1,12,1,17,5,20,5,26,1,24,3,34,1,55,1,84,1","2-6,7,7","26.0,7,4","26.1,7,3","26.2,7,3","26.3,7,2","26.4,7,6","26.5,7,1,34,1","26.6,7,1","26.7,7,5","26.8,7,2","26.9,7,4","261,7,3","262,7,2","2623-2633,84,1","26-28,13,1,17,1,20,1,22,1,28,1,24,1,29,1,31,1,52,1,131,1","263,7,2","26-30,51,1","263-171,48,1","265,7,1","267,7,1","268,7,1","269,7,1,82,1","26-jul-2010,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","26k,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","26-oct-2010,1,2,2,2,3,2,4,2,6,2,72,2,74,2,75,2,76,2","26-sep-2011,8,1,64,1,68,1,70,1,77,1,78,1,79,1,81,1,85,1,86,1,87,1,93,1,132,1,134,1,135,1,94,1,126,1,128,1,129,1,130,1,89,1,90,1,91,1,136,1,137,1,138,1,139,1,140,1,141,1,142,1,143,1,144,1,145,1,146,1,148,1,149,1","26th,45,2","27,7,17,17,1,26,1,25,1,36,1,38,1,40,1,44,1,55,1,84,2","2-7,7,6","27.0,7,5","27.1,7,5","27.2,7,3","27.3,7,2","27.4,7,2","27.5,7,7","27.6,7,6","27.7,7,4","27.8,7,4","27.9,7,4","270,7,1","271,7,3","271-283,84,1","272,7,3","273,7,5","273-281,84,1","274,7,3","274-281,84,1","275,7,1,46,1","276,7,5","277,7,4","277-281,84,1","278,7,1","279,7,6","27-apr-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,68,1,70,1,76,1,93,1,94,1,126,1,128,1,129,1,130,1,90,1,91,1,141,1,142,1,143,1,144,1,145,1,146,1,148,1,149,1","27-bed,26,1,55,1","27-jan-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","27-jul-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","27k,1,4,2,4,3,4,4,4,6,4,72,4,74,4,75,4,76,4","27-oct-2010,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","27-question,34,1","28,1,1,2,1,3,1,4,1,6,1,7,24,12,1,15,1,24,5,37,1,39,1,41,2,44,2,52,1,72,1,74,1,75,1,76,1,84,2","2-8,7,2","28.0,7,3","28.2,7,3,27,1","28.3,7,3","28.4,7,2","28.5,7,3,48,1","28.6,36,1","28.7,7,1","28.8,7,2","28.9,7,3","280,7,3","281,7,3","283,7,3,84,1","284,7,2","286,7,1","287,82,2","288,7,1","289,7,2","28-apr-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","28-sep-2011,1,2,2,2,3,2,4,2,6,2,72,2,74,2,75,2,76,2","29,7,12,12,1,33,1,44,1,54,1,48,1,82,1,84,1","2-9,7,2","29.1,7,3","29.2,7,2","29.3,7,16","29.4,7,2","29.5,7,3,53,1,56,1,57,1,58,1","29.6,7,5","29.7,7,2","29.8,7,3","29.9,7,4","290,7,3","291,7,4","292,7,2","293,7,2","29-31,9,1,10,1","29-35,84,1","294,84,1","295,7,1,84,1","296,7,3","297,7,3","298,84,1","299,7,1","29a,7,1","29b,7,1","29c,7,1","29-jun-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","29k,68,1,93,1,94,1,90,1,91,1,141,1,142,1,143,1,146,1","29-mar-2011,68,1,93,1,94,1,90,1,91,1,141,1,142,1,143,1,146,1","29-sep-2010,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","29th,16,1,42,1","2k,1,2,2,2,3,2,4,2,6,2,72,2,74,2,75,2,68,7,76,2,93,7,94,7,90,7,91,7,141,7,142,7,143,7,146,7","2-month,34,1","2nd,25,2","2pm,51,1","2pm-4pm,32,1","2-week,44,1","2-year,7,1","3.0,7,9,38,1,40,1","3.1,7,14,26,1,55,1","3.10,7,2","3.10.1,7,2","3.10.2,7,2","3.11,7,2","3.12,7,2","3.13,7,2","3.14,7,2","3.14.1,7,2","3.14.2,7,2","3.14.3,7,2","3.14.4,7,2","3.14.5,7,2","3.15,7,2","3.15.1,7,2","3.15.2,7,2","3.15.3,7,2","3.15.4,7,2","3.16,7,2","3.17,7,2","3.18,7,2","3.2,7,14,35,1","3.3,7,18,82,1","3.38,27,1","3.387,14,1","3.4,7,12,54,1","3.5,7,21,22,1,26,1,55,1","3.5.1,7,2","3.5.2,7,2","3.5.3,7,2","3.6,7,16,30,1","3.6.1,7,2","3.6.2,7,2","3.6.3,7,2","3.7,7,20","3.8,7,23","3.8.1,7,2","3.8.2,7,2","3.8.3,7,2","3.8.4,7,2","3.8.5,7,2","3.8.6,7,2","3.88,82,1","3.9,7,25,82,1","3.9.1,7,2","30,7,86,12,1,18,2,24,2,27,3,31,1,32,1,34,2,41,1,42,1,43,1,54,1,48,1,83,1,82,3,84,2,131,1","30.0,7,6","30.1,7,6","30.2,7,4","30.3,7,3","30.5,7,4","30.6,7,2","30.7,7,1","30.8,7,2","300,7,5,35,1,43,1","3000,7,1","301,7,1,84,2","302,7,4","303,7,1","303.724.1528,92,1","3034,7,5","30-34,7,2,84,1","3039,7,1","30­39,7,1","304,7,1","305,7,4","30-59,84,1","306,7,6","306.2,7,1","307-7297,35,1","308,7,1","309-321,84,1","30-mar-2011,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","30pm,42,1,60,1","30s,7,1","30th,50,1","31,1,1,2,1,3,1,4,1,6,1,7,30,18,1,16,1,36,1,37,1,42,1,53,1,56,1,57,1,58,1,72,1,74,1,75,1,76,1,82,1","3-1,7,10","31.0,7,7","31.1,7,1","31.2,7,4","31.3,7,7","31.4,7,8",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,82,1","9-5,7,5","95.3,7,1","95.6,7,1,31,1,131,1","95.9,7,1","95-103,84,1","953,7,1","954,7,5","955,7,2","956,7,3,82,1","957,7,1","958,7,1","96,7,3,33,1,54,1,82,1,84,2","9-6,7,6","96.0,7,2","96.1,7,2","96.3,7,1","96.4,7,2","96.6,7,2","96.7,7,1","96.8,7,2","96.9,7,1","961,7,1","962,7,1","964,7,2","966,7,1","966.6,7,1","967,7,2","968,7,1","969,7,3","97,7,6","9-7,7,7","97.2,7,1","971,7,2,82,1","972,7,3","973,7,12","975,7,4","976,7,1","977,7,2","978,7,3","98,7,5","9-8,7,7","981,7,1,84,2","982,7,1","983,7,1","984,7,1","985,7,5,82,1","99,7,1","9-9,7,7","99.2,7,1","99.3,7,2","99.6,7,1","992,7,1","993,84,1","994,7,3","995,7,1","996,7,3","998,7,1","999,7,11","9991006,84,1","9k,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","9th,14,2,12,1,27,2,36,1,41,1","â ,11,1,12,9,14,4,27,1,22,1,23,1,26,6,33,11,31,1,34,1,42,13,50,6,55,6,131,1","â a,50,1","â â â â â ,37,5,45,2","â an,42,1","â browse,26,1,55,1","â for,35,1","â popular,14,1","â president,26,1,55,1","â to,33,1,34,1","â we,26,1,55,1","a&amp,42,1","a.b,84,2","a.c,84,1","a.e,84,2","a.f,84,1","a.j,84,1","a.l,84,1","a.m,7,1,84,2","a.p,84,1","a.y,84,1","â€“,20,1,22,1,35,1,31,2,34,4,54,1,131,2","â€”,39,1","â€˘,28,3,37,5,45,2,49,2","â€•,37,2","â€ścoverage,39,1","a-1,7,3","a-10,7,2","a-11,7,2","a-12,7,2","a-14,7,1","a-15,7,1","a-16,7,1","a-17,7,1","a-18,7,1","a-19,7,1","a-2,7,2","a-20,7,1","a-21,7,1","a-22,7,1","a-23,7,1","a-24,7,1","a-25,7,1","a-26,7,1","a-27,7,1","a-28,7,1","a-29,7,1","a-3,7,2","a-30,7,1","a-31,7,1","a-32,7,1","a-33,7,1","a-34,7,1","a-35,7,1","a-36,7,1","a-37,7,1","a-38,7,1","a-39,7,1","a-4,7,2","a-40,7,1","a-41,7,1","a-42,7,1","a-43,7,1","a-44,7,1","a-45,7,1","a-46,7,1","a-47,7,1","a-48,7,1","a-49,7,1","a-5,7,2","a-50,7,1","a-51,7,1","a-52,7,1","a-53,7,1","a-54,7,1","a-55,7,1","a-56,7,1","a-57,7,1","a-58,7,1","a-6,7,2","a-60,7,1","a-62,7,1","a-63,7,1","a-64,7,1","a-65,7,1","a-66,7,1","a-67,7,1","a-68,7,1","a-69,7,1","a-7,7,2","a-70,7,1","a8,84,1","a-8,7,2","a-9,7,2","aacn,18,2,19,1,34,1,51,1,54,1,52,1,84,2","aan,14,1,16,2,21,1","aanp,39,3","aappn,26,1,55,1","ability,7,1,12,1,19,1,26,1,35,1,36,1,42,1,45,1,46,1,55,1,49,2,88,1","able,7,1,14,1,18,1,19,1,26,1,24,1,27,2,30,1,34,1,35,1,39,2,42,2,46,1,54,1,55,1,50,1,52,1,59,1,88,2","abns,49,1","abrams,84,1","abreast,52,1","abscess,82,1","absorption,82,1","abstinence,34,1","abstract,9,1,14,2,10,1,11,1,12,2,15,1,17,1,36,1,51,1,50,3,53,1,56,1,57,1,58,1,82,1,84,3","abstract.â ,14,1,12,1","abstracted,84,1","abstraction,84,5","abstracts,9,1,10,1,11,3,15,1,16,1,17,1,51,1,50,1,53,2,56,2,57,2,58,2,84,2","abuse,7,1,9,1,14,1,10,1,12,1,16,2,17,2,19,1,20,1,22,3,26,3,28,6,23,1,24,2,25,4,27,4,29,2,30,2,31,4,38,5,32,4,34,1,35,2,36,3,37,6,41,3,40,5,42,2,44,1,45,2,55,3,48,2,49,3,50,2,51,1,88,1,131,4","abuse-related,22,1","abusers,39,1","aca,36,1,41,2,42,1","academic,7,69,19,1,44,3","academics,25,1","academic-service,47,1","academy,14,1,16,2,21,1,25,1,39,1,46,1,69,1,82,1,84,4","acadia,47,4","accelerate,25,1","accelerated,51,1","accelerating,7,1","acceptable,39,1,84,2","acceptance,15,1,25,1","accepted,7,1,15,1,25,1","accepting,21,2,45,1,46,1,54,1","accepts,14,1","access,7,1,12,2,18,1,21,1,28,2,25,1,30,3,38,3,32,2,34,1,35,2,36,1,37,1,39,1,40,3,43,1,45,1,46,3,54,3,47,2,50,1,52,1,53,2,56,2,57,2,60,1,83,2,58,2,84,9,88,2,131,1","accessed,7,1,12,1,28,1,24,1,25,1,46,1,51,1,82,1","accessibility,32,1,35,1","accessible,45,1","accessing,27,1,49,1","accident,9,1,10,1,82,4","accommodate,12,1","accompany,88,1","accompanying,38,1,40,1","accomplishing,25,1","accomplishment,25,1","accomplishments,11,1,16,1,36,1,44,1,60,1","according,7,5,9,1,14,3,10,1,11,1,12,3,18,3,19,1,20,3,22,2,26,2,28,2,24,1,25,2,27,5,29,1,31,2,38,1,32,2,36,3,39,2,40,1,42,2,43,3,44,1,45,1,46,3,54,3,55,2,47,1,48,1,49,3,50,1,51,2,53,1,56,1,57,1,58,1,84,1,131,2","accordingly,35,1","account,7,7,20,1,21,1,30,1,36,1,82,3,84,1","accountability,12,1,21,1,82,1","accountable,30,2,84,1","accounted,7,1","accounting,7,7,39,1","accounts,7,1","accreditation,9,1,10,1,21,1,22,1,27,4,38,1,33,1,35,1,36,1,41,1,40,1,50,1,53,1,56,1,57,1,58,1","accredited,18,1,21,1,27,1,38,1,36,1,39,1,41,1,40,1","accrediting,27,2,33,1,46,1","accredits,27,1","accuracy,84,2","accurate,7,3,27,1,35,1,41,1,42,1","accurately,7,1,34,1","achievable,50,1","achieve,7,4,12,1,39,1,46,1,47,1,83,1,82,1","achieved,7,2,35,1,82,1","achievements,21,1,30,1,34,1,41,1,42,1","achieving,21,1,27,1,38,1,36,1,40,1,52,1,53,1,56,1,57,1,83,2,58,1","acid,82,1","acknowledge,20,1,30,1","acknowledgments,84,1","acmha,33,1","acnp,84,6","aco,30,1","acpe,35,2","acquire,26,1,55,1","acquired,42,1,83,1","acquiring,82,1","across,7,22,11,1,12,1,13,1,18,3,19,1,21,3,26,3,25,2,27,1,29,1,38,2,33,1,34,1,36,1,37,3,39,1,40,2,43,1,45,1,54,1,55,3,47,1,51,1,53,2,56,2,57,2,83,3,58,2,84,4,88,3","acs,7,1","act,14,4,11,1,12,4,18,2,15,1,16,2,17,1,19,1,20,1,21,2,22,2,26,5,28,1,23,1,24,2,25,3,27,2,29,2,30,2,31,4,38,3,32,6,33,3,34,3,35,2,36,3,39,1,41,3,40,3,42,3,43,2,44,2,45,1,54,2,55,5,47,1,48,2,49,5,50,2,52,2,53,3,56,3,57,3,83,2,58,3,131,4","act.â ,42,1","acted,88,1","acting,13,1,34,1","action,11,1,16,1,19,1,21,1,25,1,27,1,30,1,38,1,35,2,36,2,40,1,42,1,54,3,50,1,52,1,69,1","actionable,9,1,10,1","actions,25,1,38,1,35,1,40,1","activate,60,1","activated,41,1","activation,14,1","active,7,11,26,1,27,2,45,1,55,1,47,1","actively,7,5,27,1,36,1,82,2","activities,7,12,18,1,20,1,21,3,26,1,23,1,25,2,38,6,33,1,35,1,41,1,40,6,46,2,55,1,50,1,83,1,61,1,84,3","activity,7,3,13,1,26,1,33,1,42,2,45,1,46,2,55,1,49,1,50,1,69,1,88,1","actual,7,3,42,1,84,2","actually,7,1,14,1,49,1,82,1,84,1","actuarial,82,1","actuary,11,1","acuity,7,1,54,1,84,2","acute,7,7,26,1,35,1,55,1,50,1,83,1,84,13","ad,23,1,36,4","adams,84,1","adapt,33,1","add,7,37,18,1,30,1,34,1,45,1,47,1,49,1,63,1","added,7,2,12,1,21,1,30,1,35,1,36,2,41,1","adderall,31,1,131,1","addiction,9,1,10,1,12,1,16,1,26,1,28,1,23,1,24,2,29,2,31,3,38,1,33,2,35,1,36,1,39,1,40,1,43,1,45,4,55,1,47,1,48,2,50,1,53,1,56,1,57,1,58,1,131,3","addictions,7,1,9,1,10,1,12,1,13,1,20,1,33,1,34,1,41,1","addictive,18,1","adding,28,1,43,1,52,1","addison,33,1","addition,7,9,14,1,13,1,18,1,15,1,19,1,28,2,24,1,25,2,27,1,33,1,41,1,44,1,49,1,51,1,53,1,56,1,57,1,58,1,60,1,82,2,84,3,88,1","additional,7,32,12,2,13,1,18,1,26,1,28,2,32,1,35,1,37,1,39,1,41,1,42,1,55,1,50,1,53,2,56,2,57,2,58,2,84,3","additionally,7,2,14,1,22,1,24,1,44,1,51,1","additions,7,1,12,1,36,2,41,1","address,7,3,14,2,16,1,19,1,21,1,26,1,23,2,24,1,25,1,27,2,31,1,38,1,34,1,35,1,37,1,41,1,40,1,42,2,44,1,46,1,54,1,55,1,47,3,48,1,53,1,56,1,57,1,58,1,65,1,66,4,67,1,84,3,131,1","addressed,7,1,16,1,20,1,48,2,52,2,84,3","addresses,18,1,16,1,20,1,36,1,42,1,52,2","addressing,14,1,11,2,13,1,16,1,17,1,19,1,20,2,24,1,27,1,32,2,42,1,84,1","adds,7,1","adequacy,7,1","adequate,7,1,47,1,84,2,88,1","adequately,37,1","adhd,19,2,25,1,27,1,29,1","adherence,21,1,38,1,37,2,40,1","adi,42,1","adjudication,84,1","adjunct,33,1,41,1","adjust,7,2","adjusted,7,2","adjusting,7,3","adjustment,7,12,21,1,25,1,38,1,40,1","adjustments,7,2","adl,84,4","administer,13,1,18,1,16,1,17,1,20,1,52,1","administered,7,1,11,1,25,1","administration,7,40,9,2,10,2,11,2,12,3,18,1,15,1,16,2,17,1,19,1,20,1,22,3,26,2,28,3,24,2,25,4,27,1,29,1,31,1,38,3,32,1,34,1,35,4,36,1,37,2,39,1,41,1,40,3,42,3,45,2,55,2,47,1,48,1,49,1,50,2,51,1,83,1,69,1,88,1,131,1","administrationâ€™s,26,1,55,1","administrations,7,9","administrative,7,11,21,1,30,1,34,2,35,1,46,1","administrator,7,1,13,1,16,1,52,1","administrators,14,1,25,2","admission,17,1,84,11","admissions,20,4,22,2,26,6,27,1,54,4,55,6,92,2","admit,47,1,92,1","admitted,51,2,84,22","adn,7,42","adni,46,1","adni2,46,1","adns,7,2","adolescent,7,2,13,2,18,1,17,1,22,1,27,4,35,5,36,2,46,1,50,1,69,1,84,3","adolescents,11,1,17,2,22,3,28,1,25,1,38,1,35,1,40,1,43,1,46,1,48,1,84,1,92,1","adopted,19,1,33,1,41,1,46,1,53,1,56,1,57,1,58,1","adopters,43,1","adoption,32,1","ads,1,1,2,1,3,1,4,1,6,1,8,9,39,1,72,1,74,1,75,1,76,1,77,5,78,5,79,5,81,5,132,5,134,5,136,5,137,5","adult,7,11,12,1,21,1,43,2,82,6,84,7","adult-learning,60,1","adults,7,8,12,1,26,1,28,1,23,1,25,3,29,2,32,2,34,1,37,4,41,1,46,1,54,1,55,1,49,3,50,3,51,1,52,2,83,1,69,1,84,56,88,1,92,1","advance,7,3,12,1,16,2,26,1,39,2,41,1,42,1,45,1,46,1,55,1,50,3,51,1,59,1","advanced,7,82,13,1,18,1,16,1,17,1,20,1,21,2,26,1,27,1,30,2,38,1,34,1,35,2,40,1,42,1,46,1,55,1,47,1,50,2,51,1,52,4,82,3,84,32,92,5","advanced-practice,7,1","advancement,7,3","advances,7,3,47,1","advancing,11,1,13,1,18,1,34,1,35,2,36,1,54,1,51,1,53,1,56,1,57,1,58,1","advantage,7,1,14,1,15,1,22,1,35,1,37,1,41,1,51,1","advent,7,1,33,1","adverse,36,1,41,2,51,1","advertisers,39,1","advice,24,1,27,1,50,1,82,1","advise,21,1","advisers,31,2,131,2","advising,7,1","advisor,33,1","advisory,27,5,29,2,38,1,33,1,40,1","advocacy,14,1,11,1,12,3,18,2,15,1,16,1,21,1,26,3,23,2,25,1,27,3,30,1,38,1,32,1,33,1,34,2,35,1,36,1,37,1,41,1,40,1,42,1,43,1,45,1,46,2,54,1,55,3,49,2,50,1,53,1,56,1,57,1,58,1,92,1,131,1","advocacy&#8212,26,1,55,1","advocate,26,1,27,1,33,1,55,1,47,1","advocates,14,1,12,2,15,1,33,1,35,1,44,1,49,1,50,1","af4q,27,1","affairs,7,1,11,1,18,1,16,1,28,1,27,1,33,3,36,1,37,1,41,1,42,1,44,1,82,1,92,1","affect,7,1,16,1,22,1,30,1,33,1,35,1,39,1,60,1,84,1","affected,7,4,26,1,27,1,34,1,43,1,46,1,55,1,48,1,51,1,82,1,84,1","affecting,18,1,27,1,32,1,34,1,35,1,51,1,53,1,56,1,57,1,58,1","affects,7,1,34,1,46,1,52,1,82,1","affiliate,47,1","affiliated,7,1","afford,7,1,21,1","affordability,37,1,50,1,83,2","affordable,14,1,12,2,18,1,21,3,28,1,25,1,27,1,30,1,38,3,32,2,36,1,41,1,40,3,42,3,43,1,45,1,50,1,52,1,53,2,56,2,83,2,57,2,58,2,84,1","afghanistan,24,1,36,2","africa,12,1,54,1","african,7,11,11,1,34,1,84,1","afterward,7,2","against,26,2,29,1,31,1,39,1,43,1,55,2,82,4,84,1,131,1","age,7,300,14,1,17,1,20,2,22,1,32,1,36,1,44,1,82,2,84,2","aged,7,11,9,1,14,1,10,1,28,1,38,1,34,1,36,1,40,1,42,1,43,3","agencies,7,8,18,1,16,1,24,2,25,1,30,1,33,1,34,1,37,1,39,1,44,1,45,2,46,3","agency,7,12,9,1,14,2,10,1,18,1,16,1,28,2,25,1,30,1,54,1,83,2,84,1,88,2","agencyâ€™s,27,1","agenda,9,1,10,1,21,1,25,2,49,1,52,1","agent,28,1","agents,23,1,35,1,36,1,50,1,82,1","age-related,7,1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47,1,49,1,54,1,88,1","belittling,48,1","belizan,84,2","belle,84,1","bellig,84,1","ben,20,2","benchmark,39,1","beneficiaries,30,2,38,1,36,1,40,2,51,1,52,1,83,1","beneficiary,48,1,83,1","benefit,19,1,21,2,25,1,36,1,39,3,46,1,51,1,59,1,83,2","benefits,7,21,14,1,11,1,12,2,18,1,16,1,21,1,26,1,23,1,25,2,27,1,29,2,30,1,38,1,32,1,33,1,34,1,35,2,36,1,37,1,39,1,40,1,41,10,42,1,43,1,45,1,46,2,55,1,48,5,49,2,50,1,54,1,53,1,56,1,59,1,57,1,58,1,131,1","benjamin,30,1","berod,84,1","beronio,49,1","bershadsky,84,1","best,16,1,19,2,26,1,22,1,23,1,24,1,25,2,35,2,36,1,55,1,54,1,82,1,84,2","best-laid,27,1","bestnursingdegree.com,27,1","beta,30,1","better,7,3,14,1,11,1,12,1,17,1,18,1,21,1,26,1,22,1,25,1,27,2,31,1,34,1,35,1,36,4,39,2,44,1,45,1,46,2,55,1,50,1,52,2,53,1,56,1,59,1,83,4,57,1,58,1,84,12,92,1,131,1","better-controlled,84,1","betty,34,1","between,7,53,9,1,10,1,17,1,22,1,24,1,27,3,33,1,36,2,41,1,42,1,43,1,45,1,47,1,48,1,49,1,54,3,82,5,84,18","beverly,33,2","beyond,7,3,11,1,12,1,18,1,16,1,27,1,38,1,40,1","bh,24,3","bhc,13,1,24,1","bhpr,7,4","bhpr.hrsa.gov,7,2","bias,7,6,84,9","bibliographic,25,1","biddinger,92,1","big,30,1,39,1,59,1,88,1","biggest,22,1,34,1,43,1,52,1","bill,13,1,18,2,15,2,16,1,26,2,22,1,29,1,32,1,33,2,44,3,55,2,48,3,49,4,54,2,52,2,53,3,56,3,57,3,58,3,88,1","billing,84,1","billion,14,2,12,1,17,1,18,1,26,3,25,3,27,2,30,1,31,3,32,1,36,3,39,2,42,1,55,3,48,2,83,1,131,3","billions,25,1","bills,11,1,23,1,37,1,45,2,48,1,49,1","bi-monthly,32,1,39,2,43,1","binding,82,1","bines,84,1","binge,36,1","biochemical,82,1","biochemistry,82,1","biological,7,3,35,1,42,1","biology,7,1","biomarker,36,1,46,1","biomarkers,25,1,38,1,40,1,53,1,56,1,57,1,58,1","biomedical,27,1","biotechnology,7,1","bipartisan,16,1,48,1","bipolar,28,2,24,1,29,2,31,1,37,1,48,2,49,2,69,1,131,1","bipolarâ i,33,1","bird,14,1,15,1,21,1,28,1,22,1,27,2,38,1,35,2,37,1,40,1,50,1","birmingham,16,1","birth,7,1,42,1,84,14","birthday,27,1","birthing,84,1","birthplace,92,1","birth-related,82,3","births,84,3","birthweight,84,11","bissinger,84,8","bit,7,1","blaakman,11,2","black,7,13,32,1,44,1,84,1","black-box,38,1,40,1","blacks,7,2","blanchette,84,12","blank,7,6","blasted,15,1","blaustein,39,2","bleeding,82,1","blended,36,1","blinded,50,1,84,1","blinding,84,1","block,13,1,18,1,22,1,25,2,27,1,34,3,36,3","blocker,26,1,55,1","blocking,39,1","blocks,26,1,55,1","blog,16,1,35,1,45,1,49,1,51,1,53,1,56,1,57,1,58,1","blogs,53,1,56,1,57,1,58,1","blood,27,1,38,2,40,2,46,1,84,10","bloomberg,41,1,84,2","bloomberg.com,31,1,50,1,131,1","bls,7,3","blue,41,2","blueprint,26,1,55,1,52,1","bm8m66j,42,1","board,7,34,9,1,13,1,10,1,12,1,18,1,19,3,20,5,21,2,26,1,25,3,29,1,38,1,33,3,34,1,35,3,36,2,40,1,41,4,46,1,55,1,49,1,54,2,52,2,69,1,84,2,92,1","boarded,25,1","boards,7,9,50,1,52,1,92,1","bobby,26,2,55,2","bod,38,2,33,2,40,2,53,1,56,1,57,1,58,1","bodies,28,1,44,1,84,1","body,7,1,30,2,45,1,82,1,84,3","boggs,23,1","bonus,21,6,27,1,30,6,38,2,36,2,40,2,41,1,42,1","book,7,1,27,2,32,1,35,1,37,1","books,21,1,27,1,35,2,45,1,49,1,53,1,56,1,57,1,58,1","boosting,48,1","boosts,34,1","booth,27,1","bor,82,1","border,30,1","bordering,7,1","borderline,7,1,41,1","bored,42,1","borgmeyer,84,5","born,82,1","boston,21,1,60,1","boston.com,44,1","both,7,29,14,1,12,1,18,1,16,1,19,2,21,1,26,3,28,1,22,1,23,2,24,2,25,2,27,2,38,2,33,3,34,1,35,1,36,2,39,1,40,2,41,1,42,2,43,1,44,1,55,3,50,2,54,1,83,1,84,12","bottom,33,1,41,1,82,1","bound,82,1","bounds,41,1","bourgeois,84,1","boustani,84,1","bowers,36,1","box,59,2","boxed,50,1","boyd,38,1,40,1","bp,84,3","bradley,18,1","brain,14,1,16,1,19,1,26,1,23,1,30,2,38,3,33,1,34,1,35,1,39,1,40,3,46,2,55,1,50,2,82,7","brains,38,1,34,1,40,1,46,1","brain-wasting,12,1","brammer,21,1","brand,21,1,27,2","brandman,26,1,55,1","brand-new,26,1,55,1","braspenning,84,1","breadth,7,1","breakfast,28,1,22,1,41,2,59,1,82,1","breakfasts,23,1,37,2","breaking,27,1,35,1,42,1,54,1","breaks,18,1","breakthrough,27,1,88,1","breastfeeding,84,9","breckinridge,7,2","brenda,20,1","brennan,84,1","brfss,34,1","bridge,14,1,12,1,18,1,16,1,26,2,23,1,27,1,30,1,38,1,33,1,34,1,35,1,36,2,40,1,41,2,42,3,45,3,46,1,55,2,49,3,50,1,53,4,56,4,57,4,58,4","bridger,41,3","bridging,41,1","brief,16,1,21,1,27,2,33,1,36,1,41,1,46,1","briefing,14,2,17,1,18,2,34,1","briefings,27,1","briefs,50,1,51,2","brighter,13,1","brightest,36,1","bring,19,1,27,1,35,1,36,1","bringing,34,1,39,1,46,1","brings,52,1","briss,84,1","british,7,2,14,1,84,4","broad,15,1,18,1,53,1,56,1,58,1,57,1,84,7","broadcast,33,1","broaden,27,1","broadened,28,1","broadly,19,1","brochure,15,1","broken,35,1","brooklyn,43,1","brother,24,2","brought,14,2,35,1,82,2","browar,27,1","brown,21,1,49,1,84,8","browse,50,1,71,1","browser,63,1,66,2","browsing,35,1","brunswick,7,1","bsn,7,15,14,1,92,1","bsns,7,1","buchanan,84,1","buckwalter,14,1,34,1,42,1","budget,13,1,14,5,12,1,16,1,26,2,28,6,23,1,27,4,34,1,37,1,55,2","budgets,14,1,12,1,18,1,31,1,42,1,50,2,131,1","buffalo,12,1","buford,35,1","build,33,1,36,1,83,1","building,13,1,26,1,27,1,34,1,43,1,55,1","builds,26,1,44,1,55,1,51,1","built,36,1","bula,84,1","büla,84,6","bulletin,7,1","bumper,53,1,56,1,58,1,57,1","burden,17,1,18,1,43,1,52,1,88,1","burdens,21,1","bureau,7,3,24,1","burnout,7,2","burns,82,1,84,1","burrows,82,1","bursitis,82,1","bush,44,1,48,2,51,1,84,5","business,7,10,13,1,18,1,30,1,33,1,42,1,82,2","butler,84,9","buttar,84,1","button,63,1","buy,48,1,50,1","bybel,20,1","byczkowski,84,1","bypass,82,1,84,3","c.a,84,4","c.f,84,1","c.j,84,2","c.l,84,1","c.m,84,3","c.n.m,7,2","c.s,84,2","c.w,84,2","c-1,7,1","ca,15,1,25,1,38,1,36,1,40,1,50,2,53,1,56,1,58,1,57,1","cab,33,1","cabinet,45,1","cadc,49,1","cadigan,27,2","cae,52,1","calculate,7,1,84,1","calculated,7,1,84,1","calculating,84,2","calculation,7,3","calculations,7,35","caldwell,20,1","calendar,7,6","calibration,7,2","california,7,3,15,1,27,3,30,1,38,1,40,1,41,4,42,2,46,3,84,1","call,7,2,9,2,14,1,10,2,11,5,12,3,17,1,15,1,16,2,18,3,20,1,22,1,25,1,38,1,32,1,34,1,40,1,41,1,46,1,47,1,48,2,50,2,51,1,54,1,52,1,53,3,56,3,58,3,57,3","callahan,84,6","called,7,7,21,1,37,1,45,1,46,1,49,1","calling,26,2,55,2","calls,7,1,19,1,26,1,24,1,37,1,55,1","cambridge,39,1","came,7,2,21,1,27,1,50,1,60,1,69,1","campaign,21,2,23,3,24,1,32,2,39,2,43,1,50,1,54,2,69,13","campbellheider,84,1","campbell-heider,84,1","campell-heider,84,1","campus,14,2,20,2,54,1,92,1","campuses,12,1","canâ€™t,40,1","canada,7,6,53,1,56,1,58,1,57,1","canadian,50,1","cancer,37,1,42,1,44,1,50,1,82,5,88,1","candidate,7,1,41,1","candidates,26,1,27,1,30,5,35,1,55,1","cannot,7,1,84,1","capabilities,84,1","capacity,7,1,13,1,18,1,24,1,46,1,52,1,84,1,88,2","capitol,9,1,10,1,12,1,27,1","capture,7,1","captured,7,1,38,1,40,1,45,1,49,1","captures,25,1","car,9,1,10,1,36,1","card,7,1,19,1,25,1,30,1,39,1","cardiac,7,7,82,3,84,2","cardiology,84,1","cardiovascular,7,1,36,1,42,1,48,1,50,1,84,7","cards,7,2","care,7,249,9,5,13,6,14,9,10,5,11,3,12,9,17,1,15,2,16,4,18,6,19,7,20,4,21,16,26,5,28,6,22,5,23,5,24,5,25,14,27,24,29,4,30,10,31,3,38,12,33,8,32,2,34,4,35,3,36,14,37,9,39,9,40,13,41,3,42,12,43,5,45,4,46,11,55,5,47,4,48,3,49,3,50,6,51,3,54,2,52,13,53,4,56,4,59,1,58,4,57,4,60,1,82,9,83,12,84,232,88,7,92,2,131,3","care.â ,33,1,35,1","care.â sponsored,33,1","cared,7,2,84,17","career,7,20,21,1,26,1,33,1,55,1","careerline,26,1,55,1","careers,7,3,18,1,19,1,25,2,27,1,33,2,34,1,42,1,44,1,51,1,54,1","careful,33,1","carefully,7,1,17,1","caregiver,21,1,84,1","caregivers,37,1,44,1,49,1,50,1","carerelated,7,2","care-related,7,2","caribbean,7,1","caring,7,3,19,1,34,2,37,1,44,1,92,1","carol,9,1,10,1","carolina,9,2,10,2,28,1,24,1,30,1,37,1,54,1,60,1,131,1","carretta,20,1","carrie,20,1","carried,7,1,42,1","carriers,30,1","carroli,84,2","carroll,84,1","carry,26,1,55,1,50,1","carrying,50,1","carter,45,1","carve,21,1","casa,31,2,131,2","cascade,42,1","case,7,6,11,1,12,1,28,1,22,1,23,1,24,2,27,1,29,1,30,2,31,1,34,1,36,2,84,7,131,1","case-management,84,1","cases,7,30,11,2,12,1,17,2,29,2,35,1,36,3,50,1,84,2,88,1","cash,15,1","cast,36,1,40,1,41,1","categories,7,5,22,1,82,2,84,3","categories--permanent,82,1","categorized,7,1","category,7,7,42,1,82,3,84,7","catherine,14,1","catheter,34,1","cathi,20,1","catholic,82,1,84,1","caucus,16,2","causation,17,1","cause,7,1,14,1,17,1,34,2,35,1,88,1","caused,21,1","causes,14,1,12,1","cautions,50,1","cci,49,1","ccns,84,1","cd,42,2,50,1","cd000081,84,1","cd001271,84,1","cd004667,84,1","cdc,17,1,24,2,34,1,42,1,44,1,88,1","cdk5,38,2,40,2","ce,19,1,21,3,30,1,38,3,35,1,36,3,40,3,41,2,42,2,45,1,46,1,49,1,50,1,54,1","celebrate,12,2,21,1,27,1,41,2","celebrated,41,1","celebrating,21,1,33,1,50,1","celebration,12,1","cells,30,1","census,7,1","center,7,8,9,2,14,5,10,2,11,1,12,1,21,9,26,3,28,3,24,1,25,2,27,8,29,1,30,5,31,1,38,5,36,10,40,5,41,4,42,3,43,3,44,1,45,1,55,3,47,1,48,1,49,2,50,2,51,1,54,1,69,2,83,1,84,8,131,2","center.â ,11,1","centered,21,1,54,1,83,1","centerpiece,21,1,45,1","centers,7,4,13,1,11,1,12,6,16,3,18,1,21,1,26,1,28,1,22,1,24,1,25,2,30,3,38,2,32,1,36,1,40,3,41,1,42,1,45,1,55,1,48,1,49,3,50,1,51,1,54,1,82,1,83,1,84,2,92,1","central,7,23,15,1,26,2,27,1,38,1,37,3,40,1,43,1,45,2,55,2,49,1,51,1,54,1,52,1,82,2,84,1","centuries,7,1","century,7,1,25,1,35,1,53,1,56,1,58,1,57,1,84,1","ceo,47,1,52,1","cereal,82,1","cerebral,82,2","cerebrospinal,36,1,46,1","cerebrovascular,84,1","ceremony,18,1,23,1,41,1","certain,7,1,18,2,24,1,25,1,44,1,53,1,56,1,58,1,57,1","certainly,42,1,88,1","certificate,7,7,54,1,92,1","certification,7,78,9,1,13,2,10,1,21,1,35,1,46,1,49,3,50,1,51,1,53,2,56,2,58,2,57,2,82,1,84,1","certifications,7,13","certified,7,16,36,1,49,1,82,5,84,16,92,2","certifying,7,1","cesarean,84,18","cessation,11,3","chadd,69,1","chair,22,1,35,1,47,1,52,1,84,1,92,1","chaired,53,1,56,1,58,1,57,1","chairman,27,1,34,1,43,1","chairperson,27,1","chairs,50,1","challenge,7,1,37,1,84,1","challenged,34,1","challenges,13,2,11,1,19,1,21,1,25,1,33,1,36,1,37,1,41,1,54,1,52,1,53,1,56,1,58,1,57,1","challenging,28,1,25,1,29,1","chamber,53,1,56,1,58,1,57,1","chambers,44,1","chambliss,84,12","championed,54,1","championing,26,1,55,1","champions,11,1,34,1","chance,7,1,19,1,21,1,24,1,42,1,46,1,50,1,84,1","chances,7,2,31,1,131,1","change,7,23,14,1,26,1,33,1,35,3,36,1,37,1,42,1,44,1,46,1,55,1,47,1,49,1,54,2,82,1,84,3","change.gov,9,1,10,1,51,1","changed,7,28,84,1","changemakers,37,2","changemakers.com,37,1","changers,7,1","changes,7,26,12,1,18,1,21,1,26,1,34,1,35,1,36,1,37,1,39,1,45,1,46,3,55,1","changing,7,1,33,1,59,1","channel,83,1","chapel,60,1","chaperone,30,1","chapter,7,29,19,1,20,3,22,1,27,4,34,3,35,1,42,3","chapters,14,1,11,1,12,1,16,1,18,1,21,1,26,1,23,1,25,1,27,1,30,1,38,1,33,1,32,1,34,1,35,1,36,1,40,1,41,1,42,1,43,1,45,1,46,1,55,1,49,1,50,1,54,1,53,1,56,1,58,1,57,1,131,1","characteristic,32,1","characteristics,7,20,16,1,84,2","characterized,7,1","charge,38,2,40,2,49,1,84,1","charged,30,1","charging,41,1","charitable,53,1,56,1,58,1,57,1","charles,39,1,50,1","charleston,28,1,24,1,47,2,51,2,53,1,56,1,58,1,57,1,131,2","chart,28,1,53,3,56,3,58,3,57,3","chartbook,7,2","chartered,19,1","charting,7,8","charts,82,1","chassin,47,1","check,7,2,11,1,26,1,22,1,34,1,36,1,37,1,45,1,55,1,49,1,53,2,56,2,59,1,58,2,57,2","checked,28,1,84,1","checklist,34,2,50,1","checks,33,1,42,3","checks.â member,33,1","cheese,34,2","chef,7,1","chemical,23,1,27,1,38,1,39,1,40,1,47,1","chemistry,82,1","chewed,35,1","chf,84,1","chicago,39,1,47,1","chicago-based,30,1","chief,28,1,24,2,37,1,52,2","child,13,2,12,1,22,1,27,3,31,1,35,5,36,2,37,1,46,1,48,1,69,1,82,1,131,1","childbearing,84,2","childhood,21,1,29,1","childless,49,1","children,7,48,13,5,11,1,17,1,15,3,18,1,21,3,26,1,22,1,23,2,27,4,28,1,29,3,31,4,38,1,35,1,40,1,44,1,45,2,46,1,55,1,48,2,49,3,53,1,56,2,58,2,57,2,69,2,84,16,88,3,92,1,131,4","childrenâ€™s,13,1,22,1,53,1","chinese,7,1","chip,21,6,49,1,88,1","choice,15,1,37,2","choices,32,2,43,1","choose,7,3,33,1,66,1","choosing,7,1","chose,84,2","chosen,26,1,23,1,36,1,55,1","chrisl@thenationalcouncil.org,39,1","christine,18,1","christmas,53,1,56,1,58,1,57,1","christopher,27,1,39,1","chronic,7,8,26,1,23,1,25,2,29,2,38,1,32,1,41,1,45,1,55,1,50,1,51,3,54,4,83,10,84,10,88,3","chronically,7,1","chronicle,50,1","chronobiology,9,2,10,2","church,27,1","ciarleglio,84,1","cies,23,1","cihs,36,2","cinahl,84,2","circuit,41,1","circulating,22,1","circulation,84,1","circumstances,33,1","circumvent,35,1","citation,7,1,84,2","citations,25,1","cited,7,2,34,1,44,1,82,2","citing,37,1","citizens,18,1,34,1,45,1","citizenship,7,2","cito,54,1","city,7,3,20,1,30,1,42,1,43,2,53,1,56,1,58,1,57,1","civic,45,1","civil,7,1,12,1","civilian,24,2","claim,7,1,11,1,21,1,33,1,82,11","claimed,7,1,33,1","claims,7,6,17,1,21,1,26,1,30,1,33,1,35,1,41,1,48,1,55,1,82,92","claim-studies.jsp,82,2","clarifies,21,1,44,1","clarity,19,1","clark,28,1,82,1,84,1","class,11,3,22,1,23,1,50,2","classification,18,1","classified,84,1","classify,12,1","classifying,26,1,55,1","classmates,29,1","classroom,7,1","clause,54,1","cleanses,30,1","clear,11,1","cleared,31,1,131,1","clearinghouse,69,1","clearly,50,1","cleary,84,1","clement,69,1","clementon,20,1","clergy,7,1","clerical,7,1","clerk,7,2,48,1","clerks,7,1","cleve,84,1","clicking,13,1,12,2,17,2,15,2,16,1,18,1,22,1,24,2,25,2,28,1,37,2,39,1,46,1,49,1,51,1,66,1","client,1,5,2,5,3,5,4,5,6,5,8,5,72,5,74,5,60,1,64,5,68,5,70,5,75,5,76,5,77,5,78,5,79,5,81,5,85,5,86,5,87,5,132,5,133,5,134,5,135,5,93,5,94,5,126,5,128,5,129,5,130,5,89,5,90,5,91,5,136,5,137,5,138,5,139,5,140,5,141,5,142,5,143,5,144,5,145,5,146,5,147,5,148,5,149,5,150,5,151,5,152,5,153,5,155,5,156,5,157,5","client-centered,30,1","clients,18,1,19,1,26,1,30,1,34,1,50,1,55,1","clifton,26,1,55,1","clin,82,5","clinic,7,14,27,1,28,2,60,1,82,5,84,8","clinical,7,111,13,5,14,2,11,1,12,2,17,3,16,5,18,4,20,5,21,3,26,1,22,4,23,1,24,1,25,2,27,2,28,2,29,2,30,1,38,2,33,2,35,2,36,4,37,1,39,1,45,1,40,2,41,2,42,1,44,3,46,3,47,1,49,2,50,3,51,2,54,1,52,3,53,2,55,1,56,2,58,2,57,2,60,1,82,12,84,21,92,3","clinically,26,1,55,1","clinicians,7,2,13,1,11,1,18,1,24,1,25,1,28,2,29,1,38,1,34,1,36,1,40,2,42,1,50,1","clinician-specific,84,1","clinic­nonhospital-based,82,1","clinics,7,7,24,1,28,1,51,1,84,1,92,1","clinton,22,1,33,1","close,14,1,11,1,40,2,52,2,53,3,56,3,58,3,57,3,88,1","closed,12,1,33,1,82,29","closely,7,5,13,1,30,1,36,1,54,1","closer,41,1","closes,9,1,10,1,25,1,41,1","closing,12,1","clouded,84,1","clu,43,1","clues,25,1","cluster,7,2","clustered,7,2","clustering,7,1","clusters,7,1","cmhcs,30,4,36,1","cms,13,3,11,1,21,2,22,1,25,1,30,2,38,1,32,1,36,4,40,2,41,1,48,1,51,1,83,7","cna,21,2,82,33","cnainsured,82,2","cna-insured,82,3","cne,84,4","cnm,84,75,92,1","cnms,39,1,84,30","cnn.com,43,1","cnp,82,1","cns,7,18,22,1,38,1,40,1,84,47,92,1","cns-bc,34,1,60,1","cns-enhanced,84,1","cns-np,7,1","cns-p,42,1","cnss,7,45,22,1,39,1,84,5","co,31,1,131,1","co-abuse,26,1,55,1","coach,27,1","coaching,27,1","coalition,15,1,18,3,23,1,33,2,34,1,45,1,41,2,50,1,52,1,69,1","coast,12,1","cobalamin,82,1","cocaine,43,1","co-chair,27,1,50,1","co-chaired,18,1","co-chairs,11,1,38,1,40,1,42,1,44,1,50,1,60,2","cochrane,84,5","code,7,1,39,1,53,1,56,1,58,1,57,1","codebook,7,1","codes,23,2","codes-both,23,1","co-editor,27,1","cognition,38,1,40,1,41,1","cognitive,25,1,27,1,36,1,41,2,44,2,46,2,52,1,82,1,84,1","cohen,84,1","cohesive,35,1","cohort,7,52","cohorts,7,9","co-investigator,84,2","cole,84,1","co-leadership,38,1,40,1","collaborate,7,1,21,1,23,1,27,1,35,1,36,1","collaborating,18,1,27,1,34,1,37,1,39,1,69,1","collaboration,14,1,33,2,34,1,35,1,37,1,39,1,45,1,41,1,43,2,44,1,50,1,54,1,69,1,84,7","collaborative,14,1,25,1,27,2,28,1,35,1,36,3,39,1,43,1,84,5","collaboratively,19,1,50,1","collaboratives,27,1","collaborators,14,1,12,1","colleague,22,1","colleagues,9,1,10,1,18,1,21,2,26,1,28,1,30,2,55,1,59,1","collect,30,1","collected,7,5,84,3","collection,7,5,35,1,41,1","collective,37,1","collectively,17,1","collects,7,1","colleen,38,1,40,1","college,7,3,12,1,18,2,20,1,25,1,27,3,33,1,34,1,35,1,36,1,46,1,47,1,48,1,50,1,54,3,60,2,82,4,84,2,92,9","collegeâ€™s,47,1","college-aged,51,1","colleges,7,1,14,1,18,1,19,1,20,1,26,1,38,1,34,1,36,1,40,1,54,2,52,1,55,1","collins,35,1","colo,92,2","co-locating,32,1","co-location,31,1,45,1,131,1","colon,84,1","coloradans,47,1,92,1","colorado,7,1,30,1,36,1,47,1,92,7","colors,14,1","columbia,7,3,17,3,20,1,31,1,34,2,52,1,53,1,56,1,58,1,57,1,83,2,131,1","columbus,15,1","combat,11,1,38,1,36,1,40,1,46,1","combating,26,1,30,1,55,1","combative,39,1","combination,7,1,33,1,82,1","combinations,7,2,42,1","combine,14,1,33,1,54,1","combined,14,1,18,1,41,1,84,2","combining,23,1,27,1,44,1","come,7,1,23,1,24,1,29,1,31,1,38,1,36,1,37,2,39,1,40,1,44,1,46,1,59,1,60,2,131,1","comes,13,2,12,1,47,1,52,1,82,1,84,1,92,1","comfort,21,1,35,1,42,1","comfortable,51,1","coming,18,1,26,1,33,1,41,1,50,1,54,1,55,1","command,7,1","commenced,7,2","commended,16,1","commends,26,1,27,1,55,1","comment,16,1,18,2,22,2,26,1,34,1,40,1,41,1,55,1","commentary,34,1,84,3","commented,92,1","comments,9,1,13,1,10,1,18,5,19,1,22,6,26,2,29,3,31,1,35,1,36,2,41,2,50,1,51,3,54,1,55,2,65,1,67,1,84,1,131,1","comments.â ,29,1","commerce,45,1,54,1","commission,12,1,21,4,22,5,27,4,38,1,33,1,35,1,36,1,39,1,40,1,41,1,47,4,50,1","commissioned,7,1","commissioner,12,1","commissioners,37,1,46,1,53,1,56,1,58,1,57,1","commitment,19,1,24,1,25,2,26,1,27,2,30,1,33,2,34,1,36,1,55,1,84,1,88,1","commitments,9,1,10,1,88,1","committed,16,1,37,1,47,1,53,1,56,1,58,1,57,1,83,1,92,1","committee,9,2,13,1,14,1,10,2,11,1,12,3,17,1,15,1,18,1,19,1,21,1,22,1,23,1,25,2,26,6,27,3,28,1,29,1,30,2,31,1,38,1,33,2,34,2,35,4,36,3,45,1,40,2,41,3,42,1,43,1,44,1,46,3,50,3,51,1,52,1,53,9,55,6,56,9,58,9,57,9,131,1","committee.â ,33,1,50,1","committees,7,1,21,1,27,3,28,1,33,2,34,2,36,1,45,3","committing,50,1","common,7,37,17,1,25,1,38,1,33,1,39,1,40,1,41,1,43,1,48,1,53,1,56,1,58,1,57,1,69,1,84,2","commonly,7,7,11,1,46,1","commonwealth,14,1,11,1,45,1,46,2,84,1","communicable,7,3","communicate,7,1,34,1,45,2,49,2,53,1,56,1,58,1,57,1,84,1","communication,17,2,35,2,39,1,45,1,49,1,82,1","communications,84,1","communities,7,1,14,1,17,1,20,1,21,1,25,1,26,1,27,1,38,1,34,1,36,2,37,1,40,1,44,1,46,1,55,1,92,2","community,7,53,9,1,13,2,10,1,12,2,18,1,19,2,21,1,22,1,23,1,24,1,26,3,27,4,28,2,29,1,30,1,31,2,38,1,32,1,34,1,35,2,36,7,37,1,39,2,45,2,40,1,41,1,42,2,43,2,44,1,48,1,49,2,50,2,51,2,54,4,53,2,55,3,56,2,58,2,57,2,69,1,83,1,84,25,92,1,131,2","communitybased,83,2","community-based,13,1,27,3,31,1,38,2,32,1,40,2,44,1,51,1,84,1,131,1","communitydwelling,84,1","community-dwelling,84,4","commuting,7,3","comorbid,36,1","compact,7,25","companies,12,1,23,1,41,1","company,7,2,30,1,33,2,34,1,39,1","comparability,84,2","comparable,7,2,84,21","comparably,7,1","comparative,7,1,84,1","comparatively,7,3","compare,7,2,82,1","compared,7,46,41,1,44,1,82,1,83,2,84,23","compares,7,1,16,1,48,1","comparing,7,4,11,1,36,1,45,1,84,44","comparison,7,5,45,1,54,1,53,2,56,2,58,2,57,2,82,1,84,21","comparisons,7,2,84,6","compassion,25,1","compassionate,21,2,38,1,40,1,50,1","compelling,24,1,82,1","compelling.â ,33,1","compensate,7,1","compensated,7,1","compensation,47,1","competence,35,1,49,1","competencies,22,1,24,1,27,4,46,1","competency,7,4,49,2,53,1,56,1,58,1,57,1","competent,14,1","competition,23,1,37,1","competitive,14,1,42,1","compile,35,1","compiled,28,1","complaints,82,3","complement,26,1,55,1","complementary,52,1","complete,7,14,11,2,23,1,25,1,33,2,34,1,35,2,40,1,42,2,46,1,50,1,54,1,53,2,56,2,58,2,57,2,82,1,84,3","completed,7,40,34,1,36,1,53,1,56,1,58,1,57,1,83,1,84,1","completely,7,1,84,1","completeness,84,1","completing,7,12,19,1,25,1,34,1,35,2,42,1","completion,7,9,84,1","complex,7,1,13,1,17,1,16,2,18,2,20,2,36,1,46,2,51,1,52,2,84,3","complexity,84,1","compliance,33,1,82,2,84,1","complicated,50,1","complicating,14,1","complication,83,2,84,4","complications,25,1,83,1,84,13","complimentary,18,1,24,1,25,1,28,1,30,1,33,1,34,1,37,1,43,1","comply,33,1,35,1,49,2","component,7,1,29,1,39,1,45,1,88,1","components,7,1,23,2,26,1,55,1,84,1,88,1","composition,7,11,52,1","compounds,35,1","comprehensive,7,1,16,1,19,2,23,1,26,1,27,1,28,1,35,1,36,1,39,1,45,2,41,1,42,1,52,1,53,1,55,1,56,1,58,1,57,1,84,3","comprise,7,1","comprised,7,12,33,1,52,1","comprises,84,1","comprising,7,6,82,1","compromise,25,1","compulsive,51,1","computed,7,2","computer,7,5,36,1,48,1,53,1,56,1,58,1,57,1","computer-generated,50,1","con,47,1,92,6","conceived,7,1","concentrated,39,1","concentrations,82,3","concept,45,1","concepts,21,2,23,1,26,1,38,1,40,1,55,1","conceptual,53,1,56,1,58,1,57,1","concern,7,2,19,1,82,1,84,1","concerning,17,1,44,1,50,1","concerns,9,1,10,1,19,1,24,2,38,1,32,1,45,1,40,1,51,1,84,3","concerns.â his,33,1","conclude,47,1","concluded,18,1,30,1,33,1,48,1,84,2","concludes,12,1","conclusion,82,1,84,1","conclusions,84,1","concurrence,44,1","concurrent,26,1,50,2,55,1","condition,12,1,41,1,51,1,82,3,83,2,84,9","conditions,7,3,23,2,25,2,27,1,29,2,30,2,38,2,34,1,36,1,39,3,45,1,40,2,41,1,44,2,50,1,51,3,54,8,83,7,84,19,88,1","condolence,36,1","conduct,14,1,17,1,38,1,36,1,39,2,40,1,41,1,47,1,53,1,56,1,58,1,57,1,82,1,84,1","conducted,7,7,11,1,12,1,18,1,19,1,45,1,42,1,44,1,50,1,53,1,56,1,58,1,57,1,82,1,84,25","conducting,23,1,26,1,38,1,33,3,40,1,55,1,60,1","conduit,27,1","confer,7,4","conference,9,3,13,1,14,8,10,3,11,3,12,6,17,4,15,5,16,2,18,2,20,1,21,1,22,1,23,2,24,2,25,2,27,2,28,4,29,1,30,4,31,1,38,4,33,3,32,1,34,10,35,7,36,13,37,7,39,2,45,4,40,4,41,8,42,8,43,1,44,1,46,5,47,3,48,4,49,1,50,12,51,4,52,2,53,3,56,3,59,1,58,3,57,3,60,3,131,1","conference&#8212,46,1","conference.â ,33,1,42,1","conferenceconnect,36,1","conferences,13,2,21,1,27,1,38,1,40,1,46,1,50,1,51,1","conferred,7,2","confidence,7,1,84,3","confirm,18,1,20,1","confirmation,42,1","confirmed,18,1,34,1,88,2","conflict,82,2,84,1","confront,36,1","confronted,37,1","confusing,11,1","confusion,19,1","congenital,84,1","congratulate,20,1","congratulating,30,2,34,1","congratulations,18,1,25,1,27,2,30,1,33,1,34,1,36,1","congress,9,1,13,1,14,3,10,1,11,1,15,1,21,3,23,1,26,1,27,2,28,3,33,1,34,2,37,1,45,2,44,2,50,1,54,2,55,1","congressional,14,1,18,1,23,1,26,1,45,1,44,1,48,1,49,1,55,1","congressman,13,1,22,1","congresswoman,18,1,22,1","conjunction,27,1","connect,27,1,36,2","connected,7,1,38,1,40,1,88,1","connecticut,30,1","connecting,24,1,41,1","connection,33,1,41,1,53,1,56,1,58,1,57,1","connell,60,1","conquered,23,1","consecutive,41,1,54,1,52,1","consensus,14,1,21,1,26,1,35,2,45,1,50,1,53,5,55,1,56,5,58,5,57,5,69,1,84,2","consequence,7,2","consequences,31,1,35,1,48,1,50,1,131,1","conservative,42,1","consider,7,1,14,1,12,1,19,1,25,1,29,1,39,1,42,1,50,1,52,1,84,1","considerable,7,2,14,1,11,1,47,1","consideration,26,1,31,1,36,1,40,1,54,1,55,1,131,1","considerations,7,1,48,1","considered,7,3,9,1,14,1,10,1,11,2,12,1,17,1,15,1,21,1,36,2,45,1,44,1,51,1,84,6","considering,21,1,42,1,84,4,88,1","consisted,7,2","consistency,7,3,84,4","consistent,7,6,11,1,25,1,33,1,36,1,45,1","consistently,84,1","consists,7,1,26,1,55,1","consolidating,53,1,56,1,58,1,57,1","consortia,14,1","consta,28,1","constantly,31,1,41,1,131,1","constitute,7,1","constituted,7,1","constituting,20,1","constraints,13,1","construct,41,1","constructed,84,1","constructing,7,1","construction,7,1","consult,7,1","consultant,7,12,21,1","consultants,7,1","consultation,7,5,21,1,82,4","consultations,14,1","consulting,7,4,82,2","consume,7,1","consumer,7,1,25,1,27,1,38,1,33,3,37,1,40,1,41,3,49,1,69,1,84,1","consumers,7,1,13,1,19,1,22,1,23,1,24,1,26,1,27,2,38,1,36,1,40,1,41,1,42,1,50,1,55,1,59,1,69,1","cont,12,2,21,3,26,1,27,4,36,3,41,3,50,2,55,1","contact,7,16,14,1,11,1,12,1,16,1,19,1,21,1,22,1,23,1,25,1,27,1,28,1,30,1,38,3,33,1,34,1,35,3,36,2,37,2,39,1,45,2,40,3,41,5,42,1,43,1,44,1,46,1,49,2,50,1,51,1,54,1,52,1,53,3,56,3,58,3,57,3,92,1","contacted,7,3","contacting,44,1","contain,50,1","contained,7,2,84,1","contains,16,1,25,1,46,1,50,1,53,1,56,1,58,1,57,1","contemplated,14,1","contemplating,50,1","contemporary,27,1","content,7,1,19,2,22,1,25,3,28,1,30,1,38,1,45,1,40,1,50,1,60,1,84,1","contents,7,23","context,7,1,88,1","continue,7,7,13,2,11,1,18,1,20,1,25,1,27,2,38,1,39,1,40,1,42,1,51,1,54,1,52,1,82,2,92,2","continued,7,30,11,1,42,1,82,2,84,8","continues,7,4,12,1,17,1,36,1","continuing,7,3,14,1,19,1,21,3,22,1,23,1,27,3,28,1,30,2,38,4,32,1,34,1,35,1,36,3,40,4,41,1,42,5,46,1,48,1,49,1,54,1,52,1,53,6,56,6,58,6,57,6,84,1,131,1","continuum,7,1,18,1,45,1,47,1","contract,7,2","contractor,7,1","contractors,26,1,32,1,55,1","contracts,26,1,49,1,55,1","contradicted,11,1","contradictory,54,1","contrary,84,1","contrast,7,5","contribute,7,1,14,1,16,1,59,1,69,1,82,1,84,1","contributed,7,1,82,1","contributes,44,1","contributing,7,1,21,1","contribution,42,1","contributions,7,1,13,1,11,1,18,3,19,1,21,1,25,1,27,1,30,1,34,1,51,1,53,1,56,1,58,1,57,1","control,7,4,24,1,26,2,29,1,42,2,48,1,55,2,84,23","controlled,35,2,48,1,84,5","convened,84,1","convenient,53,1,56,1,58,1,57,1","convening,52,1","convention,47,1,131,1","conventional,39,1","conversation,51,1","conversations,22,2,27,1,53,1,56,1,58,1,57,1,84,1","conversely,7,2","converted,7,1","conveying,36,1","conveys,25,1,37,1","convinced,14,1","co-occurring,29,1","cook,84,1","cooperative,45,2,48,1","coordinate,7,1,27,1,30,1,38,1,40,1,83,3","coordinated,12,2,18,2,84,1","coordinating,38,1,36,1,40,1,41,1","coordination,29,1,30,1,42,1,52,1,83,1,84,1,88,1","coordinator,7,20,52,1,84,1","coordinators,43,1,52,1","copayment,39,1","cope,21,1,37,1,50,1","copies,39,2,50,1","co-presenter,50,1","cops,30,1,36,1","copy,7,3,35,1,36,1,48,1,66,1","copyright,45,1,49,1","core,23,1,27,1,33,1,46,1,49,2,83,1","corner,12,2,18,2,21,2,26,2,27,2,33,3,32,3,36,2,41,2,42,4,43,3,50,2,53,2,55,2,56,2,58,2,57,2,61,1,71,1","cornerstone,7,1","coronary,84,5","corps,7,2,12,1,28,1,34,2","correct,24,1,27,1","corrected,84,1","correctional,7,2","correlated,7,4","correspondence,7,1","corresponding,7,3","correspondingly,7,1","corroborating,7,2","cosmetic,7,3","co-sponsored,18,2,31,1,131,1","cost,14,1,31,1,36,1,37,1,50,1,53,1,56,1,58,1,57,1,84,14,88,2,131,1","cost-effective,27,1","cost-effectiveness,84,2","costefficient,84,1","costing,17,1","costs,20,1,25,2,26,1,30,1,36,1,39,1,45,1,42,2,54,1,53,1,55,1,56,1,58,1,57,1,83,3,84,5","cost-savings,14,1","could,7,18,14,2,11,1,12,1,25,1,26,1,28,1,30,1,38,2,34,1,36,1,39,1,40,2,46,1,50,1,55,1,84,5","council,7,5,9,5,13,1,10,5,11,2,17,2,14,1,15,1,16,1,18,5,19,1,23,4,24,2,26,1,27,3,28,1,29,3,30,2,31,2,38,7,33,2,34,1,35,11,36,2,39,2,40,7,42,3,43,2,44,3,46,1,49,1,50,9,51,2,54,3,52,2,53,2,55,1,56,2,58,2,57,2,60,5,69,1,82,2,92,1,131,2","councils,36,2,41,2","counseling,12,1,17,1,19,3,21,1,31,1,35,3,42,3,46,2,54,2,131,1","counselingpts,54,1","counsell,27,2,84,13","counselor,7,1","counselors,32,1","counted,7,2","counter,37,1","counterparts,7,4","counties,15,1,84,3","countries,7,6,16,1,23,1,84,2","country,7,6,12,2,14,1,19,1,20,1,25,1,26,1,27,1,33,1,32,1,34,1,35,2,42,1,44,1,54,2,53,1,55,1,56,1,58,1,57,1,83,1,88,2,92,3","counts,7,2","county,7,1,18,1,27,1,33,1,32,1,69,1,84,2","county-level,84,1","coup,12,1","couple,36,1,41,3,88,1","courageous,42,1","courier,54,1","course,7,2,9,4,10,4,14,1,27,1,35,3,36,1,37,1,51,2,54,1,84,1","courses,7,4","coursework,7,4,47,1,92,1","court,17,2,32,2,34,3,41,3,43,1,44,1,50,1,54,1","courtesy,42,1","courts,28,1,54,1","cover,13,1,12,2,15,1,23,1,27,1,38,1,40,1","coverage,12,1,15,2,16,1,18,1,26,1,28,2,36,1,39,1,41,3,44,1,48,3,55,1,82,3,83,1,88,2","coverage.â ,29,1","coverage.â read,26,1,55,1","covered,15,1,26,1,33,1,41,2,55,1,82,1","cpi,7,1,13,2,12,2,17,2,14,1,16,1,18,2,20,1,21,1,23,1,24,2,26,2,27,3,28,1,29,2,31,2,35,2,36,1,45,1,49,1,52,1,53,1,55,2,56,1,58,1,57,1,131,2","cpnp,35,3","cpnp.org,35,1","cppsr,24,1","cpr,7,4","cps,41,1","cpt,23,1","cragin,84,10","create,12,1,14,1,18,1,21,1,27,1,38,1,33,1,36,1,39,1,45,1,40,1,44,1,49,1,60,1","created,7,1,12,2,22,1,30,2,35,1,43,1,46,1,50,1,53,2,56,2,58,2,57,2,84,1","creating,12,2,14,1,15,1,24,1,29,1,35,2,60,1","creativity,88,1","credential,7,2","credentialing,27,1,38,1,36,1,40,1,41,1,49,1","credentials,7,6,47,1","credibility,17,1","credit,35,2,41,4,42,1","credits,53,2,56,2,58,2,57,2","crescent,51,1","crimes,32,1","criminal,12,1,88,1","crisis,17,2,18,1,22,1,23,1,38,1,40,1,42,2,46,1,49,1,51,2,52,1,84,1","criteria,7,1,16,1,18,6,25,4,26,1,27,1,33,1,34,1,35,2,41,2,42,2,44,1,46,1,50,1,51,2,55,1,82,1,84,13","criteria.â the,26,1,55,1","criterion,84,1","critical,7,14,9,2,10,2,16,1,24,2,25,1,26,1,42,1,49,1,50,1,51,1,55,1,84,14,88,3,92,1","critically,25,1,84,4","criticized,37,1","crna,84,7,92,1","crnas,39,1,84,5","crnp,16,1,21,1,82,2","crnps,39,1","croce,13,1,11,1,16,1,22,1,25,1,26,1,39,1,55,1,59,1","crocesig.jpg,68,1,93,1,94,1,99,8,90,1,91,1,141,1,142,1,143,1,146,1","cross,24,3,27,1,38,4,40,4,54,1","cross-cutting,52,1","crossett,42,1","crossing,7,2","crs,45,1","crss,38,1,40,1","crucial,9,1,10,1","crunch,15,1","crusade,44,1","crushed,35,1","cruz-uribe,84,1","cry,29,1","cs,60,1","csg,52,2","culminate,18,1","culminated,7,3","cultural,7,1,35,1,48,1","cumbersome,7,1","cumulative,84,1","cure,12,1,27,1","cures,88,3","curious,34,1","current,7,28,13,3,11,1,12,1,17,1,16,3,18,2,19,1,20,2,21,2,22,1,23,2,26,1,27,1,28,1,30,1,31,2,38,3,33,1,35,5,36,3,37,1,45,1,40,3,42,2,43,2,46,2,48,1,51,1,54,1,52,1,55,1,82,2,84,2,131,2","currently,7,11,18,1,19,1,21,1,22,1,25,2,27,2,30,1,38,2,33,1,34,1,35,4,36,2,40,2,41,1,46,1,50,1,88,2,92,1","curriculum,7,1,12,1,23,1,36,1,38,1,40,1,54,1,92,1","curtailed,88,1","customary,50,1","customer,41,2","cut,12,1,14,1,18,1,26,1,27,2,34,1,35,1,42,1,50,1,54,1,55,1","cuts,13,1,14,2,18,1,26,1,27,2,37,1,45,1,50,1,55,1","cuts.to,23,1","cutting,16,1,22,1,52,1","cutting-edge,39,1,48,1,59,1,60,2","cybertherapy,50,1","cycle,12,2","cyclin-dependent,38,1,40,1","cynthia,24,1,46,1","cystic,84,5","czar,29,1","d.c,9,1,10,1,45,1","d.e,84,1","d.h,84,1","d.j,84,2","d.l,84,1","d.m,84,3","d.o,84,1","d9m62yy,42,1","d9myqcf,42,1","dahle,84,5","daily,26,1,33,1,45,1,50,1,55,1,82,5,84,2","dakota,7,2","dallas,30,1,52,1","dalton,28,1","daly,84,2","damage,38,1,40,1","damush,84,1","dangerous,29,1,38,2,40,2","daniel,24,1","danish,82,1","danny,32,1,60,2","darlene,27,2","daryl,11,1,54,1,60,2","daschle,9,1,10,1,51,1","data,7,78,11,1,12,1,17,2,14,1,18,2,19,2,20,1,21,2,24,1,28,1,29,1,30,1,31,1,33,1,34,3,39,1,41,2,42,2,46,2,50,1,54,2,52,1,82,6,83,2,84,25,131,1","database,7,2,25,2,52,1,82,2,84,4","databases,84,2","data-driven,21,1","date,7,2,13,1,12,1,26,1,34,1,42,1,43,1,47,1,48,1,53,1,55,1,56,1,58,1,57,1,82,1","date_sent,66,1","dates,25,1","daughter,31,1,131,1","daughters,31,1,131,1","david,13,1,34,1,69,1","davis,32,1,34,1,46,1,84,10","dawley,7,1","dawn,34,1","day,7,3,13,1,12,1,23,1,25,1,26,1,27,3,28,1,38,1,40,1,50,1,55,1,82,3","days,22,2,27,1,41,1,83,1","dayton,82,2","dc,17,1,14,1,16,1,18,1,26,1,34,1,50,1,53,1,55,1,56,1,58,1,57,1,82,2,84,1","d-ca,12,1,18,1,33,1","dc-based,23,1","dea,35,5","dea.gov,35,1","deadline,13,2,12,5,17,1,14,2,15,2,16,2,18,2,22,1,23,1,25,1,28,1,32,1,35,2,38,1,40,1,50,1,51,1","deadlines,38,1,40,1","deal,21,1,36,2,42,1,50,1","deals,12,1","dean,54,1,84,1,92,1","deans,18,1,24,1","dear,22,1","death,12,1,30,1,31,1,39,1,38,1,40,1,41,1,50,1,82,16,84,2,131,1","deaths,24,1,26,1,29,1,55,1","debate,13,1,19,1,53,1,56,1,58,1,57,1,84,1","debate.â currently,33,1","debbie,22,1,29,1,49,1,54,1","debilitating,45,1","debra,20,1","debt,26,1,55,1","dec,18,1,50,1,53,1,56,1,58,1,57,1","decade,20,1,46,1,48,1,54,1,53,1,56,1,58,1,57,1","decade-long,44,1","decades,7,6,21,1,41,1","december,7,1,9,1,10,1,12,1,14,1,25,1,47,1,50,1,51,2,54,7,52,2,53,5,56,5,58,5,57,5,61,1,82,1","deciding,7,1,30,1","decision,7,2,17,1,14,1,34,1,41,1,84,2","decision-making,82,1","decisions,7,1,17,1,33,1,44,1","decline,7,10,44,1","declined,7,3,26,1,54,1,52,1,55,1","declines,7,7","declining,84,1","decompensated,84,1","deconstructing,7,1","decrease,7,1,14,1,26,1,55,1,83,1","decreased,41,1,43,2,48,1,49,1,52,1,83,1,84,1","decreases,7,2,28,1,84,2","decreasing,7,1","dedicated,7,1,9,2,10,2,19,1,42,1,50,1,52,1,53,1,56,1,58,1,57,1,92,1","dedication,21,1,25,1,30,1,33,1","deductible,53,1,56,1,58,1,57,1","deemed,7,2,21,1,83,1,84,1","deeming,21,1,22,1","deep,18,1,50,1","deepest,9,1,10,1","default.htm,7,1","defendant,82,2","defendants,32,1","defense,19,1,27,1,42,1,82,2","defensible,21,1,38,1,40,1","deficiency,82,6","deficit,31,1,46,1,82,1,131,1","deficits,41,1,82,1,84,1","define,46,2","defined,7,8,19,1,48,1,82,2,92,1","defines,39,1,38,1,40,1,51,1","defining,27,1","definition,21,2,44,1,82,1,84,2","definitions,84,3","definitive,44,1","degree,7,224,18,3,19,1,41,1,82,2","degrees,7,84,36,1,46,1,92,1","deinstitutionalization,12,1","del,42,1","delano,84,5","delaware,49,1","delay,25,1,26,1,34,1,45,1,50,1,55,1","delayed,41,1","delaying,48,1","delays,25,1,49,1,82,1","deleterious,84,1","deliberately,7,6","delirium,34,4,45,1,49,1","deliver,7,1,14,1,19,1,35,1,39,1,52,1,83,1,84,1","delivered,13,1,21,1,26,1,27,2,37,1,52,1,55,1,83,1,84,3,88,1","deliveries,7,1,84,4","delivering,11,1,17,1,26,1,42,1,46,1,50,1,55,1,84,3","delivery,7,7,16,2,18,1,20,1,30,1,31,2,38,1,40,1,43,1,44,1,51,1,82,1,83,3,84,12,92,1,131,2","delserro-knepper,20,1","delusions,39,1","demand,7,1,22,1,26,1,27,1,33,2,46,1,54,1,55,1","demanding,39,1","demands,7,1,47,1","dementia,20,1,25,2,35,1,36,1,39,2,38,3,45,3,40,3,41,1,42,3,46,1,48,4,49,1,50,1,51,1","dementia-care,20,1","dementia-related,50,2","dementias,20,1,25,1,48,1,54,1","demo,29,1","democrat,50,1","democratic,12,1,16,1,49,1","democrats,13,1,26,1,43,1,55,1","demographic,7,9,44,1,82,2,84,1","demographics,7,25,82,1","demography,16,1","demonstrate,7,1,18,2","demonstrated,7,1,21,1,36,1,84,3","demonstrates,33,1,51,1","demonstrating,7,1,34,1","demonstration,29,1,36,2,38,3,40,3","dental,7,2","denver,47,1,92,7","deny,34,1","deparle,22,1","department,7,13,9,1,10,1,12,1,17,2,15,1,18,1,19,2,21,3,24,2,25,3,27,4,29,1,33,1,35,2,36,1,37,1,38,2,40,2,41,2,42,3,44,2,48,2,50,3,54,3,82,1,83,1,84,9,88,1","departments,7,2,16,1,19,1,24,1,34,3,42,1,50,1,54,1,53,1,56,1,58,1,57,1","departures,7,1","dependants,7,2","dependence,11,5,28,2,35,1,42,2,46,2,51,1,54,2","dependency,27,1,47,1","dependent,7,7,47,1,48,1,84,1","dependents,7,6","depending,7,2,84,2","depict,7,1","depicts,84,1","deployed,36,1","deployment,33,1","deposits,38,1,40,1","depressed,11,1,27,1,31,1,131,1","depression,11,5,12,1,17,1,14,4,18,1,21,2,23,1,26,3,27,5,29,1,34,1,35,1,36,7,37,2,38,5,45,2,40,4,43,2,44,7,46,4,47,1,48,1,49,6,54,1,55,3,69,1,84,3,88,1","depression-focused,46,1","depressive,12,1,28,1,31,1,36,2,44,1,46,1,131,1","deputy,84,1","dermatology,7,3","describe,7,1,26,1,41,1,55,1,60,1,84,1","described,7,5,12,1,82,1,84,3","describes,7,1,38,1,40,1","description,1,1,2,1,3,1,4,1,6,1,7,4,8,1,25,1,26,1,33,1,55,1,72,1,74,1,64,1,68,1,70,1,75,1,76,1,77,1,78,1,79,1,81,1,82,1,83,1,85,1,86,1,87,1,132,1,133,1,134,1,135,1,93,1,94,1,126,1,128,1,129,1,130,1,89,1,90,1,91,1,136,1,137,1,138,1,139,1,140,1,141,1,142,1,143,1,144,1,145,1,146,1,147,1,148,1,149,1,150,1,151,1,152,1,153,1,155,1,156,1,157,1","descriptions,42,1","deserve,50,1","deserving,34,1","design,7,20,26,1,55,1,83,1,84,6","designated,82,2,84,5","designation,21,1,82,2","designations,7,1","designed,7,3,19,1,21,2,24,1,25,2,26,1,27,2,30,2,32,1,35,1,36,4,37,1,38,2,40,2,42,1,44,1,46,1,50,3,51,2,55,1,60,1,84,3","designs,84,6","desirable,84,3","desired,7,1","desocio,53,1,56,1,58,1,57,1","desperately,9,1,10,1","despite,7,1,13,1,11,1,14,1,18,1,19,1,21,1,31,1,36,1,39,1,45,1,47,1,82,1,84,1,131,1","destroyed,12,1","detail,7,5","detailed,7,5,23,1,49,1,84,1","detailing,23,1","details,7,3,9,1,10,1,11,1,14,1,15,1,18,1,25,1,29,1,34,1,51,2","detect,14,1,23,1,33,1","detection,25,1,49,1","deterioration,32,1,45,1","determination,7,2,16,1,38,1,40,1,84,1","determine,7,1,11,2,14,1,23,1,24,1,27,1,33,1,36,1,42,1,84,1","determined,7,1,30,1,84,1","determining,7,1","detox,27,1","detoxify,30,1","detroit,34,1","devane,84,2","devastated,12,1","develop,7,1,13,1,17,1,19,2,23,4,25,1,26,2,35,1,37,1,38,1,45,1,40,1,44,1,53,1,55,2,56,1,58,1,57,1,82,1,83,2","developed,7,5,17,1,14,2,19,1,21,1,22,1,23,1,25,1,35,2,37,1,41,1,42,1,46,1,54,2,84,3","developer,34,1","developers,44,1","developing,12,1,35,3,36,1,38,1,40,1,46,1,48,1,51,1","development,7,2,13,1,16,1,18,2,26,1,30,1,33,1,35,2,36,1,42,1,44,2,49,1,50,1,55,1,84,5","developmental,27,1,33,1,69,1,82,1","developmentally,7,1","deviations,82,1,84,1","device,7,1,9,1,13,1,10,1,11,1,12,1,17,1,14,1,15,1,16,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1,28,1,29,1,30,1,31,1,33,1,32,1,34,1,35,1,36,1,37,1,39,1,38,1,45,1,40,1,41,1,42,1,43,1,44,1,46,1,47,1,48,1,49,1,50,1,51,1,54,1,52,1,53,1,55,1,131,1","devices,11,6,12,4","devise,46,1","devoted,7,1,33,1,39,1,59,1","dhs,18,1","d-ia,13,1","diabetes,7,1,27,1,36,1,42,1,44,1,48,2,50,1,82,1,84,7,88,2","diagnosable,50,1","diagnose,12,1,33,1,34,1,38,2,40,2,53,1,56,1,58,1,57,1,82,7","diagnosed,11,1,25,1,29,1,33,1,49,1,84,7","diagnoses,12,1,16,1,41,1,42,1,44,1,50,1,84,1","diagnosing,7,1,34,1,54,1","diagnosis,25,2,26,1,35,1,36,1,38,2,40,2,41,2,42,1,48,1,50,1,55,1,82,6,84,1","diagnostic,7,1,13,1,16,2,18,2,25,2,33,1,34,2,50,2,54,1,53,1,56,1,58,1,57,1","diagnostic-related,82,1","diagnostic-specific,50,1","dialect,7,1","dialogue,26,1,27,1,55,1","dialysis,7,6","diamond,37,1","diane,20,1","did,7,35,27,2,30,1,41,1,46,1,84,6","didactic,7,2","didn,31,1,131,1","die,31,1,36,1,84,2,88,1,131,1","diego,53,1,56,1,58,1,57,1","diem,7,5","diet,42,2,50,1","dietary,82,3","differ,7,3,27,1,84,1","differed,7,1","difference,7,4,34,1,37,1,59,1,84,16","differences,7,6,9,1,10,1,17,1,14,1,15,1,45,1,47,1,84,15","different,7,36,24,1,27,2,31,2,32,1,35,2,36,1,42,1,48,1,84,2,88,1,131,2","differential,7,6","differentials,7,1","differentiate,26,1,55,1","differentiates,38,1,40,1","differs,7,3","difficult,9,1,10,1,17,1,34,1,45,1,46,2,47,1,84,1","difficulties,44,1","difficulty,24,2,46,1","dig,51,1","digital,23,1","digits,12,1,33,1","dignified,41,1","dignity,18,1","d-il,26,1,32,1,55,1","diligently,82,1","dillon,38,1,40,1","dimensional,49,1","dimensional-categorical,41,1","dimensions,26,1,55,1,84,1","dinner,37,2,41,1","diploma,7,84","diplomaeducated,7,1","diploma-educated,7,6","diploma-education,7,1","diplomas,7,1","direct,7,4,18,1,26,1,33,1,39,1,55,1,82,1,84,3","directed,18,1,35,1","direction,26,1,34,1,37,1,55,1,84,2","directions,24,1","directly,19,1,22,1,35,1,45,1,46,1,49,1,60,1,84,3","directness,84,3","director,13,1,11,1,12,2,14,1,16,1,22,1,24,1,25,1,26,3,29,1,33,2,36,1,39,1,44,1,46,1,49,1,53,1,55,3,56,1,59,1,58,1,57,1,60,2,69,1,84,5,92,1","directorate,44,1","director-at-large,52,1","directors,9,1,13,1,10,1,12,2,17,1,18,3,19,1,20,3,21,2,24,1,25,1,33,5,34,1,35,2,36,2,38,2,40,2,41,4,46,2,50,1,54,1,52,2,53,1,56,1,58,1,57,1,69,2,83,1,84,1","directory,1,1,2,1,3,1,4,1,6,1,8,1,72,1,74,1,64,1,68,1,70,1,75,1,76,1,77,1,78,1,79,1,81,1,85,1,86,1,87,1,132,1,133,1,134,1,135,1,93,1,94,1,126,1,128,1,129,1,130,1,89,1,90,1,91,1,136,1,137,1,138,1,139,1,140,1,141,1,142,1,143,1,144,1,145,1,146,1,147,1,148,1,149,1,150,1,151,1,152,1,153,1,155,1,156,1,157,1","directs,23,1","disabilities,27,1,29,1,43,1,44,4","disability,7,1,26,1,30,1,33,1,41,2,44,1,48,1,54,1,55,1,69,1,82,9,88,1","disability--incurred,82,1","disabled,7,1,44,1","disabling,51,1,88,1","disadvantaged,18,1,33,1,51,1","disagreed,84,1","disaster,7,1,24,2,38,2,40,2","disasters,7,2","discharge,15,1,34,1,83,1,84,2","discharged,84,6","discipline,33,1","disciplines,7,1,39,1","disclose,48,1","disclosing,48,1","discontinue,9,1,10,1,82,1","discount,27,1,37,1,41,1","discounted,38,1,40,1,48,1,50,1","discounts,23,1,35,3","discover,14,1,25,1,30,1","discovered,38,1,40,1,44,1","discovers,41,1","discovery,25,1,30,1,88,1","discrepancy,84,2","discriminated,43,1","discrimination,26,1,55,1","discriminatory,15,1,39,1","discuss,11,1,12,2,26,3,28,1,36,1,42,1,54,1,55,3","discussed,7,9,18,1,23,1,28,1,60,2,84,1","discusses,51,1","discussion,7,4,11,1,12,2,14,2,16,2,18,1,21,1,22,1,23,1,25,1,26,1,27,1,30,1,33,3,32,1,34,1,35,1,36,5,39,1,38,1,40,1,41,1,42,4,46,1,51,1,54,1,55,1,60,1,82,1,84,1","discussions,7,1,19,2,26,1,45,1,49,1,50,1,53,2,55,1,56,2,58,2,57,2","disease,7,7,12,1,14,2,20,1,23,1,24,1,25,7,30,4,33,5,34,2,35,3,36,7,39,2,38,1,40,1,41,1,42,4,43,2,44,4,46,3,48,3,50,2,54,2,53,1,56,1,58,1,57,1,82,3,83,1,84,11,88,2","disease...the,84,1","diseases,7,1,38,1,40,1,46,1,82,1,83,1,84,3,88,5","dislocation,48,1,82,1","dismantling,12,1","dismiss,34,1","dismissed,34,1,44,1","disneyland,50,1","disorder,12,1,17,1,16,3,19,1,20,1,24,2,25,2,26,1,28,2,29,4,33,1,34,1,36,2,37,1,39,1,38,1,45,1,40,1,41,4,42,1,44,1,46,3,48,2,49,1,50,1,51,2,54,1,52,1,55,1,69,1","disorders,13,1,17,5,15,1,16,4,18,6,20,2,23,3,25,3,26,2,27,3,28,2,29,4,30,1,31,1,33,1,34,1,35,5,36,1,39,2,45,1,41,1,42,1,44,3,46,1,49,3,50,2,51,1,54,2,52,1,53,2,55,2,56,2,58,2,57,2,88,1,131,1","disorders.â ,33,1","disorienting,34,1","disparities,24,1,27,1,28,1,30,1,36,1,84,1","disposition,7,1","disproportionate,7,1","disproportionately,7,3,34,1","dispute,84,1","disruptive,39,1","dissatisfaction,7,7","dissatisfied,7,36","disseminate,19,2,46,1","disseminated,25,1","disseminating,7,1,43,1","dissertation,11,1,38,1,40,1,46,2","dissociation,45,2","dissolved,35,1","distance,7,4","distancebased,7,1","distance-based,7,14","distances,7,1","distinct,7,1","distress,9,1,10,1,21,1,25,1,36,1,38,1,40,1,41,1","distressing,46,1","distribute,38,1,40,1,46,1","distributed,35,1,51,1","distribution,7,38,82,3,83,2","district,7,3,17,3,14,1,34,3,43,1,54,1,52,1,53,1,56,1,58,1,57,1,83,2","districts,14,1,49,2","disturbances,45,1","disturbing,21,1","diverse,7,4,27,1,34,1,42,1,52,2","diversity,7,5,27,1,33,1,48,1","divided,7,2,53,1,56,1,58,1,57,1","divine,84,1","division,7,1,29,1,46,1,49,1","divorced,7,4","d-ma,27,1,49,1,50,1","d-md,35,1","d-mi,22,1,26,1,49,1,54,1,55,1","d-mt,26,1,55,1","dna,24,1,43,1","d-nj,26,1,55,1","d-nm,16,1","dnp,7,1,34,2,84,1","dns,60,2,82,1","dnsc,82,1","d-ny,16,1,33,1","dobie,84,1","doctor,7,3,39,1,48,1,50,1,60,1,92,1","doctoral,7,1,11,1,18,2,19,1,22,1,38,1,40,1,46,1,82,1,92,2","doctorate,7,70,18,1,22,1,24,1,32,1","doctorates,7,4,52,1","doctors,11,1,14,1,21,1,28,1,29,1,34,2,36,1,48,1,50,1,54,1,84,2","doctorsâ€™,39,1","document,21,3,23,1,25,1,29,3,33,1,35,1,36,1,39,1,47,1,53,1,56,1,58,1,57,1,62,4,82,2,88,4","documentary,37,1","documentation,18,1,82,1","documented,84,1","documenting,82,2","documents,13,1,18,1,22,1,50,2","dod,27,1","doesn,24,1,29,1,36,1","d-oh,49,1","doi,38,1,40,1,82,6","doing,7,3,21,1,26,1,27,1,39,1,55,1,59,1","dollars,7,1,18,1,39,1,82,1,88,1","domain,26,1,55,1","domains,41,1,51,1","domenici,16,1,26,1,29,1,45,1,47,1,55,1","domestic,7,7,11,1","dominant,7,4","dominate,7,1","dominated,21,1","don,11,1,27,1,34,1,41,1,59,1,88,2","donâ€™t,35,1,39,1","donahoe,84,1","donald,84,2","donate,59,1","donation,39,1,59,2","donations,53,1,56,1,59,1,58,1,57,1","donna,20,1,21,1","donor,47,1,92,3","donors,53,1,56,1,58,1,57,1","doris,12,1,33,1","dose,82,1","dottie,47,1","double,12,1,28,1,32,1","double-blinding,84,1","doubled,13,1,54,1","doubling,14,1","doubt,17,1,25,1,26,1,55,1,88,1","dower,14,1","down,7,1,14,1,27,1,32,1,45,1,39,1","download,11,1,15,1,18,1,19,1,23,3,24,1,26,2,45,3,46,1,48,1,49,2,54,1,53,1,55,2,56,1,58,1,57,1","downloads,1,1,2,1,3,1,4,1,6,1,72,1,74,1,64,9,75,1,76,1,83,1,85,5,86,5,87,5,135,5,89,5,138,5,139,5,140,5","downturn,15,1,45,1","downward,48,1","dozen,43,1","dozens,7,1,44,1,88,1","dr,9,2,10,2,11,1,14,1,21,3,26,1,27,2,33,3,36,2,38,1,40,1,42,3,50,1,55,1","draft,16,2,18,3,26,2,35,1,50,2,54,1,55,2,84,1","drafted,9,1,10,1","drafting,28,1","dramatic,37,1","dramatically,20,1,51,1","draw,7,3,47,1","drawing,26,1,55,1","drawn,7,1,84,1","drew,7,1,84,1","d-ri,22,1,31,2,32,1,54,1,131,2","dried,12,1","drinking,36,1","drive,23,1,26,1,55,1","driven,14,1,23,1,38,1,40,1,42,1,50,1","driving,26,1,55,1","drop,7,1,46,1","dropped,7,1,12,1,43,1","drops,7,4","drove,7,2,51,1","drug,9,1,13,1,10,1,11,2,12,2,21,1,23,1,24,3,25,1,26,11,28,3,29,2,30,1,31,3,34,3,35,6,36,2,37,2,38,4,45,1,39,3,40,4,42,3,43,2,44,1,48,1,50,2,51,1,55,11,131,3","drug-associated,39,2","drugged,26,1,55,1","drugging,12,1","drug-related,26,1,54,3,55,1","drugs,11,3,26,1,29,1,31,2,35,2,36,1,38,2,39,4,40,2,42,1,43,1,44,3,50,2,51,1,54,1,55,1,88,3,131,2","drug-seeking,39,1","drumbeat,39,1","dsm,18,1,50,1","dsm5,54,1","dsm-5,16,1,18,1,34,2,41,1,42,3,50,3,54,1","dsm5-rcp-fieldtrials,50,1,54,1","dsm-iv,25,1","dsm-v,13,1,18,1,26,2,55,2","d-tx,31,1,131,1","dual,7,1,41,1,83,3","dualeligible,83,1","dual-prepared,7,4","due,7,27,14,2,18,1,24,1,25,3,30,1,33,1,61,1,82,1,84,2,88,1","dues,33,1","duffy-durnin,84,3","duncan,37,1","duplicate,84,1","duplicates,84,1","duplication,7,1","duration,84,10","durbin,20,1","during,7,6,12,3,15,1,18,3,20,1,21,1,22,2,26,2,28,1,33,1,34,1,35,2,36,2,39,1,41,2,42,4,46,2,50,2,52,1,55,2,60,1,82,4,83,1,84,4,92,1","duty,7,1,50,1","duty.â ,50,1","dvd,37,1","d-wi,13,1,52,1","dye,7,1,34,1","dying,84,1","dynamic,19,1,25,1","dyslipidemia,84,2","dysregulation,29,1","e.b,84,1","e.c,84,1","e.g,7,1,84,5","e.h,84,1","e.p,84,1","e.r,84,4","e.t,84,1","e.w,84,1","eager,51,1","earlier,7,16,13,1,11,2,12,1,14,2,26,1,30,1,33,1,36,1,41,1,44,1,48,1,55,1,88,2","earliest,7,1,36,1","early,7,7,12,2,14,1,15,1,18,1,21,2,22,2,24,1,27,2,28,1,32,1,35,3,36,2,37,1,38,1,40,1,43,1,46,1,48,1,50,2,54,1,52,1,53,1,56,1,58,1,57,1,84,3,88,1","earn,7,12,14,1,21,1,27,1,30,1,34,1,35,2,36,3,37,2,38,3,45,2,40,3,41,3,42,1,43,1,46,1,49,2,50,1","earned,7,21,48,1,53,1,56,1,58,1,57,1","earning,7,3,36,1","earnings,7,129","easier,21,1","easier-to-navigate,22,1","easily,13,1,25,1","east,7,9,13,1,18,2","eastern,31,1,32,1,131,1","east-south,7,1","easy-to-navigate,54,1","ebbutt,84,2","ebp,60,4","eccles,84,1","ecker,84,5","eckert,84,1","economic,7,1,13,1,11,1,15,1,18,4,45,2,42,2,54,1,52,1,53,1,56,1,58,1,57,1,84,2","economically,43,1","economics,16,1","economy,12,1,33,1,35,1,48,2","ect,11,4,12,5,34,1,46,1","ectâ€™s,11,1","ed,82,2,84,12","edd,21,1,69,1","edge,16,1,21,2,22,1,45,1","edison,20,1","edition,13,2,16,1,18,1,34,1,50,1,54,1","editions,30,1","editor,25,1,82,1","editorial,25,1,33,1,84,4","edna,53,1,56,1,58,1,57,1","educate,7,1,45,1","educated,7,61,26,1,55,1,92,1","educating,18,1","education,7,489,9,7,10,7,17,2,14,2,15,2,16,1,18,1,19,2,21,5,22,3,23,2,25,1,26,5,27,6,28,1,30,2,33,2,34,3,35,3,36,3,37,1,38,4,45,2,40,4,41,1,42,8,46,2,47,3,48,1,49,1,50,3,54,2,52,1,53,6,55,5,56,6,58,6,57,6,69,1,84,6,92,2,131,1","educational,7,14,11,1,19,1,22,1,30,1,34,3,36,2,38,2,45,1,40,2,42,1,44,2,49,1,82,1,84,1","educationally,92,1","educations,53,1,56,1,58,1,57,1","educator,7,11,42,2,84,1","educators,7,3,33,2","edward,27,1","effect,7,17,12,1,14,1,34,1,45,1,39,1,84,16","effective,7,1,13,1,11,2,12,1,17,1,26,1,27,2,34,1,35,1,38,1,40,1,42,2,44,2,46,3,49,1,52,1,55,1,60,1,82,1,84,3,88,2","effectively,7,1,14,1,21,1,43,1","effectiveness,11,2,33,1,38,1,40,1,44,1,46,3,84,7","effects,7,1,36,2,45,1,42,2,48,6,50,3,54,1,84,3","efficacy,11,1,12,1,41,1,49,1","efficiency,35,1","efficiently,7,1,21,1","effort,7,2,12,1,14,1,21,2,22,2,23,1,24,1,25,1,28,1,33,1,35,2,37,1,38,1,39,1,40,1,46,1,52,1,84,1,88,1","efforts,7,1,18,2,21,2,23,1,25,1,26,1,27,1,35,1,36,1,38,2,39,2,40,2,41,1,43,1,47,1,54,2,53,1,55,1,56,1,58,1,57,1,84,2","efird,84,1","egge,12,1","eight,35,1,53,1,56,1,58,1,57,1,84,6","eighth,52,1","eight-month,50,1","eight-point,84,1","eighty,7,1","eighty-eight,82,1","either,7,20,42,1,84,3","ej,82,1","elder,25,1","elderly,14,1,23,1,25,1,38,1,39,1,40,1,41,1,84,4","elders,27,1,37,1,84,5","elderspeak,48,4","elearning,21,8,25,1,27,1,30,4,36,3,38,3,40,3,41,2","elect,26,1,55,1","elected,20,3,26,1,33,1,55,1","election,11,1,16,1,19,1,20,3,21,1,26,2,30,1,43,1,55,2","elections,11,1,16,1,20,1,26,3,30,2,33,3,32,1,34,1,35,1,36,4,37,1,40,2,41,3,53,1,55,3,56,1,58,1,57,1","elective,84,1","electroconvulsive,11,1,12,1,34,1,46,1","electronic,7,4,54,1,82,2,84,1","electronically,21,1,30,1,36,1,48,1","elementary,7,2","elements,7,2,53,1,56,1,58,1,57,1,83,1","eleven,84,4","eli,31,1,131,1","eligibility,7,3,18,1,25,1,28,1,46,1,49,1,53,1,56,1,58,1,57,1","eligible,7,5,12,1,28,1,30,1,34,1,36,1,38,1,40,1,41,1,82,1,83,3,84,2","eligibles,83,1","eliminate,7,1","eliminated,7,2,12,1","eliminates,15,1","eliot,33,1","elizabeths,26,1,55,1","ellen,21,1,26,1,55,1","elsewhere,7,2","email,9,2,13,1,10,2,11,1,12,1,17,1,14,1,15,1,16,2,18,2,19,1,20,1,21,1,22,2,23,1,24,2,25,1,26,2,27,1,28,1,29,1,30,1,31,1,33,3,32,1,34,1,35,2,36,3,37,1,38,1,45,1,39,1,40,1,41,1,42,2,43,1,44,1,46,1,47,1,48,1,49,1,50,1,51,1,54,1,52,1,53,1,55,2,65,1,66,3,67,1,131,1","embark,12,1","embarking,39,1,59,1","embrace,33,1,45,1,53,1,56,1,58,1,57,1","embracing,36,1","emdr,11,1,38,3,40,3,46,2","emdria,11,1,46,1","emerge,12,1,82,1","emergencies,7,1,26,1,38,2,40,2,54,1,55,1","emergency,7,18,17,1,19,1,25,1,35,1,38,1,40,1,42,1,46,2,48,1,50,5,82,1,84,4","emergent,84,3","emerging,7,1,12,1,14,1,26,1,41,1,50,1,52,2,55,1","emigrate,7,1","emmet,69,1","emotional,17,2,21,1,30,1,45,1","emotionally,24,1","emphasis,7,1,24,1,33,1,38,1,40,1","emphasize,29,1,83,1","emphasizes,23,2,36,1","employed,7,320,45,1","employee,7,2","employees,7,5,18,1,24,1,25,1,47,1","employer,7,28,12,1,18,2,41,1","employer-based,82,1","employers,7,18,25,1,37,1,46,1","employing,7,2","employment,7,394,34,1,45,1,48,1","empowering,59,1","empowerment,69,1","empowers,23,1","emt,7,3","ena,50,4","enable,47,1,50,1,92,1","enables,33,1,53,1,56,1,58,1,57,1","enact,27,1","enacted,18,1,27,2","enacting,19,1","encounter,23,1,41,1","encountered,84,1","encourage,33,1,36,1,37,1,39,1,54,1,83,2","encouraged,7,1,11,1,12,1,18,1,19,1,36,1,51,1,52,1,59,1","encourages,18,1,42,1","encouraging,12,1,37,1","end,7,5,18,1,26,2,27,1,45,1,50,1,54,1,55,2,83,3,84,1","ended,7,1,36,1","endocarditis,82,1","endocrinology,7,3","end-of-life,34,1,52,1,84,2","endof-life,84,1","endometrial,82,1","endorse,53,1,56,1,58,1,57,1","endorsed,12,3,21,1,26,3,27,2,32,1,37,3,52,1,55,3","endorsement,7,1,27,1","endorses,35,1","endotracheal,84,3","endowed,39,1,47,3,92,3","endowment,47,1,92,2","ends,15,1,27,1,31,1,37,1,39,1,44,1,131,1","endured,33,1","enduring,16,1,19,1","energies,16,1","energy,45,1","e-news,52,1","enewsletter,39,2,66,2","enforce,49,1","enforcement,26,2,34,1,35,3,48,1,55,2","engage,7,1,45,1,46,1","engaged,22,1,27,1,53,1,56,1,58,1,57,1,82,1","engagement,26,1,45,1,52,1,55,1,60,1","engaging,7,1,27,2,41,1,50,1","engel,33,1","england,7,8,38,1,40,1,84,1","english,7,2,84,2","english-speaking,7,1","enhance,13,1,11,1,22,1,39,1,41,1,53,1,51,1,56,1,59,1,58,1,57,1,82,1","enhanced,35,1,49,1","enhancing,26,1,27,1,41,1,55,1","enjoy,35,1,36,1,37,1,39,1,41,1,42,1,50,1","enjoyed,30,1","enormously,19,1,21,1,25,1","enough,7,1,24,1,39,1,44,1,47,1,59,1","enpc,7,2","enrich,21,1,30,1","enroll,7,2,48,1","enrolled,7,7,19,1,24,1,36,1,84,1","enrollees,83,1","enrolling,84,2","enrollment,7,6,18,1,54,4,52,4","enrollments,7,1,18,1","ensure,7,2,9,1,10,1,12,2,18,1,24,1,26,1,34,1,37,1,49,1,55,1,88,2","ensures,92,1","ensuring,7,1,12,1,21,1,25,1,33,1,50,1,54,1,92,1","ent,84,1","enter,7,1,42,2,47,1,66,2","entered,7,4","entering,7,7,54,1,52,1,84,1","enters,46,1","enthusiasm,88,1","enthusiastic,41,1","enthusiasts,37,1","entire,14,1,41,1,53,1,56,1,58,1,57,1,82,2","entirely,27,1","entities,12,1,18,1,88,1","entitled,17,1,27,1,35,2,39,1,48,1","entity,29,1,30,1,69,1","entrants,7,3","entries,7,6","entry,13,1,21,1,53,1,56,1,58,1,57,1,84,1","entry-level,19,1,22,1,51,1,54,1,52,1","envelope,7,3","environment,7,5,21,1,33,1,36,1,82,2","environmental,7,1,19,1,52,1","environments,7,1,19,2,42,2","enzi,88,1","epidemic,52,1","epidemiol,82,1","epidemiologic,29,1","epidemiology,84,1","epidural,84,9","epilepsy,44,1","episiotomies,84,1","episiotomy,84,12","episode,20,1,28,1,32,1","episodes,34,1,35,1","equal,7,21,12,1,39,2,82,1","equaling,14,1","equally,7,1","equals,11,2","equipment,7,2,82,1","equire,39,1","equitable,18,1,84,1","equity,12,1,16,1,23,1,24,1,26,1,29,1,33,2,34,1,45,1,47,1,55,1","equivalence,84,4","equivalent,7,14,21,1,84,38","er,25,1","eric,33,3,38,1,40,1,84,2","error,7,4,30,2","error.html,1,1,2,1,3,1,4,1,6,1,72,1,74,1,63,4,75,1,76,1","errors,7,2,82,1","escalating,24,1,84,1","especially,7,3,13,1,17,1,14,1,16,1,18,1,20,1,22,1,27,1,30,1,39,1,42,1,50,1,52,1,83,1,92,1","essential,7,2,12,1,18,1,27,1,35,2,41,5","essentially,7,1","est,51,2","establish,13,1,12,2,26,1,29,1,30,1,31,1,33,1,32,1,39,1,42,1,44,1,47,1,49,1,55,1,131,1","established,7,5,11,1,12,1,14,2,16,1,18,1,19,1,21,1,26,1,35,1,36,1,38,1,40,1,50,1,54,1,55,1","establishes,7,1,21,1,33,1,92,1","establishing,7,1,22,1,27,1,39,1,49,2,54,1,82,1","establishment,7,1,33,1","estate,7,1","estimate,7,12,39,1,42,1,84,6","estimated,7,183,9,1,10,1,17,1,25,2,30,1,32,1,42,1,46,1","estimates,7,32,12,1,34,1,46,1,50,1,82,1,84,1","estimating,7,1","estimation,7,5","et,11,1,24,1,25,1,31,1,82,10,84,299,131,1","ethical,54,2,82,2","ethics,18,1","ethnic,7,44,11,1,42,1,53,1,56,1,58,1,57,1","ethnically,7,2","ethnicities,48,1","ethnicity,7,19","ethno-psychopharmacological,18,1","europe,7,1,14,1,25,1","european,7,1,43,1","evaluate,7,1,11,1,26,1,35,1,52,1,55,1","evaluated,39,2,84,3","evaluates,37,1","evaluating,7,2,23,1,27,1,36,1,38,1,40,1,84,1","evaluation,7,2,23,1,28,1,35,1,41,1,42,1,54,1,84,5","evans,20,2","eve,53,1,56,1,58,1,57,1","even,7,15,13,2,11,1,12,1,21,1,26,2,29,1,31,1,33,1,45,1,41,1,44,1,51,1,55,2,84,1,92,1,131,1","evening,14,1,35,1,42,1","event,34,1,37,1,38,1,40,1,41,2,44,1,50,1,82,1","events,9,2,13,2,10,2,11,3,12,4,17,2,14,3,15,2,16,4,18,3,19,2,20,2,21,3,22,2,23,3,24,2,25,3,26,3,27,5,28,2,29,2,30,3,31,2,33,3,32,3,34,4,35,4,36,3,37,2,38,3,40,3,45,3,39,2,41,6,42,3,43,3,44,2,46,3,53,3,47,2,48,2,49,3,50,4,51,2,54,3,52,3,55,3,56,3,58,3,57,3,82,2,84,1,131,3","eventually,33,1","everitt,39,1","everyday,37,1,51,1","everyone,27,1,33,1,34,1,41,1,48,1,50,1,59,1","everything,26,1,29,1,42,1,55,1","evidence,7,1,11,2,17,1,19,1,31,1,33,2,34,1,40,1,48,1,51,2,82,1,83,1,84,86,88,1,131,1","evidencebased,83,1,84,1","evidence-based,27,1,35,1,46,1,49,1,88,1","evident,33,1","evolution,7,3","evolved,35,1","evolving,84,1","exacerbate,15,1","exacerbation,84,3","exacerbations,84,1","exact,41,1","exactly,7,1,13,1","exam,7,6","examination,7,3,35,1,84,1","examine,19,1,22,1,48,1,50,1","examined,84,4","examines,7,2,48,1","examining,11,1","example,7,7,14,1,22,1,26,1,36,1,38,1,40,1,42,1,55,1,82,1,84,2","examples,25,1,33,1","exceed,7,1,26,1,55,1","exceeded,54,1","excel,30,1","excellence,12,1,18,1,21,1,33,1,34,4,35,1,44,1,49,2,54,1","excellent,37,1,84,1","except,7,4,82,2","exception,7,1","exceptional,18,1,19,1,21,1,25,1,30,1,34,3","excerpted,82,1","excess,46,1","excessive,30,1,49,1","exchange,18,1,25,1","exchanges,41,1","exchanging,22,1","excited,25,1,26,1,45,1,53,1,49,1,55,1,56,1,58,1,57,1","exciting,12,1,14,1,19,1,21,2,25,2,26,2,29,1,31,1,33,1,34,1,38,1,40,1,45,1,41,1,47,1,49,1,55,2,60,1,131,1","exclude,82,1","excluded,34,1,82,1,84,9","excludes,7,25,41,1","excluding,84,1","exclusion,84,5","exclusively,42,1,82,1,84,2","execution,84,1","executive,7,11,13,1,11,1,12,1,16,1,22,2,25,1,26,2,28,1,33,1,36,2,39,2,42,1,44,1,46,3,53,1,52,2,55,2,56,1,59,1,58,1,57,1,84,1","executives,26,1,35,1,52,1,55,1","exemplary,12,1","exemplify,30,1","exercise,42,1","exercised,39,1","exhausted,31,1,131,1","exist,7,1,84,1","existed,7,2","existing,12,2,15,2,33,1,35,1,41,1,42,1,48,1,69,1","ex-officio,53,1,56,1,58,1,57,1","expand,13,2,12,1,15,1,16,1,18,1,27,1,28,2,29,1,31,1,33,1,37,2,45,1,39,1,42,1,46,1,50,1,59,1,84,1,131,1","expanded,7,1,16,1,50,1,84,2","expanding,28,1,29,2,34,1,36,1,38,1,40,1,46,1,51,1,84,2","expands,28,1,48,1","expansion,7,1,39,1,41,1,42,1,43,1,46,1,53,1,49,1,54,2,56,1,58,1,57,1","expansions,7,1","expect,36,1","expectations,50,1","expected,7,5,33,1,41,1,48,1,50,1,51,1","expedited,7,1","expenditures,11,1","expense,82,6","expenses,18,2,24,2,25,1,28,2,33,2,35,1,38,1,40,1,46,2,82,2","expensive,88,2","experience,7,25,11,1,25,1,27,1,34,1,35,3,36,2,46,2,48,1,49,1,54,2,82,4,83,2,84,1","experienced,7,1,9,1,10,1,12,1,21,1,25,1,27,1,28,1,45,1,44,1,49,1,50,3,82,2,84,2","experiences,12,1,33,1,45,1,42,1,50,1,54,1","experiencing,18,1,33,1,34,1,36,2,51,1","expert,7,1,22,1,25,1,27,1,29,1,34,1,35,2,38,1,40,2,53,1,50,3,56,1,58,1,57,1,84,2","expertise,7,2,9,2,10,2,34,1,51,1,69,1,84,1","experts,9,1,13,1,10,1,14,2,15,1,18,1,19,2,33,2,32,1,35,1,40,1,39,1,44,1,46,1,48,2","explain,14,2,19,1,21,1,38,1,40,1","explains,50,1","explanation,48,1,82,1","explore,18,1,32,1,37,1,53,1,56,1,58,1,57,1,82,1","explored,84,1","explores,45,1,50,1","exploring,27,1,36,1","exposed,22,1","exposure,37,1,82,2","express,53,1,56,1,58,1,57,1","expressed,19,1,35,1,53,1,56,1,58,1,57,1,69,1,83,2","expressing,32,1,53,1,56,1,58,1,57,1","expressions,38,1,40,1","extend,16,1,18,3,27,1,32,1,35,1,84,2","extended,7,34,27,1","extending,18,1,34,1,84,1","extends,9,1,10,1,15,1,53,1,56,1,58,1,57,1","extension,18,1,49,1","extensive,7,1,45,1,44,1","extent,7,2,46,1,84,5","extern,7,1","external,7,1,92,1","externship,7,1","extra,7,3,30,1","extract,36,1","extracted,82,1,84,1","extramural,54,1","extraordinarily,9,1,10,1,92,1","extraordinary,30,1,47,1,54,1","extreme,7,7,29,1","extremely,7,53,46,1,84,2","extubation,84,1","f.j,84,1","f.w,84,1","faan,14,2,18,1,24,1,27,1,34,1,53,1,56,1,58,1,57,1,60,2,69,1,84,2,92,1","face,13,1,11,1,15,1,23,2,26,1,38,2,40,2,48,1,49,1,50,1,55,1,59,1","facebook,45,1,42,4,50,1","faced,37,1,92,1","faces,23,1","face-to-face,60,1","facets,18,1,35,1","facilitate,24,1,30,1,36,1,38,2,40,2","facilitated,45,1,84,1","facilitates,43,1","facilitating,43,1","facilitation,83,1","facilities,7,13,17,1,18,2,22,1,23,1,25,4,26,7,27,2,38,2,40,3,39,2,41,1,55,7","facility,7,9,14,1,16,1,41,2","facing,18,1,45,1,42,1,92,1","fact,7,9,12,1,15,1,19,2,23,3,27,2,33,2,48,1,52,1,84,1,88,4","factor,7,8,34,1,53,1,56,1,58,1,57,1,82,1,84,1","factors,7,12,21,1,36,2,42,3,43,1,48,3,50,3,82,3,84,2","facts,7,1,20,1,27,1","faculty,7,91,13,1,9,1,10,1,11,1,18,4,22,1,33,1,32,1,34,1,36,1,38,1,40,1,44,4,47,6,54,1,84,1,92,2","fail,33,1","failed,7,3,36,1","failing,49,1","fails,7,1","failure,11,1,27,1,82,12,84,18","fairly,7,1,42,1","fairman,7,1","falck-ytter,84,1","falcone,84,1","fall,13,1,33,1,47,1,92,1","falls,84,1","fam,82,1","familiar,50,1","families,13,1,9,1,10,1,17,2,21,1,25,1,27,1,29,1,35,1,36,2,37,2,45,3,49,1,69,1,84,1,92,2","family,7,27,12,1,21,1,22,1,24,2,29,1,33,1,31,3,45,2,41,2,42,1,44,1,52,1,82,6,84,3,131,3","family-centered,35,1","fann,34,1","fanta,84,6","faq,21,2,33,2,47,2","faqs,35,2","far,7,1,29,1,32,1,36,1,45,1,83,1","fare,36,1","farming,7,1","fast,7,1","faster,21,1","favor,14,1,18,1,31,1,84,2,131,1","favorable,84,1","favored,43,1,84,12","favoring,29,1,46,1,84,5","favorite,42,1,53,1,56,1,58,1,57,1","favorites,33,1","favorites.â ,34,1","favors,84,7","fda,11,3,12,1,24,1,27,5,28,1,31,1,38,1,40,1,39,1,88,2,131,1","fdaaa,39,1","fear,33,1","feasibility,50,1","feasible,7,3,84,1","feature,30,1,32,1,43,1,53,1,47,1,51,1,56,1,58,1,57,1","featured,11,2,12,2,14,2,16,2,18,2,21,2,23,3,25,2,26,1,27,2,30,2,33,2,34,2,35,2,36,4,37,1,38,2,40,2,41,2,42,3,46,2,53,1,50,1,54,2,55,1,56,1,58,1,57,1","features,21,1,23,1,32,1,37,1,43,1","feb,17,6,15,6,16,2","february,13,1,11,2,12,3,17,1,14,5,15,1,16,5,26,1,41,1,51,1,55,1,61,2,82,4","federal,7,13,12,2,17,2,14,1,18,7,24,3,26,3,27,2,28,1,30,2,33,3,31,4,35,2,36,2,37,1,38,2,40,2,45,1,39,3,43,2,44,2,53,1,49,2,51,1,54,4,55,3,56,1,58,1,57,1,69,2,84,1,131,4","federally,7,6,12,3,24,1,45,1","federation,42,1,69,1","federia,82,1","fedex,7,1","fee,15,2,23,1,36,1,50,1","feedback,19,1,36,3,41,1,46,1,50,2,73,1,65,1,67,1","feedback.cfm,1,1,2,1,3,1,4,1,6,1,72,1,74,1,62,4,75,1,76,1","feedback.html,1,1,2,1,3,1,4,1,6,1,72,1,74,1,65,4,75,1,76,1","feedback.php,1,1,2,1,3,1,4,1,6,1,72,1,74,1,67,4,75,1,76,1","feedbackheader.jpg,68,1,93,1,94,1,101,8,90,1,91,1,141,1,142,1,143,1,146,1","fee-for-service,13,1,30,1,52,1","feel,7,3,16,1,46,3,51,1","feeling,7,1,48,1","fees,7,2,12,3,35,1","fell,26,1,27,2,55,1","fellow,14,1,16,1,26,1,27,1,38,1,40,1,45,1,53,1,49,1,55,1,56,1,58,1,57,1","fellows,16,2,46,3,84,2","fellowship,16,1,45,1,39,2","fellowships,47,1,92,1","female,7,9,24,1,82,1","fetal,82,1,84,1","fewer,7,35,11,1,25,1,34,1,49,1,51,1,82,4,83,1,84,5","fewest,7,3","ffs,13,1,52,2","fibrosis,84,5","field,7,43,16,1,18,1,34,1,36,1,42,2,50,5,54,4","fields,7,23,12,1,45,1,53,1,52,1,56,1,58,1,57,1","field-tested,41,1","fifteen,84,1","fifth,7,1,13,1,11,1,16,1,18,1,34,1,47,1,50,1,54,1","fifty,21,1","fight,18,1,26,1,42,1,55,1","fighting,29,1","figure,7,190,82,6,84,2","figures,7,6,20,1,82,1","file,7,2,13,2,11,1,14,2,15,1,19,2,20,1,21,4,22,2,24,1,25,2,26,2,27,1,28,2,32,1,35,1,38,1,40,1,45,2,39,2,41,1,46,1,53,1,48,1,49,4,52,1,55,2,56,1,58,1,57,1","filed,34,1,36,1,49,1,82,1","files,7,4,51,1,84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","hyde,14,1,16,1","hydrochloride,12,1","hyperactivity,25,1,29,1,46,1,69,1","hypercholesterolemia,84,1","hypertension,36,1,48,1,84,4","hypothesis,14,1","i.e,19,1","î˛-amyloid,38,1","î˛-amyloidâ€“induced,40,1","i4a,60,1","ia,32,1","iadl,84,4","icad,39,1","iceberg.â more,26,1,55,1","icrc,49,1","icsi,37,1","icu,84,1","idaho,30,1","idea,29,1,33,1","ideal,84,1","ideally,7,1","ideas,11,1,12,1,14,1,22,1,37,1","identification,18,1,35,1,88,1","identified,7,2,16,1,24,1,30,1,38,1,40,1,43,1,53,1,56,1,58,1,57,1,82,3,88,1","identifies,7,1","identify,7,3,18,2,19,1,27,1,35,1,38,2,40,2,42,1,46,1,53,3,51,1,52,1,56,3,58,3,57,3,82,1,84,1","identifying,7,5,35,1,36,1,38,1,40,1,54,1,52,1","ien,7,12","iens,7,78","ifr,16,2","igap,14,1","ihs-supported,7,1","ii,7,1,11,2,16,1,20,1,31,1,35,1,131,1","iii,7,2,11,1,42,1","il,47,1","ileana,22,1,32,1","ill,7,1,11,1,12,1,25,1,36,1,37,1,43,2,44,1,84,4","illegal,34,1,35,1","illicit,29,1,34,1,36,1,42,2,43,1,54,1","illinois,38,1,40,1","illness,7,1,9,1,10,1,12,2,14,3,15,1,19,1,21,4,23,1,24,3,25,1,26,3,28,1,29,3,31,1,34,6,35,1,36,1,38,2,40,2,45,7,39,6,41,1,42,2,44,1,46,4,54,2,47,1,48,3,49,2,50,3,51,3,55,3,69,1,83,1,84,1,92,1,131,1","illness.â ,42,1","illnesses,12,2,15,1,24,2,32,1,38,1,40,1,39,1,41,1,42,1,84,2,88,3","illnesses.â ,11,1","ills,46,1","illustrate,7,2","illustrated,17,1","illustrates,7,1","im,22,1","images,1,1,2,1,3,1,4,1,6,1,72,1,74,1,68,9,70,1,75,1,76,1,133,9,93,5,94,5,126,1,128,1,129,1,130,1,90,5,91,5,141,5,142,5,143,5,144,1,145,1,146,5,147,5,148,1,149,1,150,5,151,5,152,5,153,5,155,5,156,5,157,5","imaging,23,1,38,1,40,1,46,1","imds,38,1,40,1","imha,27,2","immediate,19,1,53,1,54,1,56,1,58,1,57,1,92,1","immediately,41,1,54,1","immigrate,7,2","immigrated,7,1","immigration,7,1","immigrations,7,1","impact,7,3,11,1,12,1,18,2,25,1,26,1,31,1,37,2,42,3,44,1,54,1,48,1,50,2,55,1,84,16,92,1,131,1","impacted,21,1","impacting,19,1","impacts,45,1","impaired,9,1,10,1,37,1","impairment,25,2,27,1,41,3,44,1,46,1,52,1,84,2","imperial,84,1","implement,7,1,21,1,23,2,24,1,26,2,27,1,45,1,55,2,88,1","implementation,14,1,21,2,23,2,25,2,33,2,31,1,34,1,36,2,53,1,54,1,49,1,50,3,56,1,58,1,57,1,83,2,84,3,131,1","implemented,16,1,23,1,27,3,39,1,46,1","implementing,7,1,14,1,24,1,26,1,35,1,36,1,42,1,54,1,55,1","implications,7,3,9,1,10,1,27,1,28,1,84,3","implicit,7,1","implies,19,1","importance,7,1,11,1,14,1,23,1,27,1,29,1,39,1,41,1,82,2,84,1","important,7,10,9,1,10,1,12,2,14,1,16,1,20,1,22,1,25,2,27,2,30,1,35,1,36,1,38,1,40,1,39,1,42,2,44,1,46,1,50,2,60,1,69,1,82,2,84,5,88,3,92,5","importantly,26,2,50,1,55,2","impoverished,7,1","impressive,21,1,30,1,33,1","improper,24,1","improperly,82,1","improve,7,2,13,1,12,2,15,1,21,2,22,1,23,1,25,3,27,4,29,1,30,1,33,1,32,1,35,1,36,6,37,1,38,2,40,2,45,1,39,2,42,2,44,1,53,1,54,2,47,1,48,1,50,1,52,2,56,1,58,1,57,1,60,1,83,2,84,2,88,1","improved,7,5,21,1,27,2,49,1,83,1,84,1","improvement,7,2,14,1,20,1,21,1,26,2,29,1,31,2,36,1,37,3,39,1,53,1,48,1,52,1,55,2,56,1,58,1,57,1,131,2","improvements,16,1,36,1,46,1,48,1,49,1","improves,46,1,84,1","improving,7,1,12,1,16,1,18,1,27,1,35,1,38,1,40,1,45,1,42,1,43,1,46,2,47,1,49,1,50,2,83,3,84,5,88,1","impulse,28,1","imputation,7,23","imputed,7,6","ims,39,1","inaccurate,7,1,30,1","inactivity,36,3","inadequacy,12,1","inadequate,7,2,28,1,42,1,84,2","inadvertent,84,1","inaugural,7,2,21,1","inbox,39,1","inbox.â ,26,1,55,1","inc,26,2,28,1,33,1,31,1,46,1,52,1,55,2,131,1","incarceration,26,1,29,1,38,1,40,1,55,1","incentive,33,1","inception,7,3,54,1","incidence,84,1","incident,15,1,82,7","incidents,7,2,26,1,49,1,55,1,88,1","inclu,84,1","include,7,17,13,1,17,1,16,1,20,1,21,1,24,1,26,1,27,1,28,1,29,1,30,3,33,1,35,2,36,2,37,1,38,2,40,2,45,1,39,1,41,1,42,1,53,2,54,1,50,2,51,2,55,1,56,2,58,2,57,2,69,1,82,3,83,1,84,6,88,1","included,7,57,11,1,12,1,18,1,23,2,28,2,30,2,34,2,35,1,36,1,37,1,41,1,50,1,82,7,84,25,88,1","includes,7,67,18,1,22,1,23,1,24,1,25,1,27,1,28,2,30,1,33,3,35,1,36,1,40,1,45,1,39,1,46,3,54,2,49,2,50,2,52,2,82,6,84,3","including,7,18,11,1,12,1,15,1,16,1,18,1,19,2,20,2,21,1,22,1,24,1,25,2,26,3,27,1,28,1,36,1,37,1,45,1,39,1,41,3,42,2,43,1,46,4,53,2,48,2,49,1,51,1,52,1,55,3,56,2,58,2,57,2,82,2,84,7,88,1","inclusion,22,1,25,2,36,1,39,1,41,2,82,1,84,8","inclusive,69,1","income,7,15,48,1,84,1","incomes,44,1","incoming,42,2","incompetent,48,1","incomplete,7,6,11,1","inconsistencies,84,1","inconsistency,84,4","inconsistent,84,3","incorporate,25,1,38,1,40,1,41,1","incorporated,26,1,55,1,84,1,88,1","incorporates,21,1,82,1","incorporating,84,1","incorporation,18,1","incorrect,82,2","incorrectly,82,3","increase,7,27,13,2,12,1,14,1,18,4,19,1,22,1,23,1,24,1,25,1,26,2,27,1,28,3,30,2,33,4,31,1,34,2,35,5,36,3,39,2,41,1,42,1,46,2,54,1,48,1,52,1,55,2,59,1,82,1,83,1,88,1,131,1","increased,7,12,18,1,21,1,22,2,26,4,27,3,33,2,35,1,38,2,40,2,39,1,42,1,43,1,46,1,54,2,50,1,52,1,55,4,82,1,84,2","increases,7,3,16,1,26,1,28,1,39,1,41,1,42,2,48,2,55,1,82,1","increasing,7,8,14,1,18,2,25,1,84,2","increasingly,7,3,13,1,46,1","incredible,34,1","incredibly,92,1","incurred,82,1","indemnity,82,32","independent,7,2,21,1,27,1,44,2,50,1,84,1","independently,46,1,50,1,84,2","index,1,5,2,5,3,5,4,5,6,5,7,2,8,5,72,5,74,5,64,5,68,5,70,5,75,5,76,5,77,5,78,5,79,5,81,5,84,1,85,5,86,5,87,5,132,5,133,5,134,5,135,5,93,5,94,5,126,5,128,5,129,5,130,5,89,5,90,5,91,5,136,5,137,5,138,5,139,5,140,5,141,5,142,5,143,5,144,5,145,5,146,5,147,5,148,5,149,5,150,5,151,5,152,5,153,5,155,5,156,5,157,5","index.aspx,83,1","index.cfm,60,1","index.html,7,1,83,1","indexes,25,1","indi,84,1","india,7,6","indian,7,7,24,1,38,2,40,2","indiana,27,1","indianapolis,27,1","indians,7,1","indicate,7,9,28,1,36,1,48,1,50,1,82,1,83,1,84,4","indicated,7,4,24,1,27,1,84,2","indicates,20,1,27,1,34,1,50,1,84,3","indicating,7,5,25,1,84,2","indicative,7,1","indicator,7,1","indicators,52,1,84,1,82,1","indigent,84,1","indirect,26,1,55,1,84,1","indispensable,46,1","individual,7,14,13,1,11,1,12,1,18,2,27,1,33,1,34,1,39,1,41,1,44,1,53,1,54,1,51,1,56,1,84,3,58,1,57,1,83,1,92,1","individualized,27,1,49,1","individually,7,1,20,1,32,1,41,1","individuals,7,4,15,1,18,2,23,1,25,2,28,1,29,3,30,3,33,1,34,1,35,1,36,3,37,1,38,1,40,1,45,1,39,1,42,1,44,1,48,1,49,1,51,1,84,1,83,6,88,1,92,1","induced,38,1","inducted,27,1","induction,84,6","industries,35,1","industry,7,2,35,1,48,1,50,1,82,2","ineffective,14,1,30,1","ineligible,7,3","inequalities,16,1","inexplicable,34,1","infant,84,5,82,3","infants,7,1,48,1,84,10","infarction,82,2","infection,7,1,84,1,82,1","infections,34,1","infectious,7,6,84,1","infirmary,7,1","inflammation,14,1","inflation,7,3","inflation-adjusted,7,4","influence,7,1,9,2,10,2,15,1,23,1,42,3,50,2","influenced,7,1,84,1","influences,26,1,55,1","influential,69,1","influenza,24,1","info,13,1,9,1,10,1,11,1,12,2,14,1,16,1,18,1,21,1,23,1,25,1,26,1,27,1,30,1,33,1,32,1,34,1,35,1,36,1,37,1,38,1,40,1,45,3,41,1,42,1,43,1,46,1,53,1,54,1,49,3,50,1,55,1,56,1,58,1,57,1,131,1","inform,12,1,24,1,52,1,84,1","informatics,7,12","information,7,59,13,2,9,2,10,2,11,6,12,6,17,4,14,1,15,3,16,4,18,8,19,3,20,1,21,2,22,2,23,8,24,2,25,2,26,2,27,5,28,4,29,1,30,4,31,1,32,2,34,3,35,5,36,6,37,1,38,4,40,5,45,4,39,7,41,1,42,2,43,2,44,2,46,1,53,3,54,5,47,1,48,1,49,3,50,6,51,2,52,1,55,2,56,3,59,1,84,3,58,3,57,3,63,1,82,3,92,1,131,1","informational,11,1","informative,27,1,46,1","informed,24,1,42,1,84,1,83,1","infrequent,82,1","infusion,7,3","ingenuity,88,1","ingersoll,84,1","inherent,7,1,82,2","inherited,36,1","inhibitors,82,1","inhome,84,1","in-home,27,1,84,1","initial,7,214,14,1,23,1,32,1,34,1,49,1","initially,7,2","initiate,45,1,49,1","initiated,47,1,84,1","initiating,7,1","initiation,84,2","initiative,13,1,23,1,24,1,25,2,26,2,27,5,28,1,36,1,37,2,38,1,40,1,45,1,44,1,46,4,54,2,49,1,50,1,55,2,83,3","initiatives,16,2,25,1,26,1,33,2,34,1,36,3,39,1,55,1,84,3,69,1,88,1","initiativesâ€ť,39,1","injection,82,1","injured,84,1,83,1","injuries,7,1,19,1,21,1,25,1,84,2,82,1,83,1","injurious,29,1","injury,16,1,50,2,84,2,82,15","inmates,24,1","inner,7,1,33,1","innovation,34,2,50,1","innovations,14,1,21,1,37,1","innovative,7,1,13,1,16,1,28,1,35,1,46,1,52,1,82,1,83,1,88,1","innovators,21,1,37,1","innovtive,84,1","inpatient,7,11,9,1,10,1,12,1,18,2,19,1,22,1,25,2,26,4,27,2,33,1,38,1,40,2,45,1,41,4,46,1,49,1,50,1,55,4,84,45,82,4","inpatients,84,1","input,13,2,9,1,10,1,18,2,30,1,33,1,35,1,46,1,53,1,49,1,50,2,56,1,58,1,57,1","input.â ,33,1","inquire,35,1,42,1","inquirer,32,1","insel,36,1","insert,66,1","insertions,34,1","insight,23,1","insights,13,1,17,1,16,1,20,1,23,1,35,1,42,1,53,1,50,1,56,1,58,1,57,1","inspection,11,1","inspector,38,1,40,1","inspiration,25,1","inspirational,42,1","inspire,23,2,35,1","inspiring,41,1,42,1","instability,12,1","instances,84,1","instead,7,1,13,1,21,1","institute,13,1,12,2,17,2,14,3,16,4,18,4,19,3,20,3,21,1,22,1,23,1,25,2,26,2,27,2,28,1,29,2,30,1,33,1,31,1,32,1,35,1,36,4,37,4,38,2,40,2,45,2,41,3,42,3,44,1,46,2,53,2,54,1,49,2,52,4,55,2,56,2,58,2,57,2,131,1","institute.â ,26,1,55,1","instituteâ€™s,42,1","institutes,16,1,25,1,27,1,28,1,29,1,35,1,37,2,46,1,53,1,56,1,58,1,57,1,88,1","institution,7,2,84,1","institutional,84,1","institutions,12,1,27,1,38,1,40,1,43,1,84,2","in-store,7,1","instruction,7,21","instructions,7,4,9,1,10,1,34,1,35,1,44,1,60,2","instructor,7,8,51,1","instructors,7,1","instrument,84,1","instrumental,84,2","insufficient,7,1","insulin,41,1,48,1","insurance,7,20,13,2,11,1,12,2,14,1,15,2,18,1,21,3,26,2,28,1,30,1,34,1,37,2,45,1,41,3,43,2,53,1,54,1,48,1,49,1,55,2,56,1,84,1,58,1,57,1,82,3,88,1","insurance-related,50,1","insured,82,5","insurer,7,1,30,1","insurers,16,1,44,2,46,1,48,1,88,1","intake,82,3","integral,7,2,27,1,32,1","integrate,26,1,36,1,55,1,84,1","integrated,19,1,28,2,33,4,36,5","integrating,32,1,84,1","integration,22,1,24,1,42,1,51,1,88,1","intellectual,27,1","intellectually,19,1,21,1,25,1","intend,7,4","intended,7,13,13,1,12,1,16,1,25,2,35,2,41,1,42,1","intends,22,1","intense,18,1,50,1","intensive,7,3,84,7","intensive-care,34,1","intent,44,1,84,1","intention,7,4","intentionally,84,4","intentions,7,17","interact,37,1","interaction,16,1,18,1,20,1,27,1,52,1","interactions,23,1,26,4,48,1,55,4","interactive,11,1,30,1,33,1,34,2,38,1,40,1,41,1,42,1,44,1,50,3,60,1","interagency,54,1","interdiction,31,1,131,1","interdisciplinary,84,1","interest,7,4,13,1,16,1,18,2,19,1,23,1,24,1,25,1,26,1,33,1,35,2,45,1,39,1,44,1,53,2,47,1,49,2,50,3,55,1,56,2,84,2,58,2,57,2,82,2,83,2","interested,7,2,9,1,10,1,11,2,15,1,16,2,18,1,23,2,25,1,26,1,28,1,30,1,33,1,32,1,34,1,35,3,37,1,38,1,40,1,45,1,42,1,43,1,46,1,53,2,49,1,50,4,51,1,55,1,56,2,58,2,57,2,60,1,131,1","interesting,16,1,26,1,55,1,82,1","interests,33,1,45,1,49,1","interfere,34,1","interfered,50,1","interferes,51,1","interim,16,1,26,3,34,2,55,3","interior,38,1,40,1","intern,82,1","internal,53,1,56,1,84,1,58,1,57,1","international,7,5,14,1,18,1,33,1,34,1,37,1,45,2,39,1,42,2,46,1,53,1,49,1,50,1,56,1,84,4,58,1,57,1","internationally,7,44,33,1","internet,34,1,53,1,50,1,56,1,58,1,57,1","interns,34,1,84,1","internship,9,1,10,1,15,1,39,1","interpretation,44,1","interpreted,7,2,84,1","interprofessional,27,2,84,1","interscience,82,1","interspecialty,84,1","interstate,7,2","interval,7,1","intervention,38,1,40,1,84,5","interventions,11,2,14,1,20,1,29,1,42,2,46,2,84,4","interview,27,4,36,2,42,2,49,1","interviewed,45,1,42,2,46,1,49,2","interviewers,7,2","interviews,7,1,48,1","intimidating,39,1","intra,54,1","intracranial,82,1","intriguing,25,1","introduced,12,1,14,1,21,1,23,1,29,1,33,2,31,2,49,1,52,1,131,2","introducing,24,1,27,1,39,2,42,1","introduction,7,23,21,1,25,1,26,1,53,1,54,1,55,1,56,1,58,1,57,1","introductory,12,1,14,2,21,1,25,1,54,1,50,1","intubation,84,2","invalidate,54,1","invaluable,27,1,50,1","invasive,84,1","inventory,21,1,25,2,53,1,56,1,58,1,57,1","invest,16,1,82,1","invested,50,1","investigation,43,1,84,1,82,1","investigations,15,1,39,1,42,1,50,1","investigator,84,1","investigators,54,1","investing,52,1","investment,44,1","invisible,16,2,50,1","invitation,7,2,16,1,23,1,27,1,37,1","invite,21,1,36,1","invited,7,1,13,1,18,2,24,2,25,1,28,1,33,1,36,1,37,1,41,1,51,1,69,1,82,1","invites,9,1,10,1,17,1,15,1,36,1,39,1,50,1,51,1","involuntary,7,1,45,1","involved,7,3,35,1,38,1,40,1,46,2,54,1,48,1,49,1,51,1,84,2,82,1","involvement,12,1,21,1,24,1,37,1,38,1,40,1,43,1,46,1,50,1","involves,44,1","involving,7,1,25,1,26,1,35,2,43,1,51,1,55,1,84,6","iom,14,2,53,1,52,1,56,1,58,1,57,1","iowa,36,2,39,1,50,1","ipfs,40,1","iphone,34,1","iran,31,1,131,1","iranian,31,1,131,1","iraq,24,1,36,2","irene,38,1,40,1","irf,25,1","irfs,25,2","irritation,48,1","irs,53,1,56,1,58,1,57,1","isâ€¦,35,1","ischemic,84,4","ise,19,2","island,18,1","islander,7,5","islands,7,1,26,1,55,1","isn,14,1,31,1,131,1","isolate,84,1","ispn,21,1,50,1","israel,53,1,56,1,58,1,57,1","isstd,45,1","issue,7,1,13,1,19,1,26,1,27,1,33,2,35,4,36,1,45,2,39,1,41,2,42,4,43,1,46,5,54,5,50,1,51,2,55,1,66,1,82,4","issue.â ,50,1","issued,13,1,17,1,18,1,21,1,25,1,26,1,30,2,33,1,34,2,35,1,38,1,40,1,49,1,51,1,55,1","issues,7,10,13,3,9,4,10,4,11,2,12,3,17,4,14,3,15,2,16,5,18,9,19,5,20,5,21,2,22,3,23,3,24,3,25,3,26,2,27,4,28,2,30,2,29,2,33,4,31,4,32,2,34,3,35,7,36,4,37,3,38,2,40,2,45,2,39,2,41,3,42,3,43,2,44,3,46,4,53,5,54,4,47,2,48,2,49,2,50,3,51,3,52,5,55,2,56,5,84,1,58,5,57,5,82,1,88,2,92,2,131,4","issuing,24,1","item,7,6,84,1","items,7,5,14,1,28,1,30,1,84,1","iterations,7,1","its,7,4,13,1,9,3,10,3,12,4,14,1,15,1,16,3,18,1,19,1,21,1,22,3,23,1,24,2,25,7,26,2,27,3,30,2,29,1,33,2,31,2,32,1,34,3,35,4,36,4,37,1,38,2,40,2,39,2,42,1,44,1,46,1,53,3,54,3,48,1,49,2,51,1,52,5,55,2,56,3,84,1,58,3,57,3,82,2,83,3,92,1,131,2","itsâ ,33,1","itself,27,1","iv,7,1","ix,7,1","j.a,84,4","j.c,84,2","j.j,84,1","j.k,49,1,84,1","j.l,84,3","j.m,84,4","j.n,84,1","j.nurpra.2010.08.020,82,1","j.nurpra.2010.11.005,82,5","j.p,84,2","j.r,84,1","j.s,84,2","ja,82,1","jack,31,1,32,1,54,1,131,1","jackson,20,1,84,16","jaclene,18,3","jacobsen,84,1","jacobson,53,1,56,1,58,1,57,1","jacque,92,1","jacque.montgomery@ucdenver.edu,92,1","jacques,82,1","jadad,84,4","jail-based,13,1","jails,13,1","jaleh,31,4,131,4","jama,82,1","jamerson,84,1","jan,13,4,9,4,10,4,12,1,16,1,50,1,52,1","jan.1,45,1","jane,38,1,40,1,39,1,60,2","janet,82,2","janet.selway@gmail.com,82,1","janice,14,1,53,1,56,1,58,1,57,1","janine,82,1","janssen,18,2,25,3,28,1,33,3,36,2,46,1","january,13,1,9,1,10,1,11,5,12,9,21,1,26,1,35,1,45,1,39,1,41,1,53,2,50,1,51,3,52,1,55,1,56,2,58,2,57,2,61,2,82,1,83,1","japan,53,1,56,1,58,1,57,1","japna,25,3,28,1,33,2,41,1,48,1","jarjoura,84,1","jarvis,84,2","jaz.jpg,68,1,93,1,94,1,113,8,90,1,91,1,141,1,142,1,143,1,146,1","jb,7,1","jcr,47,2","jd,14,2","jean,14,1,24,1","jeanne,69,1","jeannie,92,2","jeannine,27,1","jenkins,24,1","jenkinson,84,1","jensen,38,1,40,1","jersey,20,2,27,3,30,1","jhuson,39,1","jim,27,2","jindal,26,2,55,2","jjq8tm8,42,1","jnp,21,1,82,7","jnpfeb2011.pdf,68,1,82,4,93,1,94,1,90,1,91,1,141,1,142,1,143,1,146,1","joanna,29,2","job,7,307,42,1","jobs,7,49,45,1","joe,42,1","johantgen,84,3","john,33,1,36,1,49,1,50,1","johns,13,1,39,1,41,1,84,7","johnson,23,1,25,1,27,2,34,1,37,1,44,1,46,2,53,2,54,1,51,1,56,2,84,6,58,2,57,2","join,11,1,12,1,25,1,26,1,27,1,28,1,30,3,33,1,34,2,35,1,37,2,41,2,46,1,53,1,50,2,55,1,56,1,58,1,57,1,60,1,69,1,83,3","joined,32,1,34,1,35,2,36,1,37,1","joining,11,1,16,1,18,1,21,1,23,1,26,1,33,1,32,1,34,1,35,3,37,1,38,1,40,1,45,1,42,1,43,1,46,1,53,1,49,1,50,2,55,1,56,1,58,1,57,1,131,1","joins,69,4","joint,21,3,22,5,27,3,33,2,35,1,36,2,37,1,39,2,53,1,47,4,50,2,56,1,58,1,57,1","jointly,42,1,46,1","jolie,27,1","jonathan,84,2","jones,84,2","journal,7,2,13,2,11,2,12,1,21,1,23,1,24,1,25,8,28,2,30,2,29,1,36,1,38,1,40,1,42,1,44,1,47,1,48,1,84,48,82,11","journals,25,1,35,1","journey,33,1,41,2","jr,11,1,16,1,25,1,39,1,59,1,84,1","judge,14,2,43,2,54,3,69,1","judged,84,5","judgment,82,1","judgments,82,2","judi,34,1","judicial,44,1","judy,53,1,56,1,58,1,57,1","julie,7,1,84,2","july,7,2,18,1,26,1,30,2,33,8,32,8,34,1,35,1,36,6,41,1,42,3,43,1,55,1,61,2,82,1","june,13,1,17,1,14,2,18,1,20,1,21,1,22,2,24,2,26,1,27,2,28,2,30,6,29,7,33,2,31,9,34,9,35,2,45,1,54,1,49,2,52,1,55,1,61,2,82,1,131,9","june...now,41,1","junior,44,2,46,1","jurisdiction,45,1","justice,12,1,15,1,24,3","justification,82,1","justified,34,1","justifying,21,1","juvenile,88,1","k.a,84,1","k.l,84,1","k.m,84,1","k.r,84,1","k-12,7,1","kaiser,25,1,45,1,41,1","kane,84,9","kansas,22,1,30,1,54,1,88,1","kaptan,82,1","kare11.com,18,1","karen,25,1,46,1,53,1,56,1,58,1,57,1","karlowicz,84,6","kathleen,14,1,21,1,22,1,25,1,28,1,33,3,34,1,37,1,38,1,40,1,45,1,42,6,84,2","kathryn,53,1,56,1,58,1,57,1","kathy,27,1,52,1","katrina,42,1","katz,53,1,56,1,58,1,57,1","kay,49,1","kayne,84,1","kazer,84,1","keckhafer,84,1","keefe,26,1,55,1","keeping,7,2,45,2,39,1,59,1","keeps,41,1","keita,44,1","kelly,32,1,45,1","ken,38,1,40,1","kennedy,22,1,32,1,45,1,84,2","kentucky,7,2,13,1,30,1,42,1","kentucky.â ,33,1","kepferle,84,1","kept,46,1","kerlikowske,26,1,29,1,55,1","kerry,13,1,49,1","kerson,46,1","kessen,84,1","kevin,49,1","key,7,3,13,1,11,1,12,1,17,1,19,1,24,1,25,2,27,1,39,1,42,2,46,1,50,1,51,1,84,2,82,1,83,1","keynote,21,1,24,1,33,1,34,1,36,1,37,1,42,1,43,1,53,1,47,1,56,1,58,1,57,1","keynotes,14,2,33,1","keystone,54,1","keywords,82,1","kicking,33,1","kill,50,1","killed,9,1,10,1","killer,20,1","kim,84,1","kinase,38,1,40,1","kind,7,1,9,1,10,1,52,1","kinds,45,1,88,1","king,27,1","kingdom,7,4","kings,27,1","kippes,84,1","kirsten,49,1","kl,82,2","knee,84,4","knicks,50,1","know,11,1,12,1,16,1,23,1,24,1,26,1,30,1,33,2,32,1,36,2,39,1,41,1,42,3,46,2,48,1,49,2,55,1,84,1,88,3","knowledge,7,3,13,1,9,1,10,1,11,1,14,1,23,1,25,1,27,1,30,1,34,1,39,1,42,1,53,1,54,1,51,1,56,1,58,1,57,1","knowledgeable,44,1","known,7,28,13,1,18,1,26,1,33,1,38,1,40,1,42,1,44,1,54,1,49,1,55,1,84,3,82,1","koch,84,5","koepsell,84,1","kohl,52,2","kollef,84,1","korea,7,2","korean,7,1","kotagal,84,1","kretschman,82,2","krichbaum,84,4","kristof,46,1","kstestimony.htm,64,1,88,4,85,1,86,1,87,1,135,1,89,1,138,1,139,1,140,1","kuehn,84,3","kupfer,34,1","kutzleb,84,3","kwaski,34,1","ky,18,1,34,1,35,1,46,1,53,1,56,1,58,1,57,1","l.a,84,1","l.c,84,2","l.d,84,2","l.g,84,2","l.h,84,1","l.j,84,1","l.k,84,1","l.l,84,2","l.m,84,1","l.p,35,1,84,1","l.r,84,2","lab,82,1","label,38,2,40,2","labeled,82,1","labeling,39,1","labette,54,1","labor,7,9,16,1,29,1,34,2,38,1,40,1,45,2,84,23","laboratories,39,1","labor-hhs,22,1","labor-hhs-and,26,1,55,1","lace,9,2,10,2,12,1,14,1,21,2,25,1,27,1,30,1,36,1,38,1,40,1,41,1,43,1,53,1,54,1,50,2,56,1,58,1,57,1","laceration,84,2","lacerations,84,6","lacetf,53,1,56,1,58,1,57,1","lack,7,3,27,2,31,1,32,1,45,1,42,1,84,2,60,1,88,1,131,1","lacks,43,1","lactation,7,1","lady,92,2","lafontaine,35,1","lag,32,1","laid,12,1","laird,84,2","lake,84,1","lakhan,84,2","lam,84,1","lambing,84,6","landefeld,84,1","landmark,15,1,42,1,54,1,50,1","landscape,13,1","lang,84,15","language,7,8,26,2,48,1,55,2,84,2","lantrip,12,1,18,1","lapse,7,2","lapsed,7,3","large,7,7,21,1,25,1,41,1,42,1,50,1,51,1,83,1","largely,7,2","larger,7,9,35,1","large-scale,32,1","largest,7,19,14,1,20,1,25,1,26,1,27,2,35,1,42,1,43,1,50,1,55,1","laros,84,1","last,1,1,2,1,3,1,4,1,6,1,7,19,8,1,13,1,12,3,14,2,18,1,19,1,27,1,33,2,35,2,36,1,41,1,42,2,46,1,50,1,84,1,72,1,74,1,60,1,64,1,68,1,70,1,75,1,76,1,77,1,78,1,79,1,81,1,85,1,86,1,87,1,132,1,133,1,134,1,135,1,93,1,94,1,126,1,128,1,129,1,89,1,90,1,91,1,136,1,137,1,138,1,139,1,140,1,141,1,142,1,130,1,143,1,144,1,145,1,146,1,147,1,148,1,149,1,150,1,151,1,152,1,153,1,155,1,156,1,157,1","last.â ,33,1","lasted,7,2","lastly,7,1","lasts,35,1","late,7,2,12,1,35,1","late-onset,43,1","latest,14,1,18,1,19,1,22,1,24,1,45,1,39,2,46,1,49,1","latino,7,12","latinos,48,2","latter,7,1,50,1","latuda,50,2","launch,14,1,21,1,37,2,45,1,42,1,49,1","launched,7,1,9,1,10,1,11,1,12,1,21,1,25,1,23,2,24,1,26,1,27,2,34,1,35,1,37,2,45,1,43,1,54,1,55,1","launching,13,1,32,2","laura,53,1,56,1,58,1,57,1","laurant,84,5","laurel,20,1","laurie,21,1","law,7,3,11,1,12,4,14,3,15,2,23,2,24,2,26,4,30,1,29,1,33,2,34,2,35,1,38,1,40,1,45,1,41,1,44,3,54,1,47,1,48,3,49,3,55,4,69,1,88,1","lawâ€™s,54,1","lawmakers,26,2,50,1,55,2","laws,28,1","lawsuit,15,1,34,2","laying,39,1","lays,21,1","lead,7,1,14,1,25,1,22,1,27,1,34,1,46,1,53,1,48,1,51,1,56,1,84,1,58,1,57,1,61,1,83,1,88,1","leader,27,1,33,1,84,1,88,1","leader.â ,12,1","leaders,12,1,14,2,16,1,25,1,22,1,23,1,27,1,33,1,36,1,41,1,42,1,44,1,46,2,52,1","leadership,13,1,11,2,18,1,19,2,21,3,25,2,27,2,30,2,33,1,31,1,34,1,46,2,49,1,50,1,131,1","leadership.â â â ,33,1","leading,7,1,16,1,21,1,22,1,24,1,29,1,54,1,82,2,88,1","league,26,1,55,1","leahy,53,1,56,1,58,1,57,1","leap,12,1","leaps,41,1","learn,9,2,10,2,11,4,12,3,14,3,15,2,16,2,18,2,19,1,21,4,25,4,22,1,23,3,24,1,26,3,27,3,30,4,29,1,33,2,31,1,32,1,34,3,35,3,36,4,37,1,38,4,40,4,45,2,41,3,42,4,43,1,46,2,53,4,54,3,49,1,50,3,55,3,56,4,58,4,57,4,83,3,131,1","learned,43,1","learning,7,3,9,1,10,1,12,1,15,1,21,1,22,1,36,2,39,1,42,1,52,1","leased,26,1,55,1","least,7,52,12,2,25,1,22,2,24,1,28,2,30,1,33,1,31,1,37,1,39,1,41,1,84,4,83,1,88,1,131,1","leave,7,37,25,1","leaving,7,2,27,1,43,1","leavitt,44,1","lebanon,53,1,56,1,58,1,57,1","lecturer,7,5","led,12,1,25,1,29,1,39,1,41,1,42,1,50,1,84,1,82,1","lee,25,1","left,7,7,28,1,35,1,41,1,50,1","legal,7,5,21,1,23,2,30,1,82,1","legally,7,1","legislation,7,1,13,1,9,1,10,1,12,5,14,1,18,2,20,1,25,1,23,2,26,4,27,1,33,1,34,2,35,2,39,1,44,4,54,2,48,2,49,2,50,1,55,4,69,1,88,1","legislative,13,2,9,2,10,2,11,2,12,3,17,2,14,2,15,4,16,2,18,3,19,2,20,2,25,2,22,2,23,2,24,2,26,2,27,3,28,2,30,2,29,2,33,2,31,2,32,2,34,2,35,2,37,2,45,2,39,3,41,2,42,1,43,2,44,3,46,2,53,2,54,2,47,2,48,2,49,2,50,2,51,2,52,2,55,2,56,2,84,1,58,2,57,2,131,2","legislators,26,2,52,1,55,2","legislature,22,1,37,1","lehman,84,1","leininger,21,1","lemasters-parzel,20,1","lenaway,84,11","length,7,10,84,9","lengths,22,1,84,1","lenz,84,20","less,7,84,18,1,19,1,20,1,25,1,23,1,35,1,36,2,37,1,45,1,41,1,42,1,47,2,48,2,84,8,82,6","lessinvasive,84,1","lessons,43,1","less-severe,84,1","lets,27,1","letter,7,5,13,2,12,3,14,1,16,1,20,1,21,1,25,1,22,2,23,1,32,3,34,2,37,1,38,3,40,3,45,1,48,1,49,3,84,3","letters,12,1,34,1,36,1","level,7,51,17,1,19,1,22,2,27,2,30,1,34,1,43,3,44,2,48,1,52,1,84,56,92,1","level.â ,11,1","levels,7,14,14,1,15,1,26,1,27,1,28,1,30,1,34,1,36,2,37,1,38,3,40,3,45,1,39,1,42,1,54,2,49,1,55,1,84,23,82,1","leveraging,83,1","levin,26,1,55,1","lewis,84,2","lexicon,26,1,55,1","liability,41,1,82,31","liaison,9,1,10,1,12,2,14,1,20,1,25,1,24,1,26,3,33,1,32,2,35,1,47,1,55,3","liberal,7,5","liberia,12,4,54,1","librarian,84,1","library,25,1,36,1","license,7,32,53,1,56,1,58,1,57,1","licensed,7,80,9,1,10,1,46,1,54,1","licensees,7,1","licenses,7,16","licensing,7,23,9,1","licensure,7,50,10,1,21,1,35,1,53,1,50,1,56,1,58,1,57,1","lieberman,84,1","lies,12,1,19,1,35,1","life,7,6,21,2,25,2,24,1,27,1,38,1,40,1,45,1,42,1,44,2,46,1,50,1,51,2,59,1,84,3,60,2,82,1","lifespan,19,1,21,2,29,1,36,1,38,1,40,1,42,1","lifestyle,42,2,50,1","lifestyle-based,36,1","lifestyles,42,1","lifetime,18,1,46,1","light,14,1,26,1,35,1,55,1","lighten,50,1","likelihood,84,1","likely,7,84,25,1,24,1,31,1,36,1,45,3,47,3,48,1,84,3,82,6,131,1","lilly,31,2,131,2","lily,84,2","limandri,14,1,21,1,36,1","limbs,17,1","limit,7,2,54,1,82,1","limitations,7,1,21,2,84,4,82,1","limited,7,1,24,1,50,1,84,1,82,1","limiting,44,1","limits,7,1,26,1,55,1,82,2","lin,84,2","lincroft,20,1","linda,20,2,42,2,50,1,59,1,60,2","lindsay,27,1","line,14,1,21,1,33,1,38,1,40,1","lined,30,1","lines,7,3,45,1,42,1","lineup,14,1,36,1","link,7,1,9,1,10,1,18,1,27,2,32,1,35,1,41,1,50,1,66,3,82,1","linked,24,1,33,1,45,1,48,1,84,2","linking,49,1,84,2","links,27,1,32,1,43,1,61,1","lipid,84,7","lipids,84,3","lippincott,7,1","liptak,84,1","lisa,31,1,36,1,131,1","list,7,4,12,1,23,1,27,1,34,1,35,1,53,2,56,2,58,2,57,2,82,2","listed,7,1,25,1,32,1,43,1,84,1","listen,36,1,37,1,39,1","listing,7,7,18,2,21,1,36,2,42,1,43,2,50,1","listings,7,4","lists,7,6,12,1,54,1,50,1","litaker,84,14","literacy,27,1,51,1","literally,11,1","literature,7,1,13,1,19,1,25,1,40,1,48,1,84,6","lithium,28,1","little,7,5,14,1,25,1,36,1,41,1,43,2","live,7,11,36,1,43,1,53,1,50,1,56,1,58,1,57,1","lived,7,3,34,1","lively,60,1","lives,7,1,18,1,25,1,27,1,34,2,44,1,52,1,83,1","living,7,11,20,1,21,1,26,1,30,1,44,1,46,2,49,1,50,1,55,1,84,4,60,1","lk,82,1","ll,26,1,30,2,33,1,34,2,41,1,42,1,54,1,55,1","llc,18,1,33,1","lnguyen@apna.org,24,1,36,1","load,36,1,50,2","loan,7,6,12,2,22,1,28,2,34,3,48,1","loans,7,3,18,2,33,1","local,7,7,20,1,21,1,22,1,26,3,31,2,34,1,35,1,42,1,46,1,55,3,131,2","located,7,18,22,1,26,1,55,1,92,1","location,7,26,82,4","locations,7,1","lodging,18,1,25,1,24,1,28,1,33,1","loftis,39,1","log,21,1,26,1,35,1,38,1,40,1,47,1,55,1","logging,7,1","login,9,1,10,1","log-on,7,3","lombness,84,5","london-based,42,1","long,7,7,13,1,22,1,26,1,30,1,35,2,44,1,54,1,47,1,49,1,55,1","longer,7,2,21,1,25,1,31,1,35,1,131,1","longer-term,44,1","longest,42,1,50,1","longstanding,36,1","longterm,7,1,83,1","long-term,7,7,12,1,25,1,31,1,42,1,52,1,131,1","look,11,1,18,1,21,1,26,1,30,1,35,1,38,1,40,1,45,1,41,1,44,1,53,1,49,1,55,1,56,1,58,1,57,1,82,1,88,2","looked,36,1","looking,7,6,13,1,9,1,10,1,12,1,14,1,21,1,33,1,35,1,39,1,50,3,59,1,88,1","looks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essary,7,1,12,1,18,1,41,1,49,2,84,2","needed,7,1,18,1,21,1,23,1,28,1,33,1,53,2,54,1,50,2,52,1,56,2,84,2,58,2,57,2,60,2,92,1","needs,7,4,13,2,14,3,18,1,20,1,21,2,25,1,23,1,24,1,26,5,27,1,33,2,35,1,31,1,32,1,34,1,36,1,38,2,40,2,41,1,42,2,43,1,47,2,48,1,50,1,51,1,52,1,55,5,84,2,88,1,92,2,131,1","needy,25,1","negative,34,1,42,1,48,1","neglected,25,1,50,1","negligence,82,5","negligible,7,1","negotiate,46,1","negotiated,11,1,45,1","negotiating,46,2","neighborhood,26,1,55,1","neighboring,7,1","neither,7,12","nelson,84,5","neocortical,36,1","neonatal,7,3,84,10,82,6","neonate,7,3","neonates,84,7","neonatology,7,1","nephrology,7,1","nervosa,41,1","nervous,31,1,131,1","nesarc,29,2","nested,7,3","net,7,2,13,1,12,1,18,1,26,1,33,1,55,1","nettina,82,1","network,9,1,10,1,12,2,15,1,16,1,18,1,20,1,21,1,27,1,28,1,37,1,38,1,40,1,45,1,49,1,52,1,69,1","networking,19,1,21,1,25,1,35,1,34,1,37,1,39,1,41,1,60,1","networks,27,1,38,1,40,1","neurobiological,16,1,20,1,24,1,26,1,55,1","neurofeedback,46,3","neuroimaging,46,1","neurologic,35,1","neurological,7,4,46,1,84,2,82,2","neurologists,38,1,40,1","neurophysiology,21,1,36,1,38,1,40,1","neuroscience,7,1,13,1,84,1","neurosurgery,84,2","neurosurgical,84,2","neutral,39,1","nevada,7,1,30,1,52,1","never,7,7,45,1,42,1","new,1,1,2,1,3,1,4,1,6,1,7,31,13,1,9,3,10,3,11,5,12,5,17,2,14,10,16,3,18,5,19,3,20,2,21,11,25,6,22,5,23,3,24,3,26,8,27,14,28,5,29,3,30,8,33,9,35,10,31,2,32,3,34,8,36,18,37,4,38,8,40,8,45,6,39,8,41,11,42,10,43,7,44,5,46,10,53,2,54,8,47,1,48,6,49,3,50,10,51,4,52,2,55,8,56,2,84,3,58,2,57,2,72,1,74,1,70,9,75,1,76,1,82,2,83,6,88,2,92,2,133,5,126,5,128,5,129,5,130,5,131,2,144,5,145,5,147,5,148,5,149,5,150,5,151,5,152,5,153,5,155,5,156,5,157,5","newâ ,50,1","newborn,7,1,84,1","newborns,84,2","newer,39,1,48,1","newest,39,1,69,1","newhouse,84,8","newly,7,1,9,1,10,1,20,1,21,1,25,2,27,1,30,1,33,1,41,1,42,1","newly-added,30,1","news,13,2,9,3,10,3,11,5,12,7,17,5,14,5,15,4,16,5,18,5,19,4,20,6,21,5,25,8,22,4,23,5,24,5,26,7,27,7,28,4,29,4,30,5,33,6,35,6,31,4,32,6,34,5,36,5,37,6,38,5,40,5,45,6,39,5,41,6,42,6,43,6,44,3,46,6,53,5,54,5,47,2,48,3,49,5,50,5,51,2,52,5,55,7,56,5,58,5,57,5,73,4,60,1,61,26,63,4,65,5,67,5,69,1,71,5,92,1,131,5","newsfeed,25,1,27,1,30,1,36,2,38,1,40,1,41,1","newsletter,36,1,53,1,56,1,58,1,57,1,66,2","newsroom,92,1","nexo,82,1","next,7,8,12,1,16,1,20,1,25,2,23,2,39,1,41,2,42,3,44,2,46,2,54,1,48,2,50,1,84,1","nguyen,36,1,84,1","nhdr,30,2","nhqr,30,2","nhsc,12,1,28,3,34,2","nia,16,1,25,1,41,1,53,1,56,1,58,1,57,1","niaaa,29,1,37,1","nicholas,13,1,11,1,16,1,25,1,22,1,39,1,43,1,59,1","nick,26,1,55,1","nicole.falco@in2meded.net,36,1","nicu,84,8","nida,37,1","nigeria,7,1","nigerian,7,1","night,7,1,50,1","nightingale,27,1","nih,7,1,25,1,27,1,37,1,53,1,56,1,58,1,57,1,88,1","nimh,11,1,25,1,26,2,27,1,32,2,36,5,46,1,53,1,54,2,55,2,56,1,58,1,57,1","nimh-funded,36,1,48,2","nine,14,1,20,1,36,1,84,5","ninety,46,1,82,1","ninr,29,2","ninth,7,1,41,1","niwi,9,3,10,3,15,3","niwi&#8482,39,2","nj,20,3","nm,7,5","nms,7,39","nnp,84,3","nominal,11,2","nominate,18,3,21,1,25,1,24,1,37,1","nominated,30,1","nominating,11,1,16,1,19,1,21,1,25,3,26,1,30,1,33,1,34,1,36,1,41,1,53,2,55,1,56,2,58,2,57,2","nomination,18,1,32,1","nominations,11,1,16,1,18,2,21,3,25,1,30,1,34,1,36,1,53,1,56,1,58,1,57,1","nominees,24,1","nonacute,7,1","nonattentive,31,1,131,1","non-claim,82,2","noncns,84,1","non-cns,84,5","non-compact,7,1","non-compliance,33,1","non-compliant,33,1","non-cumulative,41,1","nondegree,7,1","none,44,1","nonelderly,41,1","non-english,84,1","nonetheless,7,5","non-federal,7,2","nongovernment,7,4","nonhealth,7,3","nonhealthcare-related,7,1","nonhealthrelated,7,1","nonhealth-related,7,2","nonhispanic,7,7","non-hispanic,7,55,44,1","nonhospital,7,29","nonhospital-based,7,1","nonlocal,7,1","nonmembers,14,1","non-nurse,7,1","nonnursing,7,3","non-nursing,7,36","nonpharmacologic,42,1,46,1","non-pharmacologic,84,2","nonprofit,24,2,30,1,35,1,42,1","non-profit,30,1,36,1,47,1","nonpsychiatric,19,1","non-psychiatric,50,2","nonrespondents,7,2","nonresponding,7,2","nonresponse,7,23","nonsampling,7,1","nonsignificance,84,1","non-significance,84,1","nonsignificant,84,1","non-significant,84,1","non-specialist,14,1","nonteaching,7,1","nonthoracic,84,1","non-thoracic,84,1","nontravel,7,4","nontrivial,7,1","nonurban,7,1","non-voting,53,1,56,1,58,1,57,1","nonwhite,7,2","non-white,7,4","nonworking,7,2","nor,7,13,18,1","normal,7,3,34,1,38,1,40,1,46,1,48,1","normally,7,2,30,1","north,7,10,9,2,10,2,37,1,60,1","northeast,33,2,38,1,40,1","northern,41,2","norwitz,84,1","notable,7,3","notably,7,3,15,1","note,7,13,24,1,35,1,42,1,46,1,50,1,61,1,66,2,82,3,84,1","noted,7,1,25,1,35,1,42,1,82,1,84,4","notes,34,1,84,1","not-for-profit,47,1","notice,30,1,35,1,34,1,50,1","noticed,26,1,39,1,55,1,59,1","notification,7,1","notified,7,1,35,1","notify,82,1","noting,26,1,55,1","nottingham,42,1","nov,45,2,49,2,51,2,92,1","novel,36,1","november,12,2,16,1,35,1,34,2,53,1,47,1,49,5,50,7,56,1,58,1,57,1,61,1","np,7,20,82,20,84,67,92,1","npclaimstudy2009,82,2","npp,60,1","nprm,35,2","nps,7,73,82,44,84,15","nqf,12,1,26,1,27,3,31,1,37,1,53,1,52,3,55,1,56,1,58,1,57,1,131,1","nri,33,1","nrp,7,3","ns,84,1","nsduh,42,1,43,1","nso,21,2,82,31","nso-insured,82,3","nsojune.gif,8,1,77,1,78,1,79,1,80,8,81,1,132,1,134,1,136,1,137,1","nssrn,7,92","nth,7,1","nuclear,7,1","number,7,195,13,2,11,1,18,1,19,1,24,1,26,1,27,1,28,3,33,1,32,2,36,3,39,2,41,1,42,2,43,1,46,1,54,4,48,2,51,1,52,1,55,1,59,1,82,4,83,1,88,1,84,17","numbering,82,2","numbers,7,22,33,1,35,1,83,1,88,1,84,1","numerous,7,2,26,1,28,1,34,1,53,1,55,1,56,1,58,1,57,1,84,1","nurs,82,2","nurse,7,419,13,2,9,1,10,1,12,1,14,1,15,1,18,1,19,1,21,5,25,2,22,2,24,3,26,2,27,7,28,1,33,8,35,3,31,1,34,3,36,1,38,1,40,1,39,3,42,9,44,4,46,2,53,3,54,1,50,2,52,1,55,2,56,3,58,3,57,3,60,1,82,62,84,82,92,8,131,1","nurse..&gt,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","nurse.com,46,1","nurse-directed,84,1","nurse-led,21,1","nurse-managed,84,1","nurse-midwife,7,1,84,3","nurse-midwifery,7,5,84,5","nursemidwives,84,2","nurse-midwives,84,9","nurse-participants,50,1","nurse-patient,27,1,41,1","nurses,7,944,13,1,9,5,10,5,11,2,17,1,14,2,15,2,16,1,18,5,19,3,20,1,21,3,25,5,22,2,23,1,24,1,26,7,27,12,28,3,30,4,33,7,35,2,31,2,34,1,36,5,37,1,38,3,40,3,45,1,39,3,41,3,42,5,43,2,44,1,46,8,53,2,54,6,47,5,48,1,49,3,50,11,51,1,52,5,55,7,56,2,59,5,58,2,57,2,69,2,82,7,84,10,92,9,131,2","nursing,7,1087,13,12,9,8,10,8,11,7,12,9,17,4,14,5,15,7,16,8,18,22,19,9,20,4,21,11,25,15,22,6,23,8,24,12,26,12,27,24,28,8,29,6,30,9,33,11,35,7,31,4,32,4,34,12,36,11,37,6,38,7,40,7,45,5,39,17,41,6,42,7,43,4,44,7,46,9,53,11,54,16,47,12,48,5,49,8,50,11,51,13,52,15,55,12,56,11,59,10,58,11,57,11,73,4,60,7,63,4,65,4,66,1,67,4,69,1,84,44,92,16,131,4","nursing.â ,50,1","nursinghome,84,1","nursingnumber,7,1","nursingrelated,7,11","nursing-related,7,69","nursing-resources,82,2","nurturing,24,1","nutr,82,4","nutritional,42,1","ny,20,1","nys,20,1","oakley,84,19","obama,12,1,15,1,16,4,18,2,19,1,22,2,26,1,28,1,29,1,35,1,34,2,37,1,43,1,54,2,55,1","obamaâ€™s,9,1,10,1,19,1","obesity,36,1,48,1","obey,13,1","objectives,25,1,24,1,54,1","obligation,25,1","observable,26,1,55,1","observation,46,1","observational,84,32","observed,82,1","obsessive,51,1","obsessive-compulsive,38,1,40,1,41,2","obstacles,34,1","obstetric,84,7","obstetrical,84,1","obstetrician,84,1","obstetricians,84,8","obstetrics,7,8,82,1,84,6","obtain,7,11,19,1,44,1,54,1,82,1","obtained,7,16,84,1","obtaining,7,1,27,1","oc,35,1","occupancy,26,2,27,1,50,1,55,2","occupation,7,16","occupational,7,22,19,1","occupations,7,16,54,1","occupies,7,2","occupy,7,2,82,1","occur,7,2,82,1,83,1","occurred,7,2,50,1,82,3","occurrence,82,1","occurring,7,1,20,1","occurs,7,4","ocd,41,1","oct,18,1,35,1,44,1,48,1","october,9,1,10,1,12,1,18,1,25,1,24,1,28,1,30,1,33,1,34,2,36,1,45,5,41,2,42,2,44,1,46,7,53,1,47,2,48,2,50,2,51,2,56,1,58,1,57,1,60,2,61,1,131,1","odegarden,35,1","off,7,2,12,1,18,1,22,1,24,1,36,1,38,1,40,1,42,1,54,1,50,1","offender-reentry,28,1","offer,7,2,13,1,12,1,21,1,28,1,33,1,34,1,36,1,38,1,40,1,41,3,46,1,48,1,49,1,92,1","offered,7,3,12,1,28,2","offering,7,2,9,1,10,1,11,1,26,1,34,1,37,1,38,2,40,2,39,1,46,2,48,1,55,1,92,1","offerings,45,1,42,1,49,1","offers,23,1,27,1,32,1,36,1,38,1,40,1,42,1,46,1,92,2","office,11,1,12,1,22,2,24,1,26,1,27,2,33,1,35,1,38,2,40,2,41,1,55,1,82,6","officer,52,1","officers,26,1,37,1,50,1,52,1,55,1","offices,12,1,82,1","official,20,1,21,1,22,1,33,1,46,1,84,1","officially,11,1","officials,9,1,10,1,15,1,19,1,44,1,54,2,49,1","off-label,38,1,40,1,39,1,41,1,50,1","offset,7,1,18,1,26,1,35,1,39,1,55,1","off-site,7,1","offspring,82,1","oh,28,1,82,1","ohio,30,1,53,1,56,1,58,1,57,1,82,1","oins,69,1","olanzapine,41,1","old,7,106,24,1,29,1,33,1,34,1","older,7,110,9,1,10,1,17,1,14,1,20,1,25,2,35,1,32,5,34,3,36,2,37,2,39,1,42,1,43,3,44,2,46,1,54,2,48,4,50,1,52,2,61,1,83,1,84,11","oldest,7,1,26,1,55,1","olds,23,1,44,1","olson,82,1","olver,50,1","omaha,14,1","omh,27,1","omni,16,1","omnibus,53,1,48,1,56,1,58,1,57,1","on-call,7,19","on-campus,38,1,40,1","once,7,1,9,1,10,1,84,1","oncology,7,9,46,1,84,4","ondcp,26,1,55,1","one,7,63,13,2,9,1,10,1,11,1,12,2,17,2,14,1,15,1,16,2,18,2,20,2,21,4,25,3,22,3,23,2,24,3,26,4,28,3,29,2,33,1,35,1,31,2,34,3,36,2,37,1,38,2,40,2,39,1,41,1,42,2,44,2,54,2,47,1,50,2,51,1,55,4,60,1,83,3,88,2,84,53,92,1,131,2","one-hour,25,1","one-month,50,1","one-quarter,7,5,82,1","ones,16,1,35,1,45,1,39,1,53,1,56,1,59,1,58,1,57,1","one-third,7,3,34,1,46,1","ongoing,23,1,33,1,53,1,56,1,58,1,57,1,82,1,83,1,88,1","online,7,2,9,2,10,2,17,1,15,1,16,1,21,5,26,2,27,1,28,1,30,1,35,4,34,1,36,4,40,1,45,7,39,1,42,4,43,1,44,1,46,2,53,6,54,1,47,1,49,6,50,1,51,1,55,2,56,6,58,6,57,6,82,3","on-line,34,1","onset,14,1,25,1,48,1","onsite,53,1,47,1,56,1,58,1,57,1,82,1","on-site,14,1,36,1,82,1","on-the-go,36,1","onto,35,1,47,1,48,1","op,35,1","open,9,2,10,2,12,2,14,2,15,1,16,1,23,1,26,1,27,1,30,3,34,1,36,1,45,1,39,1,53,1,55,1,56,1,58,1,57,1,82,10","opened,7,1,9,1,10,1,21,1,28,1,41,1","opening,42,1","opens,17,1","operates,26,1,55,1","operating,27,3","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7,8,28,3,30,1,33,1,31,1,36,3,37,2,38,7,40,7,45,2,39,2,41,2,44,1,53,1,54,4,46,2,48,1,49,2,50,2,51,1,52,3,55,1,56,1,58,1,57,1,82,1,83,7,84,1,92,3,131,1","progress,15,1,21,1,25,1,26,1,38,1,40,1,39,1,42,1,55,1","progresses,25,1,84,1","progression,35,1,46,1","progressive,7,1,23,1,45,1","project,12,1,14,1,16,1,23,1,26,2,27,1,35,1,32,2,34,1,36,3,37,1,38,2,40,2,45,2,53,1,55,2,56,1,58,1,57,1,84,3","project.â ,26,1,55,1","projected,12,1,14,1,25,2,48,1","projection,7,1","projections,7,1,33,1","projects,9,1,10,1,18,1,35,1,42,1,48,1,49,1","prominently,37,1","promise,14,1","promised,9,1,10,1,54,1","promises,33,1","promising,19,1,39,1,53,1,56,1,58,1,57,1","promote,16,1,19,2,21,2,25,1,23,1,27,1,30,1,35,2,38,1,40,1,41,1,44,1,53,1,50,2,56,1,58,1,57,1,84,2","promotes,21,1","promoting,17,1,18,1,27,2,38,2,40,2,41,1","promotion,7,1,16,1,21,1,27,3,30,2,34,1,54,1,84,1","prompted,54,1","promulgate,34,1","pronounced,7,1,88,1","propelled,50,1","propensities,7,2","propensity,7,1","proper,53,1,56,1,58,1,57,1","properly,82,2","proponents,27,1","proportion,7,9,26,3,32,1,54,1,55,3,83,1,84,2","proposal,12,4,14,2,15,1,16,4,26,1,53,1,55,1,56,1,58,1,57,1","proposals,11,2,12,1,14,1,28,1,30,4,31,1,34,1,36,3,37,1,45,1,39,1,53,1,51,2,56,1,58,1,57,1,131,1","proposed,12,1,14,1,18,3,25,4,22,2,28,1,30,6,35,1,34,1,36,3,41,4,54,1,50,1","proposes,25,1,26,1,55,1","proposing,16,1,33,1","proprietor,7,1","proprietors,7,1","proquest,84,2","prospective,25,1,27,1,29,1,84,1","prostatectomy,84,6","protect,33,1,31,1,49,1,82,1,131,1","protecting,18,1,27,1","protection,12,1,44,2,53,1,52,1,56,1,58,1,57,1","protective,30,1","protein,38,1,40,1","protocol,7,2,82,1","protocols,7,1,15,1,82,2","proton,82,1","proud,50,1,69,1,88,1","prove,36,1","proven,12,1","provide,7,23,13,1,9,1,10,1,12,2,17,1,14,1,18,1,19,3,20,1,21,1,25,3,27,2,22,2,24,2,26,1,28,2,33,1,35,2,31,1,32,2,36,4,38,2,40,2,39,1,41,2,42,2,43,1,44,1,53,1,46,1,47,1,48,1,50,1,52,1,55,1,56,1,58,1,57,1,60,1,82,1,83,3,88,1,84,8,92,1,131,1","provided,7,54,12,3,18,2,21,2,22,1,24,1,28,2,30,1,36,1,38,2,40,3,39,3,41,1,42,1,53,2,47,1,50,1,51,1,52,1,56,2,58,2,57,2,69,1,82,1,83,2,84,12,92,1","providence,18,1","provider,27,1,23,1,26,3,30,1,33,1,36,2,38,1,40,1,39,2,41,2,47,1,55,3,84,13","providers,7,1,13,2,16,1,18,1,19,2,21,1,22,1,23,3,24,1,26,1,29,1,30,3,35,1,32,1,36,1,37,1,45,2,43,1,53,1,46,1,48,1,50,2,55,1,56,1,58,1,57,1,82,1,84,37","provides,7,12,13,1,9,2,10,2,11,1,17,1,15,2,18,2,27,1,23,3,28,1,33,1,35,1,32,1,36,1,38,1,40,1,39,1,42,1,53,1,49,2,52,1,56,1,58,1,57,1,82,1","providing,7,9,17,1,16,1,18,1,27,2,24,1,28,1,30,1,33,1,36,2,37,1,38,1,40,1,45,2,41,1,42,1,53,4,46,1,48,1,49,2,50,1,56,4,58,4,57,4,82,2,83,2,88,1,92,1","provision,7,1,53,1,54,1,52,1,56,1,58,1,57,1,84,1","provisions,11,1,16,1,19,1,21,1,23,4,30,1,35,1,36,1,38,1,40,1,45,2,39,1,53,2,49,1,52,1,56,2,58,2,57,2,88,1","provocative,11,1","prows,24,1","psa,23,1","psi,26,2,55,2","psych,12,1,14,1,21,1,27,1,38,1,40,1,53,1,51,1,52,1,56,1,58,1,57,1","psychcentra,39,1","psychcentral,44,1","psychcentral.com,14,1,22,1,30,1,41,1","psychiatric,7,14,13,9,9,11,10,11,11,8,12,12,17,5,14,5,15,6,16,6,18,14,19,8,20,5,21,14,25,9,27,17,22,6,23,7,24,6,26,20,28,6,29,4,30,9,33,10,35,16,31,6,32,5,34,9,36,12,37,6,38,11,40,12,45,5,39,14,41,11,42,12,43,5,44,6,53,9,54,8,46,14,47,9,48,4,49,5,50,16,51,7,52,7,55,20,56,9,59,9,58,9,57,9,73,4,60,3,63,4,65,4,66,1,67,4,69,3,82,1,88,1,92,1,131,6","psychiatric-mental,13,1,11,1,21,1,26,1,33,2,35,1,45,1,53,1,54,1,47,2,49,1,50,1,51,1,55,1,56,1,58,1,57,1,92,4","psychiatric-mental-health-nursing,27,1","psychiatrists,21,1,27,2,23,1,26,2,42,1,55,2","psychiatry,7,1,21,1,30,1,46,1,51,1,69,1,84,1","psychological,9,1,10,1,12,1,21,2,36,1,44,3,47,1,69,1","psychologist,54,1","psychologists,23,1,26,2,47,1,55,2","psychology,52,1","psychopharmacological,36,1","psychopharmacology,13,2,12,1,17,2,14,2,16,3,18,2,20,3,21,1,27,1,22,2,23,2,26,1,28,1,29,1,35,2,36,2,38,3,40,3,45,1,41,1,49,1,52,2,55,1","psychosis,14,3,21,1,50,2","psychosocial,18,1,27,1","psychotherapies,46,1","psychotherapy,11,1,14,2","psychotic,14,1","psychotropic,26,3,55,3,88,1","ptsd,27,4,23,1,24,2,33,2,50,2","public,7,50,12,3,14,2,15,1,16,2,18,3,25,1,27,5,22,1,23,1,24,4,26,1,30,3,33,1,35,1,31,1,34,2,37,1,40,1,39,1,41,2,42,3,43,1,44,1,53,1,54,2,46,2,48,1,49,4,51,2,55,1,56,1,58,1,57,1,69,1,82,1,83,1,84,8,92,1,131,1","publicâ€™s,9,1,10,1","publication,7,2,13,1,16,1,19,1,35,1,41,1,42,1,82,1,84,2","publications,7,1,35,2,82,1,84,1,131,1","publicity,39,1","publicly,25,1,27,1,42,1","publicly-funded,39,1","publicprivate,83,1","public-private,84,1","publish,34,1,48,1","published,11,2,14,1,19,1,21,1,25,3,27,1,26,1,28,1,30,1,35,1,38,1,40,1,45,1,41,1,42,1,46,1,51,1,55,1,82,2,84,5","publishers,35,1","publishes,19,1","publishing,33,1","pubmed,84,1","puerto,7,1,26,2,34,1,55,2,83,1","puget,41,1","pulmonary,7,4,84,5","pump,82,1","punishment,32,1","purchase,14,1,21,1,35,1,42,1","purchased,35,1,42,1","purchasing,13,1","purdue,35,3","purpose,7,1,16,1,25,1,33,1,45,1,42,2,54,1,83,1,84,4","purposes,7,3,18,1,26,1,38,1,40,1,55,1,82,1","pursue,7,5,13,1","pursued,7,5","pursuing,7,8","puryear,44,1","push,16,2","pushed,37,1,42,1","pushing,23,1","putting,33,1","q13,82,1","q14,82,1","q19,82,1","q2,82,1","q22,82,1","q24,82,1","q27,82,1","q6,82,1","q7,82,1","qfd,7,1","quad,50,1","qualifications,7,1,21,1","qualified,7,1,13,1,12,2,14,1,18,1,19,2,27,1,30,1,45,1","qualify,7,1,52,1","quality,7,4,13,3,12,2,21,5,25,7,27,5,26,3,28,3,30,5,33,7,35,2,32,1,36,5,37,4,38,1,40,4,45,1,41,5,53,2,54,1,46,1,47,1,50,1,52,4,55,3,56,2,58,2,57,2,83,4,84,67","quantitative,84,2","quantity,36,1","quarter,7,2","quasi-experimental,84,1","queried,7,1","question,7,11,22,1,23,1,44,2,49,1,60,2,88,2,84,8","questioning,11,1","questionnaire,7,17,82,2","questionnaires,7,1","questions,7,6,12,3,21,1,26,1,33,2,35,2,32,1,34,1,38,1,40,1,39,1,41,1,42,3,46,1,47,1,50,3,55,1,82,1,88,1,84,1","quetiapine,41,1","quick,7,1,12,1,36,1,88,1","quickfacts.census.gov,7,1","quickly,19,1,48,2,88,1","quite,7,4","r.a,84,2","r.h,84,1","r.k,84,1","r.l,84,5","r.n,29,1","r.p,84,1","r.r,84,1","rac,32,1","race,7,30,84,1","races,7,5","rachel,20,1","racial,7,44,11,1,47,1","racially,7,1","radical,84,5","radio,18,1,33,1","radiological,7,1","radiology,7,4","radosevich,84,1","raine,84,1","raise,16,1,21,3,32,1,39,2,41,1,42,1,50,1,59,1,82,1","raising,53,1,56,1,58,1,57,1,92,1","r-ak,31,1,131,1","raking,7,2","ramin,41,1","rampant,12,1","ranching,7,1","randall,20,1","random,7,3","random-effects,84,1","randomized,20,1,82,1,84,11","randomly,7,4,84,1","range,7,2,12,1,18,1,27,1,36,1,41,1,84,3","ranged,7,1","ranges,7,1","ranging,7,2,44,1","rank,54,1","ranked,92,2","ranking,22,1","rankled,48,1","ranks,54,1","rao,84,1","rapidly,7,4,35,1,32,1,34,1","rare,7,1,29,1,88,1,84,1","rasmussen,82,1","ratchet,16,1","rate,7,42,11,1,15,1,27,2,23,1,26,2,30,1,35,1,34,2,36,1,37,1,38,1,40,1,45,1,42,1,54,3,46,1,48,4,50,1,55,2,82,1,83,1,84,3","rated,84,5","rates,7,28,11,1,12,1,14,2,16,1,18,1,21,2,25,2,22,2,23,1,24,1,26,3,30,1,35,2,34,1,38,1,40,1,45,1,44,2,54,1,46,4,48,1,50,2,55,3,84,50","rather,7,7,32,1,39,1,48,2,84,2","rating,25,1,84,12","ratings,7,1","ratio,7,3","rational,14,1,21,1,36,1,38,2,40,2,84,1","rats,39,1","rct,84,39","rcts,84,59","rd,82,1","rdoc,26,1,55,1","re,11,1,16,1,25,1,33,1,42,1,88,2","reach,7,1,15,1,18,1,34,1,53,1,56,1,58,1,57,1","reached,15,1,38,1,40,1,41,1,50,1,82,2,83,1,84,1","reaching,34,1,38,1,40,1,48,2","reachout.com,23,2","react,48,1","reaction,26,1,55,1","reactions,21,1,50,1","read,13,3,11,1,12,1,17,2,14,1,16,1,18,1,19,1,20,1,21,2,25,1,27,2,22,2,23,1,26,3,28,1,29,2,30,2,33,5,35,1,31,1,32,1,34,1,36,2,38,1,40,1,45,1,39,2,41,3,42,7,43,1,53,2,54,1,46,1,47,2,49,3,50,3,51,1,55,3,56,2,58,2,57,2,66,2,131,2","reader,51,1","readers,82,1","readily,16,1","reading,19,1,30,1,35,1,42,1","readjust,24,1","readmissions,83,2","reads,11,1","ready,26,1,34,1,55,1","ready-to-use,25,1","reaffirm,27,1","real,7,5,33,1,36,1,45,1","reality,37,1,47,1","realize,92,1","real-life,37,1","really,21,1,38,1,40,1,88,2","real-world,44,1,50,1","reappeared,7,1","reason,7,7,17,1,38,1,40,1,84,1","reasonable,26,1,55,1","reasons,7,51,17,1,21,1,31,1,84,4,131,1","reassurance,92,1","reauthorization,25,1,49,1","reauthorized,88,1","rebased,25,1","rebecca,12,1","rebetron,84,1","rebutting,37,1","recall,12,1,39,1","recalled,82,1","recap,36,1,50,1","receive,7,10,9,1,10,1,11,2,18,2,25,3,23,1,24,1,26,1,28,3,30,2,33,2,35,2,32,1,34,6,37,1,38,1,40,1,39,1,53,1,54,2,47,1,48,4,49,1,52,1,55,1,56,1,59,1,58,1,57,1","received,7,36,9,2,10,2,11,1,17,4,21,1,27,1,28,2,35,1,34,1,41,1,54,1,47,1,51,2,92,2","receives,92,1","receiving,7,3,17,1,14,1,21,1,27,1,34,1,38,1,40,1,41,1,42,1,49,1,50,1,82,2,84,7","recent,7,97,17,1,18,1,21,1,27,1,22,1,26,1,29,2,33,2,35,2,34,1,36,2,38,2,40,2,45,1,47,1,48,2,50,1,51,1,55,1,82,1,83,1,84,2","recently,7,17,13,1,12,2,17,1,16,1,18,2,20,2,21,4,27,2,22,1,23,1,26,2,28,1,33,2,36,2,37,1,38,1,40,1,45,2,39,1,41,3,42,3,53,1,54,3,46,1,50,1,52,1,55,2,56,1,82,1,58,1,57,1,84,4","reception,34,2,41,1","receptive,48,1","receptor,39,1,82,1","receptors,82,1","re-certify,38,1,40,1","recess,35,1","recession,37,1","rechecked,84,1","recidivism,24,1","recipient,33,1","recipients,11,1,25,1,28,1,30,7,33,1,34,6,36,2,41,3,42,2","reciprocal,45,1","reclassification,12,1","reclassified,11,1","reclassify,11,2","reclusive,31,1,131,1","recognition,7,51,13,2,18,1,25,1,23,1,28,1,30,1,33,1,34,1,52,1","recognize,7,1,11,1,18,1,21,2,30,1,36,1,50,1","recognized,7,17,12,2,18,1,21,2,24,1,30,1,34,1,41,1,53,2,56,2,58,2,57,2,92,1","recognizes,16,1,19,1","recognizing,16,1,20,1,30,1,52,1","recollections,39,1,82,1","recommend,27,1,38,2,40,2","recommendation,19,1","recommendations,14,1,18,1,19,2,21,3,26,1,30,1,35,2,31,1,41,1,54,1,46,1,50,2,55,1,82,2,84,3,131,1","recommended,7,1,24,1,28,1,82,1","recommending,53,1,56,1,58,1,57,1","recommends,36,1,50,1","reconciliation,18,1,31,1,37,1,131,1","reconsider,36,1","reconsideration,27,1","record,7,7,22,1,36,1,41,1","recorded,84,1","recording,23,1,36,1","recordings,36,1","recordkeeping,7,2","records,7,5,82,3","recover,18,1,83,1","recovering,39,1","recovery,13,2,12,1,17,1,16,3,18,2,19,1,20,1,21,8,25,1,22,2,23,6,26,3,28,1,29,1,33,1,31,3,32,3,34,1,36,7,38,16,40,16,41,7,53,2,54,4,49,2,55,3,56,2,58,2,57,2,88,1,131,3","recovery-focused,36,1","recovery-oriented,23,3,26,3,36,1,38,2,40,2,55,3","recruit,35,1,46,1,47,2","recruited,7,2,84,1,92,1","recruiting,33,1,35,1,34,1,38,1,40,1","recruitment,7,1","recurrent,82,2","recurring,42,1,82,1","red,27,1,24,3,38,4,40,4","redefined,82,1","re-designed,22,1","reduce,7,3,20,1,25,1,27,1,23,1,24,1,26,1,29,1,30,1,32,1,34,1,36,1,39,1,53,1,46,1,55,1,56,1,58,1,57,1,84,3","reduced,7,2,16,1,27,2,22,1,35,1,45,2,48,1,83,1,84,4","reduces,33,1,82,1","reducing,21,1,25,1,26,1,36,1,43,1,44,1,55,1,84,1","reduction,7,1,14,1,20,1,25,1,27,1,26,1,49,1,50,1,55,1","reductions,14,1,18,1,27,2,26,1,55,1","reed,31,1,32,3,54,1,131,1","reemployment,48,1","reentry,24,1","re-establishes,47,1,92,1","re-evaluated,23,1","re-evaluating,26,1,55,1","reeves,84,1","refer,7,1","reference,35,1","references,7,1,84,1","referred,7,3","refers,7,1,82,3,84,1","reflect,7,4,82,2","reflected,7,2,41,1,84,2","reflecting,7,2,34,1","reflection,7,1","reflective,33,1","reflects,7,1,14,1,20,1,25,1,42,1","reform,9,1,10,1,12,3,14,1,15,1,16,3,19,5,27,1,22,5,23,7,26,3,33,3,35,1,34,1,37,5,38,1,40,1,45,2,39,4,43,2,53,2,46,1,49,4,51,1,55,3,56,2,82,1,58,2,57,2,69,9,88,7,84,4","reforms,53,1,56,1,58,1,57,1","reformulated,35,4","refusals,7,1","refusing,48,1","regard,42,1,44,1","regarded,14,1","regarding,7,15,15,1,19,1,29,1,33,1,34,1,36,1,37,1,38,1,40,1,42,1,43,1,54,1,46,2,50,1,82,3","regardless,7,5,82,1","regency,28,1,52,1","regina,30,1","region,7,17","regional,7,1,9,1,10,1,14,1,15,1,28,1,41,1,84,3","regions,7,8","register,9,1,10,1,11,1,17,1,14,2,15,1,18,1,27,2,22,1,24,3,26,2,28,1,29,1,30,2,33,1,35,4,31,1,32,2,36,1,38,2,40,2,39,1,42,4,43,1,54,2,51,1,55,2,131,1","registered,1,1,2,1,3,1,4,1,6,1,7,773,9,1,10,1,19,2,21,1,25,2,26,1,30,2,33,3,41,1,54,1,46,1,50,1,55,1,82,8,72,1,74,1,75,1,76,1,84,7,92,1","registration,13,1,9,1,10,1,12,4,17,1,14,2,15,2,16,2,18,3,21,2,25,1,27,2,22,2,24,1,26,1,28,2,29,1,30,4,33,1,31,1,34,3,36,5,37,1,38,3,40,3,45,1,41,1,42,2,44,1,46,1,49,1,50,1,55,1,131,1","regression,7,4","regular,7,3,18,1,27,1,22,1,38,1,40,1,42,1","regulation,7,1,21,1,33,2,35,1,31,1,39,2,53,1,50,1,56,1,82,1,58,1,57,1,131,1","regulations,7,2,12,1,16,1,23,1,30,1,35,1,45,2,51,1,82,1","regulator,7,7","regulators,26,1,31,1,46,1,55,1,131,1","regulators.â while,26,1,55,1","regulatory,7,1,9,1,10,1,15,1,21,1,27,1,33,3,39,2,54,1,51,2,82,1","rehabilitation,7,3,21,1,25,1,69,1,84,3","rehospitalization,83,1,84,1","reimbursed,37,1","reimbursement,7,4,23,1,26,3,54,2,48,1,55,3,88,1,84,2","reimbursing,48,1","reiner,84,3","reintegration,24,1","reintroduced,22,1,35,1,32,1","re-introduced,50,1","reinvestment,17,1,16,1,18,1,19,1,28,1,32,1,53,1,49,1,56,1,58,1,57,1","reject,18,1,26,1,55,1","rel0903.html,1,1,2,1,3,1,4,1,6,1,72,1,74,1,69,4,75,1,76,1","relapsing,39,1","relate,39,1,82,1","related,7,26,9,1,10,1,11,1,23,2,26,1,28,1,29,1,33,2,31,1,36,1,37,1,38,3,40,3,45,1,42,1,43,1,54,1,46,1,55,1,82,3,83,1,84,1,131,1","relates,88,1","relating,11,1,24,1,26,1,52,1,55,1","relation,36,1,84,1","relationship,7,3,9,1,10,1,14,1,34,1,41,1,82,2","relationships,34,1,82,2,84,1","relative,7,1,26,1,55,1","relatively,7,6,48,1","relatives,7,3","re-launched,26,1,55,1","relaxed,35,1,36,1","relaxes,48,1","release,26,2,30,1,33,1,55,2,69,1,92,1","released,11,1,17,1,14,1,16,1,18,2,19,3,20,1,21,2,25,1,27,4,23,2,24,1,26,1,28,1,30,3,35,2,37,1,40,1,39,1,41,1,42,1,48,2,50,1,52,1,55,1","releases,82,1","releasing,42,1","relevant,7,1,17,1,84,2","reliability,44,1,84,1","reliable,34,1,42,2,84,1","reliance,26,1,55,1","relied,7,3","relief,18,1,22,1,24,1,38,2,40,2,84,1","relies,33,1","relieving,36,1","religious,7,1","relocation,7,2","rely,15,1","remain,7,10,12,2,27,1,30,1,44,2","remainder,7,2","remained,7,4,26,1,41,1,43,1,55,1","remaining,7,3,31,1,84,5,131,1","remains,82,1","remarkable,23,1,33,1,37,1,52,1","remember,27,1,36,1,38,2,40,3","remind,26,1,36,1,55,1","reminded,21,1","reminder,12,1,82,1","reminding,7,1,23,1,35,1","remission,36,1","remove,30,1,50,1","renal,7,4","renee,84,2","renew,30,2","renewal,30,1,38,1,40,1,41,1,53,1,56,1,58,1,57,1","renewed,7,1,16,1,82,1","renewing,21,1","renews,25,1","reno,52,1","rep,12,1,14,2,26,2,32,3,55,2","repair,84,1","repayment,12,2,18,1,22,1,28,2,34,3","repeal,12,1,18,1","repeated,14,1","replaced,43,1","replacement,84,4","replacing,46,1","replicate,7,1","report,7,70,9,1,10,1,11,2,17,5,15,1,18,2,19,7,20,2,21,4,25,4,27,3,22,4,23,4,24,3,26,1,28,5,29,3,30,3,35,1,31,2,32,1,36,2,38,1,40,1,45,6,39,5,42,3,44,2,54,4,46,8,48,6,49,4,50,1,51,3,52,1,55,1,82,7,84,6,92,1,131,2","reported,7,130,13,2,9,1,10,1,11,2,12,4,14,4,15,3,16,2,18,3,19,1,21,2,25,3,27,2,22,1,23,1,24,1,26,5,28,1,29,2,30,3,33,2,35,3,31,1,32,1,34,3,36,6,37,5,38,3,40,3,45,2,39,4,41,4,42,1,43,5,44,7,54,6,46,3,48,2,49,1,50,2,51,2,55,5,56,1,82,1,58,1,57,1,84,42,131,1","reportedly,82,1","reporter,45,1","reporters,34,1","reporting,7,11,25,3,27,4,22,1,24,2,26,2,45,1,41,5,53,1,52,1,55,2,56,1,82,3,58,1,57,1,84,4","reports,11,1,17,2,27,3,28,1,32,1,37,2,46,2,52,1,82,1,84,2","represent,7,5,41,1,82,1,69,1,84,2","representation,7,6","representative,11,1,53,1,50,1,56,1,58,1,57,1,69,1","representatives,11,1,16,1,27,1,22,1,26,1,33,2,31,1,34,2,44,1,48,1,55,1,131,1","representatives.â these,33,1","representativesâ€™,45,1","represented,7,6,30,1,41,1,51,1,84,1","representing,7,6,20,1,52,1","represents,14,1,18,1,22,1,35,1,54,2,84,2","reproducibility,82,1","reproducible,84,1","reps,16,1,27,1","republican,39,1,49,1,50,1","republicans,13,1,18,1","repudiation,14,1","reputation,22,1","reputational,17,1","request,27,1,24,1,29,1,34,1,36,1,53,1,56,1,82,1,58,1,57,1","requested,18,1,21,1,82,1","requesting,7,2,12,1,23,1,34,1","requests,7,2,18,1,36,1","require,7,10,31,1,41,1,43,1,44,1,82,1,88,1,131,1","required,7,30,11,1,21,1,27,1,26,2,28,1,29,1,30,1,31,1,34,1,36,3,38,3,40,3,42,1,46,1,49,1,55,2,82,2,63,1,131,1","requirement,7,4,14,1,54,1","requirements,7,4,21,1,25,1,22,3,33,1,34,1,49,3,92,1","requires,7,1,15,1,33,1,41,1,44,1","requiring,7,1,11,1,18,1,23,1,30,1,39,1,54,1,48,1,51,1,83,1,84,3","requisite,25,1","research,7,12,13,3,9,1,10,1,11,3,12,3,17,3,14,2,15,1,16,2,18,3,19,2,20,1,21,2,25,2,27,4,23,2,24,3,26,5,28,1,29,4,30,5,33,8,35,1,31,1,32,1,34,5,36,2,37,2,38,6,40,6,45,1,39,6,41,1,42,1,43,1,44,4,53,7,54,5,46,4,47,2,49,1,50,1,51,2,55,5,56,7,59,7,82,3,58,7,57,7,60,9,88,1,84,16,92,1,131,1","research-andtrends,7,1","researcher,7,9,38,1,40,1","researchers,7,2,13,1,12,1,14,3,25,2,30,3,35,1,34,1,36,1,38,1,40,1,39,4,41,1,44,2,53,1,46,3,48,2,50,1,56,1,59,1,58,1,57,1,88,1","research-focused,52,1","resection,84,1","resembles,14,1","reserve,82,1","reserved,82,1","reserves,7,1","reservists.the,48,1","reside,7,3,32,1","resided,7,1","residence,7,3","resident,7,1,84,4","residential,7,1,18,1,20,1,22,1,26,3,41,2,43,1,55,3","residents,7,1,35,1,34,1,38,1,40,1,43,1,48,1,84,12","resides,7,2","residing,7,2","resiliency,49,1","resilient,41,1","resolved,84,2","resort,7,1,50,1","resounding,50,1","resource,7,2,13,1,12,1,14,1,21,1,25,1,27,3,30,1,35,3,36,5,38,1,40,1,41,1,42,1,43,5,54,2,50,3,84,2","resourcecenter,43,1","resources,7,25,13,1,11,1,12,1,14,1,18,1,21,1,25,1,27,7,23,2,28,1,35,1,36,3,38,1,40,1,45,1,42,3,43,3,47,1,49,2,50,2,52,1,88,1","respect,30,1","respectful,41,1","respectively,7,7,34,1,82,1","respiratory,7,4,84,4","respond,7,6,13,1,18,1,21,1,27,1,29,1,42,2,44,2,51,1,82,3,60,1","responded,7,4,22,1,45,1","respondent,7,4","respondents,7,16,12,1,14,1,54,1,46,1,49,1,82,9","responding,7,5,25,1,26,1,37,1,55,1","responds,24,1,53,1,56,1,58,1,57,1","response,7,23,18,2,23,1,26,3,29,2,33,1,35,1,34,1,36,1,41,2,54,1,47,1,50,1,55,3,82,1","responses,7,4,12,1,27,1,33,1,36,1,41,1,42,1,46,1,49,1,50,1,52,1,82,1","responsibilities,7,5,46,1,84,1","responsibility,16,1,26,1,55,1,84,1","responsible,7,1,24,1","responsive,50,1","responsiveness,7,1","rest,27,1,26,1,33,1,55,1,84,1","reston,17,1,14,1,20,1,27,1,24,1,28,3,29,1,31,1,36,1,52,2,131,1","restoration,44,1","restore,44,1","restrained,29,1","restraint,15,1,19,1,22,1,23,1","restraints,26,1,29,1,37,1,49,1,55,1","restrict,30,1","restricted,7,1,84,2","restrictions,84,1","restructuring,14,1","result,7,3,25,1,36,1,42,1,44,1,46,1,84,1","resulted,7,2,82,2","resulting,7,1,35,1,34,1,38,1,40,1,82,9,84,1","results,7,6,12,2,18,1,20,2,27,1,23,1,33,3,35,1,36,1,37,1,39,1,41,3,42,2,43,1,49,1,50,1,82,3,84,19","resurrection,41,2","resuscitation,7,4","retail,7,3,35,1","retain,7,3","retained,7,1","retano,20,1","retarded,7,1","retention,83,1","retinal,36,1","retire,7,1","retired,7,2,47,1","retirement,7,25,92,1","retirements,7,2","retooling,52,2","retrieval,7,3","retrieved,7,1,84,1","retroactive,34,1","retropubic,84,2","retrospective,84,1","return,7,11,14,1,26,1,34,1,50,1,55,1,66,1","returned,7,6,50,1","returning,24,1,36,1","reuters,28,1,44,1","revamped,21,1,25,1","revascularization,84,2","reveal,7,1,25,1,82,1","revealed,27,1,46,1,60,1","reveals,7,1,28,1,36,1","revenue,53,1,56,1,58,1,57,1","reverse,15,1,34,1","reversed,36,1,41,1","review,7,21,13,1,11,1,12,1,16,2,18,1,19,2,27,2,22,1,23,1,26,1,35,2,32,1,34,1,36,2,37,2,38,1,40,1,42,1,44,1,50,4,52,1,55,1,82,4,84,53","reviewed,7,1,11,1,17,1,23,1,33,1,82,1,84,4","reviewer,84,4","reviewer.â ,12,1","reviewers,11,2,12,1,50,1,51,1,84,4","reviewing,12,1,36,1,38,1,40,1,41,1","reviews,7,2,11,1,15,1,19,1,32,1,40,2,45,1,48,1,84,11","revise,37,1,44,1","revised,7,1,25,1,22,1,33,1,35,1,92,1","revisions,7,3,16,1,22,2","revolution,31,1,131,1","revolutionary,39,1,59,1","rewarding,19,1,21,1,25,2","reynolds,20,1,84,2","rfi,29,1","r-fl,16,1,22,1,32,1","rhode,18,1","rhythms,26,1,55,1","ri,18,1","rice,14,2,34,1","rich,16,1,82,1","richard,20,1,42,1","richmond,54,1","richness,7,1","rickets,84,1","ricketts,84,1","rico,7,1,26,2,34,1,55,2,83,1","rideout,84,3","riedmann,84,1","right,14,1,49,1,88,1","rights,18,2,33,1,48,1","rigorous,84,1","rise,7,2,22,1,26,1,42,1,55,1","risen,20,1","rises,7,1","rising,7,9","risk,17,2,21,1,27,1,26,1,33,1,31,1,34,1,36,2,38,3,40,3,39,1,43,2,53,1,46,1,48,2,50,3,51,1,55,1,56,1,82,11,58,1,57,1,83,1,84,12,131,1","riskcontrol,82,1","risk-level,11,1","risk-management,82,1","risk-related,82,1","risks,21,1,38,1,40,1,48,1,49,2,82,1","risperdal,28,1,39,1","risperidone,41,2","rita,42,1","ritalin,31,1,131,1","ritter,92,2","r-me,35,1","rn,7,141,9,1,10,1,14,2,15,1,21,2,27,5,24,3,33,2,32,1,34,3,38,2,40,2,42,1,54,2,46,1,47,1,49,1,52,1,82,1,60,3,84,5,92,2","rn-bc,18,1","r-nj,27,1","rn-pmh,18,3,27,1,34,1","rns,7,821,19,1,33,1,46,2","rnsurvey,7,2","rns--who,7,1","rn-to-population,7,1","roadmap,35,1","roadmaps,13,1","robbins,84,1","robert,12,1,25,1,27,2,23,1,26,1,34,1,37,1,42,1,44,1,54,1,46,2,51,1,55,1","roberta,53,1,56,1,58,1,57,1","roberts,84,1","robin,84,2","robinson,84,7","robust,23,1","robustness,36,1","rochester,11,1,60,1","rocky,31,1,131,1","roe,16,1","roets,20,1","roger,14,1","r-oh,49,1","role,7,3,13,1,18,1,21,1,24,1,38,1,40,1,45,1,42,1,82,1,88,1,84,9,92,1","roles,7,12,46,1,84,4","role-specific,84,1","rolin-kenny,20,1","romano,20,1","ronald,33,2","roof,28,1","rooks,84,1","room,7,1,18,1,35,1,50,1","room.please,60,1","roommate,36,1","rooms,14,1,50,1","rooney,16,1","roots,7,1","rorie,84,1","rose,7,5,42,1","rosedale,34,2","rosenbery,82,1","rosenblatt,84,9","rosenthal,84,1","ros-lehtinen,22,1,32,1","roster,30,1","roughly,7,1","round,44,1,51,1","rounding,7,28","route,7,1","routes,7,1","routine,50,1,84,1","routinely,44,1","royal,27,3","r-pa,31,1,131,1","rpl,25,1","rs,24,1","rst,54,1","r-tn,16,1","r-tx,49,1","ruc,26,2,55,2","rudy,84,11","ruiz,84,7","rule,16,1,25,2,30,2,36,2,51,2","ruled,41,2,43,2,54,1","rulemaking,30,1,35,1","rules,21,1,26,3,34,4,36,1,48,1,55,3","ruling,14,1,34,1","rumors,31,1,37,2,131,1","run,7,1,25,1,26,1,43,1,55,1","runners,21,2","running,16,1,42,2,50,1","rural,7,3,23,1,28,1,82,1,92,2","ruscian,82,1","rush,26,1,55,1","russell,84,9","rutgers,7,1","rvs,26,2,55,2","rwjf,27,1,34,2,44,2,46,2,51,2","s.a,84,3","s.c,84,3","s.e,84,1","s.k,84,2","s.m,84,2","s.r,84,1","s.s,84,1","s.x,84,2","sabrina,54,1","sadly,44,1","sadowski,82,1","safe,19,1,24,2,26,1,30,1,33,1,31,2,38,1,40,1,42,2,49,2,55,1,59,1,69,1,88,1,84,1,131,2","safely,12,1,24,1,38,1,40,1,59,1,84,2","safety,11,1,12,2,18,1,19,3,21,1,26,1,28,1,30,2,33,3,31,2,37,2,45,1,41,1,42,3,44,1,49,3,52,1,55,1,83,2,84,2,131,2","safety-related,39,1","said,7,4,13,1,11,1,12,2,14,3,25,2,22,1,28,1,29,1,30,1,31,1,42,1,43,1,44,1,54,1,47,1,49,1,82,2,92,2,131,1","saint,7,1","sajtar,84,1","salaried,7,2","salaries,7,2","salary,7,3","salazar,38,1,40,1","sales,7,3,39,1","salisbury,84,2","same,7,40,12,1,15,2,21,1,22,2,23,1,24,1,26,2,35,1,38,1,40,1,42,1,44,1,46,1,47,1,48,2,55,2,82,3,84,4","samhsa,9,1,10,1,11,1,17,3,14,2,16,2,20,1,25,3,27,5,22,2,23,5,24,1,26,4,28,3,32,1,36,3,38,3,40,3,45,1,41,2,42,2,54,1,48,1,49,1,50,1,55,4","samhsaâ€™s,14,1","samhsa-hrsa,36,1","sample,7,283,12,1,23,1,35,1,82,3,84,4","sampled,7,6","samples,7,1,43,1,84,19","sampling,7,14","sampson,82,1","samuels,84,1","san,21,1,53,1,56,1,58,1,57,1,84,1","sandall,84,2","sander,26,1,55,1","santos-eggimann,84,1","saphris,37,1","sapiro,84,1","sapt,34,3","sarasota,14,1","sat,45,1","sateren,34,1","sates,84,1","satisfaction,7,74,12,1,29,1,46,1,84,22","satisfactory,7,2","satisfied,7,77,21,1,84,1","satisfying,7,1,21,1","saturate,82,1","saturday,41,1,42,1,49,1","save,13,1,18,1,25,2,22,1,24,1,26,1,28,2,29,1,36,1,37,1,38,1,40,1,42,2,53,1,47,1,50,1,55,1,56,1,58,1,57,1","saved,83,1","savings,7,4,25,1,41,1","savvy,50,1,88,1","saw,33,1,41,1,42,1,82,2","say,7,5,25,1,26,1,35,1,34,1,39,1,44,1,46,1,48,3,49,1,51,1,55,1","saying,7,1,15,1","says,12,1,17,2,27,3,29,2,30,1,33,1,38,1,40,1,41,1,42,1,44,1,46,1","sc,53,1,47,1,51,2,56,1,58,1,57,1","scale,25,1,84,5","scales,84,2","scan,34,1,38,1,40,1","scand,82,1","scans,23,1,33,1,35,1","scant,12,1,34,1","scarce,7,1","scarring,82,1","scars,82,1","schakowsky,14,1","scharfenberg,84,1","schauberger,84,1","schedule,7,1,23,2,26,1,29,1,30,1,31,1,34,1,53,1,55,1,56,1,58,1,57,1,131,1","scheduled,7,2,13,1,51,1,84,1","schedules,7,2","scheutz,27,1","schip,15,3","schizoaffective,29,1","schizophrenia,14,2,24,1,28,1,29,1,35,1,31,1,32,2,37,1,38,2,40,2,41,3,44,1,48,3,50,3,131,1","schizotypal,41,1","schneede,82,1","schneeweiss,84,1","scholar,23,2","scholarly,7,1,11,1,12,1,18,1,36,1,50,1","scholars,33,1,39,1,44,1","scholars@iie.org,23,1","scholarship,7,9,18,3,25,10,27,1,24,4,28,4,33,3,34,1,36,2,51,3,84,1","scholarships,7,2,22,1,33,1,34,1,36,1,39,2,51,1","school,7,36,13,3,9,1,10,1,11,1,12,1,14,1,16,1,18,1,27,1,22,1,23,1,28,1,36,1,37,1,39,1,41,1,54,1,47,1,49,3,60,3,84,10","school-based,17,1","schools,7,4,13,1,12,1,14,3,18,2,25,1,24,2,26,1,28,1,33,1,34,2,37,1,38,1,40,1,44,1,54,2,49,2,51,2,55,1,92,1","schultz,84,6","schumacher,25,1","schwab,84,1","schwarzeneggerâ€™s,15,1","schweer,84,1","science,7,11,18,1,28,1,47,1,52,1,88,1,92,1","science-based,30,1,33,1,36,1,88,1","sciences,7,5","scientific,13,1,11,1,12,1,17,1,18,1,27,1,26,1,29,1,30,1,33,1,35,1,34,1,36,1,38,1,40,1,53,1,51,1,55,1,56,1,82,1,58,1,57,1,84,2","scientist,27,1","scientists,18,1,35,1,38,1,40,1,43,1,44,1,88,1","scope,7,2,19,1,21,1,38,1,40,1,44,1,51,1,82,2,84,2","score,84,7","scored,50,1","scores,21,1,33,1,41,1,84,9","scott,54,1","screaming,48,1","screen,27,1,82,1","screening,24,1,28,1,34,1,82,1","scroll,27,1","seamless,24,1,36,1,43,1","search,7,1,18,2,27,1,44,1,71,5,84,7","search.html,1,1,2,1,3,1,4,1,6,1,72,1,74,1,71,4,75,1,76,1","searched,84,1","searches,7,1","searchfunc.js,1,1,2,1,3,1,4,1,6,1,72,1,74,1,75,1,76,1","searching,7,2","season,53,3,56,3,58,3,57,3","seats,26,1,31,1,55,1,131,1","seattle,41,1","sebelius,21,1,25,1,22,1,28,1,33,1,37,1,38,1,40,1,45,1,42,5,88,2","secluded,29,1","seclusion,15,1,19,1,22,1,23,1,26,1,37,1,49,1,55,1","second,7,16,25,1,24,1,38,1,40,1,42,1,46,2,51,2,82,1,83,1,84,2","second.â ,53,1,56,1,58,1,57,1","secondary,7,81,84,1","second-highest,7,1","secondly,88,1","second-phase,82,2","second-semester,46,1","secretaries,45,1","secretary,20,1,21,1,25,2,28,1,33,2,31,1,34,1,37,2,38,2,40,2,45,1,41,1,42,6,44,1,46,1,88,3,131,1","section,7,1,9,3,10,3,14,1,18,1,19,1,27,2,30,2,35,1,36,3,38,1,40,1,53,1,54,1,47,1,50,1,56,1,58,1,57,1,84,5","sections,7,1,24,2,84,5","sector,7,1,42,2,54,1,52,1","secure,37,1","secured,48,1","securely,59,1","security,26,1,35,2,55,1","see,7,2,16,1,21,1,27,2,26,1,28,2,29,1,36,1,37,1,38,1,40,1,39,1,42,1,53,1,46,1,48,1,50,3,51,1,55,1,56,1,82,7,58,1,57,1,60,1,88,2","seed,54,1","seeing,41,1,50,1,82,1","seek,7,1,14,1,21,1,24,1,50,1,59,1,82,2","seeking,7,15,13,1,9,2,10,2,11,1,18,1,20,1,22,2,24,2,35,1,31,1,34,1,45,1,46,1,50,2,51,1,131,1","seeks,13,1,9,1,10,1,12,1,25,1,36,1,53,1,54,1,56,1,58,1,57,1","seem,34,1","seemed,29,1","seems,27,1","seen,7,3,29,1,33,1,36,1,84,4","segment,7,1","select,5,1,7,4,20,1,23,1,33,1,35,1,42,1,84,1","selected,7,10,18,1,26,1,33,1,36,2,37,2,53,1,46,1,52,1,55,1,56,1,82,2,58,1,57,1,83,1,84,1","selecting,7,1","selection,7,9,46,1,51,1,84,2","selective,25,1,84,1","self,12,1,29,1","self-assessed,84,1","self-assessment,35,2,84,1","self-disclosure,48,1","self-employed,7,2","self-employment,7,1","self-esteem,48,1","self-harm,42,1","self-help,69,1","selfmanagement,83,1","selfreport,84,1","self-report,84,2","self-reported,82,1,84,7","self-reports,49,1","selway,82,2","semaan,84,1","semiclosed,84,1","seminars,38,1,40,1","semiquantitative,82,1","sen,22,1,26,1,35,2,49,1,52,1,55,1","senate,13,1,11,1,16,1,18,3,22,2,28,2,29,1,31,1,34,2,45,2,43,1,44,2,53,2,54,1,49,1,50,1,52,1,56,2,58,2,57,2,131,1","senator,13,1,9,1,10,1,20,1,22,2,26,1,29,1,31,1,32,1,39,1,50,2,51,1,55,1,88,5,131,1","senators,22,1,31,1,34,1,54,1,49,1,131,1","send,11,1,16,1,25,1,27,1,22,2,33,1,36,1,44,1,50,1,66,6","send&update,66,1","sender_name,66,1","sending,36,1,59,1","sendtofriend_logs,66,1","seng,84,1","senior,7,17,33,1,50,1,84,1","senior-level,46,1","seniors,84,1","sensitivity,48,1,84,1","sent,7,8,13,1,14,1,18,1,32,2,37,1,45,1,42,1,44,1,53,1,46,1,48,1,56,1,59,1,58,1,57,1","sentence,33,1,35,1","sentence.â ,42,1","sentinel,50,1","separate,7,3,11,1,42,1,46,1","separated,7,1","separately,82,2","sepsis,82,1","sept,27,1,38,1,40,1,44,1","september,7,2,35,1,38,2,40,2,39,1,41,7,42,5,43,6,44,1,50,1,61,2,69,1","septemberâ issue,33,1","sequence,43,1","sequential,82,1","serenity,14,3","sergeant,36,1","series,7,1,13,1,19,1,27,1,22,1,35,1,37,2,39,1,42,4,54,1,46,2,48,1,51,1,84,23","serious,9,1,10,1,19,1,27,1,24,2,26,1,34,1,38,1,40,1,45,1,39,3,44,1,50,1,55,1,88,1","seriously,15,1","seroquel,31,1,39,1,131,1","serum,38,1,40,1,82,1,84,7","serve,7,2,18,3,20,1,25,2,27,2,22,1,24,1,29,1,30,2,35,2,34,1,38,1,40,1,44,1,53,1,50,1,51,1,52,3,56,1,82,1,58,1,57,1,88,1,92,1","served,7,5,19,1,34,1,41,1,53,1,47,1,50,1,56,1,58,1,57,1,92,1","server,1,1,2,1,3,1,4,1,6,1,8,1,72,1,74,1,64,1,68,1,70,1,75,1,76,1,77,1,78,1,79,1,81,1,85,1,86,1,87,1,132,1,133,1,134,1,93,1,94,1,126,1,128,1,129,1,89,1,90,1,91,1,135,1,136,1,137,1,138,1,139,1,140,1,141,1,130,1,142,1,143,1,144,1,145,1,146,1,147,1,148,1,149,1,150,1,151,1,152,1,153,1,155,1,156,1,157,1","serves,26,1,33,1,42,1,53,1,52,1,55,1,56,1,58,1,57,1","service,7,17,12,1,17,1,18,1,19,1,25,1,23,1,28,1,33,1,31,1,34,4,36,1,45,1,42,1,50,1,82,2,83,1,84,2,92,1,131,1","service.â â this,33,1","servicemembers,45,1","services,7,38,13,4,9,5,10,5,11,1,12,6,17,4,14,1,15,3,16,5,18,2,19,1,20,1,21,4,25,9,27,10,22,9,23,2,24,3,26,6,28,10,29,2,30,5,33,4,35,2,31,4,32,7,34,3,36,5,37,1,38,9,40,10,45,6,39,2,41,5,42,10,43,2,44,3,53,3,54,5,47,1,48,5,49,4,50,2,51,3,52,1,55,6,56,3,82,6,58,3,57,3,83,5,88,2,84,5,92,1,131,4","services.â we,26,1,55,1","serving,7,1,33,2,53,1,56,1,58,1,57,1","session,11,1,14,2,21,1,23,2,26,1,35,2,31,1,36,4,41,1,42,2,50,2,55,1,131,1","sessions,11,1,21,1,23,1,28,2,29,1,30,1,35,2,34,2,36,1,38,2,40,2,45,3,41,5,42,1,43,1,53,4,54,1,47,1,48,2,49,3,50,2,56,4,58,4,57,4,83,1","set,7,2,14,1,15,1,20,1,23,1,26,1,28,1,33,1,35,1,34,1,41,2,46,2,51,1,52,1,55,1,84,3","sets,14,1,27,1,50,1","setting,7,154,17,3,19,1,33,1,36,1,44,1,46,1,50,1,82,1,83,1,84,13","settings,7,154,11,1,17,1,18,1,19,3,20,1,25,1,23,1,26,1,31,1,32,3,39,1,41,1,42,2,48,1,50,3,55,1,60,1,84,24,92,1,131,1","settled,12,1","settlement,49,1,82,1","set-up,27,1","seven,12,1,14,1,15,1,28,1,30,1,31,1,84,7,131,1","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trategies.â ,42,1","strategize,11,1","strategy,12,1,21,5,23,1,26,3,30,3,45,1,50,1,46,1,55,3,84,1","stratification,7,1","stratum,7,2","stream,39,1","streamline,25,1","street,23,1,29,1","stremikis,46,1","strength,19,1,35,1,50,1,84,2","strengthen,27,1,42,1,44,1,84,1","strengthening,26,1,55,1,84,1","strengthens,25,1,46,1,48,1","strength-ofevidence,84,1","stress,7,1,14,1,16,1,19,1,24,1,42,1,44,1,45,1,50,1,54,1","stressful,7,3","strides,23,1","strike,14,1","strikes,25,1","striving,39,1","strobino,84,1","stroke,48,1,84,5","strong,11,1,15,1,18,1,27,1,22,1,26,1,36,1,55,1","stronger,18,1,50,1","strongest,84,2","strongly,54,1,46,1,88,1","structure,7,2,19,1,34,1,46,1,82,1","structures,31,1,53,1,56,1,58,1,57,1,131,1","struggle,9,1,10,1,50,1","struggles,24,1","struggling.â ,26,1,55,1","stti,18,1","stuart,12,2,29,1,53,1,54,1,46,1,56,1,58,1,57,1","stuck,84,8","student,7,12,9,1,10,1,15,1,18,5,25,4,24,2,28,3,33,2,36,1,54,1,47,2,48,4,52,1,92,1","student-centered,60,1","students,7,13,13,2,12,1,18,3,20,1,25,3,27,1,24,3,28,2,29,1,33,5,36,3,37,1,38,4,40,4,50,1,54,2,46,2,47,1,49,4,51,4,52,1,84,2,92,1","studentscholars,18,1","studies,7,1,11,1,14,1,16,1,19,1,25,2,22,1,23,1,35,1,41,1,42,2,44,2,50,3,53,1,48,1,56,1,58,1,57,1,60,1,84,160","studios,41,1","study,7,11,11,2,12,1,14,2,18,1,21,2,25,1,23,1,24,1,26,1,28,1,29,3,30,1,35,1,31,3,34,1,36,6,38,4,40,4,39,1,41,2,42,4,43,4,44,1,45,3,50,1,53,1,46,4,47,1,48,2,49,1,51,2,55,1,56,1,82,12,58,1,57,1,84,76,131,3","studying,26,1,55,1","study-quality,84,1","stuff,27,1","stumbling,26,1,55,1","stump,84,1","subacute,7,1,84,3","subcommittee,22,1,26,1,42,1,55,1","sub-committee,38,1,40,1","subject,7,1,33,1,45,1","subjected,45,1","subjects,36,1,53,1,56,1,58,1,57,1","submenu_bg.jpg,68,1,93,1,94,1,127,8,90,1,91,1,141,1,142,1,143,1,146,1","submission,9,1,10,1,11,1,17,1,53,1,56,1,58,1,57,1","submissions,13,1,12,1,15,1,51,1","submit,9,1,10,1,11,2,17,1,15,1,16,1,18,1,21,1,22,1,34,1,36,5,37,1,50,2,51,1","submitted,11,1,12,1,23,1,24,1,26,2,28,1,29,2,30,2,33,1,34,1,36,1,41,2,42,1,54,1,51,1,55,2,83,1,84,2","submitting,12,3,14,2","subsamples,84,1","subscribe,35,1,66,2","subscribed,66,2","subsequent,7,2,84,1","subsequently,7,1","subset,7,3,44,1,82,1","subsetting,7,1","subsidies,12,1","subspecialty,50,1","substance,7,1,9,1,10,1,12,2,17,2,14,1,16,3,18,1,20,1,25,5,27,4,22,7,23,3,24,2,26,3,28,5,29,2,30,1,33,1,31,4,32,4,34,2,36,3,37,4,38,5,40,5,39,3,41,5,42,3,45,2,50,3,54,1,48,3,49,6,55,3,88,1,131,4","substances,26,1,30,1,35,2,55,1","substantial,7,3,28,1,83,1","substantially,7,4,18,1,50,1,48,1,49,1,51,1","substitution,84,2","subtle,46,1","suburban,82,1","success,18,1,24,1,33,1,36,1,50,2","successes,36,1","successful,21,1,24,1,30,1,39,1,53,1,48,1,56,1,58,1,57,1","successfully,14,2,20,1,23,2,35,1,45,1","sudden,31,1,131,1","suddenly,31,1,131,1","sue,21,1,35,1","suffer,20,1,23,1","suffered,31,1,50,1,131,1","suffering,16,1,21,1,28,1,33,1,36,1,38,2,40,2,46,1,83,1","suffers,28,1","sufficient,7,1,18,1,33,1,84,1","sufficiently,7,1,52,1","suggest,7,3,38,1,40,1,48,1,84,1","suggested,28,1,33,2,82,1,84,1","suggesting,7,1,36,1","suggestions,9,1,10,1,19,1,29,1,35,1,42,1,53,1,56,1,58,1,57,1","suggests,7,3,14,2,21,1,27,1,36,3,41,1,45,1,46,1","suicidal,32,2,38,1,40,1,50,1","suicide,12,2,18,1,25,1,27,1,23,3,36,1,38,4,40,4,42,2,50,2,54,1,69,1","suit,14,2","suitable,66,1","sulsky,82,1","summa,28,2","summaries,23,1,46,2,82,1","summarize,84,2","summarized,39,1,82,1,84,1","summarizes,19,1,36,1,53,1,56,1,58,1,57,1","summary,7,16,11,1,17,1,16,2,23,1,26,2,29,1,32,1,36,2,39,2,47,1,55,2,84,17","summer,30,1,33,1,34,2,37,1","summit,16,1,37,1,49,1","sunday,14,1,22,1","superb,36,1","superintendents,37,1","superior,30,1,84,1","superstars,42,1","supervised,84,1","supervising,7,2","supervision,7,4,82,1","suppl,82,1","supplement,82,1","supplements,82,1","supplied,7,2","suppliers,30,1","supplies,7,1","supply,7,6,33,2,38,1,40,1,84,3","supply-demand,7,1","support,7,15,13,1,12,1,17,1,14,2,16,4,18,3,19,2,20,2,25,6,27,2,22,1,23,1,24,1,26,1,28,2,29,1,30,1,33,1,31,1,32,3,36,3,37,2,38,3,40,3,42,1,43,1,44,1,45,1,50,2,46,4,49,2,52,1,55,1,59,3,60,1,69,1,84,38,92,1,131,1","supported,7,1,11,1,59,1,84,2","supporter,12,1","supporters,37,1","supporting,27,1,33,1,47,1,49,2,84,2,92,2","supportive,18,1,37,1,42,1,84,1","supports,13,1,16,1,27,1,24,1,29,1,33,1,34,1,43,1,44,1,50,1,83,2,84,7","supreme,44,1","sure,24,1,41,1,69,1,88,2","surely,30,1","surgeon,30,1,84,1","surgery,7,9,34,1,82,1,84,14","surgical,7,12,39,1,50,1,48,1,84,6","surpassing,7,1","surprising,7,4","surrogate,7,3","surrounding,27,1,22,1,24,1","surveillance,34,1","survey,7,289,13,1,12,3,14,3,18,4,19,1,21,2,25,1,27,4,22,1,23,1,26,1,33,6,35,3,32,1,39,2,41,1,42,6,43,2,45,3,50,3,53,5,54,3,46,9,49,4,52,1,55,1,56,5,82,28,58,5,57,5,60,2","surveyed,11,1,25,1,29,1,46,1,82,3","surveyor,7,6","surveys,7,18,11,1,22,1,33,1,42,4,46,1,48,1","survivor,69,1","survivors,42,1","susan,9,1,10,1,11,1,35,1,53,1,56,1,58,1,57,1","suspend,92,1","sustain,60,2","sustainable,34,1","sustained,12,1","sustaining,33,1","suturing,84,1","suzane,41,2","swartz,84,13","sweeping,14,1","sweetly,48,1","swiftly,34,1","swindle,84,5","swine,24,2","switch,36,1","sympathetic,34,1","sympathies,9,1,10,1","symposia,34,1","symposium,36,2,41,1","symptom,41,1,42,1","symptoms,27,2,23,1,33,1,32,1,34,1,36,2,44,1,45,2,46,1,48,1,82,1","synaptic,38,1,40,1","synchronized,53,1,56,1,58,1,57,1","syndromes,16,1,20,1","synopsis,21,1,82,6","synthesis,84,8","synthesize,84,1","system,7,4,11,1,12,1,14,2,18,1,19,1,21,3,25,1,27,4,22,3,26,1,28,1,33,2,34,1,36,2,37,1,39,1,41,1,53,2,46,7,49,1,51,1,52,1,55,1,56,2,58,2,57,2,60,1,83,1,88,1,84,6","systematic,7,2,38,1,40,1,84,44","systematically,84,1","systems,7,1,11,1,18,2,25,1,22,1,26,1,33,2,31,1,32,1,37,1,41,1,42,1,43,1,45,1,52,1,55,1,83,1,84,4,131,1","sze,84,5","t.a,84,1","t.d,84,1","t.e,84,1","t.f,84,1","t.g,84,2","t.l,84,2","t.m,84,1","table,7,353,37,1,49,1,82,10,69,1,88,1,84,24","tables,7,23,82,1,84,2","tablets,12,1,35,5,37,1,50,1","tabs,39,1,59,1","tacked,48,1","tactics,50,1","tag,50,1","tagalog,7,1","tailored,12,1,20,1","take,7,9,11,2,17,1,14,1,15,1,18,2,21,1,27,1,22,2,23,1,26,2,30,1,33,4,35,2,31,1,34,1,36,1,37,1,39,1,41,4,42,5,50,2,54,2,46,1,49,1,55,2,59,1,82,1,88,1,131,1","taken,7,3,16,1,25,1,30,1,49,1","takes,7,3,26,1,42,1,45,1,55,1","taking,7,2,12,1,19,1,25,1,27,1,29,1,31,1,36,1,39,1,45,1,46,1,131,1","talented,39,1,59,1","talents,54,1","tales,21,1","talk,21,1,88,5","talking,12,1","talks,48,1","taller,41,1","tallied,33,1","tamp,39,1","tandi-jo,12,1,18,1","target,27,1,34,2,38,1,40,1,42,1,53,1,56,1,58,1,57,1","targeted,32,1,53,2,56,2,58,2,57,2","task,19,4,21,1,34,1,36,3,38,2,40,2,42,1,44,1,50,5,53,3,46,1,56,3,58,3,57,3","tasked,18,1,35,1","tasks,7,7","tasota,84,1","tattle,37,1","tau,18,1","tax,18,2,44,1,50,1,53,1,46,1,56,1,58,1,57,1","taxation,31,1,131,1","tax-deductible,59,1","taxes,16,1","taylor,41,2,53,1,56,1,58,1,57,1","teach,7,4,33,1,47,1,60,1","teaches,27,1","teaching,7,6,16,1,27,1,23,1,60,1","teaching-related,7,1","teague,16,1","team,9,1,10,1,27,5,33,1,39,1,48,1,51,1,84,13","team.â when,26,1,55,1","team-based,27,1","teams,84,6","tear,84,1","tebaldi,18,1","technical,27,1,36,1,40,1,41,1,42,1,83,3,84,1","technically,88,1","technician,7,4","technique,14,1,38,1,40,1","techniques,7,2,37,1,46,1","technological,7,3","technologically,88,1","technologies,18,1","technologist,7,1","technology,33,1,32,1","tedious,7,1","teds,20,1","teen,23,1","teena,16,1","teenagers,25,1,44,1,53,1,56,1,58,1,57,1","teens,23,1,31,1,131,1","tehansky,51,1","telecommunications,52,1","teleconferences,36,1","telehealth,7,2","tele-mental,31,1,131,1","telemetry,7,2","telenursing,7,2","telephone,7,11,32,1","television,45,1","tell,41,1,42,1","template,47,1","temporarily,7,1","temporary,7,15,82,2","ten,16,1,25,2,28,1,29,1,50,1,84,5,92,1","tend,7,6","tended,7,1,82,1","tendencies,51,1","tendency,7,1","tennessee,30,1","tens,34,1","tentative,13,1","tenure-track,7,1","ten-year,84,1","teoss,48,1","tep,84,2","teps,84,3","term,7,1,20,3,21,1,22,1,35,2,52,1","termed,7,2","terminal,45,1,50,1","terminology,7,1","terms,7,1,12,1,15,1,48,1,88,2,84,2","terrific,26,1,55,1","territorial,42,1","territories,7,3,14,1,41,1","territory,7,1","terrorist,33,1","terry,28,1,92,1","tes,7,5","test,7,1,19,1,24,2,35,2,36,2,38,1,40,1,44,2,50,1,48,1,84,3","testament,25,1,50,1","tested,36,1,84,1","testimonials,35,1","testimony,50,1","testing,24,1,34,1,44,3,49,1,84,1","tests,7,1,35,1,38,1,40,1,44,1,46,1","texas,7,2,30,2","text,27,1,66,1","textbook,21,1","textbooks,12,1","thank,30,2,33,1,34,1,36,1,41,1,42,1,50,1,48,1,52,1,73,1,66,1,88,1","thanks,7,1,27,1,36,1,50,1","thanks.html,1,1,2,1,3,1,4,1,6,1,72,1,73,4,74,1,75,1,76,1","thatcher,7,1","theaters,37,1,41,1","theirs,44,1","theme,9,1,10,1,17,1,15,1,18,1,26,1,34,1,36,1,55,1","themselves,43,1,50,2,82,1","theoretical,7,1","theories,11,1,14,1","theory,17,2","therapeutic,32,1,50,1,82,1,84,1","therapies,39,1,53,1,56,1,58,1,57,1","therapists,50,1","therapy,7,2,11,1,12,2,21,1,27,1,23,1,28,1,34,1,44,1,54,1,46,1,84,1","thereby,12,1,44,1","therefore,7,5,25,1,26,1,49,1,51,1,55,1","theta,18,1","thimerosal,17,1","things,27,1,23,1,39,2,59,1,88,2","think,33,2,88,5","thinking,12,1,21,1,50,1,49,1","third,7,8,31,1,39,1,54,1,52,1,84,3,131,1","thirteen,84,2","thirty-seven,84,1","thomas,36,1","thoroughly,17,1,26,1,55,1","those,7,115,13,1,11,1,12,3,17,1,14,3,16,2,18,2,20,2,21,2,25,2,27,1,22,1,26,1,35,2,36,4,37,1,38,2,40,2,41,1,42,4,43,2,44,1,45,2,50,4,53,2,54,2,46,1,47,1,48,1,51,1,52,2,55,1,56,2,82,11,58,2,57,2,83,1,88,1,84,4,92,1","though,7,2,18,1,19,1,31,2,41,1,45,1,54,1,52,1,84,1,131,2","thought,7,1,84,1","thought.â ,26,1,55,1","thoughtful,27,1","thoughts,18,1,19,1,25,1,26,1,32,2,38,1,40,1,39,1,41,1,42,1,55,1","thousands,7,11,19,1,38,1,40,1,42,1,43,1,88,1","threatening,51,1","threats,19,1","three,7,12,11,1,12,1,17,1,14,4,16,1,18,2,19,1,20,1,25,2,27,2,24,1,26,2,30,1,33,1,35,1,34,1,36,3,37,1,38,1,40,1,39,1,41,1,42,3,44,1,45,1,54,1,46,1,49,1,55,2,82,3,83,2,84,23","threefold,33,1","three-minute,34,1","three-month,23,1","three-quarters,7,2","three-year,43,1,46,1,49,1,52,1","threshold,25,1","thresholds,54,1","thrill,12,1","thrilled,14,1,30,1,39,1,47,1,69,1","thriving,21,1","through,7,26,9,1,10,1,11,2,12,2,14,1,15,1,16,1,18,3,21,1,25,2,27,3,23,1,24,1,26,1,28,1,30,1,33,1,32,3,34,4,36,1,37,3,38,3,40,3,39,1,41,1,45,1,50,3,53,1,47,1,51,1,52,1,55,1,56,1,59,1,82,1,58,1,57,1,83,3,84,3,92,2","throughout,7,1,19,1,20,1,24,1,30,2,35,1,34,2,38,2,40,2,41,2,42,2,92,1","thursday,14,2,16,1,31,1,36,1,37,2,41,2,42,1,60,1,131,1","thus,7,14,32,1,36,1,82,2,83,1","tickets,50,1","tied,7,2,88,1","tight.â ,50,1","tim,31,1,131,1","time,7,69,13,1,12,2,16,1,18,1,19,2,21,3,25,5,27,2,22,1,26,3,30,1,33,2,35,1,34,2,38,1,40,1,41,1,42,2,45,1,50,3,53,2,54,2,46,3,52,1,55,3,56,2,82,8,58,2,57,2,88,1,84,4,92,2","time-consuming,7,1","timed-release,35,1","timeframe,82,1","timely,26,1,34,1,39,1,55,1,82,1","times,11,1,12,1,18,1,20,1,21,1,25,2,23,2,26,1,33,2,35,2,31,1,34,2,36,1,38,1,40,1,39,2,41,2,42,2,43,1,44,1,45,4,50,1,54,3,46,1,48,2,51,1,55,1,82,2,131,1","tiny,34,1","tip,26,1,35,2,55,1","tips,18,1,23,2,28,1,33,1,35,1,34,1,42,1,46,1","tirelessly,26,1,55,1","title,7,126,82,1,84,1","titles,7,89,35,1,82,1,84,2","tlantrip@apna.org,12,1,18,1","tm,82,1","tmit,31,1,131,1","tncc,7,2","to100,7,2","tobacco,11,5,28,2,30,1,35,1,42,3,54,2,46,2","today,12,3,16,1,19,1,21,1,27,1,23,1,26,1,35,1,32,1,40,2,39,1,42,2,52,1,55,1,92,1","today.â ,33,1","todd,36,1","together,7,1,13,1,22,1,23,2,26,1,30,1,33,3,35,2,36,2,41,3,42,1,47,1,55,1,82,1,69,1,83,1,88,1","told,33,1,31,1,34,1,131,1","toll,17,1,42,1,45,2","tom,7,1,13,1,9,1,10,1,16,1,51,1","tomorrow,18,1,52,1","too,7,14,21,1,28,1","­too,7,2","took,7,4,33,1,34,1,41,1,42,1,46,1","tool,16,1,42,1,45,2,49,1","toolkit,35,1,50,3","toolkits,12,2","tools,11,1,27,1,35,1,34,1,39,2,45,1,53,1,56,1,59,1,58,1,57,1","top,13,1,12,1,25,1,36,1,37,2,45,1,50,1,82,1,92,1","topic,27,1,33,1,42,2,88,1","topics,7,2,26,1,42,1,47,1,52,1,55,1","top-line,27,1","topofpage,83,1","torrisi,21,1","tort,82,1","total,7,145,12,1,14,2,18,2,20,1,23,1,26,1,32,1,37,1,42,1,55,1,82,4,84,4","totaled,39,1","totaling,42,1","totally,7,1","totals,7,10","totten,84,1","touch,47,1","tough,23,2","toward,7,2,12,1,21,1,27,1,30,1,33,1,34,2,38,1,40,1,42,1,44,1","towards,14,1,18,2,23,1,36,2,39,1,53,1,56,1,58,1,57,1,69,1,83,1","town,28,1","toxic,30,1","traced,39,1","tracheostomy,84,3","track,7,1,27,1,34,1,46,2","tracking,11,1","traditional,13,1,29,1,82,1,84,1","traditionally,7,1","traditions,7,1","tragic,42,1","tragically,9,1,10,1","trail,50,1","train,45,1","trained,21,1,52,1","traineeship,7,3","training,7,12,14,1,21,1,25,1,22,1,23,1,32,1,34,1,37,3,38,2,40,2,41,1,42,3,50,1,54,2,49,1,51,1,82,1,84,1","trait,41,2","traits,41,1","trajectories,54,1","transaction,26,1,55,1","transcript,22,1,36,1,48,1","transcultural,16,1,20,1,31,2,52,1,131,2","transform,18,1,21,1,23,1,26,1,49,1,52,1,55,1","transformed,27,1","transforming,18,1","transient,84,4","transition,9,1,10,1,46,1,51,1,83,1","transitional,7,1,27,1,24,1,84,2","translate,38,1,40,1","translates,23,1","translating,18,1","translation,33,1","transparent,33,1,84,2","transplant,7,1","transport,7,1","trauma,7,6,11,1,12,1,21,3,33,2,36,1,38,1,40,1,41,3,42,1,44,1,45,2,46,1,88,1,84,4","trauma-informed,49,1","traumas,12,1,21,1","traumatic,16,1,19,1,27,2,24,1,42,1,44,1,50,2,84,4","travel,7,8,18,1,25,1,24,1,28,1,30,1,33,1,50,1,53,1,48,1,56,1,58,1,57,1","treasurer,20,1,27,1,26,1,53,1,46,1,47,1,55,1,56,1,58,1,57,1","treasury,16,1,29,1,34,1","treat,12,2,29,1,33,1,35,1,32,1,37,2,39,2,50,2,53,1,48,1,56,1,59,1,82,2,58,1,57,1","treated,14,2,37,1,41,1,45,1,46,1,84,4","treating,37,1,39,1,42,1,50,1,54,2,46,1,88,1","treatment,13,3,11,5,12,2,17,3,14,1,15,1,16,2,18,2,19,1,20,4,21,1,25,1,27,4,22,4,23,1,24,4,26,7,28,8,29,5,30,1,33,2,35,1,31,1,32,3,34,5,36,5,37,1,38,1,40,1,39,3,41,5,44,3,45,6,50,2,54,3,46,3,47,7,48,7,49,6,51,1,52,1,55,7,82,4,88,2,84,1,131,1","treatment-related,41,1","treatment-resistant,23,1,46,1","treatments,39,1,45,1,46,1,88,1,84,1","tremendous,17,1,50,1","trend,7,7,18,1,22,1,26,1,36,1,55,1,84,1","trended,22,1,26,2,55,2","trending,82,1","trends,7,5,12,1,26,1,55,1","trendwatch,7,1","triad,21,1","triage,54,1","trial,20,1,36,1,41,2,82,1,84,11","trials,11,1,12,1,29,1,34,1,39,1,41,1,42,2,44,2,50,4,53,1,54,4,56,1,58,1,57,1,84,4","tribal,38,1,40,1,42,1","tribes,14,1,24,1,41,1","tri-council,26,2,33,2,55,2,84,2","tried,9,1,10,1,46,1","trigger,14,1,88,1","triggers,34,1","trillion,11,1","trimyer,42,1","tripled,13,1","triumph,41,2","trouble,13,1,9,1,10,1,11,1,12,1,17,1,14,1,15,1,16,1,18,1,19,1,20,1,21,1,25,1,27,1,22,1,23,1,24,1,26,1,28,1,29,1,30,1,33,1,35,1,31,1,32,1,34,1,36,1,37,1,38,1,40,1,39,1,41,1,42,1,43,1,44,1,45,1,50,1,53,1,54,1,46,1,47,1,48,1,49,1,51,1,52,1,55,1,131,1","troubled,54,1","troubling,37,1,48,1","true,7,2,14,1,25,1,26,1,55,1","truly,30,1,41,1,50,1","trusted,54,1","truth,44,1","trying,13,1,29,2","tsai,84,1","tssi.org,84,1","tu,84,1","tube,84,1","tucker,82,2","tuesday,12,1","tuition,7,6","tumult,12,1","tune,11,1","tuned,30,1,34,1","tuned.â ,12,1","turned,13,1,18,1,19,2,43,1","tv,41,1","twelve,35,1,45,1,49,1","twentieth,35,1","twenty,84,1","twice,7,4,45,1,82,1","twin,84,4","twins,84,2","twitter,45,1","two,7,13,11,1,12,2,16,1,21,2,25,3,27,2,26,3,28,2,33,3,31,2,34,4,36,3,37,2,39,1,43,2,44,1,45,1,50,1,54,1,46,1,48,2,49,1,51,1,55,3,82,1,83,3,84,27,131,2","two-fifths,28,1","two-fold,7,2","two-part,22,1","two-thirds,7,3,49,1","two-year,39,1,84,1","tx,52,1","type,7,51,14,1,45,1,46,1,48,1,49,1,84,4","types,7,14,18,1,25,2,33,1,36,1,41,1,44,1,84,3","typical,7,3","typically,7,6,82,2","u.s,7,70,12,1,17,4,14,2,15,1,18,1,19,1,21,3,25,7,27,2,23,1,24,3,26,3,29,1,30,1,33,1,31,2,34,2,36,2,37,3,38,2,40,2,39,2,41,1,42,3,43,1,44,4,45,1,50,3,54,2,46,3,47,2,48,2,52,1,55,3,84,3,92,1,131,2","u.s.educated,7,1","u.s.-educated,7,27","u.s.-educated--were,7,1","u.s.-trained,84,2","uab,16,1","uality,84,1","uc,92,5","ucdenver.pdf,64,1,85,1,86,1,87,1,92,4,89,1,135,1,138,1,139,1,140,1","ug,82,1","uhs,26,1,55,1","uk,14,2,42,1,53,1,56,1,58,1,57,1","ultimate,82,5","ultimately,45,1,84,1","umbrella,14,1","unacceptable,39,2","unacknowledged,21,1","unanimously,52,1","unaware,12,1","unbiasedness,7,1","uncertain,84,1","unchanged,7,1,41,1","unclear,34,1","uncomplicated,84,1","unconstitutional,14,1,54,1","uncover,27,1","undecided,7,6","under,7,63,14,1,15,1,16,1,18,1,21,1,25,1,24,1,26,1,28,1,30,1,33,1,35,4,31,1,34,1,38,2,40,3,39,1,41,3,42,3,53,2,54,1,48,1,51,1,55,1,56,2,82,1,58,2,57,2,131,1","undercoverage,7,2","underestimate,7,1","underestimated,7,1","underestimation,7,2","undergoing,84,5","undergone,14,1,84,2","undergraduate,7,1,18,1,24,3,28,1,33,2,36,1","underlie,34,1,44,1","underrepresentation,7,2","underrepresented,7,3,33,1,54,1,51,1","underscore,29,1","underserved,7,1,27,2,28,1,36,1,84,2","understand,9,1,10,1,11,1,17,1,18,2,21,1,35,2,41,1,42,1,50,1,53,1,51,1,56,1,82,1,58,1,57,1,84,1,92,1","understanding,7,3,21,1,26,1,34,1,37,1,41,1,45,2,46,2,51,1,55,1,82,2","understated,7,1","understatement,7,1","understood,37,1","undertake,18,1,35,1","undertaken,7,3","underused,84,1","underway,35,1","undesirable,7,1","undiscovered,88,2","unduplication,7,1","unemployed,45,1","unexplained,31,1,131,1","unfamiliar,7,1","unhappy,7,1","unified,33,1,39,1,49,1,69,1,84,1","uniform,21,1,25,1","uniformity,53,1,56,1,58,1,57,1","uninsured,13,1,15,1,36,1","union,7,1","unionization,7,7","unionized,7,3","unique,21,1,27,1,35,1,37,2,39,1,42,1,48,1,59,1","unit,7,6,21,2,27,1,26,1,44,1,55,1,84,14","unit.â ,33,1","unit-based,84,2","unit-by-unit,33,1","unit--community,7,2","united,7,58,13,1,11,1,18,1,25,1,27,1,26,1,28,1,30,1,33,1,35,1,38,2,40,2,42,2,45,1,50,2,55,1,82,1,69,1,88,1,84,8","unites,7,2","unit--federal,7,2","unit--long-term,7,2","unit--other,7,2","unit--psychiatric,7,2","units,7,5,26,1,41,1,45,1,50,3,54,1,49,1,55,1,84,6","units.â the,41,1","unit--specialty,7,1","unity,33,1","universal,26,1,55,1","universities,14,2,16,1,20,1,35,1,54,1","university,7,3,13,2,9,1,10,1,11,1,12,2,14,1,16,1,18,2,20,1,27,1,23,1,28,1,33,1,31,1,34,3,36,2,38,2,40,2,39,2,42,1,54,2,46,1,47,3,52,1,82,3,60,2,84,12,92,2,131,1","unknown,7,3","unless,7,2,27,1","unlike,14,2","unlikely,48,1,84,1","unlock,88,1","unmet,34,1","unnecessarily,36,1","unparalleled,36,1","unprecedented,34,1","unpublished,84,1","unsettling,35,1","unspecified,7,1","unstable,12,1","unsuccessful,7,1","unsure,7,2","unsurpassed,35,1","untenable,84,1","until,7,7,12,1,15,1,27,1,26,1,30,1,50,1,54,1,49,1,55,1","untitled,62,4,88,4","untreated,21,1,26,1,55,1","unusually,52,1","unveiled,16,1,26,1,35,1,43,1,52,1,55,1","unverzagt,84,1","unweighted,7,10","upcoming,23,1,26,1,33,1,36,2,55,1","update,25,2,26,2,36,1,41,1,42,1,53,1,54,1,46,1,47,3,55,2,56,1,82,1,58,1,57,1,66,1,83,6","updated,13,1,35,1,50,1,46,1,82,1,84,1","updates,11,1,12,1,14,1,21,1,25,1,27,1,30,1,36,3,38,1,40,1,41,2,54,1,52,1","updating,13,1,27,1","upgrade,7,2","upgraded,7,1","upload,45,1,49,1","upon,7,1,12,1,25,1,26,1,42,1,50,1,53,1,47,1,55,1,56,1,82,1,58,1,57,1","upper,7,1","up-to-date,7,1,27,1,30,1,36,1,38,1,40,1,41,1","upward,18,1,82,1","urban,7,1,36,1,82,1,92,1","urge,18,1","urged,12,1","urgent,7,2,23,1,52,1,82,2,84,6","urgently,18,1","urges,50,1","urging,13,1,11,1,16,1,30,1,31,1,131,1","urogynecology,84,1","urology,7,4,84,1","us.â ,53,1,56,1,58,1,57,1","usa,12,2,23,1,69,1,84,1","usable,84,1","uscis,7,1","use,7,8,13,1,11,2,12,2,16,1,18,2,21,1,25,3,22,3,23,3,24,4,26,6,28,1,29,2,30,2,33,1,35,1,31,1,34,2,36,5,37,5,38,2,40,2,39,5,41,4,42,8,43,4,44,3,50,3,53,1,54,1,46,2,48,3,49,5,52,1,55,6,56,1,58,1,57,1,60,1,63,1,83,1,84,29,131,1","used,7,64,11,2,12,1,18,1,21,1,30,1,33,1,35,2,36,1,38,2,40,2,42,2,53,1,48,1,56,1,82,2,58,1,57,1,88,1,84,7","useful,11,1,82,1","usefulness,50,1","users,7,5,27,2,23,1,42,1,44,1,66,2","uses,27,1,38,3,40,3","ushered,12,1","using,7,11,13,1,9,1,10,1,11,1,12,1,17,1,14,1,15,1,16,2,18,2,19,1,20,1,21,3,25,1,27,1,22,1,23,2,24,1,26,1,28,2,29,1,30,1,33,3,35,3,31,1,32,2,34,2,36,1,37,1,38,1,40,1,39,1,41,1,42,2,43,1,44,1,45,1,50,1,53,2,54,3,46,3,47,1,48,1,49,1,51,1,52,1,55,1,56,1,59,1,82,2,58,1,57,1,60,1,83,1,84,8,131,1","usps,7,4","usual,7,3,20,1,21,1,84,12","usually,7,6,21,1,27,1,31,1,88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Nurses","Registered nurse population, RN, National Sample Survey of Registered Nurses 2008, NSSRN, U.S. Department of Health and Human Services, HHS, Health Resources and Services Administration, HRSA","The registered nurse population in the United States: 2008","The Registered Nurse Population  Findings from the 2008  National Sample Survey of  Registered Nurses September 2010  U.S. Department of Health and Human Services  Health Resources and Services Administration   The Registered Nurse Population  Findings from the 2008  National Sample Survey of  Registered Nurses September 2010  U.S. Department of Health and Human Services  Health Resources and Services Administration   Preface  The U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), is the principal Federal agency responsible for the evaluation and development of the nursing workforce in the United States. HRSA \'s Bureau of Health Professions (BHPr) works to appraise and improve the U.S. nursing workforce with the goal of ensuring there are enough qualified nurses to meet the Nation \'s health needs. To do this, BHPr reviews the supply, composition, and distribution of nurses on the national and State levels. To that end, BHPr commissioned the National Sample Survey of Registered Nurses (NSSRN). This publication is the report of the ninth NSSRN representing data collected about registered nurses (RNs) holding active nursing licenses as of March 2008. As with previous iterations of the NSSRN, this report is available to all primary stakeholders involved in health care planning and evaluation as well as the public. The 2008 NSSRN public use files and code book are available to researchers and analysts and can be accessed at http://bhpr.hrsa.gov/healthworkforce/rnsurvey/ default.htm. The 2008 NSSRN was developed for the U.S. Department of Health and Human Services, Health Resources and Services Administration under contract with Westat. The study was overseen by BHPr and funded through the Division of Nursing. The first national survey was conducted in 1977; HRSA has conducted this national survey every 4 years since 1980. Data from these periodic surveys provide the basis for evaluating trends and projection of the future supply of nursing resources at the national and State levels. The NSSRN is the cornerstone of nursing workforce data. It is the principal data source used for disseminating information to the Federal Government, researchers, and the public on the nursing workforce. It provides essential information for performing supply-demand projections of nursing requirements and foreseen shortages. Periodic monitoring of the number and characteristics of the registered nurse population is vital to effectively maintain an up-to-date picture of the RN population and to assess the future availability of this critical resource. For example, previous surveys were integral in identifying the shortages of RNs that occurred at the end of the 1980s and then reappeared around 2000. The NSSRN is the Nation \'s most extensive and comprehensive source of statistical data on all individuals in the United States that hold active RN licenses, whether they are currently practicing  iii  Preface  nursing or not. The survey assesses the number of RNs; their educational background; employment setting, position, and specialty areas; job satisfaction; and salaries. In addition, the survey also identifies the geographic distribution of nurses throughout the United States, as well as the personal composition of the U.S. nursing workforce in terms of gender, racial/ethnic background, age, and family structure.  iv  Table of Contents  Chapter Preface .................................................................................................................. Executive Summary ............................................................................................ Introduction ........................................................................................................ 1 Survey Methods .................................................................................................. 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Summary ................................................................................................. 2008 Questionnaire ............................................................................... Sample Design ....................................................................................... Data Collection Methods ..................................................................... Sample Performance ............................................................................. Imputation ............................................................................................. Sample Weighting ................................................................................. 1.7.1 1.7.2 2 Overview of the Weighting Process .................................. Implications of Weighting for NSSRN Data Users ....................................................................................... Page iii xxvii xxxvii 1-1 1-1 1-3 1-4 1-5 1-6 1-7 1-9 1-9 1-9 2-1 2-1 2-1 2-2 2-3 2-5 2-6 2-7 2-11 2-12 2-13 3-1 3-1 3-1 3-3 3-5 3-7  Education and Licensing of Registered Nurses ............................................. 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 Introduction ........................................................................................... Initial Nursing Education .................................................................... Age at Graduation ................................................................................. Sources of Financing ............................................................................ Education and Experience Prior to Initial Nursing Education ............................................................................................... Nursing Licensure ................................................................................. Degrees Obtained After Initial Nursing Education ......................... Currently Enrolled Students ................................................................ Emergency Preparedness ..................................................................... Certifications ..........................................................................................  3  The Employment of Registered Nurses .......................................................... 3.1 3.2 3.3 3.4 3.5 Introduction ........................................................................................... Nursing Workforce Size....................................................................... Employment and Age........................................................................... Employment and Education ............................................................... Employment Settings ...........................................................................  v  Contents (continued) Chapter 3.5.1 3.5.2 3.5.3 3.6 Employment Setting Trends ............................................... Employment Settings and Age ........................................... Employment Settings and Education ................................ Page 3-11 3-11 3-13 3-14 3-15 3-16 3-16 3-17 3-19 3-24 3-24 3-25 3-25 3-26 3-28 3-29 3-31 3-33 3-34 3-34 3-36 3-37 3-37 3-38 3-40 3-41 3-41 3-42 3-42 3-43 3-45 3-45  Job Titles ................................................................................................ 3.6.1 3.6.2 3.6.3 Job Titles and Employment Settings ................................. Job Titles and Experience ................................................... Job Titles and Education .....................................................  3.7 3.8  Secondary Nursing Jobs ....................................................................... Supply of Registered Nurses ............................................................... 3.8.1 3.8.2 3.8.3 3.8.4 3.8.5 3.8.6 Hours and Weeks Worked and Age Group ..................... Hours and Weeks Worked and Highest Education ............................................................................... On-Call Work ........................................................................ Overtime Work ..................................................................... Hours Worked and Employment Setting ......................... Hours Worked and Job Title ..............................................  3.9  Employment Settings and Level of Care ........................................... 3.9.1 Education and Areas of Clinical Specialty ........................  3.10  Composition of Nursing Work ........................................................... 3.10.1 3.10.2 Composition of Work and Job Title .................................. Composition of Work and Education ...............................  3.11 3.12 3.13 3.14  Temporary and Travel Work ............................................................... Crossing State Lines and Compact States ......................................... Unionization in Principal Nursing Positions .................................... Earnings of Registered Nurses............................................................ 3.14.1 3.14.2 3.14.3 3.14.4 3.14.5 Earnings and Job Titles ....................................................... Earnings and Employment Setting .................................... Earnings From Secondary Jobs .......................................... Earnings and Experience ..................................................... Earnings and Education ......................................................  3.15  Job Satisfaction ...................................................................................... 3.15.1 3.15.2 Job Satisfaction and Employment Setting ........................ Job Satisfaction and Job Titles ............................................  vi  Contents (continued) Chapter 3.15.3 3.15.4 3.16 3.17 3.18 4 Job Satisfaction and Age ...................................................... Job Satisfaction and Education .......................................... Page 3-48 3-48 3-51 3-53 3-54 4-1 4-1 4-2 4-3 4-4 4-5 4-6 5-1 5-1 5-1 5-3 5-5 5-7 5-10 5-13 5-14 5-15 5-17 5-19 5-20 5-21 5-22 5-24 5-25 5-26 5-26 5-27 5-30  Job Changes of Registered Nurses ..................................................... Plans for Future Employment ............................................................ Non-Nursing Jobs.................................................................................  Nurse Faculty ...................................................................................................... 4.1 4.2 4.3 4.4 4.5 4.6 Introduction ........................................................................................... Number of Nurses Working in Faculty Roles .................................. Faculty and Age ..................................................................................... Faculty and Education.......................................................................... Faculty and Hours of Work................................................................. Faculty Earnings and Satisfaction .......................................................  5  Advanced Practice Registered Nurses ............................................................. 5.1 5.2 Introduction ........................................................................................... Nurse Practitioners ............................................................................... 5.2.1 5.2.2 5.2.3 5.2.4 5.3 Number of Nurse Practitioners .......................................... Nurse Practitioners and Education .................................... Nurse Practitioners and Employment ............................... Nurse Practitioner Earnings and Job Satisfaction ...........  Nurse Midwives..................................................................................... 5.3.1 5.3.2 5.3.3 5.3.4 Number of Nurse Midwives ............................................... Nurse Midwives and Education ......................................... Nurse Midwives and Employment .................................... Nurse Midwife Earnings and Job Satisfaction .................  5.4  Nurse Anesthetists ................................................................................ 5.4.1 5.4.2 5.4.3 5.4.4 Number of Nurse Anesthetists........................................... Nurse Anesthetists and Education..................................... Nurse Anesthetists and Employment ................................ Nurse Anesthetist Earnings and Job Satisfaction ............  5.5  Clinical Nurse Specialists ..................................................................... 5.5.1 5.5.2 5.5.3 Number of Clinical Nurse Specialists ................................ Clinical Nurse Specialists and Education .......................... Clinical Nurse Specialists and Employment .....................  vii  Contents (continued) Chapter 5.5.4 6 Clinical Nurse Specialist Earnings and Job Satisfaction ............................................................................. Page 5-32 6-1 6-1 6-1 6-1 6-2 6-3 6-4 6-6 7-1 7-1 7-1 7-2 7-5 7-11 7-11 7-12 7-13 8-1 8-1 8-1 8-3 8-5 9-1 9-1 9-1 9-2 9-7 9-8 9-8 9-11  Nurses Who Do Not Work in Nursing .......................................................... 6.1 6.2 Introduction ........................................................................................... Demographics of Nurses Not Working in Nursing ........................ 6.2.1 6.2.2 6.3 6.4 6.5 Nurses Not Working in Nursing and Age ........................ Presence of Children ............................................................  Length of Time Away From Nursing Work ..................................... Reasons for Not Working in Nursing................................................ Plans Regarding Nursing Work ..........................................................  7  Demographics of the Registered Nurse Workforce ...................................... 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 Introduction ........................................................................................... Registered Nurses and Age .................................................................. Registered Nurses and Gender ........................................................... Registered Nurses and Race and Ethnicity ....................................... Registered Nurses and Language Competency ................................ Registered Nurses and Marital Status and Dependents .................. Registered Nurses and Household Income ...................................... Geography, Nurse Demographics, and Employment .....................  8  Internationally Educated Nurses (IENs) ........................................................ 8.1 8.2 8.3 8.4 Introduction ........................................................................................... IEN Licensure and National Origin .................................................. IEN Demographic Characteristics ..................................................... IEN Employment .................................................................................  9  Recent Registered Nurse Graduates ................................................................ 9.1 9.2 9.3 9.4 9.5 9.6 9.7 Introduction ........................................................................................... Demographic Characteristics of Recent Registered Nurse Graduates ............................................................................................... Recent Registered Nurse Graduates and Education........................ Recent Registered Nurse Graduates and Diversity .......................... Family Situation of Recent Nurse Graduates ................................... Recent Registered Nurse Graduates and Employment ................... Recent Registered Nurse Graduates and Job Changes....................  viii  Contents (continued) Chapter 9.8 9.9 10 Recent Registered Nurse Graduates and Secondary Nursing Jobs .......................................................................................... Recent Registered Nurse Graduates and Earnings .......................... Page 9-13 9-14 10-1 10-1 10-1 10-2 10-3 10-5 10-5 10-6 10-6 10-8  Registered Nurses Nearing Retirement ........................................................... 10.1 10.2 10.3 Introduction ........................................................................................... Demographic Characteristics of Registered Nurses Nearing Retirement .............................................................................. Employment Characteristics of Older Registered Nurses .............. 10.3.1 10.3.2 10.3.3 10.3.4 10.4 10.5 Employment Positions and Settings .................................. Hours Worked by Older Registered Nurses ..................... Secondary Nursing Employment ....................................... Earnings of Older Registered Nurses ................................  Job Changes and Intentions Regarding Nursing Work ................... Older Registered Nurses Not Working in Nursing .........................  Appendixes A B Data Tables .......................................................................................................... Survey Methodology .......................................................................................... B.1 Sampling ................................................................................................. B.1.1 B.1.2 B.2 Sample Selection ................................................................... Final Sample Allocation ....................................................... A-1 B-1 B-1 B-1 B-3 B-3 B-11 B-13 B-14 B-15 B-16 B-17 B-18 B-24  Sample Performance ............................................................................. B.2.1 Vermont Sample Performance ...........................................  B.3  Imputation ............................................................................................. B.3.1 B.3.2 B.3.3 Imputation Methods ............................................................ Procedures ............................................................................. Results and Implications on Variance Estimates .............  B.4  Weighting and Estimation ................................................................... B.4.1 B.4.2 Sample Weighting ................................................................. Estimation, Variance Estimation, and Sampling and Nonsampling Errors .....................................................  ix  Contents (continued) Appendixes B.5 Nonresponse Bias Analysis ................................................................. B.5.1 B.5.2 B.5.3 Underrepresentation of Racial and Ethnic Minorities ............................................................................... Underrepresentation of Younger Nurses.......................... Comparative Analyses .......................................................... Page B-29 B-29 B-30 B-31 B-41 C-1  References ............................................................................................................ C Tables 1-1 2-1 2-2 2-3 2-4 2-5 2-6 2-7 3-1 3-2 3-3 3-4 3-5 Summary of 2008 NSSRN sample performance ........................................... Degrees prior to initial nursing education, by survey year, 20002008 ...................................................................................................................... Education and health occupation experience prior to initial nursing education, by initial nursing education .............................................. Highest nursing degree, by employment status .............................................. Master \'s and doctorate degrees as highest nursing or nursingrelated education preparation, 2000-2008 ....................................................... Average years between completion of initial and highest nursing degrees .................................................................................................................. Enrollment in nursing and nursing-related education programs ................. Registered nurse certifications .......................................................................... Employment in hospital units, by type of hospital ........................................ Employment settings, by age group ................................................................. Job titles of registered nurses ............................................................................ Job titles, by experience in nursing ................................................................. Job titles, by highest nursing or nursing-related education .......................... NSSRN Questionnaire .......................................................................................  1-7 2-5 2-6 2-7 2-9 2-11 2-12 2-13 3-10 3-13 3-15 3-16 3-17  x  Contents (continued) Tables 3-6 3-7 3-8 3-9 3-10 3-11 3-12 3-13 3-14 3-15 3-16 3-17 3-18 3-19 3-20 Employment arrangements in secondary nursing positions ........................ Employment settings of secondary nursing positions .................................. Average hours and weeks worked in secondary nursing positions ............. Average hours per year worked in all nursing jobs, by number of nursing jobs ......................................................................................................... Average hours worked per year in all nursing positions, by age group..................................................................................................................... Average hours worked per year in all nursing positions, by highest nursing and nursing-related education ............................................... Average hours on standby or worked from on-call per week in the principal nursing position ........................................................................... Average hours per week in principal nursing position, by fulltime/part-time status and employment setting .............................................. Average hours per week in principal nursing position, by fulltime/part-time status and job title ................................................................... Levels of care in nursing work for hospital and nonhospital settings .................................................................................................................. Primary patient age group cared for in principal nursing position, for hospital and nonhospital settings ............................................................... Primary clinical specialty in principal nursing position for hospital and nonhospital settings .................................................................................... Primary clinical specialty in principal nursing position, by highest nursing and nursing-related education............................................................. Average percent time spent on various activities, by highest nursing or nursing-related education ............................................................... Employment by temporary employment services (TES), for primary and secondary nursing positions, by principal nursing position in a hospital .......................................................................................... Employment settings of secondary employment through a nontravel temporary employment service ....................................................... Page 3-19 3-19 3-23 3-23 3-24 3-24 3-25 3-27 3-28 3-29 3-30 3-31 3-32 3-35  3-36 3-36  3-21  xi  Contents (continued) Tables 3-22 3-23 3-24 3-25 3-26 3-27 Licensure in a Compact State, by where registered nurses live and work ...................................................................................................................... Unionization, by employment setting .............................................................. Average annual earnings from all nursing positions, by total number of hours worked per year in all nursing positions ........................... Average annual earnings, by job title of principal nursing position, for registered nurses working full-time ........................................... Average annual earnings, by employment setting of principal nursing position, for registered nurses working full-time ............................. Average annual earnings for registered nurses working full-time in their principal nursing position, by years since initial nursing education .............................................................................................................. Average annual earnings of registered nurses working full-time in their principal nursing position, by highest nursing or nursingrelated education and job title ........................................................................... Employment status in 2008, compared with status in 2007 ......................... Employment changes among registered nurses employed in nursing in both 2007 and 2008 ......................................................................... Employment in non-nursing occupations, by nursing employment status .............................................................................................. Registered nurses employed as faculty in their principal nursing position, by type of nursing education program ............................................ Registered nurses employed as faculty in their secondary nursing position(s), by job title of principal nursing position .................................... Months worked per year and hours worked per week, by registered nurses who are faculty in their principal nursing position................................................................................................................. Average annual earnings of registered nurses who work full-time as faculty in their principal nursing position ................................................... Certification and State Board recognition of nurse practitioners employed in nursing, and whether certification or recognition is required for their job .......................................................................................... Page 3-37 3-38 3-39 3-40 3-41  3-42  3-28  3-43 3-52 3-53 3-57 4-2 4-2  3-29 3-30 3-31 4-1 4-2 4-3  4-6 4-7  4-4 5-1  5-6  xii  Contents (continued) Tables 5-2 5-3 5-4 Primary clinical specialties of employed nurse practitioners with job title of nurse practitioner ............................................................................ Employed nurse practitioners whose primary level of care is ambulatory or primary care, by job title .......................................................... Certification and State Board recognition of nurse midwives employed in nursing, and whether certification or recognition is required for their job .......................................................................................... Clinical specialties of registered nurses prepared as nurse midwives, for selected job titles in the hospital setting ................................. Certification and State Board recognition of nurse anesthetists employed in nursing, and whether certification or recognition is required for their job .......................................................................................... Certification and State Board recognition of clinical nurse specialists employed in nursing, and whether certification or recognition is required for their job ................................................................. Intentions of nurses who are not working in nursing, overall, and by marital status .................................................................................................. Median age of registered nurses ....................................................................... Gender of employed registered nurses, by year of initial registered nurse license ........................................................................................................ Highest education of registered nurses working in nursing, by gender ................................................................................................................... Employment settings, by gender ...................................................................... Median current age and age at licensure of registered nurses working in nursing, by race/ethnicity .............................................................. Initial nursing education of registered nurses employed in nursing, by race/ethnicity .................................................................................. Highest education of registered nurses employed in nursing, by race/ethnicity....................................................................................................... Advanced practice preparation of registered nurses, by race/ethnicity....................................................................................................... Page  5-9 5-9  5-17 5-19  5-5 5-6  5-23  5-7  5-29 6-6 7-2 7-3 7-3 7-4 7-8 7-8 7-9 7-9  6-1 7-1 7-2 7-3 7-4 7-5 7-6 7-7 7-8  xiii  Contents (continued) Tables 7-9 7-10 7-11 7-12 7-13 8-1 8-2 8-3 8-4 8-5 8-6 8-7 Employment setting of registered nurses, by race/ethnicity ........................ Job titles of registered nurses, by race/ethnicity ............................................ Marital status and presence of children or adult dependents at home ..................................................................................................................... Employment of registered nurses, by presence of children or adult dependants in the home ........................................................................... Annual household income of registered nurses, by employment status of the nurse............................................................................................... Internationally educated nurses in the United States .................................... Years between initial nursing education and first U.S. licensure ................. Median current age and age at licensure of registered nurses employed in nursing, by international education status ................................ Men among U.S. and internationally educated employed nurses, by year of licensure ............................................................................................. Registered nurses working in nursing with at least a bachelor \'s degree, by location of education ....................................................................... Registered nurses working full-time, by location of education and year of licensure .................................................................................................. Average hours worked per year and per week in principal nursing position, by full-time and part-time status and location of education .............................................................................................................. Number and percent of nurses employed in a hospital setting for their principal nursing position, by location of initial education and year of licensure ........................................................................................... Registered nurses employed in ambulatory care and academic education, by location of initial education ...................................................... Registered nurses employed as staff nurses, by location of initial education and year of licensure ........................................................................ Employment intentions, by location of initial education.............................. Page 7-10 7-10 7-11 7-12 7-12 8-2 8-3 8-3 8-4 8-4 8-5  8-5  8-8  8-6 8-7 8-7 8-7  8-9 8-10 8-11  xiv  Contents (continued) Tables 9-1 9-2 9-3 9-4 9-5 9-6 9-7 9-8 9-9 9-10 Estimated population of registered nurses, by graduation cohort .............. Initial education of registered nurses, by graduation cohort ........................ Location of initial education of nurses, by graduation cohort ..................... Initial nursing education, by graduation cohort and location of education .............................................................................................................. Average age at graduation and age distribution at graduation, by graduation cohort ............................................................................................... Registered nurses with postsecondary education degrees before starting initial nursing education program ...................................................... Fields of study for registered nurses who had postsecondary degrees before initial nursing education, by graduation cohort ................... Employment in a health occupation, by registered nurses before initial nursing education, by graduation cohort .............................................. Sources of financing for initial nursing education, by graduation cohort ................................................................................................................... Highest level of nursing or nursing-related education for recent registered nurse graduates, by initial nursing education (2001­ 2004) ..................................................................................................................... Gender of registered nurses, by graduation cohort ....................................... Racial/ethnic composition of registered nurse population, by graduation cohort ............................................................................................... Marital status and presence of children, by graduation cohort .................... Employment of registered nurses, by graduation cohort ............................. Employment of new registered nurse graduates, by presence of children ................................................................................................................. Employment setting of principal nursing position, by graduation cohort, 2008 and 2004 ....................................................................................... Job titles of registered nurses, by graduation cohort ..................................... Page 9-2 9-2 9-3 9-3 9-3 9-4 9-4 9-5 9-6  9-6 9-7 9-7 9-8 9-9 9-9 9-9 9-10  9-11 9-12 9-13 9-14 9-15 9-16 9-17  xv  Contents (continued) Tables 9-18 9-19 9-20 9-21 9-22 9-23 9-24 9-25 10-1 10-2 10-3 10-4 10-5 10-6 10-7 10-8 10-9 10-10 Average hours worked per year and per week by registered nurses, by full-time/part-time status and graduation cohort ....................... Satisfaction with principal nursing position, by graduation cohort............. Intentions regarding nursing employment, by graduation cohort ............... Job changes between March 2007 and March 2008, for registered nurses employed in 2008, by graduation cohort ............................................ Reasons for job changes, by graduation cohort ............................................. Employment setting changes for registered nurses who graduated 2001­2008 ............................................................................................................ Secondary nursing positions, by graduation cohort ...................................... Average earnings from principal nursing position, and from all nursing positions, by graduation cohort .......................................................... Demographic and educational characteristics of registered nurses, by age .................................................................................................................... Employment settings of registered nurses in their principal nursing position, by age group.......................................................................... Job titles of registered nurses in their principal nursing position, by age group ........................................................................................................ Job satisfaction, by principal employment setting ......................................... Average hours worked per week for registered nurses in their principal nursing position, by age ..................................................................... Percent of employed registered nurses with secondary nursing positions, by age .................................................................................................. Average earnings from primary nursing employment, by age ..................... Registered nurses employed in nursing in 2007 who changed position or employer, by age ............................................................................. Reasons for job changes, by age group ........................................................... Intentions to change employers or leave the nursing profession, by age group ........................................................................................................ Page 9-10 9-11 9-11 9-12 9-12 9-13 9-13 9-14 10-2 10-4 10-4 10-5 10-5 10-6 10-6 10-7 10-7 10-8  xvi  Contents (continued) Tables 10-11 10-12 10-13 Length of time since last employed in nursing, for registered nurses not employed in nursing in 2008, by age group................................. Reasons for not working in nursing, by age group ........................................ Percent of registered nurses not employed in nursing who work in non-nursing positions, by age group ........................................................... Page  10-8 10-9 10-9  Appendix A Tables 1 2 3 4 Gender, racial/ethnic background, and age group, by employment status: 2008 ................................................................................... Year of graduation from initial nursing education and the average age at graduation, by type of initial nurse education: 2008 ........................... Financial resources used for tuition and fees for initial nursing education, by type of initial nursing education: 2008 .................................... Characteristics of registered nurses with a degree before entering initial nursing education, by type of initial nursing education: 2008 ...................................................................................................................... Health occupations prior to initial nursing education, by type of initial nursing education: 2008 .......................................................................... Registered nurses who were ever licensed as practical/vocational nurse, by type of initial nursing education: 2008............................................ State of location of registered nurses as of March 2008 and State of graduation, by type of initial nursing education and number of years since graduation: 2008 .............................................................................. Highest nursing or nursing-related education, by initial nursing education: 2008 ................................................................................................... Primary focus of post-nursing master \'s and doctorate degrees: 2008 ...................................................................................................................... Current enrollment in nursing or nursing-related education programs, by employment status and student status: 2008 .......................... National nursing certifications for registered nurses: 2008 .......................... Employment setting in principal nursing position: 2008 .............................. A-1 A-2 A-3  A-4 A-5 A-6  5 6 7  A-7 A-8 A-9 A-10 A-11 A-12  8 9 10 11 12  xvii  Contents (continued) Appendix A Tables 13 14 15 16 17 18 19 20 21 22 23 24 25 Employment setting in principal nursing position, by age group: 2008 ...................................................................................................................... Employment setting in principal nursing position, by highest nursing or nursing-related education: 2008 .................................................... Job title in principal nursing position: 2008 .................................................... Job title in principal nursing position, by hospital and nonhospital setting: 2008 ......................................................................................................... Employment setting in principal nursing position, by selected job titles: 2008 ............................................................................................................ Job title in principal nursing position, by highest nursing or nursing-related education: 2008 ........................................................................ Employment status and average total earnings for registered nurses with one and more than one nursing position: 2008 ........................ Average annual hours worked and employment setting in principal nursing position: 2008 ....................................................................... Average hours per week and employment setting for registered nurses working full-time in their principal nursing position: 2008 ............. Average hours per week and employment setting for registered nurses working part-time in their principal nursing position: 2008 ............ Level of care by type of clinical specialty in principal nursing position: 2008 ...................................................................................................... Clinical specialty by patient population in principal nursing position for registered nurses who provide patient care: 2008 .................... Level of care by clinical specialty in principal nursing position for registered nurses who provide patient care in hospital settings: 2008 ...................................................................................................................... Clinical specialty by patient population in principal nursing position for registered nurses who provide patient care in hospital settings: 2008 ....................................................................................................... Percent of time in each functional area during usual work week in principal nursing position: 2008 ....................................................................... Page A-14 A-15 A-16 A-17 A-18 A-19 A-20 A-21 A-22 A-23 A-24 A-25  A-26  26  A-27 A-28  27  xviii  Contents (continued) Appendix A Tables 28 Average percent of time in each functional area during usual work week in principal nursing position, by highest nursing or nursing-related education: 2008 ........................................................................ Employment setting in principal nursing position, by employment relationship: 2008......................................................................... Average annual earnings for registered nurses working full-time in their principal nursing position, by job title: 2008..................................... Average annual earnings for registered nurses working full-time in their principal nursing position, by employment setting: 2008 ............... Average annual earnings for registered nurses working full-time in their principal nursing position, by job title and highest nursing or nursing-related education: 2008 ................................................................... Job satisfaction, by employment setting in principal nursing position: 2008 ...................................................................................................... Job satisfaction, by job title in principal nursing position: 2008 .................. Job satisfaction of registered nurses employed in nursing, by age group: 2008 .......................................................................................................... Job satisfaction of registered nurses employed in nursing, by highest nursing or nursing-related education: 2008 ....................................... Employment status in 2007, by employment status in 2008: 2008 ............. Employment setting in 2007, by employment setting in 2008: 2008 ...................................................................................................................... Reasons for employer or position change among registered nurses employed in nursing in 2007 and 2008: 2008..................................... Reasons for registered nurses to have occupation other than nursing: 2008 ....................................................................................................... Type of employment of registered nurses who are in non-nursing occupations and not employed in nursing: 2008 ........................................... Detailed type of employment of registered nurses who are in non-nursing occupations and not employed in nursing: 2008 ..................... Page  A-29 A-30 A-31 A-32  29 30 31 32  A-33 A-34 A-35 A-36 A-37 A-38 A-39 A-40 A-41 A-42 A-43  33 34 35 36 37 38 39 40 41 42  xix  Contents (continued) Appendix A Tables 43 44 45 46 47 48 49 50 51 Job title of registered nurses who are in non-nursing occupations and not employed in nursing: 2008 .................................................................. Advanced practice registered nurses, by employment status: 2008............. Advanced practice registered nurses and job title, by national certification and State Board recognition: 2008 ............................................. Advanced practice study focus: 2008............................................................... Certifications in advanced practice registered nursing: 2008 ....................... Age distribution of registered nurses not employed in nursing, by length of time not working in nursing: 2008 .................................................. Age and presence of children, by employment status in principal nursing position: 2008 ........................................................................................ Resident State in 2007 and 2008, by age group: 2008 ................................... Registered nurses not employed in nursing and length of time since last worked as a nurse, by whether or not registered nurse was seeking nursing position or had other occupation outside of nursing: 2008 ....................................................................................................... Registered nurses not employed in nursing and actively seeking nursing employment, by type of employment sought and number of months looking: 2008.................................................................................... Age and caring for adults at home or others elsewhere, by employment status in principal nursing position: 2008 ................................ Marital status and presence of children, by employment status in principal nursing position: 2008 ....................................................................... Marital status and caring for adults at home or others elsewhere, by employment status in principal nursing position: 2008 ........................... Household income and marital status, by employment status in principal nursing position: 2008 ....................................................................... Registered nurses in each State and geographic area, by activity status: 2008 .......................................................................................................... State and geographic area of registered nurses, by employment status in principal nursing position: 2008........................................................ Page A-44 A-45 A-46 A-47 A-48 A-49 A-50 A-51  A-52  52  A-53 A-54 A-55 A-56 A-57 A-58 A-60  53 54 55 56 57 58  xx  Contents (continued) Appendix A Tables 59 60 Employment setting of principal nursing position, by geographic area: 2008 ............................................................................................................. Average annual earnings for registered nurses working full-time as staff nurses in their principal nursing position, by geographical area: 2008 ............................................................................................................. Registered nurses employed in nursing in each State and geographic area, by highest nursing or nursing-related education: 2008 ...................................................................................................................... Age distribution and average age of registered nurses, by geographic area for all registered nurses and registered nurses employed in nursing: 2008 ................................................................................ Racial/ethnic background of registered nurses, by geographic area: 2008 ............................................................................................................. Geographic location of registered nurses, by employment status: 2008 ...................................................................................................................... Predominant countries where internationally educated nurses received initial nursing education, by employment status: 2008 .................. Predominant States employing internationally educated nurses (IENs): 2008 ........................................................................................................ Employment setting of internationally educated nurses (IENs), by selected job titles: 2008 ................................................................................. Page  A-62  A-63  61  A-64  62  A-65 A-66 A-67 A-68 A-69 A-70  63 64 65 66 67  Appendix B Tables B1-1 B1-2 B1-3 B2-1 Sample information for States where the strata were based only on Alaska, Hawaii, and New Mexico (sorted by frame size) ........................ Sample information for States where strata were based only on Alaska, Hawaii, and New Mexico (sorted alphabetically) ............................. Sampling States where strata are based on RNs licensed in neighboring States as well .................................................................................. Response rates, unweighted and weighted by State and for the United States as a whole .................................................................................... B-4 B-5 B-6 B-12  xxi  Contents (continued) Appendix B Tables B3-1 B4-1 B5-1 Distribution of imputation rates....................................................................... Standard errors for select estimates ................................................................. Evaluating potential for reduction in bias: Comparing final 2008 estimates with 2008 estimates using a weight that does not account for differential response rates by age ................................................ Comparing 2008 NSSRN and 2008 American Community Survey (ACS) estimates on racial/ethnic background, and age group..................... Page B-17 B-27  B-34 B-38  B5-2  Figures 1-1 2-1 2-2 2-3 2-4 2-5 3-1 3-2 3-3 3-4 3-5 3-6 3-7 The nursing workforce of the United States, 1980-2008 .............................. Distribution of registered nurses according to initial nursing education, 1980-2008 ......................................................................................... Average age at graduation from initial nursing education, by type of program ........................................................................................................... Sources of financing for initial education for all U.S. registered nurses .................................................................................................................... Highest nursing or nursing-related education preparation, 19802008 ...................................................................................................................... Highest education of registered nurses, by initial nursing education .............................................................................................................. The nursing population and workforce in the United States, 1980-2008............................................................................................................. Employment status of registered nurses ......................................................... Age distribution of the registered nurse population, 1980-2008 ................. Employment of registered nurses, by age group............................................ Employment rates, by initial nursing education ............................................. Employment rates, by highest nursing or nursing-related education .............................................................................................................. Employment settings of registered nurses ...................................................... xxxviii 2-2 2-3 2-4 2-8 2-10 3-2 3-3 3-4 3-5 3-6 3-7 3-9  xxii  Contents (continued) Figures 3-8 3-9 3-10 3-11 3-12 3-13 3-14 3-15 3-16 3-17 3-18 3-19 3-20 3-21 3-22 3-23 3-24 3-25 3-26 Types of hospitals in which registered nurses employed in hospital settings work......................................................................................... Employment settings of registered nurses, 1980-2008 ................................. Employment settings, by highest nursing or nursing-related education .............................................................................................................. Registered nurses holding multiple positions, by primary employment status .............................................................................................. Months worked per year in principal nursing position ................................. Hours worked per year in all nursing positions ............................................. Hours worked per week in principal nursing position .................................. Time spent by registered nurses in various activities .................................... Time spent by registered nurses in various activities, by job title................ Actual and inflation-adjusted  real  average earnings for full-time registered nurses in their principal nursing position...................................... Job satisfaction of registered nurses ................................................................ Job satisfaction, by employment setting of principal nursing position................................................................................................................. Job satisfaction, by job title in principal nursing position ............................ Job satisfaction of registered nurses employed in nursing, by age .............. Job satisfaction of registered nurses employed in nursing, by highest nursing or nursing-related education ................................................. Comparison of employment status of registered nurse population in 2007 and 2008 ................................................................................................. Intentions to stay in nursing over the next 3 years, by age group ............... Non-nursing positions among registered nurses not employed in nursing, by years since last worked in nursing................................................ Employment settings of registered nurses employed outside of nursing .................................................................................................................. Page 3-10 3-12 3-14 3-18 3-21 3-22 3-23 3-33 3-35 3-39 3-44 3-46 3-47 3-49 3-50 3-52 3-54 3-56 3-57  xxiii  Contents (continued) Figures 3-27 4-1 4-2 4-3 4-4 5-1 5-2 5-3 5-4 5-5 5-6 5-7 5-8 5-9 5-10 5-11 5-12 5-13 5-14 Job titles of registered nurses employed outside of nursing......................... Age distribution of registered nurses who work as faculty........................... Highest education of registered nurses who work as faculty ....................... Highest education of registered nurses who work as faculty in their principal position, by type of program in which they work ................ Satisfaction of registered nurses who work as faculty in their principal nursing position .................................................................................. Registered nurses prepared for advanced practice, 2004-2008 .................... Registered nurses prepared in advanced practice nursing ............................ Age distribution of registered nurses prepared as nurse practitioners ......................................................................................................... Nurse practitioner preparation, by highest nursing or nursingrelated degree....................................................................................................... Hours worked per week by employed nurse practitioners in their principal nursing position .................................................................................. Job titles of nurse practitioners......................................................................... Employment settings in which nurse practitioners work ............................. Percent of nurse practitioners whose primary level of care is ambulatory or primary care, by employment setting ..................................... Nurse practitioner satisfaction with principal position ................................. Age distribution of registered nurses prepared as nurse midwives ............. Nurse midwife preparation, by highest nursing or nursing-related degree ................................................................................................................... Hours worked per week by employed nurse midwives in their principal nursing position .................................................................................. Job titles of nurse midwives .............................................................................. Employment settings in which nurse midwives work ................................... Page 3-58 4-3 4-4 4-5 4-7 5-2 5-4 5-5 5-6 5-7 5-8 5-11 5-12 5-13 5-15 5-16 5-17 5-18 5-19  xxiv  Contents (continued) Figures 5-15 5-16 5-17 5-18 5-19 5-20 5-21 5-22 5-23 5-24 5-25 5-26 6-1 6-2 6-3 6-4 6-5 7-1 Nurse midwife satisfaction with principal position ....................................... Age distribution of registered nurses prepared as nurse anesthetists ........................................................................................................... Nurse anesthetist preparation, by highest nursing or nursingrelated degree....................................................................................................... Hours worked per week by employed nurse anesthetists in their principal nursing position .................................................................................. Nurse anesthetists satisfaction with principal position ................................. Age distribution of registered nurses prepared as clinical nurse specialists.............................................................................................................. Clinical nurse specialist preparation, by highest nursing or nursing-related degree ........................................................................................ Hours worked per week by employed clinical nurse specialists in their principal nursing position ......................................................................... Job titles of employed nurses prepared as clinical nurse specialists ............ Job titles of employed nurses dual-prepared as clinical nurse specialists and nurse practitioners .................................................................... Employment settings in which clinical nurse specialists work..................... Clinical nurse specialist satisfaction with principal position......................... Age distribution of nurses who are not working in nursing......................... Percentage of nurses not working in nursing, by age and presence of children ............................................................................................................ Length of time since nonworking nurses last worked in nursing, by age .................................................................................................................... Reasons nurses are not working in nursing, by age group ........................... Percent of registered nurses seeking nursing employment, by number of years since last worked in nursing and age .................................. Percent of registered nurses working in nursing, by age cohort, 1988-2008............................................................................................................. Page 5-20 5-22 5-23 5-24 5-25 5-28 5-29 5-30 5-31 5-32 5-33 5-34 6-2 6-3 6-4 6-5 6-7 7-2  xxv  Contents (continued) Figures 7-2 7-3 7-4 7-5 7-6 7-7 7-8 7-9 8-1 8-2 10-1 Percent of men employed in nursing, by job title .......................................... Percent of registered nurses who are White or non-White .......................... Racial/ethnic distribution, by year of graduation from initial nursing education................................................................................................ Distribution of registered nurses and the U.S. population, by racial/ethnic background ................................................................................... Distribution of employment settings, by geographic region ........................ Median earnings for staff and management/administration registered nurses, by geographic region........................................................... Percent of employed registered nurses with a bachelor \'s degree and higher, by region .......................................................................................... Percent of employed registered nurses in racial/ethnic minority groups, by geographic region ............................................................................ Countries of origin of internationally educated nurses in the United States........................................................................................................ Secondary nursing positions held by IENs working full-time in their principal nursing position ......................................................................... Percent of employed registered nurses working full-time and part-time, by age group ...................................................................................... Page 7-4 7-5 7-6 7-7 7-13 7-14 7-15 7-16 8-2 8-6 10-3  For citation please use: U.S. Department of Health and Human Services, Health Resources and Services Administration (2010). The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses. For an electronic copy of the report and further information: http://bhpr.hrsa.gov/healthworkforce/rnsurvey  xxvi  Executive Summary  Purpose of the National Sample Survey of Registered Nurses  The National Sample Survey of Registered Nurses (NSSRN), which has been conducted since 1977, is the largest survey of registered nurses (RNs) in the United States. Nurses with active RN licenses are asked to report on their education, employment, intentions regarding nursing work, and demographics. These data are used by policymakers and numerous stakeholders, both domestic and international, to assess the status of and trends in the U.S. nursing workforce.  The Size of the Registered Nurse Workforce  There were an estimated 3,063,162 licensed registered nurses living in the United States, as of March 2008. This is an increase of 5.3 percent from March 2004, representing a net growth of 153,806 RNs. An estimated 444,668 RNs received their first U.S. license from 2004 through 2008, and thus approximately 291,000 RNs allowed their U.S. licenses to lapse, possibly indicating that the substantial retirements that have been anticipated may have begun.  Initial Education of Registered Nurses  The most commonly reported initial nursing education of RNs in the United States is the Associate Degree in Nursing (ADN), representing 45.4 percent of nurses. Bachelor \'s or graduate degrees were received by 34.2 percent of RNs, and 20.4 percent received their initial education in hospital-based diploma programs. The average age of RNs who graduated from their initial nursing education program is rising. More than 21 percent of RNs earned an academic degree prior to their initial nursing degree. Nearly two-thirds of RNs reported working in a health occupation prior to their initial nursing education.  xxvii  Executive Summary  Highest Education Preparation of Registered Nurses  After initial licensure, RNs can obtain additional academic degrees in nursing or nursing-related fields. In 2008, half of the RN population had a bachelor \'s or higher degree in nursing or a nursingrelated field, while the other half \'s highest education level was a diploma or an ADN.  Employment of Registered Nurses  In 2008, an estimated 2,596,399 RNs were employed in nursing, representing 84.8 percent of licensed RNs. This was the highest rate of nursing employment since the NSSRN commenced in 1977. There also has been the first increase in full-time employment since 1996, rising from 58.4 percent of RNs in 2004 to 63.2 percent in 2008. Among nurses under 50 years old, 90 percent or more are employed in nursing positions; this percentage drops to less than half of RNs over age 65. Hospitals remain the most common employment setting for RNs in the United States, increasing from 57.4 percent in 2004 to 62.2 percent of employed RNs in 2008. The increase in this percentage is the first increase since 1984. While nearly 90 percent of RNs under 25 years old work in hospitals, less than 53 percent of RNs age 55 and older work in hospitals. Fewer than half of nurses with master \'s degrees work in hospitals; more than 18 percent are in ambulatory care settings and nearly 12 percent are in academic education. The most common job title of RNs in the United States is  staff nurse,  or its equivalent (66.3 percent). Between 2004 and 2008, the proportion of staff RNs increased by 2.2 percent. Just under 20 percent of RNs with graduate degrees are staff RNs, compared with 72.8 percent of those without a graduate degree. The next most common job title in 2008 included management and administration titles (12.5 percent). Many registered nurses hold more than one job in nursing. Overall, about 12 percent of RNs who have a full-time primary nursing position and 14 percent of those with part-time primary positions have additional nursing positions. More than half of RNs work at least 40 hours per week in their principal nursing position, and another 24.2 percent work 32 to 39 hours per week. A total of 19.1 percent of RNs report that they  xxviii  Executive Summary  worked on-call or could have been called to work (on  standby ) during a typical work week in their principal nursing positions. Among RNs employed in nursing positions, 27.5 percent report that they worked overtime averaging 7.5 hours per week and received pay for such work.  Earnings and Satisfaction of Registered Nurses  Average annual earnings for RNs employed full-time in 2008 were  66,973, rising 15.9 percent since the 2004 average of  57,785. When annual earnings are adjusted for inflation to 1980 dollars, earnings in 2008 increased only 1.7 percent from average inflation-adjusted 2004 earnings. The highest earnings were reported by nurse anesthetists (NAs), who averaged  135,776 per year. Staff nurses earned  61,706 per year, on average. Registered nurses with graduate degrees earned an average of at least  20,000 more than did RNs with other levels of education. In 2008, 29.3 percent of RNs reported that they were extremely satisfied and a further 51.8 percent reported being moderately satisfied with their principal nursing position. This compares with 2004 rates of satisfaction of 27.5 percent and 50.5 percent, respectively. Only 11.1 percent were dissatisfied in 2008, as compared with 13.8 percent in 2004. The highest rates of being moderately or extremely satisfied were reported by registered nurses working in academic education programs (86.6 percent), while the lowest rate of being either moderately or extremely satisfied was reported by nurses in nursing homes/extended care (74.5 percent).  Job Changes and Future Employment Plans  Nearly 80 percent of RNs were employed in nursing in both 2007 and 2008, while 12.3 percent were not employed in nursing in either year. Nearly 3 percent were employed in nursing in 2007, but not in 2008, and conversely, 2.4 percent returned to employment in 2008. Of those who were employed in 2007 but not in 2008, 27.3 percent (24,430) reported that they stopped working due to retirement. Among nurses who worked full-time in 2007, 11.6 percent changed to a different employer by 2008. Another 6.5 percent of these RNs worked with the same employer, but held a different position. More than 73 percent of RNs reported that they changed positions or employers due at least in part to workplace issues, such as lack of good management or inadequate staffing. Personal career reasons, such as interest in another position or improved pay or benefits, were a factor in job  xxix  Executive Summary  changes for 37.5 percent of nurses. Nearly 30 percent of nurses changed jobs at least in part due to personal family reasons. The percentage of employed RNs who intended to leave nursing within 3 years is quite small, at 3 percent or fewer, among nurses under 55 years old. Among RNs 55 and older who worked in nursing in 2008, 12.5 percent intended to leave the nursing profession within 3 years and another 8.9 percent intended to leave their current nursing jobs and were unsure if they will remain in nursing afterward.  Nurse Faculty  There were an estimated 31,056 RNs working as faculty in their principal nursing position in 2008. The majority (60 percent) of these worked in programs that provide education at the Bachelor \'s of Science in Nursing (BSN) level or a higher level. Another 38.3 percent worked in ADN education programs. An additional 34,666 RNs worked in academic education settings as a secondary nursing position. In 2008, more than 40 percent of RNs who worked as faculty in their principal nursing position were between the ages of 50 and 59, and more than 19 percent of RNs whose principal position is as faculty were 60 years or older. Nursing faculty received somewhat lower annual earnings than RNs in general from their principal full-time nursing position. Earnings from principal nursing positions for RNs who work full-time averaged  66,973 in 2008, while earnings for faculty RNs were  63,985 on average. Nearly 90 percent of faculty reported that they are moderately or extremely satisfied with their position, as compared with 81.1 percent of all working RNs. The satisfaction of faculty is similar to that of nurses with graduate degrees, of whom 87.3 percent were moderately or extremely satisfied.  Nurse Practitioners  In 2008, an estimated 158,348 nurses had preparation as nurse practitioners (NPs). NPs represent the largest group of advanced practiced registered nurses (APRNs). About 35 percent of NPs were under 45 years old. Nearly 85 percent of NPs reported that they held a master \'s degree and 3.9 percent reported holding a doctorate degree. Of all NPs, 10.3 percent also were prepared as clinical  xxx  Executive Summary  nurse specialists (CNSs). More than 93 percent of NPs employed in nursing reported having either national certification or State Board recognition. Most NPs were employed in nursing (89.2 percent), and 69.6 percent of these NPs had a principal position job title of NP. Virtually all NPs who reported NP as their job title had national certification or State Board recognition. Some NPs (11.4 percent) reported that their job title was staff nurse or an equivalent; others worked in instruction or had a management or administration title. More than 38 percent of NPs were employed in hospital settings, including primary care clinics located in or owned by a hospital. Another 35.3 percent worked in ambulatory care settings outside hospitals. Nurses prepared as NPs in 2008 earned an average of  73,776 per year in their principal nursing position. More than 87 percent of NPs were moderately or extremely satisfied with their principal position.  Nurse Midwives  Nurse midwives (NMs) were the smallest of the APRN groups, with an estimated 18,492 nurses prepared as NMs. More than 54 percent were 50 years or older, and half (50.3 percent) reported having a graduate degree. More than 91 percent of NMs employed in nursing had national certification or recognition from their State Board of Nursing. The majority (84.3 percent) of NMs were employed in nursing positions in 2008, but only 41.7 percent of employed NMs reported a job title of nurse midwife. All of these NMs also had State Board recognition or national certification in this field. The majority (57.9 percent) of NMs worked in hospital settings, and 25.1 percent worked in ambulatory care. Nurses prepared as NMs earned an average of  69,222 per year. They had a high level of satisfaction with their principal nursing position, with 86.2 percent being moderately or extremely satisfied.  xxxi  Executive Summary  Nurse Anesthetists  NAs were the third largest group of APRNs, with an estimated 34,821 nurses prepared as anesthetists in 2008. NAs were also the youngest group of APRNs: nearly 40 percent were under 45 years old. Nearly 40 percent of NAs were men. In 2008, 65.4 percent of NAs held a master \'s or doctorate degree as their highest nursing or nursing-related degree, and almost all had national certification or State Board recognition (99.3 percent). In 2008, 31,868 NAs were employed in nursing positions (91.5 percent). Registered nurses prepared as NAs earned an average of  135,776 per year, making them the highest-paid APRN group. They were the most satisfied of the APRN groups, with 93.5 percent reporting moderate or extreme satisfaction with their principal position.  Clinical Nurse Specialists  In 2008, there were an estimated 59,242 nurses prepared as CNSs. CNSs were the second largest group of APRNs. There was a marked decline of 18.3 percent in the number of CNSs between 2004 and 2008. CNSs were older than other APRNs in 2008, with 63.6 percent over 50 years old. The vast majority of CNSs (92.8 percent) reported at least a master \'s degree as their highest preparation, with 7.2 percent completing a doctorate degree for their CNS preparation. More than 50 percent had national certification or recognition from their State Board of Nursing. CNSs had the lowest rate of employment in nursing of all the advanced specialties, with 84 percent working in nursing. Only 18.8 percent of CNSs reported their job title as clinical nurse specialist. Other common job titles among nurses prepared as CNSs are instruction (21.1 percent), and management or administration (17.8 percent). Nearly half of nurses prepared as CNSs worked in hospitals (49.4 percent). Some nurses prepared as CNSs also had preparation in other advanced specialties. More than 27 percent of CNSs also had preparation as NPs. Among such dual-prepared RNs the most common job title was nurse practitioner (54.8 percent). Nurses prepared as CNSs in 2008 earned an average of  74,918 per year in their principal nursing position. CNSs were very satisfied with their principal positions, with 91 percent being moderately or extremely satisfied.  xxxii  Executive Summary  Nurses Who Do Not Work in Nursing  An estimated 466,564 RNs were not employed in nursing in 2008. Nearly one-third of RNs who were not working in nursing were 65 years of age or older; almost half were 60 years of age or older. The decision to work in nursing is more closely tied to age of registered nurses \' children than presence of them; RNs whose children were all under age 6 were less likely to work in nursing than were RNs whose children were all at least 6 years old. Overall, about half of RNs who were not working in nursing in 2008 have been out of nursing work for 4 or fewer years. Among nurses who were under 50 years old, 57.5 percent have been out of nursing for less than 4 years. Reasons for not working in nursing are often associated with life stages, such as the need to care for children or retirement. However, 41 percent of RNs under 50 years old reported that they were not working in nursing due to workplace problems such as burnout, stressful work environment, and poor management. This is of concern. Among nurses 50 years and older, personal and family reasons (41.5 percent), workplace reasons (35.5 percent), and personal career factors (32.4 percent) also were important. Among RNs under 50 years old who were not working in nursing, only about 15 percent did not intend to return to nursing work.  Demographics and Diversity  For the first time in the past three decades, the aging of the nursing workforce slowed. In 1988, half of the working population of RNs was less than 38 years of age, but in 2004 that figure rose to 46 years and remained steady at 46 years of age in 2008. This slowdown in the aging trend resulted from an increase in employed RNs less than 30 years of age--the first increase seen in this age group since the inaugural NSSRN in 1977. Men comprised a growing percent of the RNs in 2008, making up 6.2 percent of employed RNs who were licensed before 2000 and 9.6 percent of those licensed in 2000 or more recently. The employment profile of men who work in nursing differs from that of women. More men reported principal employment in a hospital and work as NAs. Significant gains in racial/ethnic minority representation among RNs have been made over time. The population of RNs from minority racial/ethnic groups increased from 333,368 in 2000 to 513,860 in 2008, with the growth occurring primarily among recently graduated RNs. However, the  xxxiii  Executive Summary  racial and ethnic distribution of the RN population is substantially different from that of the U.S. population. Approximately 65 percent of the U.S. population is White, non-Hispanic, while 83.2 percent of RNs are White, non-Hispanic.  Internationally Educated Nurses  Internationally educated nurses (IENs) are RNs whose initial nursing education took place outside of the United States or in the U.S. territories (formerly termed foreign-trained or foreign-educated nurses). They represent a larger percentage of the U.S. nursing workforce in recent years, comprising 5.1 percent of RNs licensed before 2004, compared with 8.1 percent since then. The Philippines continued to dominate as the source country of the IEN workforce (50 percent), followed by Canada at nearly 12 percent. India supplied 9.6 percent and the United Kingdom provided 6 percent, with the contributions from India accelerating and surpassing those from the United Kingdom among recent licensees. Approximately one-quarter of IENs lived in California in 2008, with New York, Florida, and Texas each home to 10 to 12 percent of IENs. Most IENs (88.3 percent) were employed in nursing in 2008, a somewhat higher percentage than RNs in general (84.8 percent). IENs were more likely than their U.S.-educated counterparts to work full-time. A greater percentage (17.2 percent) of internationally educated RNs hold secondary nursing positions than do RNs in general. Approximately three-quarters of IENs licensed since 2004 are employed in hospital settings. Most IENs licensed since 2004 (94.1 percent) have staff nurse job titles.  Recent Nurse Graduates  In this report, recent graduates are defined as those RNs who completed their initial nursing education after 2000 (from 2001 to 2008). The most recent graduates are those who completed their initial nursing education after 2004 (2005 to 2008). Recent graduates comprised nearly 20 percent of all RNs in the United States in 2008 and about 23 percent of employed RNs. About 39 percent of recent graduates entered the profession with a BSN; only 3 percent had a diploma nursing education. RNs who graduated before 2001 completed their nursing programs at an average age of 26.7 years, while the average age of the recent graduates was a little over 30 years.  xxxiv  Executive Summary  RNs among the most recent graduate cohort were more likely than RNs who graduated in any previous cohort to have received a postsecondary degree prior to entering nursing; 31.7 percent of graduates from 2001 to 2004 had a prior postsecondary degree, compared with 37.1 percent of graduates from 2005 to 2008. More than 10 percent of RNs who completed their initial nursing education between 2001 and 2004 later completed additional degrees. Bachelor \'s degrees were completed by nearly 10 percent of graduates from diploma or ADN programs; master \'s or doctorates were completed by more than 10 percent of BSN graduates and almost 2 percent of diploma or ADN graduates. The vast majority of recent graduates were employed in nursing positions in 2008 (94.5 percent of 2001­2004 graduates and 96.6 percent of 2005­2008 graduates), and 83.8 percent of the most recent graduates worked full-time. Hospitals employed more than 83 percent of the most recent graduates and more than 75 percent of RNs who graduated in 2001 to 2004. The most common job title held by all working RNs was staff nurse or an equivalent title, with 92.2 percent of the most recent graduates and 80.7 percent of graduates from 2001 to 2004 having this title. Recent graduates were less satisfied with their principal nursing positions than were RNs who graduated before 2001. In addition, recent graduates change jobs somewhat more frequently than RNs who graduated prior to 2001. Of all employed RNs, 14.9 percent of graduates from 2001 to 2004 had changed employers for their principal nursing position in the previous year and 7.5 percent had changed positions but were with the same employer. Among the 2005 to 2008 graduates, the percentages for job changing were similar. The reasons for job changes varied, but those cited most frequently were related to working conditions. Recent graduates were more likely to report that they changed jobs for career reasons than were pre-2001 graduates. Recent graduates also were more likely than pre-2001 graduates to report that personal or family reasons drove their job change. Nearly 40 percent of recent graduates planned to leave their current jobs within 3 years, compared with 27.1 percent of pre-2001 graduates. Nonetheless, the vast majority of recent graduates intended to remain in the nursing profession, with only 3.3 percent of those who intended to leave their current job stating that they did not plan to stay in nursing.  xxxv  Executive Summary  Average earnings from all nursing positions for the most recent graduates were  52,994. The total nursing earnings of the most recent graduates were lower on average than the average total earnings of RNs who graduated from 2001 to 2004 ( 57,489) and lower than the average total earnings for RNs graduating before 2001 ( 62,903).  Nurses Nearing Retirement  Older RNs over age 50 comprised 44.7 percent of the total RN population in 2008, compared with 33 percent in 2000. The percentage of older RNs working in nursing in 2008 declines steadily from 87.5 percent for those 50­54 years of age to 33.3 percent for those aged 75 and older. RNs aged 50­ 54 in 2008 who were employed full-time worked an average of 43.7 hours per week, slightly more than the average for full-time nurses under age 50. Beginning at age 60, the hours worked by parttime nurses declines steadily with age. Older RNs are also less likely than younger RNs to have secondary positions in nursing. While a smaller percentage of older nurses worked in hospital positions in 2008, higher percentages are employed in nursing homes/extended care, academic education programs, and home health settings. The majority of RNs in 2008 remained employed with the same employer, and older RNs were more likely to be in the same position and with the same employer year to year when compared with younger nurses. Registered nurses 50 to 59 years old were less likely to report an intention to leave their current nursing position within 3 years than were RNs under 50 years old. As RNs grow older, and especially for RNs older than age 60, retirement becomes an increasingly dominant reason for employment changes.  xxxvi  Introduction  Conducted since 1977, the National Sample Survey of Registered Nurses (NSSRN) is the largest survey of the Registered Nurses (RNs) workforce in the United States. A sample of nurses with active RN licenses from every State are asked to report on their education, employment, intentions regarding nursing work, and demographics. The resulting data are used by policymakers and numerous stakeholders, both domestic and international, to assess status and trends in the U.S. nursing workforce. The data are also used to evaluate the responsiveness of the workforce to Federal and State programs seeking to ensure workforce capacity for providing essential health care services and identifying areas for further research. These data illustrate education and skills of the RN workforce, portray the diversity of RNs, illustrate the U.S. employment of internationally educated nurses, depict the factors that affect RNs \' decisions to work in the nursing profession, and support efforts to forecast the future supply of and demand for RNs. After the first survey was conducted in 1977, the NSSRN has been conducted every 4 years since 1980. This report provides findings from the survey conducted in 2008.  The Registered Nurse Workforce in the United States  There were an estimated 3,063,162 licensed RNs living in the United States, as of March 2008 (Figure 1-1 and Appendix A, Table 1). 1 This is an increase of 5.3 percent from March 2004, representing a net growth of 153,806 RNs. 2 Based on data from the results of the 2008 survey, an estimated 444,668 RNs received their first U.S. license from 2004 through 2008, and thus approximately 291,000 RNs had a lapsed RN license during this time period. These data indicate that the long anticipated and substantial retirements from the nursing field may have begun. Thus, even as new graduates enter the field, overall nursing workforce growth may be affected by RNs leaving the profession.  1  The standard error for the estimate of the total number of RNs licensed and living in the United States is 4,045.8. The 95 percent confidence interval has a lower limit of 3,055,232 and an upper limit of 3,071,092. Please see Chapter 1 and Appendix B for more details on weighting and estimation. There were an additional estimated 11,903 internationally educated RNs holding active U.S. licenses who were not living in the United States as of March 2008. RNs living outside of the Unites States are not included in the analyses of the U.S. nursing workforce for the purposes of this report.  2  xxxvii  Introduction  Figure 1-1.  The nursing workforce of the United States, 1980-2008  3,063,162 2,909,357 2,696,540 2,558,874 2,596,599 2,417,090 2,033,032 1,887,697 2,201,814 2,115,815 1,853,024 1,626,065 1,485,421  2,239,816  1,662,382  1,272,851 1980 1984 1988 1992 Employed in nursing  Source: 1980-2008 National Sample Survey of Registered Nurses  1996  2000 Licensed RNs  2004  2008  xxxviii  Survey Methods  1.1 Summary  1  The 2008 National Sample Survey of Registered Nurses (NSSRN) was based on a randomly selected sample of individual RNs from each State \'s listing of licensed RNs. The sampling rate differed by State. Sampling for all previous administrations of NSSRN was based on a randomly selected sample of alphabetic clusters of names in each State using a  nested alpha segment design.  When nested alpha-segment design was used for the first administration of the NSSRN in 1977, available data sources for identifying eligible RN listings could be on paper listings, index cards, electronic files, or other media. The alpha-segment design provided an innovative way of determining an RN \'s probability of selection for the survey, in spite of the data source limitations, especially for those RNs licensed in multiple States, without having to identify a given RN on all the lists on which that individual appeared. Technological advances in computer hardware and software since earlier NSSRN surveys have made identifying multiple appearances of the same RN on different lists feasible. The sample design for the 2008 NSSRN takes advantage of such technological advances. In so doing, the precision of the national estimates has improved. The 2008 NSSRN included a sample of 55,151 RN records. From this sample, 33,549 surveys were completed, yielding an unweighted response rate 1 of 62.41 percent. Data were collected between July 2008 and March 2009 using mailed paper surveys, electronic surveys on the World Wide Web (the Web), and direct telephone interviews. Each survey was carefully reviewed for missing or inaccurate data. When critical data were found to be missing, incomplete, or insufficient, professional telephone interviewers called the respondent to ask about the data item(s) in question. When complete data could not be obtained from the sampled RN, appropriate statistical imputation methods were used to reduce nonresponse error. The 2008 NSSRN imputation protocol used regression modeling to generate likely responses for missing values for individual questions within completed cases. Imputation of this type had not been  1  The American Association for Public Opinion Research Response Rate #3 calculation was used; it is defined as the number of completed surveys divided by the number of returned surveys (complete plus partial) plus an estimate of the number of eligible cases among those who did not respond and whose eligibility could not be ascertained.  1-1  Survey Methods  1  undertaken for any previous administration of the NSSRN but is a powerful statistical method using defined protocols. The establishment of sample weights for the participating RNs was the final step in preparing the data for analysis and reporting. The weighting process for the 2008 NSSRN had several steps, which included identifying the initial probability of selection for each sampled record; adjusting for survey nonresponse; and accounting for multiple chances of selection for RNs who appeared on the listings of more than one State. In addition, a weight calibration procedure known as  raking  was employed to achieve consistency between the counts appearing on each State listing and the estimates of the number of RNs currently licensed in each State, based on the survey weight assignments. Weighted responses were then used to calculate national estimates. Also different from prior NSSRN survey analyses, the nonresponse adjustment procedure used for the 2008 NSSRN used weighting to adjust for differences in rates of response to the survey by different age groups. Response rates by age group varied; generally older RNs participated at a higher rate than younger RNs. Without a weighted adjustment for age group response rates, older RNs would be overrepresented in population estimates, leading to a disproportionately large effect on survey estimates associated with age. Thus, adjusting sample weights to reflect age group participation rate served to reduce the potential for bias in some NSSRN estimates. This chapter provides an overview of the survey methods used in the 2008 NSSRN process. Appendix B provides a more detailed description of the sample allocation, sample performance, imputation, weighing methods, and comparisons with previous survey sampling and weighting techniques. NSSRN data users who are interested in comparing the 2008 NSSRN findings with findings from previous NSSRN administrations should pay particular attention to the discussions of imputation and weighting here and in Appendix B. The data reported in tables in the body of the report may differ slightly from data in the correspondingly cited appendix. This may be due to several factors such as the rounding of aggregate data or the context of the discussion where there is some difference in the population of interest.  1-2  Survey Methods  1  1.2  2008 Questionnaire  The content and structure of the 2008 questionnaire were very similar to the questionnaire used for the 2004 NSSRN administration. A copy of the 2008 questionnaire is included in Appendix C. The following were key questionnaire topics:   Eligibility for the survey; Education, including initial nursing education, upgrade education post licensure, and education preparation for advanced practice nursing; Principal nursing employment, including geographic location, employment setting, job title, hours worked, level of care, patient population, clinical specialty, earnings, and job/employment intentions; Secondary employment, including employment settings, hours worked, and earnings; Nurses not working in nursing, including their intention to return to nursing and reasons for not working in nursing; Employment outside nursing, including area/field of work, hours worked, and earnings; Prior nursing employment, including reasons for job change, geographic location of prior employment, and prior employment setting; General information about the responding RN, including job satisfaction, geographic location of current residence and residence 1 year ago, race and ethnicity, language fluency, number of dependents in the household, and household earnings; and Licensing and certification information.          Some revisions to the 2008 questionnaire addressed new or emerging topics of interest and improved data quality. Additionally, some questions were converted from  check one  to  check all that apply  to better capture the richness and breadth of information about RNs. Of particular note are the survey additions or revisions in the following areas:    Employment setting (questions 23 and 57); Job title (question 24); Level of care (question 29a); Patient population served by the RN (question 29b); Clinical specialty (question 29c);  1-3  Survey Methods  1  Hours worked per week in their principal nursing position (question 27) and in any secondary nursing positions (question 36); and Distribution of time across job functions (question 28).    1.3  Sample Design  From the inception of the NSSRN in 1977 through the 2004 administration, the sample of RNs was identified using a nested cluster design in which RNs were clustered alphabetically by last name: This last name cluster design is referred to as the  alpha-segment design.  Although the alpha-segment design produced good estimates of the nursing workforce over the years, it has some shortcomings. First, because RNs of the same racial/ethnic background may have similar alphabetically clustered names, the alpha-segment design may have resulted in larger than desired variation for some estimates, such as racial and ethnic composition of the RN workforce. Second, constructing an alpha-segment frame and implementing the sample design were tedious and time-consuming tasks. Third, sorting to achieve implicit stratification was not feasible. Lastly, the alpha-segment design made adjustments for differential nonresponse a bit more cumbersome. The 2008 NSSRN sample design is based on independent systematic random samples selected from State-based strata, with equal probability of selection within each stratum. An equal probability systematic random sample can be thought of as randomly selecting a record from the beginning of a list with probability 1/n and then every nth record after that until all records on the list have had a chance of being selected. This kind of design was not feasible in 1976, but technological advances and the advent of electronic recordkeeping have largely eliminated the barriers. The 2008 NSSRN sample design was straightforward to implement and eliminated the clustering that could contribute undesirable variability to survey estimates, particularly for survey results associated with race/ethnicity. The sample design was developed to address a number of issues:   A given RN may be licensed in more than one State. Unduplication was carried out to eliminate additional records for a single nurse, such as a record associated with advanced practice nursing when an RN already had a basic RN license record. Therefore, for the purposes of sampling, an individual RN in a given State is associated with exactly one RN license.  1-4  Survey Methods  1  Some States (22 at the time of the 2008 administration) participate in what is known as the Nurse Licensure Compact, which affects who may appear on a given State \'s listing of licensed RNs. An RN licensed in one Compact State would not have a license in other Compact States, but could work as an RN in any of the Compact States. Some areas of the country experience significant interstate commuting of RNs, with RNs who live in one State working in another, nearby State or participate as a travel nurse for a short period of time.    Each State (and the District of Columbia) maintains a list of RNs actively licensed in that State. These State lists were used to draw a probability sample of RNs for the NSSRN from among those RNs who were licensed as of the end of 2007/early 2008. RNs appearing in the listings of licensed RNs for more than one State had multiple chances of selection for the 2008 NSSRN. To avoid duplication, multi-State strata were formed for several groups of States where interstate commuting was expected to be fairly sizeable. Probability matching was used to form such strata so that only a single record for those RNs appears in the listing for the multi-State stratum. After these adjustments, a sample of 55,151 licensed RNs was drawn for the 2008 NSSRN. This sample size was expected to yield sufficient completed surveys to support stable State, regional, and national estimates. Data were collected on the RN population who were actively licensed as of March 10, 2008. Appendix B provides a detailed description of the sample strata, determination of the probabilities of selection, and allocation of the 55,151 RNs across the 50 States and the District of Columbia.  1.4  Data Collection Methods  The 2008 NSSRN employed a multimode approach to data collection. Data were collected from July 2008 through March 2009. Using contact information contained in State licensing records, sampled RNs were first notified of the study via a letter mailed through the U.S. Postal Service (USPS). The letter invited RNs to complete a survey via the Web. Shortly after the Web invitation was sent, paper surveys were also sent via USPS. Finally, RNs who did not respond were contacted by telephone and expedited mail. The different steps of data collection were as follows:  First Contact. A survey notification letter was sent via USPS to all RNs in the sample. The first contact mailing included a description of the study and instructions for logging on and completing the survey via the Web. No paper questionnaire was included in this first contact mailing.  1-5  Survey Methods  1  Second Contact. Two weeks after the first contact mailing, a paper questionnaire was sent via USPS to all RNs who had not completed their survey via the Web. The second contact mailing included a description of the study, a second invitation to complete the survey via the Web, and Web log-on instructions. A paper questionnaire and a postagepaid return envelope for the questionnaire were included to increase response from those RNs without Web access or who preferred paper questionnaires. Third Contact. Approximately 3 weeks after the second contact mailing, post cards were sent to all sampled RNs reminding them to complete their survey either on paper or on the Web. A note of thanks was also included on the post card for RNs who had already completed their surveys. Fourth Contact. A second copy of the paper questionnaire was sent to nonrespondents 3 weeks after the third contact. The fourth contact mailing was sent only to nonrespondents and included a letter requesting completion of the survey, Web log-on instructions, a paper questionnaire, and a postage-paid return envelope for the questionnaire. Fifth Contact. After 3 weeks had passed following the fourth contact, nonresponding RNs were contacted. RNs who failed to respond after the first four contact attempts were split into two groups for follow-up. RNs whose telephone numbers were available from licensing lists were contacted for follow-up by professional telephone interviewers. Services that provide matching and telephone number searches were also used to find a telephone number for a telephone follow-up with nonresponding RNs. If the telephone number search was unsuccessful, RNs who did not respond were sent a final package via FedEx that included a letter requesting completion of the survey, Web log-on instructions, a paper questionnaire, and a postage-paid return envelope for the questionnaire.      When a survey was received that contained responses to all questions deemed necessary to meet the requirement for a completed survey, the survey was noted as  complete  and the survey data were added into the database of 2008 NSSRN complete surveys. Data collection for the 2008 NSSRN ended on March 31, 2009.  1.5  Sample Performance  Response rates are often used to help assess the quality or unbiasedness of survey results. The 2008 NSSRN unweighted response rate was 62.41 2 percent with a weighted response rate of 61.48 percent.  2  The American Association for Public Opinion Research Response Rate #3 calculation was used. It is defined as the number of completed surveys divided by the number of returned surveys (complete plus partial) plus an estimate of the number of eligible cases among those who did not respond and whose eligibility could not be ascertained.  1-6  Survey Methods  1  Weighted response rates take into account sample design and probabilities of selection, adjusting for the fact that some States and strata are represented disproportionately in the sample. The weighted response rate for this survey can be interpreted as an estimate of the expected propensity to respond of an RN randomly selected from among all RNs currently licensed in the Nation. Table 1-1 shows the overall performance of the sample. Table B2-1 in Appendix B provides a distribution of response rates by State.  Table 1-1. Summary of 2008 NSSRN sample performance  Number in sample 33,549 13,066 14,897 5,586 870 14,160 6,572 55,151  Sample disposition Completed surveys Over the Web On paper Over the telephone Ineligible for the survey Nonresponse Refusals Total sample  Source: 2008 National Sample Survey of Registered Nurses  1.6  Imputation  There are two types of nonresponse in surveys: unit nonresponse and item nonresponse. Unit nonresponse occurs when a sampled RN does not complete the survey at all. Unit nonresponse was reflected in the calculation of the response rate and in weighting through nonresponse adjustment. Item nonresponse occurs when an RN responded to the survey but failed to provide answers to one or more individual questions appropriate for that individual. This results in a missing value for one or more survey items. When items were missing values, the items were filled in from the State sample frame files (licensure lists) when possible. The variables usually available on the sample frames included demographic characteristics (date of birth, race/ethnicity, and gender), home address, and first RN license date. Not all States provided these variables, and data for them could be very sparse even when the variable was included in the State frame. If any important item nonresponse existed after review of the State sample files, respondents were called and queried about the missing data item(s), a process referred to as data retrieval. Some items deemed important and worthy of initiating data retrieval were year of licensure, employment setting  1-7  Survey Methods  1  for principal nursing position, job title, number of hours worked, and other data elements central to the analysis of the 2008 NSSRN data. As a last resort, when item nonresponse persisted after review of the sample frame file and data retrieval, statistical imputation was used to assign values for missing data. The 2008 NSSRN imputation protocol relied on regression modeling to generate likely responses where there were missing values for individual questions within completed cases. Imputation statistical procedures identify a value that not only would probably be appropriate for the respondent but would also be in keeping with the distribution of values for that variable. For example, the survey items  Nurse \'s year of graduation from initial nursing education  and  Year of first licensure  are highly correlated. If the year of licensure is missing from an RN \'s record but not the year of graduation, the missing year of licensure value can be imputed using regression modeling. The year of licensure is the dependent variable in this case, and the year of graduation is the independent (or predictor) variable. The regression model is established using respondent cases in which both the year of licensure and year of graduation are known. There is a component of variation associated with the generation of imputed values that is generally not reflected in survey estimates of variance. As a result, imputation can result in an understatement of the variance in survey estimates. The degree to which estimates of variability have been understated is generally considered negligible if the imputation rate is low (less than 10 percent). However, if the imputation rate is more than 20 percent, the degree of underestimation may be nontrivial. Eighty percent of the imputed variables for the 2008 NSSRN have imputation rates below 10 percent, 19 percent are borderline (imputation rate of 10-19 percent), and three variables (1 percent of all survey variables) have an imputation rate greater than 20 percent. 3 The three variables are question 11B--total number of hours provided for emergency preparedness training in the past year (imputation rate: 46 percent); question 13D_A--year of receiving an (upgrade) Associate Degree in Nursing (ADN) (imputation rate: 36 percent); and question 41--years until planned return to paid work in nursing (imputation rate: 21 percent). When working with these three variables, NSSRN data users should be aware of the potential underestimation of the variance and bias in the point estimates.  3  Imputation rates were computed as the ratio of the number of imputed cases of that variable to the total number of applicable cases in the data set.  1-8  Survey Methods  1  Further information on imputed variables and data file flags for imputed variables are included in the 2008 NSSRN codebook.  1.7  1.7.1  Sample Weighting  Overview of the Weighting Process  Data weighting was one of the final steps in preparing the data for analysis and reporting. The 2008 NSSRN weighting process consisted of several steps, as follows:    Determination of the initially assigned weights at the sampled license level; Adjustment for survey nonresponse by age group (for strata where age was available); Assignment of factors to account for multiple opportunities for selection (determined as part of the matching effort to determine the number of sample frames on which an RN appeared); Establishing an initial weight at the RN level; and Calibration of the RN level weights (via raking) to achieve consistency with State and national totals.   A detailed discussion of each of these steps in the weighting processes is found in Appendix B. The remainder of this overview discussion focuses on some key issues related to sample weighting for the 2008 NSSRN.  1.7.2  Implications of Weighting for NSSRN Data Users  Sampling error can cause sample estimates to differ from true population parameter values. Sampling error is the consequence of not measuring every unit in the population. It can be reduced with larger sample sizes, with efficiently designed sampling strategies, or with a combination of both. In the 2008 NSSRN, both strategies were employed. For example, higher sampling rates were used for smaller States to permit more accurate State-level estimation for these States. However, this served to reduce the precision associated with national estimates compared with what would have  1-9  Survey Methods  1  been achieved with a simple random sample of the same size but with no variation by State in sampling rates. The factor by which the variance is reduced is known as a  design effect.  In the 2008 NSSRN, sampling rates also varied between strata within a State for RNs who were either:  Residents of Alaska, New Mexico, or Hawaii but were on another State \'s listing of RNs with currently active licenses; or Members of the groups of States for which the design used multi-State strata.    Replicate weights were computed for use in estimating the variability of 2008 NSSRN estimates. Users of the 2008 NSSRN data as well as past NSSRN data are encouraged to use these weights to assess the precision of sample estimates as well as to compare estimates either within the 2008 NSSRN database or between estimates from various years. Another important difference in the weighting methods for 2008 was the adjustment of differential nonresponse by age group. Earlier administrations of the NSSRN may have underestimated the representation of younger RNs due to undercoverage on State sampling frames. In the 2000 and 2004 NSSRN administrations, poststratification of the weights of the youngest RNs (those under the age of 26) was done to adjust the weights. However, this group represented only a small portion of licensed RNs, and the overall impact of this procedure did not address any issues that may have existed for other age categories. While undercoverage of newly licensed RNs may still be an issue, another source of bias associated with younger RNs is that response propensities by age showed that younger RNs responded at lower rates than older RNs in the 2008 NSSRN. In administrations prior to the 2008 NSSRN, the weight adjustment processes were global in nature. Generally speaking, poststratification was used to achieve consistency between responding RNs associated with a given State of licensure and the corresponding control total, licensed RNs in the State (who were currently active). The control total took into account RNs who were also licensed in what were characterized as  higher priority  States. Thus, if older RNs had higher response rates in a State, as they often did, they would be represented at a disproportionately high rate among the population of currently active RNs licensed in the State. This is a potential source of bias for survey estimates that are correlated with age. In addition to the general age distribution of the RN  1-10  Survey Methods  1  population, other variables that could be affected include those related to education and employment. In summary, the 2008 NSSRN final weighting processes included a poststratification adjustment of eligible and ineligible respondents by age group to corresponding age group totals for each State frame where age was provided by the State licensing Boards (44 of 51 State Boards).  Assessing the Impact of Accounting for Differential Nonresponse by Age To assess the extent to which survey estimates may have changed after accounting for differential nonresponse by age group, a separate set of weights was developed using a global approach to nonresponse adjustment. That is, a poststratification of all responding eligible and ineligible RNs to a single State control total for each State was undertaken. This approach thus served to simulate the approach to nonresponse adjustment used in past NSSRN administrations. This weight is referred to here as the  surrogate  weight. A series of statistics were run to compare the estimate based on the final weight to the estimate based on the surrogate weight. Looking at some key data elements from the 2008 NSSRN, the comparison of the final weight to the surrogate weight suggests that including a weight adjustment reflecting differential response propensities by age had an important impact on the 2008 NSSRN survey estimate. Estimates where sizeable effect is in evidence are: initial nursing education, RNs with a bachelor \'s degree; RNs employed in nursing; white, non-Hispanic RNs; RNs employed in a hospital setting; and most of the age group and graduation year categories. These findings regarding the effects of nonresponse adjustment by age group should be taken into account when comparing estimates from the 2008 NSSRN to those from previous NSSRN administrations. Differences between the 2008 NSSRN estimates and those from prior years for estimates correlated with age may be due to an improvement in the weighting process rather than a significant change in the RN population over time. Appendix B provides a more detailed discussion of the weighting process and nonresponse adjustment by age.  1-11  Survey Methods  1  This page deliberately blank.  1-12  Education and Licensing of Registered Nurses  2.1 Introduction  2  RNs are prepared in several types of education programs. The most frequent initial education program is the Associate Degree in Nursing (ADN), with 45.4 percent of U.S. RNs prepared in ADN programs (Figure 2-1). Some RNs pursue their initial registered nurse education after completing postsecondary education in other fields or working in another occupation. After completing an approved initial education program, a registered nurse candidate takes the National Council Licensure Examination (NCLEX), which is created and administered by the National Council of State Boards of Nursing (NCSBN), in order to receive a State license. RNs subsequently can pursue additional nursing education, including graduate-level degrees and education in Advanced Practice fields such as nurse practitioner or nurse anesthetist. Some RNs seek higher degrees in non-nursing fields (such as education and business) that are related to their nursing career.  2.2  Initial Nursing Education  Initial RN education occurs through a variety of routes. ADN programs generally require 2 years of nursing coursework after completion of prerequisites that include basic science. Bachelor \'s degree programs typically span 4 years of full-time education. Diploma programs, which are traditionally based in hospitals and last 3 years, were once the most common form of nursing education in the United States. The number of these programs has steadily declined since the 1970s and many now offer an Associate of Science Degree (AS) through local community colleges. A small number of RNs qualify for their licenses based on military training or other licensing credentials. There are a few initial RN education programs that confer a master \'s degree or a doctorate but most are specifically designed for students who have obtained a bachelor \'s or higher degree in another field prior to pursuing nursing education. The most commonly reported route for initial nursing education of RNs in the United States is the ADN program (Figure 2-1).  2-1  Education and Licensing of Registered Nurses  2  Figure 2-1.  Thousands 3500  Distribution of registered nurses according to initial nursing education, 1980-2008*  3000  2500  26.6% 29.8%  31.5%  34.2%  2000  20.7% 22.5%  24.9%  1500  17.6% 18.7% 24.9% 28.5% 32.6% 37.7% 40.4% 42.9% 45.4%  1000  500  63.7%  54.4%  49.0%  42.5%  35.6%  29.7%  25.6%  20.4%  0 1980 1984 1988 1992 1996 2000 2004 2008 ** Degree Program Bachelor \'s and higher Associate Diploma  * The counts for all initial degrees may not add to the total registered nurse estimates for each survey due to incomplete information provided by respondents and the effect of rounding. Only those who provided education preparation information are included in the calculations used for this figure. **For 2008 initial education, there were 13,325 registered nurses with master \'s degrees (0.4%) and 954 registered nurses with doctorate degrees (0.03%). Source: 1980-2008 National Sample Survey of Registered Nurses  Since 1980, there has been a steady shift away from RN education in diploma programs to ADN and bachelor \'s programs although diploma education still accounts for the initial education of 20.4 percent of RNs in 2008. However, only 3.1 percent of RNs who graduated after 2004 reported a diploma as initial nursing education. Fully 34.2 percent of RNs in 2008 were initially prepared at a bachelor \'s or higher degree level, almost twice as many as in 1980.  2.3  Age at Graduation  Average age at graduation has been comparatively stable since 1994, with the exception of diplomaeducated RNs, for whom the average age has continued to rise. The average age at graduation of  2-2  Education and Licensing of Registered Nurses  2  RNs who graduated from their initial nursing education program after 2004 is 31 years, notably higher than the average age of 24 years for RNs who graduated before 1985 (Figure 2-2). The increase in average age at graduation occurred primarily among RNs who graduated between 1985 and 1994. Registered nurses whose initial nursing education is a bachelor \'s degree or higher tend to be 5 years younger on average than either ADN or diploma graduates.  Figure 2-2.  34 33 33 32 32 31 30 30 30 28 28 29 28 26 26 26 24 24 24 22 22 20 1984 or earlier 19851989 19901994 19951999 Year of graduation from initial nursing education Diploma Associate degree 20002004 2005 or later 25 27 27 27 30 30 30 31 33 33  Average age at graduation from initial nursing education, by type of program  Average age (years)  All graduates  Bachelor \'s and higher  Source: 2008 National Sample Survey of Registered Nurses  2.4  Sources of Financing  The most common source of educational financing used by RNs for their initial education was from family resources (42.7 percent), with health care-related employment earnings (30.5 percent), and federally assisted loans (29.3 percent) comprising the next highest sources of nursing education  2-3  Education and Licensing of Registered Nurses  2  payment sources (Figure 2-3 and Appendix A, Table 3). Details about the sources of financing for recently graduated RNs are presented in Chapter 9. Registered nurses who completed ADN programs were most likely to have received some financial support for their education from earnings from their health care-related employment (Appendix A, Table 3). RNs prepared in ADN programs, are older than RNs prepared in Bachelor of Science in Nursing (BSN) programs, and may have continued their employment while pursuing their RN education.  Figure 2-3. Sources of financing for initial education for all U.S. registered nurses*  Earnings from health carerelated employment Earnings from nonhealth carerelated  employment Earnings from other household  members Personal household  savings Other family resources (parents or relatives) Employer tuition, reimbursement  plan  Federal traineeship,  scholarship or grant  Federally assisted loan  Other type of loan State/local government scholarship or grant Nongovernment scholarship  or grant  Other resources 0.0 4.9 10.0 20.0 10.8 16.3 14.0 10.2 15.9 19.2 22.8 24.3  30.5  42.7  29.3  30.0  40.0  50.0  Percent of nurses with the source of financing  *Entries for sources of financing add to more than 100 percent because more than one source of financing may have been used by an individual RN. Source: 2008 National Sample Survey of Registered Nurses  2-4  Education and Licensing of Registered Nurses  2  2.5  Education and Experience Prior to Initial Nursing Education  Among the 21.7 percent of the RN population in 2008 who had an academic degree prior to their initial nursing degree, 47.8 percent had an ADN, 52.8 percent a bachelor \'s, and 7.2 percent had a master \'s or higher degree 1 (Table 2-1 and Appendix A, Table 4). More than 40 percent of all degrees obtained by RNs prior to initial nursing preparation were in a health-related field. A growing percentage of RNs are earning academic degrees prior to their initial nursing education. From 2000 to 2008, the percentage with prior postsecondary degrees rose from 13.3 percent to 21.7 percent. This trend is discussed in more detail in Chapter 9.  Table 2-1. Degrees prior to initial nursing education, by survey year, 2000-2008  2000 (percent) 13.3 2004 (percent) 16.2 2008 (percent) 21.7  Nurses with degrees prior to initial nursing education  Source: 2000-2008 National Sample Survey of Registered Nurses  More than two-thirds of RNs (67.2 percent) reported working in a health occupation prior to their initial nursing education. Of these, the majority (68.6 percent) worked as aides or nursing assistants (Table 2-2 and Appendix A, Table 5). A higher percentage of registered nurses whose initial RN education was an ADN had previously worked in a health occupation than RNs with other initial education. The length of time in which RNs worked in these other health occupations and the extent to which this work experience might be important to RNs \' careers is unknown. Among all RNs, 17.9 percent were licensed at one time as a licensed practical or vocational nurse (LPN or LVN) (Table 2-2 and Appendix A, Table 5). Registered nurses whose initial RN education was in an ADN program were more likely to have previously held an LPN or LVN license. In some States, partial completion of an RN education program provides the qualifications to take the exam for LPN/LVN licensure so that RN students may take the exam and work prior to completion of the RN program. Other ADN programs provide flexible fast track education for LPN or LVNs.  1  The number of degrees adds to more than the total because more than one degree may have been named by an RN.  2-5  Education and Licensing of Registered Nurses  2  Table 2-2.  Education and health occupation experience prior to initial nursing education, by initial nursing education  Initial nursing education Bachelor \'s and Diploma Associate higher (percent) (percent) (percent) 9.8 49.1 7.1 77.1 24.6 76.3 30.0 61.3 25.0 66.2 8.3 76.1  Total (percent) All nurses Nurses with prior academic degrees Nurses with prior health occupations Nurses with prior LPN license Of those with prior health occupations Nursing aide or assistant  Source: 2008 National Sample Survey of Registered Nurses  21.7 67.2 17.9 68.6  2.6  Nursing Licensure  The majority of RNs who earn their initial nursing education in the United States obtain their first license in the same calendar year they graduate from their initial nursing education program and most RNs are first licensed in the State in which they were educated. Internationally educated nurses have different patterns of graduation and U.S. licensure, as described in Chapter 8. About 1 percent of RNs obtained their first U.S. nursing license before the calendar year in which they graduated from their initial nursing education program. With the introduction of more nursing master \'s programs, some State licensing boards permit students who have completed a specific subset of courses and training to take the licensing examination and receive an RN license. Registered nurses are then expected to complete the remaining requirements for their degree, although in some States completion of the degree is not required to retain an RN license. A small number of RNs reported their initial nursing degree or credential as  other  and described such a situation. More than 90 percent of RNs receive their first license in the State where they were educated. Over time, however, although some RNs may leave their State of initial education, approximately 80 percent remain in the same State at least 5 years after graduation. By 16 to 25 years after graduation however, 30 percent reside in a different State (Appendix A, Table 7). RNs whose initial nursing education is a bachelor \'s or higher degree are the least likely group of RNs to reside in the State in which they were educated, with 34.8 percent overall living in a different State than that in which they were educated (Appendix A, Table 7). Some RNs may live in a State bordering that in which they were educated and could be commuting to that State.  2-6  Education and Licensing of Registered Nurses  2  RNs who work in a State that participates in the Nurse Licensure Compact (the Compact) can work in multiple States even if they hold only one RN license. States in the Compact agree to recognize licenses from other States in the Compact rather than require another RN State license. The effect of the Compact on employment is discussed in Chapter 3.  2.7  Degrees Obtained After Initial Nursing Education  The NSSRN collects data on all academic degrees received after initial RN education; this includes both nursing degrees and non-nursing degrees. Table 2-3 presents the highest nursing degrees of RNs. Among all licensed RNs, 47.2 percent have earned at least a bachelor \'s degree in nursing.  Table 2-3. Highest nursing degree, by employment status  Total (number) 3,063,162 474,043 1,140,465 1,444,528 Total (percent) 100 15.5 37.2 47.2 Working in nursing (number) 2,596,599 345397 1,002,682 1,245,180 Working in nursing (percent) 100 13.3 38.6 48.0 Not working in nursing (number) 466,564 128,646 137,783 199,348 Not working in nursing (percent) 100 27.6 29.5 42.7  Total Diploma Associate Bachelor \'s and higher  Source: 2008 National Sample Survey of Registered Nurses  Many RNs hold additional degrees that are not specifically nursing degrees but which are related to their nursing employment. If an RN respondent indicated that a non-nursing degree was related to his or her career in nursing, the degree is described as a  nursing-related  degree. Nursing-related degrees include public health, health administration, social work, education, and other fields. For much of this report, nursing and nursing-related degrees are presented together to provide a measure of the level of education from which RNs draw to complete their jobs. In 2008, half of the RN population had a bachelor \'s or higher degree in nursing or a nursing-related field (Figure 2-4 and Appendix A, Table 8). In 2008, 32 percent of RNs with a bachelor \'s or higher degree reported that their initial RN education was a diploma or an ADN, demonstrating that many RNs pursue additional degrees after completion of their initial RN education. Other data reveal that RNs with graduate degrees have increased significantly in the last 20 years (Figure 2-4).  2-7  Education and Licensing of Registered Nurses  2  Figure 2-4.  Thousands 3,500   Highest nursing or nursing-related education preparation, 1980-2008*  3,000  13.2% 13.2% 2,500  6.5% 2,000  5.2% 1,500  25.6% 27.6% 5.9% 31.3% 30.0% 8.0% 32.8% 34.7% 36.8% 9.7% 10.3%  22.3% 17.9%  1,000   22.9%  25.3%  28.3%  31.8%  34.5%  34.3%  36.1%  500  54.7%  1980 1984 1988 1992 1996 Degree Program Bachelor \'s 2000 Associate 2004 Diploma 2008 45.6% 40.6% 33.7% 27.2% 22.4% 17.8% 13.9%  Master \'s/doctorate  *The totals in each bar may not equal the estimated numbers for registered nurses in each survey year due to incomplete information provided by respondents and the effect of rounding. Only those who provided nursing education preparation information are included in the calculations used for this figure. Source: 1980-2008 National Sample Survey of Registered Nurses    Registered nurses with graduate degrees comprised 13.2 percent of all licensed RNs in 2008, twice the proportion in 1988. There has been marked growth in the numbers of RNs with a master \'s degree in nursing or a related field in less than 10 years rising from 257,812 in 2000 to 375,794 in 2008, a 45.8 percent increase (Table 2-4). There were an estimated 28,369 RNs with a doctorate degree in nursing or a nursingrelated field in 2008, which is an increase of 64.4 percent since 2000.    Although many RNs pursue additional degrees after their initial RN education, many did not obtain further academic degrees post-licensure (Figure 2-5 and Appendix A, Table 8).  2-8  Education and Licensing of Registered Nurses  2    Among the 623,548 RNs whose initial nursing education culminated in a diploma, 31.6 percent obtained additional degrees after licensure. The degree most commonly obtained was a BSN (81,689, or 13.1 percent). Among the 1,388,884 RNs whose initial nursing education culminated in an ADN, 20.8 percent obtained additional degrees after licensure. BSNs were received by 12.1 percent. Among the 1,044,306 RNs whose initial nursing education culminated in a bachelor \'s degree or higher, 21.6 percent held advanced degrees in 2008.  Master \'s and doctorate degrees as highest nursing or nursing-related education preparation, 2000-2008  Estimate 2000 257,812 202,639 55,173 78.6% 17,256 8,435 8,821 48.9% Estimate 2004 350,801 256,415 94,386 73.1% 26,100 11,548 14,552 44.2% Estimate 2008 375,794 290,084 85,709 77.2% 28,369 13,140 15,229 46.3%    Table 2-4.  Degree Master \'s MSN nursing degree Nursing-related master \'s degree Percent of master \'s that are nursing (MSN) Doctorate Doctorate in nursing Nursing-related doctorate degree Percent of doctorates that are nursing  Source: 2000-2008 National Sample Survey of Registered Nurses  2-9  Education and Licensing of Registered Nurses  2  Figure 2-5.  Thousands 1,400  Highest education of registered nurses, by initial nursing education  1.7% 5.2% 2.0%  1,200  12.1%  1,000 17.5%  4.2%  Master \'s/doctorate nursingrelated  Highest education  800  Master \'s/doctorate nursing  Bachelor \'s nursingrelated  600 7.5% 4.6% 13.1% 400 78.4% 5.3% 79.0%  Bachelor \'s nursing  Associate nursingrelated  200  68.4%  Associate nursing  Diploma  0  Diploma  Associate Initial nursing education  Bachelor \'s and  higher  Source: 2008 National Sample Survey of Registered Nurses  There can be considerable time between the initial nursing degree and subsequent degrees (Table 2-5).  Among diploma-educated nurses who continued their education, there was an average 10.5 year gap between initial RN education and attaining a bachelor \'s degree. Those whose highest education was a doctorate had a gap of more than 15 years between the diploma and the final doctorate in nursing. Nurses whose initial RN education was an ADN averaged 7.5 years between their ADN and attaining a BSN degree. Nurses whose initial RN education was a BSN took an average of 8.2 years to reach a master \'s degree as their highest degree in nursing; they took an average of 12.4 years to obtain a doctorate if that was their highest degree in nursing.    2-10  Education and Licensing of Registered Nurses  2  Table 2-5.  Average years between completion of initial and highest nursing degrees*  Bachelor \'s 10.5 7.5 ­ Master \'s 13.9 11.5 8.2 Doctorate 15.6 12.5 12.4  Initial nursing education Diploma Associate Bachelor \'s  * Average years between diploma and ADN not calculated due to larger than average rates of missing data. ­ Too few cases to report estimated percent (fewer than 30 respondents). Source: 2008 National Sample Survey of Registered Nurses  Post-licensure graduate degree programs have a variety of foci. Among RNs who obtained a nursing or nursing-related master \'s degree or doctorate, 46.6 percent reported the focus of those degrees to be clinical practice; 19.2 percent had a focus of administration, business, or management; and 13.3 percent reported a focus of education. Education was the most common focus of doctoral studies (please see Appendix A, Table 9 for similar data). Only 2.2 percent of RNs obtained an undergraduate or graduate level non-nursing degree that they reported was not related to their career in nursing. The most common focus of these degrees was humanities; liberal arts or social sciences; and administration, business, or management. Education programs are increasingly being offered through distance-based learning. The flexibility offered by distance-based education permits working professionals and those in nonurban centers to pursue degree programs while continuing to work without having to travel to an educational institution. Just over 15 percent of RNs who completed any additional nursing or nursing-related degree program reported that the program was primarily undertaken through distance-based learning, with more than 50 percent of coursework through correspondence or online. Those who completed doctorate degrees had the highest rates of participation in distance-based programs (16.3 percent). The continued prevalence of distance and online education may influence further growth in RNs continuing education beyond their initial preparation program.  2.8  Currently Enrolled Students  Only 6.6 percent of all RNs were enrolled in March 2008 as students in nursing and nursing-related academic education programs. Of these, 44.5 percent were pursuing a bachelor \'s degree and 46.3 were pursuing a master \'s (Table 2-6). Among RNs who were students in 2008, 74.2 percent were working in nursing full-time and 18.7 percent were employed in nursing part-time. Only 7.1 percent were not employed in nursing while they were pursuing additional education (Appendix A, Table 10).  2-11  Education and Licensing of Registered Nurses  2  Table 2-6.  Enrollment in nursing and nursing-related education programs  Number enrolled in 2008 3,151 90,553 94,205 13,479 2,065 203,453 Percent of those enrolled 1.5 44.5 46.3 6.6 1.0 100.0 Percent with more than 75 percent distancebased ­ 49.1 41.5 35.0 ­ 44.3  Degree pursued Associate Bachelor \'s Master \'s Doctorate Post-master \'s certificate Total  ­ Too few cases to report estimated percent (fewer than 30 respondents). Source: 2008 National Sample Survey of Registered Nurses  Distance-based programs are more common for programs offering a post-licensure bachelor \'s degree (49.1 percent) than for other post-licensure degrees (Table 2-6). Full-time RNs are more likely than part-time RNs or those not employed in nursing to take more than 75 percent of their coursework in a distance based format. Overall, RNs working full-time in nursing are more likely than any other group of RNs (48.2 percent) to take more than 75 percent of their coursework as distance learning (Appendix A, Table 10).  2.9  Emergency Preparedness  When emergencies and disasters occur, RNs are often required to assume responsibilities for managing and caring for overwhelmingly large numbers of patients with unfamiliar injuries, sometimes in environmental conditions that are extreme. More than half of working RNs (53.8 percent) indicated that they neither received nor provided emergency training in the previous year. Of those who had received or provided training, the most commonly reported training was for infectious disease incidents (71.1 percent) or natural disasters (70.0 percent). Only 31.3 percent of RNs reported receiving or providing training for nuclear or radiological incidents. Of the 46.2 percent of RNs who received training in some form of emergency preparedness training, the training they received averaged 10.5 hours in the year. Few registered nurses reported feeling well prepared for an emergency. Of those RNs who have received or provided emergency preparedness training, only 10.5 percent feel very prepared, while 44.1 percent feel somewhat or not at all prepared. Nonetheless, 94.9 percent of RNs claim to have some understanding or a full understanding of the disaster plan at their place of work.  2-12  Education and Licensing of Registered Nurses  2  2.10  Certifications  After receiving initial RN education and licensure, registered nurses demonstrate knowledge and skill for a population or in a patient care specialty by obtaining national standardized certifications from a variety of organizations. Certifications can be obtained in dozens of fields, ranging from clinical specialties such as oncology, pediatrics, and critical care, to functional specialties such as administration, case management, or legal consulting. A myriad of organizations offer certifications, which are usually conferred only after completing a specified education or training program, a period of clinical practice and/or passing a national test. Advanced practice RNs, such as nurse practitioners, can and often must obtain certification in their advanced area. This is discussed further in Chapter 5. More than 35 percent of RNs report some type of certification (Table 2-7 and Appendix A, Table 11). The most frequently held certification is life support/resuscitation. More than 31 percent of RNs have life support or resuscitation certification (BLS, ALS, BCLS, CPR, NRP, and others). The most common areas for clinical or managerial certification are critical care, maternal/neonate, oncology, case management, general surgery, and medical/surgical areas. In the 2008 NSSRN, some RNs report certifications that are not specific to nursing but may be relevant to their nursing careers, such as massage therapy.  Table 2-7. Registered nurse certifications*  Total (number) 1,094,838 956,472 125,008 58,320 43,123 36,175 31,106 28,599 26,594 Total (percent) 35.7 31.2 4.1 1.9 1.4 1.2 1.0 0.9 0.9  Type of certification Total registered nurses with certifications Life support/resuscitation (BLS, ALS, BCLS, CPR, NRP, and others) Trauma nursing/emergency medicine (TNCC, ATCN, ATN, EMT, ENPC, and others) Critical care Maternal/neonate Oncology Case management General surgery Medical/surgical  *Table excludes advanced practice RN certifications, which are reported in Chapter 5.  **Entries for types of certification do not add to the total because an individual registered nurse may have reported more than one type of certification. Source: 2008 National Sample Survey of Registered Nurses  2-13  Education and Licensing of Registered Nurses  2  This page deliberately blank.  2-14  The Employment of Registered Nurses  3.1 Introduction  3  The RN workforce consists of nurses who have valid, active RN licenses and are employed in a nursing position. The vast majority of RNs are employed in nursing. Their attachment to the labor market is high, and in general RNs are satisfied with their work. Although RNs work in a variety of settings and roles, more than half are employed in hospitals and 66.3 percent are in staff nurse roles.  3.2  Nursing Workforce Size  In 2008, an estimated 3,063,162 RNs were in the United States (Figure 3-1 and Appendix A, Table 1), and 84.8 percent of them were employed in nursing positions (2,596,599). This was the highest rate of nursing employment since the NSSRN commenced in 1977 (Figure 3-2). Full-time employment has also increased, rising from 58.4 percent of RNs in 2004 to 63.2 percent in 2008. This is the first increase in the percentage of RNs working full-time since 1996. The number of employed RNs per 100,000 population is a ratio used to measure whether the RN workforce is growing more or less rapidly than the U.S. population as a whole. In 2008, there were an estimated 854 employed RNs per 100,000 population, an increase from 825 per 100,000 population in 2004 (Appendix A, Table 57). This measure varies widely among the States. The lowest numbers of employed RNs per 100,000 population were in Utah (598), Nevada (618), and California (638), while the largest numbers were in the District of Columbia (1,868), South Dakota (1,333), and North Dakota (1,273).  3-1  The Employment of Registered Nurses  3  Figure 3-1.  The nursing population and workforce in the United States, 1980-2008  3,063,162 2,909,357 2,696,540 2,558,874 2,596,599 2,417,090 2,033,032 1,887,697 2,201,814 2,115,815 1,853,024 1,626,065 1,485,421  2,239,816  1,662,382  1,272,851 1980 1984 1988 1992 Employed in nursing  Source: 1980-2008 National Sample Survey of Registered Nurses  1996  2000 Licensed RNs  2004  2008  3-2  The Employment of Registered Nurses  3  Figure 3-2.  Employment status of registered nurses*  Thousands 3,500  3,000  2,500 58.4% 63.2%  2,000 59.0% 57.0% 1,500 52.2% 1,000 24.4% 500 23.4% 0 1980 1984 1988 1992 Year Employed in nursing fulltime 1996 21.3% 20.0% 17.3% 17.3% 26.5% 25.9% 25.8% 23.7% 52.2% 54.1%  58.5%  23.2%  24.8%  21.5%  18.3% 2000  16.8% 2004  15.2% 2008  Employed in nursing parttime  Not employed in nursing  *The totals of full-time and part-time employment may not add to the estimate of all RNs employed in nursing due to incomplete information provided by respondents on employment status and the effect of rounding. Source: 1980-2008 National Sample Survey of Registered Nurses  3.3  Employment and Age  The age distribution of the RN population has been rising for more than two decades (Figure 3-3). In recent years this aging trend has slowed. RNs are less likely to work in nursing positions as they age (Figure 3-4). Among RNs under 50 years old, 90 percent or more are employed in nursing positions. The percentages of RNs working in nursing drops in each age group older than 50, decreasing from 87.5 percent of RNs aged 50-54 to 85.2 percent of RNs aged 55 to 59 years and to less than half of RNs over age 65. More than 70 percent of RNs under 30 years old work full-time. The percentage of RNs aged 30 to 59 years and working full-time ranges between 65 percent and 70 percent. The percent of RNs who work full-time drops rapidly after age 60 though more than 30 percent of RNs over the age of 70 continue to work in nursing in either full-time or part-time positions.  3-3  The Employment of Registered Nurses  3  Figure 3-3.  Age distribution of the registered nurse population, 1980-2008  Thousands 600  500  400  Number of RNs  300  200  100  0 Less  2529 than 25  1980  3034  3539  4044  4549  5054  5559  6064  Age groups  1988 1996 2004  65 and  over  2008  Source: 1980-2008 National Sample Survey of Registered Nurses  3-4  The Employment of Registered Nurses  3  Figure 3-4.  Employment of registered nurses, by age group*  Thousands 500  450  400  350  300  69.3% 68.3% 65.0%  250  67.0%  66.1%  200  69.3% 47.6%  150  75.2% 21.6% 19.1% 20.2% 23.3% 28.0% 24.5% 25.1% 8.9% 10.2% 10.0% 12.5% 14.9% 29.1% 50.4% 63.2% 66.7%  100  24.2% 23.7% 20.7%  50  22.0% 88.1% 20.1% 8.7%  0 Less  2529 than 25  3034  3539  4044  4549  5054  5559  6064  6569  7074 75 and  over  Age groups Employed in nursing fulltime Employed in nursing parttime Not employed in nursing  * The total percent of registered nurses across age groups may not equal the estimated total of all RNs due to the effect of rounding. Source: 2008 National Sample Survey of Registered Nurses  3.4  Employment and Education  Employment rates of RNs vary both by initial and highest education. More than 87 percent of nurses whose initial RN education was an ADN, bachelor \'s, or master \'s degree report that they are employed in nursing positions, as compared with less than 75 percent of those whose initial  3-5  The Employment of Registered Nurses  3  education was a nursing diploma (Figure 3-5 and Appendix A, Table 8). This is consistent with the older average age of diploma graduates, discussed in Chapter 7. Further, RNs whose initial education was in an ADN program have a higher rate of full-time employment than do those who entered the profession with a bachelor \'s or master \'s degree.  Figure 3-5.  Thousands 1600 1400 11.9% 1200 19.8% 1000 800 600 25.9% 400 200 0 Diploma Fulltime Associate degree Parttime Bachelor \'s degree and higher Not employed in nursing 23.9% 13.3% 22.5%  Employment rates, by initial nursing education*  68.4% 64.2%  50.2%  *Percents may not add to 100 due to the effect of rounding. Only those who provided education preparation information are included in the calculations used for this figure. Source: 2008 National Sample Survey of Registered Nurses  Figure 3-6 illustrates that the relationship between highest education and employment is similar to the relationship for initial education. About 26 percent of RNs for whom diploma-education was their highest education no longer work in nursing, as compared with about 12 percent, 14 percent, and 17 percent for RNs whose highest education is an ADN, bachelor \'s, and master \'s/doctorate, respectively. RNs with a bachelor \'s or master \'s/doctorate degree are somewhat less likely to work  3-6  The Employment of Registered Nurses  3  full-time than RNs with an ADN. Overall, more than 75 percent of RNs, regardless of current education level, work in nursing.  Figure 3-6. Employment rates, by highest nursing or nursing-related education*  Thousands 1,200  1,000  11.8%  14.1%  20.1% 800  22.8%  600  400  26.1% 25.0%  68.2%  63.1%  16.5% 18.1%  200 49.0% 0 Diploma FullTime Associate degree PartTime Bachelor \'s degree Master \'s or doctorate Not employed in nursing 65.3%  *Only those who provided education preparation information are included in the calculations used for this figure. Source: 2008 National Sample Survey of Registered Nurses  3.5  Employment Settings  RNs work in a variety of settings and have many different roles and responsibilities in each of these settings. For this report, employment settings are defined using industry categories in labor market analyses by the U.S. Bureau of Labor Statistics. For the first time, in the 2008 NSSRN, nursing home  3-7  The Employment of Registered Nurses  3  and skilled nursing units that are based within hospitals are grouped as part of the hospital setting. In the 2004 NSSRN, these settings were grouped with nursing homes and extended care facilities. Therefore, in the 2008 NSSRN the number of RNs working in hospital settings versus nursing home and skilled care facilities are not completely comparable to previous surveys. Hospitals remain the most common employment setting for RNs in the United States, with 62.2 percent of employed RNs reporting that they worked in hospitals in 2008 (Figure 3-7). 1 Ambulatory care is the next most common setting, with 10.5 percent of employed RNs. Public and community health settings, which include schools and public health departments, account for the worksite of almost 8 percent of RNs, while 6.4 percent work in home health settings. Another 5.3 percent work in nursing homes and extended care facilities. Only 3.8 percent work in academic education. Therefore, almost 30 percent of RNs worked in nonacute patient care settings; more than 90 percent of RNs work in patient care settings of some sort. Among RNs who work in hospitals, the majority (82.6 percent) worked in community hospitals. Another 7.8 percent were employed in specialty hospitals (Figure 3-8).  More than 76 percent of RNs employed in non-Federal specialty hospitals worked in inpatient units (Table 3-1). Among RNs who worked in community hospitals, 11.7 percent were employed in outpatient clinics or medical practices. Only 1.5 percent of RNs who worked in hospital settings were employed in a long-term hospital, and 2 percent worked in a psychiatric hospital (Appendix A, Table 12). 2 Slightly more than 3 percent of RNs who worked in hospital settings were employed in Federal hospitals, such as the U.S. Department of Veterans Affairs (VA), military facilities, or Indian Health Services hospitals.      1  For the 2008 NSSRN, as with previous administrations, the list of employment settings from which RNs could select was revised. Despite these revisions, the major employment categories are sufficiently distinct to support comparisons over time. RNs who worked in long-term hospitals are not grouped with nurses employed in other long-term or skilled nursing facilities in this report.  2  3-8  The Employment of Registered Nurses  3  Figure 3-7.  Employment settings of registered nurses*  Other**** 3.9%  Ambulatory care*** 10.5%  Public/community  health** 7.8%  Home health 6.4%  Academic education 3.8% Hospital 62.2% Nursing  home/extended care 5.3%  *Percents may not add to 100 due to the effect of rounding. Only RNs who provided setting information are included in the calculations used for this figure. **Public/community health includes school and occupational health. ***Ambulatory care includes medical/physician practices, health centers and clinics, and other types of nonhospital clinical settings. ****Other includes insurance, benefits, and utilization review. Source: 2008 National Sample Survey of Registered Nurses  3-9  The Employment of Registered Nurses  3  Figure 3-8.  Types of hospitals in which registered nurses employed in hospital settings work*  Federal hospital 3.3% Other hospital 2.8%  Psychiatric hospital 2.0%  Longterm hospital 1.5% Specialty hospital 7.8%  Community hospital 82.6%  *Percents may not add to 100 due to the effect of rounding. Only registered nurses who provided hospital subset information are included in the calculations used for this figure. Source: 2008 National Sample Survey of Registered Nurses  Table 3-1.  Employment in hospital units, by type of hospital*  Community hospital (percent) 78.1 0.0 11.7 9.8 100.0 Specialty hospital (percent) 76.5 0.0 15.6 8.0 100.0 Long-term hospital (percent) 80.6 9.2 0.0 10.2 100.0 Psychiatric hospital (percent) 82.1 1.6 7.1 9.1 100.0 Federal hospital (percent) 52.9 3.5 26.8 16.8 100.0 Other hospital (percent) 61.7 1.1 14.3 22.9 100.0 Total (percent) 76.8 0.7 12.3 10.2 100.0  Inpatient Nursing home unit Outpatient Other Total  *Percents may not add to 100 due to the effect of rounding. Only registered nurses who provided hospital subset information are included in the calculations used for this table. Source: 2008 National Sample Survey of Registered Nurses  3-10  The Employment of Registered Nurses  3  3.5.1  Employment Setting Trends  The employment settings of RNs have changed over the decades (Figure 3-9). In 2004, 57.4 percent of RNs worked in hospitals. The increase in the percentage of RNs working in hospitals between 2004 and 2008 is the first increase since 1984. The 17.7 percent growth in the number of RNs employed in hospitals is consistent with American Hospital Association (AHA) data. The AHA reported that between 2004 and 2008, RN full-time equivalent (FTE) employment increased 16.6 percent. The AHA also reported that RN FTE percent of total hospital employment rose from 25.4 to 27. 3 Hospitals are employing more RNs than in 2004. There also was a 68 percent increase from 2004 to 2008 in the percentage of RNs working in home health services from 3.8 percent in 2004 to 6.4 percent in 2008. Between 2004 and 2008, little else changed in the percentage of RNs employed in other settings.  3.5.2  Employment Settings and Age  Registered nurses \' employment settings change with nurses \' ages (Table 3-2 and Appendix A, Table 13). Nearly 85 percent of RNs under 30 years old work in hospitals, but this percentage declines steadily with age; less than 50 percent of RNs age 55 and older work in hospitals. Hospitals have historically been viewed as offering a good initial career development opportunity for a new RN because new RNs can gain hands-on experience with patients with varied and complex needs while having the support of other experienced clinicians inherent in the hospital setting. Nonhospital settings such as home health, public and community health, nursing homes and extended care, and academic education are employment settings for increasing percentages of the older RN age groups. It is not surprising that RNs working in academic education are older because RNs need to complete graduate education before moving into faculty positions.  3  Data retrieved from American Hospital Association, Trendwatch Chartbook 2009, available at http://www.aha.org/aha/research-andtrends/chartbook/index.html. 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Listing these resources is not an endorsement by HHS or its components.  3-11  The Employment of Registered Nurses  3  Figure 3-9.  100%  Employment settings of registered nurses, 1980-2008*  1.7% 8.1% 8.7% 1.4% 9.8% 2.6% 7.8% 3.0% 8.5% 3.7% 9.5% 11.7% 12.5% 11.3% 3.8% 2.7% 7.7% 6.6% 11.1% 1.8% 7.0% 8.1% 13.5% 17.2% 2.0% 2.3% 7.0% 2.1% 6.5% 18.3% 15.2% 3.8% 2.7% 5.3% 14.2%  3.9%  6.6% 10.5%  3.9%  90%  80%  70%  8.0%  60%  50%  40% 65.9% 30% 68.2% 68.0% 66.75 60.1% 59.3% 57.4% 62.2%  20%  10%  0% 1980 1984 1988 1992 1996 2000 2004 2008  Hospital Public/community health**  Nursing home/extended care Ambulatory care  Academic education Other***  *The total percent by setting may not equal the estimated total of all registered nurses due to incomplete information provided by respondents and the effect of rounding. **Public/community health includes school health, occupational health, and home health. ***Other includes insurance, benefits, and utilization review. Source: 1980-2008 National Sample Survey of Registered Nurses  3-12  The Employment of Registered Nurses  3  Table 3-2.  Employment settings, by age group*  Age group (percent) Under 30 84.5 2.1 1.7 2.6 2.7 5.8 0.8 3034 73.5 3.4 1.8 4.3 4.3 10.6 2.1 65 and over 35.5 10.7 10.5 10.5 14.8 11.3 6.8  Employment setting Hospital Nursing home/ extended care Academic education Home health Public/community health** Ambulatory care Other***  35-39 68.3 4.7 2.4 6.6 4.1 9.7 4.1  40-44 64.7 4.5 2.7 6.7 7.4 10.5 3.6  45-49 61.3 5.6 3.8 6.7 8.3 10.7 3.5  50-54 55.9 5.9 4.5 7.2 9.9 11.5 5.1  55-59 53.0 6.5 5.1 7.7 9.9 12.6 5.2  60-64 46.5 7.6 6.6 7.8 13.7 12.1 5.8  *Percents may not add to 100 due to the effect of rounding. Only registered nurses who provided setting information are included in the calculations used for this table. **Public/community health includes school and occupational health. ***Other includes insurance, benefits, and utilization review. Source: 2008 National Sample Survey of Registered Nurses  3.5.3  Employment Settings and Education  The highest level of nursing or nursing-related education varies with employment setting (Figure 310 and Appendix A, Table 14). A larger percentage of RNs whose highest education is a bachelor \'s degree are employed in hospitals as compared to RNs with an ADN or diploma. Fewer than half of RNs with master \'s or doctorate degrees work in hospitals; more than 18.6 percent are in ambulatory care settings, and nearly 12 percent are in academic education. The relatively high percentage in ambulatory care reflects the large number of advanced practice registered nurses with master \'s degrees who work in ambulatory settings as discussed in Chapter 5. Among diploma-educated RNs, 14 percent work in ambulatory care settings, and more than 7 percent work in each of long-term care and home health. These results are consistent with the fact that diploma-educated RNs are older than other RNs, on average, and that older RNs are more likely to work in nonhospital settings.  3-13  The Employment of Registered Nurses  3  Figure 3-10.  100%  Employment settings, by highest nursing or nursing-related education*  4.9% 3.1% 9.1% 14.0% 5.9% 8.3% 6.0% 2.5% 3.5% 10.7% 3.8% 11.9% 2.4% 4.2% 8.0% 18.6% 4.8%  90%  80% 9.0% 70% 7.7% 3.5% 7.2% 50%  7.3% 2.4% 7.4%  60%  40% 64.8% 53.7% 47.8% 20% 67.4%  30%  10%  0% Diploma Hospital  Home health setting Other Associate degree Bachelor \'s degree Master \'s or doctorate Academic education program Ambulatory care setting (not hospital)  Nursing home/extended care facility Public or community health setting  *Percents may not add to100 because of rounding. Only those who provided education preparation information are included in the calculations for this figure. Source: 2008 National Sample Survey of Registered Nurses  3.6  Job Titles  The specific roles of RNs are defined by their job titles within each employment setting. RNs have a variety of roles and job titles. Different settings and employers often use different terminology to describe the same type of work performed by RNs. For example, some hospitals use the title  direct care nurse,  while others use the title  staff nurse  even when the work of RNs with these titles is essentially the same. Job titles can indicate the clinical area or expertise of an RN, but even within a clinical area a variety of job titles can be found. Moreover, some RNs work in several roles within  3-14  The Employment of Registered Nurses  3  the same facility. For the purposes of the 2008 NSSRN, RNs were asked to report a single job title corresponding to their position. The most common job title of RNs in the United States is  staff nurse  or an equivalent title (Table 3-3). The percentage of RNs reporting this title increased from 64.1 percent in 2004 to 66.3 percent in 2008. Job titles of RNs in 2008 also included management and administration titles (12.5 percent) and patient coordinator (5.4 percent). The number responding with advanced practice titles (nurse practitioner, clinical nurse specialist, nurse anesthetist, and nurse midwife) were relatively unchanged since 2004.  Table 3-3. Job titles of registered nurses*  Job title Staff nurse First-line management Middle management Senior management Patient coordinator Nurse practitioner Clinical nurse specialist Nurse anesthetist Nurse midwife Instruction Patient educator Consultant Researcher Informatics Survey/auditor/regulator Other** Total 2004 (percent) 64.1 6.2 5.9 2.5 5.5 3.5 1.2 1.1 0.3 2.6 0.3 1.5 0.8 0.4 0.5 3.5 100.0 2008 (percent) 66.3 4.1 6.0 2.4 5.4 3.8 0.9 1.1 0.3 3.7 0.7 0.9 0.7 0.3 0.4 3.0 100.0  *Only those who provided job title information are included in the calculations used for this table. The response categories for job title were slightly different across the 2004 and 2008 survey administrations which may account for some of the change in distribution. **Other includes registered nurses who reported they had no job title. Source: 2004 and 2008 National Sample Survey of Registered Nurses  3.6.1  Job Titles and Employment Settings  Within hospitals, RNs are most likely to be a staff nurse or have an equivalent title (Appendix A, Table 16). Within nursing homes, 40.5 percent of RNs have management or administration job titles. These titles also are common among RNs in home health settings (20.9 percent). Patient  3-15  The Employment of Registered Nurses  3  coordinator job titles are frequently reported in insurance claims/utilization review (40.1 percent) and home health (19.6 percent) employment settings.  3.6.2  Job Titles and Experience  Job titles of RNs change with experience and age, much as do the settings in which they work. A higher percentage of recently graduated RNs have staff nurse job titles, and the percentage of RNs with this title declines with increasing years of experience. The percentage of RNs with advanced practice titles is relatively similar for RNs with 6 or more years of experience (Table 3-4). After 10 years of experience, RNs tend to move from staff nursing to management and other positions, though even after 40 years of experience, 50 percent of RNs reported being staff nurses.  Table 3-4. Job titles, by experience in nursing*  Years since graduation from initial nursing education 5 or fewer years 88.4 2.1 2.2 2.0 0.8 4.6 6 to 10 years 72.2 4.0 6.1 6.2 3.0 8.5 11 to 15 years 65.5 4.6 8.9 5.9 3.6 11.5 16 to 20 years 63.2 5.0 9.4 5.9 3.9 12.5 21 to 25 years 57.3 4.8 11.1 8.4 4.7 13.6 26 to 30 years 55.4 5.6 11.9 8.4 4.5 14.1 31 to 35 years 53.8 4.7 12.0 8.9 5.4 15.2 36 to 40 years 55.2 3.5 11.8 6.3 5.5 17.7 More than 40 years 50.1 2.8 11.8 6.3 8.0 21.0  Job title Staff nurse First-line management Middle/senior management Advance practice registered nurse Instruction Other job title  *Percents may not add to 100 because of rounding. Only those who provided job title information are included in the calculations used for this table. Source: 2008 National Sample Survey of Registered Nurses  3.6.3  Job Titles and Education  Nursing and nursing-related education can support registered nurses \' career goals and education is associated with RN job titles. More than 69 percent of RNs whose highest education is a nursing diploma, ADN, or bachelor \'s degree have staff nurse job titles, whereas less than 20 percent of those with graduate degrees hold a staff nurse job title (Table 3-5 and Appendix A, Table 18). Approximately 70 percent of RNs with graduate degrees have advance practice, management, and instruction titles.  3-16  The Employment of Registered Nurses  3  Table 3-5.  Job titles, by highest nursing or nursing-related education*  Highest nursing or nursing-related education preparation (percent) Associate Bachelor \'s Master \'s/ Diploma degree degree doctorate 69.7 76.4 71.4 19.4 4.6 4.1 4.2 3.4 7.7 7.1 7.5 15.5 1.0 0.1 0.5 6.1 0.5 0.5 0.5 3.2 0.1 0.0 0.1 1.5 0.9 0.3 0.4 26.3 0.7 0.6 0.8 0.8 1.7 1.5 3.1 13.6 7.2 5.2 5.9 3.1 0.3 0.3 0.4 0.5 1.1 0.5 0.9 1.8 0.6 0.5 0.9 0.8 0.5 0.4 0.4 0.4 3.5 2.5 3.1 3.4  Job title Staff nurse First-line management Middle/senior management Certified registered nurse anesthetist Clinical nurse specialist Certified nurse-midwife Nurse practitioner Patient educator Instruction Patient coordinator Informatics nurse Consultant Researcher Surveyor/auditor/regulator Other  *Percents may not add to 100 because of rounding. Excludes registered nurses for whom education preparation was not known and registered nurses for whom job title was not known. Source: 2008 National Sample Survey of Registered Nurses  3.7  Secondary Nursing Jobs  Overall, 327,259 RNs have more than one nursing position (Appendix A, Table 19), slightly less than the 352,027 who held more than one nursing position in 2004. More than 12 percent of RNs who have a full-time principal nursing position have reported at least one other nursing job, and 14 percent of those with part-time principal positions have reported more than one nursing job (Figure 3-11). RNs may hold their secondary positions as employees of health care facilities or temporary placement agencies, or as consultants. Some RNs work  per diem  for hospitals, nursing homes, home care agencies, and outpatient facilities as facility employees or through agencies. Per diem employment arrangements allow RNs to work shifts for specific employers on an as needed basis, often without employee benefits but at a slightly higher pay rate than scheduled employees, based on employers \' requests and the nurses \' willingness to fill these requests. Per diem employment is often possible for all levels of RN clinicians including both staff nurses and advanced practice registered nurses.  3-17  The Employment of Registered Nurses  3  Figure 3-11.  Thousands 2,000   Registered nurses holding multiple positions, by primary employment status  1,800   1,600   1,400   1,200  87.8% 1,000   800   600   400   86.0%   200  12.2% Work fulltime in principal position No additional nursing position  Source: 2008 National Sample Survey of Registered Nurses  14.0%  Work parttime in principal position Hold additional nursing position  More than half of RNs who hold secondary nursing positions report that, for at least one of their secondary positions, they are regular employees of some firm (Table 3-6). About 36 percent of RNs with secondary nursing jobs report that at least one of these secondary positions is per diem or they are self-employed. Another 8.4 percent of full-time RNs and 4.9 percent of part-time RNs say their secondary nursing jobs involved employment through a temporary placement agency that does not require them to travel long distances for assignments. Agency employment may afford the same flexibility as do per diem arrangements, allowing RNs to work a schedule of their own choosing.  3-18  The Employment of Registered Nurses  3  Table 3-6.  Employment arrangements in secondary nursing positions*  Principal nursing position (percent) All nurses with Full-time Part-time multiple positions 57.1 62.6 58.6 8.4 4.9 7.4 1.8 1.3 1.7 36.7 36.3 36.6  Secondary nursing position Regular employee Nontravel agency Travel agency Self-employed or per-diem  *Percents will not add to 100 because RNs could select more than one employment arrangement. Source: 2008 National Sample Survey of Registered Nurses  Hospitals have the largest percent of secondary nursing positions, with 43.3 percent of RNs who have secondary nursing employment working in this setting (Table 3-7). Ambulatory care secondary positions are reported by 13.5 percent of RNs who have secondary employment, while home health is reported by 11.4 percent. Academic education is another setting for secondary employment (10.6 percent); employment in academic education is discussed in more detail in Chapter 4.  Table 3-7. Employment settings of secondary nursing positions*  Percent 43.3 9.4 10.6 11.4 7.2 4.4 1.7 13.5 1.5 0.8 1.0 0.7 0.9 1.4  Employment setting Hospital Nursing home/extended care Academic education program Home health Public/community health School health services Occupational health Ambulatory care Insurance claims/benefits Telehealth/telenursing/call center Military/reserves/national guard Medical legal Consultant/contractor Other  Source: 2008 National Sample Survey of Registered Nurses  *Percents will not add to 100 because RNs could select more than one secondary employment setting.  3.8  Supply of Registered Nurses  The amount of hours that RNs work per week and per year are measures of the supply of nursing services available for patient care, management, and other services. In the 2008 NSSRN, RNs were asked to report the number of months they work per year in their principal nursing position and the  3-19  The Employment of Registered Nurses  3  number of weeks they work per year in their secondary nursing positions. RNs also were asked about the number of hours per week they work in each of their nursing positions. The vast majority of RNs (92.7 percent) report that they work at least 11 months per year in their principal nursing position (Figure 3-12). This level of employment is equivalent to full-year employment for most positions. Another 5 percent of RNs work 9 to 10 months per year, which is full-year for the academic or school calendar. The remaining 2.3 percent work 8 or fewer months per year. More than half of RNs work at least 2,000 hours per year in their nursing positions (54.2 percent). 4 Only 7.6 percent of employed RNs work fewer than 1,000 hours per year in nursing (Figure 3-13). More than half of RNs work at least 40 hours per week in their principal nursing position (Figure 314), and another 24.2 percent work 32 to 39 hours per week. Some hospitals use 12-hour shifts for their schedules and consider three 12-hour shifts per week (36 hours) a full-time position. In this arrangement, RNs who choose to work one extra shift per week will normally work 48 hours. Only 4.5 percent of RNs work fewer than 16 hours per week in their principal nursing position; this is consistent with the small percentage of RNs that work fewer than 1,000 hours per year. RNs work an average of 1,944 hours per year in their principal nursing position (Appendix A, Table 20). Almost 17 percent of RNs work more than 2,500 hours per year. RNs who hold one additional nursing position work an average of 29.6 weeks per year and 15.2 hours per week in their second job (Table 3-8). These data indicate that many RNs work only part of the year and part of the week in their second positions. RNs who work in third jobs average only 23.1 weeks per year and 11.7 hours per week, while those who work four and more jobs work even fewer hours in these additional jobs. RNs employed in multiple nursing positions work more hours per year than do those with only one nursing position (Table 3-9). However, RNs employed in four or more positions work fewer hours per year on average than do RNs with three positions, suggesting that RNs with more positions may work several part-time positions.  4  A full-time position of 40 hours per week for 52 weeks is equal to 2080 hours per year. A registered nurse who works 48-50 weeks per year, allowing for vacation time, at 40 hours per week would work from 1920­2000 hours per year.  3-20  The Employment of Registered Nurses  3  Figure 3-12.  Months worked per year in principal nursing position  Less than 9 months 2.3% 9 to 10 months 5.0%  11 to 12 months 92.7%  Source: 2008 National Sample Survey of Registered Nurses  3-21  The Employment of Registered Nurses  3  Figure 3-13.  Hours worked per year in all nursing positions  3,500 to 3,999 hours 1.6% 3,000 to 3,499 hours 3.7% More than 4,000 hours 1 to 499 hours 1.8% 2.9% 500 to 999 hours 4.7%  2,500 to 2,999 hours 9.8%  1,000 to 1,499 hours 11.3%  2,000 to 2,499 hours 37.3%  Source: 2008 National Sample Survey of Registered Nurses  1,500 to 1,999 hours 26.9%  3-22  The Employment of Registered Nurses  3  Figure 3-14.  Hours worked per week in principal nursing position  1 to 7 hours 0.9% 56 or more hours 6.1% 8 to 15 hours 3.6% 16 to 23 hours 5.6%  48 to 55 hours 13.2% 24 to 31 hours 11.3%  40 to 47 hours 34.9%  32 to 39 hours 24.2%  Source: 2008 National Sample Survey of Registered Nurses  Table 3-8.  Average hours and weeks worked in secondary nursing positions  Weeks per year 29.6 23.1 11.9 Hours per week 15.2 11.7 7.8  Second nursing job Third nursing Job Fourth or more nursing jobs  Source: 2008 National Sample Survey of Registered Nurses  Table 3-9.  Average hours per year worked in all nursing jobs, by number of nursing jobs  Average hours worked per year 1,945.4 2,349.9 2,859.7 2,519.4  One nursing job Two nursing jobs Three nursing jobs Four or more nursing jobs  Source: 2008 National Sample Survey of Registered Nurses  3-23  The Employment of Registered Nurses  3  3.8.1  Hours and Weeks Worked and Age Group  RNs tend to work fewer hours as they grow older, in addition to being less likely to work in nursing (Table 3-10). RNs through age 60 worked, on average, more than 2,000 hours per year. After age 65, the average number of hours per year drops rapidly. Still, RNs who are 65 years or older do work an average of 1,393 hours of nursing work per year.  Table 3-10.  Age group Under 30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 and over  Average hours worked per year in all nursing positions, by age group  Average hours worked per year 2,020.2 2,005.7 2,007.2 2,003.5 2,095.0 2,092.0 2,047.0 1,826.9 1,392.7  Source: 2008 National Sample Survey of Registered Nurses  3.8.2  Hours and Weeks Worked and Highest Education  The number of hours per year that RNs work in nursing positions is least for RNs whose highest nursing or nursing-related education is a diploma (Table 3-11). This is not surprising, since the average age of diploma-educated RNs is higher than for RNs with other types of education and older RNs work less hours. RNs with master \'s and doctorate degrees report the most hours worked per year. These are RNs who are also likely to be managers, faculty, or advanced practice registered nurses.  Table 3-11. Average hours worked per year in all nursing positions, by highest nursing and nursing-related education  Average hours worked per year 1,864.9 2,047.1 1,966.6 2,122.7  Degree Diploma Associate degree Bachelor \'s degree Master \'s or doctorate  Source: 2008 National Sample Survey of Registered Nurses  3-24  The Employment of Registered Nurses  3  3.8.3  On-Call Work  Some RNs work in an  on-call  arrangement for at least some of their total hours. In this type of arrangement, an RN is not physically present at an employer \'s facility (or at a patient \'s home in the case of hospice or home care services) but is available to be on-call to work during a prescheduled time. For example, a surgical nurse or nurse anesthetist might be on-call to assist in a surgery between 8 p.m. and 6 a.m. or a nurse midwife may be on-call for deliveries at night or on weekends. Often advanced practice primary care nurses take telephone calls for patient care issues after normal hours. RNs can be paid additionally for these on-call hours usually at a lower rate than is paid for regular work. However, if the RN is called in to work, the RN is paid the normal hourly rate often with an added premium for working after normal scheduled hours. Sometimes, if an RN works in a salaried position, the RN may be on-call but may not receive additional hourly standby pay. In their principal nursing positions, 19.1 percent of RNs report that they worked on-call or were on standby in a typical work week. Most RNs who reported any on-call activity indicated that they were on standby or worked 20 or fewer hours in a typical week (Table 3-12). RNs who had any on-call activity indicated that they were called to work an average of 12.5 hours per week. They were on standby without being called to work an average of 23.1 hours per week. An average of 14 percent of on-call hours were paid at a standby rate.  Table 3-12. Average hours on standby or worked from on-call per week in the principal nursing position  Percent 80.9 12.2 3.8 1.4 1.6 100.0  Hours 0 hours 1 to 20 hours 21 to 40 hours 41 to 60 hours 61 or more hours Total  Source: 2008 National Sample Survey of Registered Nurses  3.8.4  Overtime Work  Typically, RNs paid on an hourly wage basis may be paid for overtime work beyond 40 hours a week and may be compensated at a premium rate. Salaried RNs normally do not receive additional payment for overtime work but may sometimes take paid extra time off later to compensate for working extra hours. While overtime work is ideally a match between an employer \'s need for  3-25  The Employment of Registered Nurses  3  additional effort and the nurse \'s willingness to provide additional hours, sometimes RNs are required to work overtime ( mandatory overtime ). Mandatory overtime may sometimes be voluntarily accepted as part of the employment arrangement, rather than being totally involuntary. Moreover, in States or facilities where RNs are unionized, overtime may be subject to union contract. The majority of RNs do not work overtime. Among RNs employed full-time in nursing positions, 27.5 percent report that they worked overtime and received pay for such work (Appendix A, Table 21). Mandatory overtime was reported by 7 percent of RNs. RNs work an average of 7.5 overtime hours per week and averaged 6.6 hours per week of mandatory overtime.  3.8.5  Hours Worked and Employment Setting  The number of hours RNs work per week and per year varies across employment settings (Table 313 and Appendix A, Tables 20, 21, and 22).  RNs whose principal nursing position is in a school health setting reported the fewest hours per year, with an average of 1,443 hours per year; this low work rate is likely related to their work schedules being based on an academic calendar and the holidays, vacation periods, and other time off related to the school calendar. They also reported the fewest hours worked per week, averaging 39 hours for full-time RNs. The greatest number of average hours RNs worked per year in their principal nursing position (2,107 hours) was in nursing homes and extended care facilities. Among RNs working full-time, the greatest number of hours per week was reported by RNs whose principal position was in a nursing home (45.8), followed by those in home health (45.3). For RNs working part-time, the greatest number of hours per week was reported by RNs whose principal position was in a hospital (25.2), followed by home health (24.4). The average number of hours worked per week in principal nursing positions was more than 40 for full-time RNs in all settings, except those in school health.        3-26  The Employment of Registered Nurses  3  Table 3-13.  Average hours per week in principal nursing position, by full-time/part-time status and employment setting  Employment setting Mean hours/week full-time nurses 42.9 42.6 45.8 44.0 45.3 42.7 39.0 42.4 42.5 43.1 45.1 Mean hours/week part-time nurses 24.1 25.2 22.4 22.8 24.4 21.6 18.9 22.5 22.3 21.0 23.0  All settings Hospital Nursing home/extended care Academic education Home health Public/community health School health Occupational health Ambulatory care Insurance/benefits/utilization review Other  Source: 2008 National Sample Survey of Registered Nurses  Overtime work was more common among RNs who worked in hospital settings than among those in other settings; 33.8 percent of full-time hospital RNs reported that they worked paid overtime, with an average of 7.5 hours per week (Appendix A, Table 21). Mandatory overtime was reported by 8.2 percent of these RNs, averaging 6.4 hours per week. Among part-time RNs who worked in hospital settings, 19.9 percent worked paid overtime, with an average of 5.5 hours per week. Only 3.7 percent reported any mandatory overtime, with those who worked mandatory overtime averaging 4.5 hours per week (Appendix A, Table 22). On-call work was most prevalent in nonhospital work settings.  The settings in which the fewest full-time RNs reported that they worked paid overtime were school health and insurance claims. In all other settings, at least 10 percent of RNs worked some paid overtime. After hospital-based RNs, full-time home health RNs were the second most likely group to report that they worked mandatory overtime (7.9 percent).    Full-time RNs in home health settings reported the highest rate of on-call hours (30.1 percent), with the second-highest percentage being among those in nursing homes and extended care facilities (15.9 percent) (Appendix A, Table 21).  Full-time RNs in home health settings also had the highest rate of standby on-call hours, with 25.5 percent listing that they had some standby hours. Full-time RNs who worked in ambulatory care settings and had some standby hours (6.9 percent) reported an average of 40.9 standby hours per week. Less than half of these RNs were paid at a standby rate.    3-27  The Employment of Registered Nurses  3  Full-time home health RNs had the highest percentage of RNs whose standby hours were paid.  3.8.6  Hours Worked and Job Title  The number of hours that RNs work per week, which includes overtime and on-call hours worked, is associated with job title (Table 3-14).  Table 3-14. Average hours per week in principal nursing position, by full-time/part-time status and job title*  Mean hours/week full-time nurses 41.6 46.3 48.1 46.2 43.8 44.2 48.7 43.9 45.1 42.6 45.6 42.2 43.2 40.0 42.5 Mean hours/week part-time nurses 24.4 24.2 25.3 21.7 21.1 24.3 23.1 25.8 26.4 23.9 21.7 24.7 24.6 21.3 20.6  Job title Staff nurse First-line management Middle/senior management Consultant Instruction Nurse practitioner Nurse midwife Clinical nurse specialist Nurse anesthetist Researcher Informatics Surveyor/auditor/regulator Patient coordinator Patient educator Other  *Excludes registered nurses for whom job title was not known. Source: 2008 National Sample Survey of Registered Nurses    Full-time staff nurses work an average of 41.6 hours per week, which is less than the average for all job titles except patient educators. The greatest number of hours per week is worked by full-time RNs with nurse midwife job titles (48.7 hours), followed by those with middle or senior management job titles (48.1 hours). Among part-time RNs, those with the greatest number of average hours per week are nurse anesthetists (26.4 hours), followed by clinical nurse specialists (25.8 hours), and nurses in middle or senior management positions (25.3 hours).    3-28  The Employment of Registered Nurses  3  3.9  Employment Settings and Level of Care  RNs work in a variety of clinical settings, providing care at different levels of acuity or patient need. Tables 3-15, 3-16, and 3-17 present data on the level of care, types of patients, and clinical specialties of nurses. (Further detail can be found in Appendix A, Tables 23, 24, 25, and 26.)  Table 3-15. Levels of care in nursing work for hospital and nonhospital settings*  Hospital setting (number) 595,742 328,932 187,973 44,131 174,635 22,717 45,278 17,610 304,117 136,200 3,969 8,042 61,002 93,509 43,548 1,571,861 Hospital setting (percent) 37.9 20.9 12.0 2.8 11.1 1.4 2.9 1.1 19.3 8.7 0.3 0.5 3.9 5.9 2.8 Nonhospital setting (number) 101,768 15,265 8,707 25,258 24,194 26,190 39,569 134,362 70,671 221,145 151,332 116,892 117,291 133,281 30,819 943,026 Nonhospital setting (percent) 10.8 1.6 0.9 2.7 2.6 2.8 4.2 14.2 7.5 23.5 16.0 12.4 12.4 14.1 3.3  Level of care General or specialty inpatient Critical/intensive care Step down/transitional/progressive/telemetry Subacute care Emergency Urgent care Rehabilitation Long-term care/nursing home Surgery Ambulatory care Home health Public/community health Education Business/administration/review Other** Total number of registered nurses  *Only registered nurses who provided setting and level of care information are included in the calculations used for this table. Percents add to more than 100 as RNs may have reported more than one level of care. **Other level of care/type of work includes ancillary care, research, informatics, flight nurse, and other. Source: 2008 National Sample Survey of Registered Nurses  Among RNs who worked in hospital settings, the largest percentage (37.9 percent) worked in general or specialty inpatient environments, followed by 20.9 percent of RNs who worked in critical or intensive care, and 19.3 percent who worked in surgical services. Among RNs in nonhospital settings, the most common nonhospital level of care is ambulatory care (23.5 percent), followed by home health (16 percent of nonhospital RNs). Nearly 11 percent of RNs who do not work in hospitals report that they spend the majority of their time in a general or specialty inpatient setting. The largest percentage of these RNs work in school health (35.3 percent) and academic education (21.4 percent).  3-29  The Employment of Registered Nurses  3  RNs care for patients across the age span in all settings (Table 3-16). Among RNs who worked in hospital settings, more than half reported that they spend at least 50 percent of their patient care time with adult patients (56 percent). Geriatric patients are the second most commonly reported patient population in hospital settings, with 11.9 percent of RNs spending the majority of time with these patients. Slightly more than 10 percent of hospital-based RNs provided care for children. Among RNs employed in nonhospital settings, adult patients consume roughly one-third of RN time for patient care. An additional 25 percent of RN time is devoted to geriatric patients. Pediatric and adolescent patients are the majority of patients for 13.4 percent of nonhospital RNs probably reflecting school based and home care nursing populations.  Table 3-16. Primary patient age group cared for in principal nursing position, for hospital and nonhospital settings*  Hospital setting (number) 891,482 189,969 34,119 88,723 90,185 192,472 104,312 1,591,261 Hospital setting (percent) 56.0 11.9 2.1 5.6 5.7 12.1 6.6 100.0 Nonhospital setting (number) 342,703 240,652 13,116 6,368 129,546 88,587 143,255 964,227 Nonhospital setting (percent) 35.5 25.0 1.4 0.7 13.4 9.2 14.9 100.0  Patient Type Adult Geriatric Prenatal Newborn or neonatal Pediatric/adolescent Multiple age groups No patient care Total number of nurses  *Only registered nurses who provided setting and patient type information are included in the calculations used for this table. Source: 2008 National Sample Survey of Registered Nurses  Table 3-17 presents the clinical specialty in which RNs spend most of their time in their principal nursing position. Among RNs who worked in hospital settings, the most common clinical area is general medical or surgical care, in which 29.3 percent of RNs provide care. Critical care and cardiac/cardiovascular care are common clinical specialties for hospital-employed RNs, with 19.2 and 16.7 percent of RNs, respectively. Among RNs working in nonhospital settings, the most common clinical area is general medical or surgical care (21.1 percent), with primary care being reported by nearly as many RNs (19.7 percent). A relatively high percentage of nonhospital RNs report that their primary clinical area is chronic care  3-30  The Employment of Registered Nurses  3  (13.6 percent), indicating that RNs may be providing care to chronically ill patients in homes and extended care facilities.  Table 3-17. Primary clinical specialty in principal nursing position for hospital and nonhospital settings*  Hospital setting (number) 301,271 262,175 60,237 186,451 85,806 459,315 60,739 22,459 50,647 86,271 67,151 102,300 89,611 57,861 79,638 85,602 57,094 95,595 17,526 1,566,645 Hospital setting (percent) 19.2 16.7 3.8 11.9 5.5 29.3 3.9 1.4 3.2 5.5 4.3 6.5 5.7 3.7 5.1 5.5 3.6 6.1 1.1 Nonhospital setting (number) 16,465 46,518 110,942 31,888 34,610 172,075 37,878 58,713 44,084 8,180 17,771 30,296 29,919 161,041 53,130 34,774 31,295 140,565 42,628 816,982 Nonhospital setting (percent) 2.0 5.7 13.6 3.9 4.2 21.1 4.6 7.2 5.4 1.0 2.2 3.7 3.7 19.7 6.5 4.3 3.8 17.2 5.2  Clinical Specialty Critical care Cardiac care Chronic care Emergency/trauma care Gastrointestinal General medical surgical Gynecology (women \'s health) Hospice Infectious/communicable disease Labor and delivery Neurological Obstetrics Oncology Primary care Psychiatric/mental health Pulmonary/respiratory Renal/dialysis Other specialty** No patient care Total number of nurses  *Only registered nurses who provided setting and clinical specialty information are included in the calculations used for this table. Percents add to more than 100 as registered nurses may report more than one clinical specialty. **Other clinical specialty includes dermatology, endocrinology, infusion, occupational health, ophthalmology, orthopedic, otolaryngology, plastic/cosmetic surgery, radiology, urology, no specific area, and other specialties. Source: 2008 National Sample Survey of Registered Nurses  3.9.1  Education and Areas of Clinical Specialty  An RN \'s highest nursing or nursing-related education is associated with the clinical specialty in which the RN works (Table 3-18).  General medical-surgical care is the most common specialty of RNs, regardless of education. However, the percentage in this area is lower for RNs with graduate degrees. RNs with master \'s degrees and doctorates are more likely to work in primary care (19.2 percent) than are RNs at other education levels. They also are more likely to work in gynecology/women \'s health (6.2 percent), obstetrics (6.9 percent), and mental health    3-31  The Employment of Registered Nurses  3  (8.9 percent). These are fields in which advanced practice registered nurses with graduate degrees often have specific preparation.  RNs with bachelor \'s degrees are more likely to work in critical care (17.4 percent), cardiac care (15.0 percent), labor and delivery (4.6 percent), neurological (4.1 percent), and oncology (6.1 percent) than are RNs with other education preparation. RNs with ADNs are more likely to work in general medical surgical care (29.3 percent), chronic care (8.5 percent), emergency/trauma (10.7 percent), hospice (4.1 percent), infectious disease (4.3 percent), pulmonary/respiratory (5.7 percent), and renal/dialysis (4.6 percent) than are RNs with other education preparation. RNs with diplomas are somewhat more likely to work in gastrointestinal (6 percent) than are other RNs. More than 10 percent work in primary care.  Primary clinical specialty in principal nursing position, by highest nursing and nursing-related education*  Diploma (percent)  10.6 11.1 7.6 7.6 6.0 27.6 4.8 3.8 3.7 3.7 2.7 6.6 4.7 10.4 5.9 4.9 2.9 3.1 12.0 Associate degree  (percent) 12.8 14.1 8.5 10.7 5.7 29.3 4.1 4.1 4.3 4.0 3.8 5.1 4.5 8.4 6.4 5.7 4.6 2.1 10.3 Bachelor \'s degree  (percent) 17.4 15.0 6.5 9.7 5.2 27.2 3.8 3.3 4.2 4.6 4.1 5.9 6.1 7.8 4.3 5.5 4.0 2.7 9.8 Master \'s or doctorate  (percent) 9.5 9.4 7.2 7.3 3.3 23.9 6.2 2.3 4.1 3.6 3.5 6.9 5.2 19.2 8.9 3.6 2.2 4.1 10.5    Table 3-18.  Clinical Specialty Critical care Cardiac care Chronic care Emergency/trauma care Gastrointestinal General medical surgical Gynecology (women \'s health) Hospice Infectious/communicable disease Labor and delivery Neurological Obstetrics Oncology Primary care Psychiatric/mental health Pulmonary/respiratory Renal/dialysis No patient care Other specialty**  *Only registered nurses who provided clinical specialty and highest education information are included in the calculations used for this table. Percents add to more than 100 as registered nurses may have reported more than one clinical specialty. **Other clinical specialty includes dermatology, endocrinology, infusion, occupational health, ophthalmology, orthopedic, otolaryngology, plastic/cosmetic surgery, radiology, urology, no specific area, and other specialties. Source: 2008 National Sample Survey of Registered Nurses  3-32  The Employment of Registered Nurses  3  3.10  Composition of Nursing Work  RNs spend the majority of their time performing direct patient care and recordkeeping related to patient care called  charting  (Figure 3-15 and Appendix A, Table 27). Nearly half of RNs (46.8 percent) spend at least 75 percent of their day in these activities, and nearly 70 percent spend at least half their day in this area.  Figure 3-15. Time spent by registered nurses in various activities  100%  0.4%  2.9%  1.4% 4.6%  3.2% 4.4% 6.7%  1.5%  0.4% 2.9% 18.7%  1.6%  3.4%  1.5%  2.3%  90%  18.6% 80% 46.8% 70% 64.2% 60% 54.1% 31.0% 45.7%  14.0%  50% 22.4% 75.8%  40%  79.7%  80.5%  30% 8.2% 20% 9.9% 10% 12.6% 0% Patient  care/charting Nonnursing tasks 0% of time Consultation Supervision 2549% of time Administration Research Teaching 75100% of time Other 32.4% 38.9% 54.7% 47.4%  124% of time  5074% of time  Source: 2008 National Sample Survey of Registered Nurses  Non-nursing tasks, which include housekeeping and searching for supplies do not appear to be significant tasks for RNs; only 3.3 percent of RNs reported that non-nursing activities occupy 25 percent or more of their time. Consultation with other professionals and agencies occupies at least 25 percent of the time of 7 percent of RNs. Nearly 40 percent of RNs do not engage in consultation at all (38.9 percent).  3-33  The Employment of Registered Nurses  3  Teaching, precepting, or orienting students or new hires occupies at least some work time of 52.6 percent of RNs. Only 6.9 percent of RNs say they spend at least 25 percent of their time in teaching-related activities.  3.10.1  Composition of Work and Job Title  The activities of RNs vary by job title (Figure 3-16).  Staff nurses spend an average of 71.8 percent of their time performing patient care and keeping patient care records. Non-nursing tasks occupy an average of 7.6 percent of staff nurse time. RNs in first-line management positions spend an average of 45 percent of their time supervising others and 25.3 percent of their time providing patient care and charting. Middle and senior managers spend an average of 38.3 percent of their time in supervision, 25 percent performing administrative responsibilities, and 11.5 percent providing patient care and charting. An average of 9.9 percent of their time is spent consulting with other providers or agencies. Nurse practitioners spend an average of 79.7 percent of their time providing patient care and charting patient care information.      3.10.2  Composition of Work and Education  The highest nursing or nursing-related education of RNs is associated with the activities performed by RNs (Table 3-19 and Appendix A, Table 28). While RNs with graduate degrees spend less time doing patient care and charting on average than do other RNs, this is probably associated with the fact that RNs who are managers and educators would have less patient care activities than staff nurses. Only nurse practitioners, nurse midwives, and nurse anesthetists would have patient contact similar to staff nurses (Table 3-5).  3-34  The Employment of Registered Nurses  3  Figure 3-16.  100%  Time spent by registered nurses in various activities, by job title  4.6% 5.2% 14.1% 3.7% 3.9% 8.5% 5.3% 8.2% 25.0% 5.4%  3.3% 14.7% 6.2%  90%  5.6% 5.3% 7.6%  80%  23.8%  70%  60% 21.2% 50% 3.3% 40% 71.8% 30%  45.0%  7.1% 6.6% 38.3% 79.7% 6.8%  7.2% 5.1% 42.4% 25.3% 9.9% 3.2% 11.5%  12.3%  20%  26.2%  10%  0% Staff nurse Patient care/charting Patient coordinator Firstline management Nonnursing tasks Consultation Middle/senior  management Nurse practitioner Research Other* Teaching Other  Supervision  Administration  *Excludes registered nurses for whom job title was not known. Source: 2008 National Sample Survey of Registered Nurses  Table 3-19.  Average percent time spent on various activities, by highest nursing or nursingrelated education  Diploma 60.3 6.0 7.2 10.3 3.3 1.5 5.6 6.0 Associate degree 61.4 6.9 6.7 9.9 3.2 1.7 6.1 4.1 Bachelor \'s degree 58.1 6.5 7.9 10.2 3.9 1.9 7.0 4.6 Master \'s degree 48.2 3.0 8.9 10.7 9.7 2.5 12.4 4.7 Doctorate 18.1 1.6 8.8 8.7 19.6 9.7 26.7 6.7  Functional Area Patient care/charting Non-nursing tasks Consultation Supervision Administration Research Teaching Other  Source: 2008 National Sample Survey of Registered Nurses  3-35  The Employment of Registered Nurses  3  3.11  Temporary and Travel Work  An estimated 88,495 RNs, or 3.4 percent of all employed RNs, are employed through temporary employment agencies. Temporary agencies may provide either temporary local placements for RNs, often on a per-shift basis, or short- to mid-term placements with nonlocal employers. The latter type of agency focuses on  travel  placements that typically last from 3 months to 1 year and often occur in a State other than where the travel RN resides. About 2.5 percent of RNs employed in hospital settings report that they are employed by a temporary service for their principal nursing position, and 1 percent say they are employed by a temporary service for at least one secondary nursing position (but not their principal position) (Table 3-20 and Appendix A, Table 29). Temporary agency employment is somewhat more common among RNs whose principal nursing position is in a hospital.  Table 3-20. Employment by temporary employment services (TES), for primary and secondary nursing positions, by principal nursing position in a hospital  Hospital setting (percent) 2.5 1.0 0.1 96.4 100.0 Nonhospital setting (percent) 2.0 1.1 0.1 96.8 100.0  TES principal position only TES secondary position only Both principle and secondary position Not employed by TES Total  Source: 2008 National Sample Survey of Registered Nurses  More than half of RNs who have secondary employment through a nontravel temporary placement agency report that they are placed in a hospital (Table 3-21).  Table 3-21. Employment settings of secondary employment through a nontravel temporary employment service  Number 13,096 11,241 24,337 Percent 53.8 46.2 100.0  Employment setting Hospital Nonhospital setting Total  Source: 2008 National Sample Survey of Registered Nurses  3-36  The Employment of Registered Nurses  3  3.12  Crossing State Lines and Compact States  As of December 2008, 23 States participated in the Nurse Licensure Compact. A multi-State or mutual recognition licensure model, the Compact allows a nurse to have an RN license in the State where she or he resides and practice with that license in other States that are part of the Compact. Thus, an RN may practice across State lines unless otherwise restricted. RNs who do not reside in a Compact State must have a separate license for each State in which they work. Advanced practice nursing licenses are not part of the Compact model in any state. An estimated 824,662 RNs live in a Compact State (Table 3-22). Of these, 96 percent live and work in the same State, 1.6 percent work in a different State that is part of the Compact, and 2.4 percent work in a State different from that in which the nurse lives, which is not a Compact State.  Table 3-22. Licensure in a Compact State, by where registered nurses live and work  Number 791,444 13,537 19,681 824,662 Percent 96.0 1.6 2.4 100.0  Live and work in same Compact State Live in one Compact State and work in another Compact State Live in a Compact State and work in non-Compact State Total  Source: 2008 National Sample Survey of Registered Nurses  3.13  Unionization in Principal Nursing Positions  Table 3-23 presents unionization by employment setting for registered nurses \' principal nursing positions. Among RNs who work in hospital settings, 18.6 percent are unionized. Unionization is most prevalent among RNs whose principal positions are in school health (40.4 percent), public health (26.0 percent), and academic education (19.2 percent). This is consistent with the comparatively high rate of unionization in school systems, among academic faculty, and among public sector and government employees.  3-37  The Employment of Registered Nurses  3  Table 3-23.  Unionization, by employment setting*  Unionized (percent) 18.6 5.8 19.2 5.9 26.0 40.4 6.0 7.3  Employment setting Hospital Nursing home/extended care Academic education Home health Public/community health** School health Ambulatory care Other***  **Public/community health includes occupational health. ***Other includes insurance/benefits/utilization review. Source: 2008 National Sample Survey of Registered Nurses  *Only registered nurses who provided employment setting information are included in the calculations used for this table.  3.14  Earnings of Registered Nurses  Average annual earnings for full-time employed RNs were  66,973 in 2008, rising 15.9 percent since the 2004 average of  57,785 (Figure 3-17 and Appendix A, Table 32). When annual earnings are adjusted for inflation using the Consumer Price Index (CPI), earnings in 2008 were  26,826, which is only a 1.7 percent increase from average real (inflation-adjusted to a 1980 base) 2004 earnings of  26,366. Thus, growth in earnings of full-time RNs between 2004 and 2008 only slightly outpaced inflation. Total annual earnings from nursing work are closely associated with the total number of hours RNs work per year in principal and secondary positions (Table 3-24). In general, total earnings from all nursing positions increase with the number of hours worked in these positions, up to 3,500 hours per year.  3-38  The Employment of Registered Nurses  3  Figure 3-17.  Actual and inflation-adjusted  real  average earnings for full-time registered nurses in their principal nursing position*  Salary 80,000 70,000 60,000 50,000 42,071 40,000 30,000 20,000 10,000 0 1980 1984 1988 1992  Actual Salary  66,973 57,785 46,782 37,738 28,383 23,505 17,398 17,398 19,079 20,839 23,166 23,103 23,369 26,366 26,826  1996  Real Salary  2000  2004  2008  *Only registered nurses who provided earnings information are included in the calculations used for this figure. Source: 1980-2008 National Sample Survey of Registered Nurses  Table 3-24.  Average annual earnings from all nursing positions, by total number of hours worked per year in all nursing positions*  Average annual earnings 13,850 26,271 42,582 58,140 68,327 80,537 92,254 85,117 93,865  Hours per year 1 to 499 hours 500 to 999 hours 1,000 to 1,499 hours 1,500 to 1,999 hours 2,000 to 2,499 hours 2,500 to 2,999 hours 3,000 to 3,499 hours 3,500 to 3,999 hours More than 4,000 hours  *Only registered nurses who provided earnings information are included in the calculations used for this table. Source: 2008 National Sample Survey of Registered Nurses  3-39  The Employment of Registered Nurses  3  3.14.1  Earnings and Job Titles  The average annual earnings of full-time RNs are reported by job title in Table 3-25 and Appendix A, Table 30.    The highest earnings are reported by nurse anesthetists, who average  154,221 per year. The lowest earnings are reported by patient educators, at  59,421 per year. Staff nurses earn  61,706 per year, on average. Nurse practitioners average  85,025 per year, while nurse midwives average  82,111. RNs whose positions involved instruction of health professions students average  65,844 per year.  Average annual earnings, by job title of principal nursing position, for registered nurses working full-time*  Average annual earnings 61,706 78,356 72,006 74,799 96,735 154,221 72,856 82,111 85,025 59,421 65,844 62,978 75,242 76,473 67,491 65,009 64,003 66,973  Table 3-25.  Job title Staff nurse Management/administration First-line management Middle management Senior management Nurse anesthetist Clinical nurse specialist Nurse midwife Nurse practitioner Patient educator Instruction Patient coordinator Informatics nurse Consultant Researcher Surveyor/auditor/regulator Other** Total  *Only registered nurses who provided earnings and job title information are included in the calculations used for this table. **Other job title includes registered nurses for whom job title is unknown. Source: 2008 National Sample Survey of Registered Nurses  3-40  The Employment of Registered Nurses  3  3.14.2  Earnings and Employment Setting  Earnings of RNs vary across the setting of their principal nursing position (Table 3-26 and Appendix A, Table 31).  RNs who work full-time in hospitals earn an average of  69,079 per year and staff nurses in hospitals earn an average of  63,809 per year. The setting with the lowest average pay for full-time RNs is school health service, although this may be because school health RNs typically work only an academic year rather than a full calendar year.  Average annual earnings, by employment setting of principal nursing position, for registered nurses working full-time*  Overall average 69,079 61,507 66,701 63,490 60,580 47,851 65,947 65,976 67,897 72,750 66,973 Staff nurse 63,809 54,239 66,542 59,289 55,708 46,416 62,086 55,657 61,370 67,660 61,706    Table 3-26.  Employment setting Hospital Nursing home/extended care facility Academic education program Home health setting Public or community health setting School health service Occupational health Ambulatory care setting (not hospital) Insurance claims/benefits/utilization review Other** Total  *Only registered nurses who provided earnings and setting information are included in the calculations used for this table. **Other employment setting includes registered nurses for whom employment setting is unknown. Source: 2008 National Sample Survey of Registered Nurses  3.14.3  Earnings From Secondary Jobs  Secondary nursing positions are held by 12.6 percent of RNs employed in nursing. Appendix A, Table 19 presents details about the earnings of RNs in their principal and secondary nursing positions, according to whether they hold only one nursing job or multiple nursing jobs.  RNs who work full-time in their principal position and have multiple nursing jobs earn more in their principal position ( 68,618) than do RNs who do not have multiple jobs ( 66,742).  3-41  The Employment of Registered Nurses  3  Average earnings in secondary positions are  15,201 for RNs whose principal position is full-time and  13,392 for those with a part-time principal position.  These data indicate that RNs who hold multiple positions earn more overall and in their principal positions. The reasons for this are not known based on 2008 NSSRN data findings. RNs with two or more positions earn an average of  74,894 annually from all nursing jobs. For those whose principal position is full-time, the average for all earnings is  83,818 per year.  3.14.4  Earnings and Experience  RNs employed full-time receive higher earnings from their principal nursing position as they gain experience up to 30 years (Table 3-27). However, after 30 years of experience, average annual earnings decline, largely due to older RNs working fewer hours. Nonetheless, earning differentials based on years of experience are relatively modest. RNs at the height of their earning potential with 30 years experience earn, on average, only  19,281 more than RNs with less than 5 years experience.  Table 3-27. Average annual earnings for registered nurses working full-time in their principal nursing position, by years since initial nursing education*  Average annual earnings 56,118 65,604 67,212 69,388 71,216 75,399 73,733 71,551 70,358  Years since initial nursing education Less than 5 years 6 to 10 years 11 to 15 years 16 to 20 years 21 to 25 years 26 to 30 years 31 to 35 years 36 to 40 years More than 40 years  Source: 2008 National Sample Survey of Registered Nurses  *Only registered nurses who provided earnings information are included in the calculations used for this table.  3.14.5  Earnings and Education  The highest nursing or nursing-related education level of RNs is associated with job titles and subsequent earnings. Some RNs with graduate degrees earn substantially more than do other nurses (Table 3-28 and Appendix A, Table 32). In part, they earn more because they command high earnings when they hold management job titles or are in advanced specialties. The earnings of RNs  3-42  The Employment of Registered Nurses  3  who work as faculty are somewhat less than other RNs with advanced degrees. RNs working as faculty are discussed further in Chapter 4.  RNs with graduate degrees earn an average of at least  20,000 more than do RNs with other levels of education. Staff nurses with graduate degrees average about  6,000 more than other staff RNs. Diploma RNs earn, on average, more than ADN nurses but not more than bachelor \'s degree RNs for the same job titles.  Average annual earnings of registered nurses working full-time in their principal nursing position, by highest nursing or nursing-related education and job title*  Job title Diploma 65,349 63,027 68,089 74,090 62,693 Associate degree 60,890 59,310 66,138 69,871 60,240 Bachelor \'s degree 66,316 63,382 75,144 79,878 64,068 Master \'s/ doctorate 87,363 69,616 85,473 101,730 71,516 Overall average 66,973 61,706 72,006 81,391 62,978   Table 3-28.  All nurses Staff nurse First-line management Senior/middle management Patient coordinator  *Only registered nurses who provided earnings and job title information are included in the calculations used for this table. Source: 2008 National Sample Survey of Registered Nurses  3.15  Job Satisfaction  The 2004 and 2008 surveys asked RNs to report their satisfaction with their principal job. In 2008, 29.3 percent of RNs reported that they were extremely satisfied with their principal nursing position, compared with 27.5 percent in 2004. In 2004, 50.5 percent where moderately satisfied while in 2008, 51.8 percent were moderately satisfied (Figure 3-18). Only 11.1 percent were dissatisfied in 2008, compared with 13.8 percent in 2004. While the differences from 2004 to 2008 are small, RN job satisfaction may be somewhat improved.  3-43  The Employment of Registered Nurses  3  Figure 3-18.  100%  Job satisfaction of registered nurses*  90% 27.5% 80% 29.3%  70%  60%  50% 50.5% 51.8% 40%  30%  20% 8.2% 7.8% 10% 10.9%  8.6% 2.5% 2008 Moderately dissatisfied Extremely satisfied Neither satisfied nor dissatisfied  0%  2.9% 2004  Extremely dissatisfied Moderately satisfied  * Only registered nurses who provided job satisfaction information are included in the calculations used for this figure. Source: 2004-2008 National Sample Survey of Registered Nurses  3-44  The Employment of Registered Nurses  3  3.15.1  Job Satisfaction and Employment Setting  Employment setting is associated with overall satisfaction. Appendix A, Table 33 presents satisfaction ratings for RNs according to the setting of their principal nursing position. Figure 3-19 provides data for the most common employment settings.  Registered nurses who work in academic education programs, ambulatory care, and home health settings, although paid less than RNs in other settings, reported the highest rates of job satisfaction (86.6 percent, 85.5 percent, and 82.8 percent, respectively). Working in nursing homes/extended care was associated with the lowest rate of RNs being moderately or extremely satisfied with their work (74.5 percent). These RNS also reported the most dissatisfaction with their work (moderate or extreme dissatisfaction at 16.9 percent; extreme dissatisfaction at 4.8 percent). Almost 12 percent of RNs employed in hospitals reported moderate or extreme dissatisfaction (11.8 percent).    3.15.2  Job Satisfaction and Job Titles  Registered nurses \' satisfaction with their jobs also varies with their job title. Appendix A, Table 34 provides information for all job titles; Figure 3-20 provides data for the largest groups.  Staff nurses were less likely to report that they were moderately or extremely satisfied than RNs with other job titles. Being  extremely satisfied  was reported more often by RNs in senior or middle management (39.2 percent) or other job titles (40.2 percent). The  other job titles  category includes advanced practice fields and education. Moderate or extreme dissatisfaction was reported more often by RNs in first-line management positions (12.3 percent) and staff nurses (12 percent).  Extremely dissatisfied  was reported more often by RNs in senior or middle management positions (2.9 percent).      These data suggest that RNs in positions of the most autonomy and agency, middle managers, faculty, and advanced practice registered nurses, were most likely to be extremely satisfied with their jobs. Staff nurses were least likely to be fully satisfied with their positions.  3-45  The Employment of Registered Nurses  3  Figure 3-19.  100%  Job satisfaction, by employment setting of principal nursing position*  90% 25.9% 26.0% 34.4% 80% 32.5% 35.7% 38.5% 38.8%  70%  60%  50% 53.9%  48.5%  50.3% 40% 52.2% 49.0% 47.0% 42.7%  30%  20% 8.3%  8.6%  6.9% 10% 9.3% 2.5% Hospital 4.8% 6.1% 2.6% Home health 12.1% 6.0% 7.7% 7.1% 5.8% 7.0%  9.4%  6.0% 2.3% Public/ community  health**  6.6% 2.6%  0%  Nursing home/  Academic  extended care education  program  Ambulatory  care  Other***  Extremely dissatisfied Moderately satisfied  Moderately dissatisfied Extremely satisfied  Neither satisfied nor dissatisfied  *Only registered nurses who reported employment setting information are included in the calculations used for this figure. Percents may not add to100 due to the effect of rounding. **Public/community health includes school and occupational health. ***Other includes insurance, benefits, and utilization review, and other settings. Source: 2008 National Sample Survey of Registered Nurses  3-46  The Employment of Registered Nurses  3  Figure 3-20.  100%  Job satisfaction, by job title in principal nursing position*  90% 25.3% 31.0% 80% 39.2% 31.3% 40.2%  70%  60%  50%  53.8% 49.2% 50.9% 45.7% 47.6%  40%  30%  20% 8.9% 10% 9.4% 0% Staff nurse Extremely dissatisfied Moderately satisfied Firstline  management Senior/middle  management Patient coordinator Other position titles Neither satisfied nor dissatisfied 9.8% 7.6% 8.0% 7.5% 4.6% 7.5% 5.0% 5.6%  Moderately dissatisfied Extremely satisfied  *Only registered nurses who provided job title information are included in the calculations used for this figure. Source: 2008 National Sample Survey of Registered Nurses  3-47  The Employment of Registered Nurses  3  3.15.3  Job Satisfaction and Age  RN satisfaction generally increases with age (Figure 3-21 and Appendix A, Table 35). This may be because those who are dissatisfied have changed to positions or employment situations which are more satisfying for them.  The percentage of employed RNs who are extremely satisfied continues to increase with age through age 74 years. The percent of employed RNs who are moderately to extremely satisfied averages around 78 percent for RNs under 35 years old. It averages about 80 percent for RNs who are ages 35 to 49 years. About 82 percent of RNs in their 50s report that they are moderately to extremely satisfied, and after age 60 job satisfaction rises to more than 85 percent. Moderate and extreme dissatisfaction is greatest between ages 40 and 50, averaging 12.4 and 12.5 percent, respectively.    This should not necessarily be interpreted to mean that age is a factor in job satisfaction. Rather, perhaps young RNs or recent graduates who are dissatisfied with a position may change jobs until they find a position that is more satisfactory. Registered nurses who cannot find a satisfactory position may leave nursing altogether.  3.15.4  Job Satisfaction and Education  Figure 3-22 and Appendix A, Table 36 present data on RNs \' job satisfaction according to their highest nursing or nursing-related education.  RNs with graduate-level education report the highest rates of being extremely satisfied (39.2 percent). A high percentage of diploma-educated RNs (31.4 percent) are extremely satisfied; diploma-educated RNs also tend to be older than other nurses, and age is correlated with satisfaction. RNs with ADNs most often report being moderately to extremely dissatisfied (13.1 percent).    3-48  The Employment of Registered Nurses  3  Figure 3-21.  Job satisfaction of registered nurses employed in nursing, by age  100%  18.6%  22.1%  22.2%  25.7%  25.2% 30.2% 31.4% 34.3% 37.8% 46.8% 57.2% 54.7%  80%  60%  59.9%  56.1%  56.8% 55.5%  54.0% 50.2% 50.6% 47.7% 46.7% 42.5% 29.6% 38.1%  40%  20%  9.9% 11.1% 9.1% 8.5% 8.5% 7.1% 6.8% 8.9% 6.7% 8.3% 6.3% 6.8% 5.4% 7.0% 4.5%  9.8%  9.1%  9.3%  8.0%  9.7%  9.6%  0% Less than  2529 25 3034 3539 4044 4549 5054 5559 6064 6569 7074  Age group  Moderately dissatisfied Extremely satisfied  75 and  over  Extremely dissatisfied Moderately satisfied  Neither satisfied nor dissatisfied  Source: 2008 National Sample Survey of Registered Nurses  3-49  The Employment of Registered Nurses  3  Figure 3-22.  Job satisfaction of registered nurses employed in nursing, by highest nursing or nursing-related education*  100% 90% 31.4% 80% 70% 60% 50% 40% 30% 20% 6.9% 10% 7.3% 0% Diploma Associate degree Bachelor \'s degree Master \'s/ doctorate Highest nursing or nursingrelated education  Extremely dissatisfied Moderately satisfied Moderately dissatisfied Extremely satisfied Neither satisfied nor dissatisfied  26.1%  28.4% 39.2%  51.9% 51.9%  52.9% 48.1%  8.9% 10.1%  8.1% 4.5% 8.5% 6.1%  *Only registered nurses who provided information on education preparation are included in the calculations used for this figure. Source: 2008 National Sample Survey of Registered Nurses  3-50  The Employment of Registered Nurses  3  3.16  Job Changes of Registered Nurses  The 2008 NSSRN asked RNs to provide information about their employment status in 2007. Nearly 80 percent of RNs were employed in nursing in both 2007 and 2008 (Figure 3-23). Another 12.3 percent were not employed in nursing in either year. Nearly 3 percent were employed in nursing in 2007, but not in 2008. Conversely, 2.4 percent were employed in 2008 but had not been employed in 2007. Of those who were employed in 2007 but not in 2008, 27.3 percent (24,430) reported that they stopped working due to retirement. A group comprising 2.5 percent of RNs graduated in 2007 or 2008 and was employed only in 2008. These data indicate that departures from nursing work are often short-lived. Table 3-29 provides more information about principal nursing employment in 2008 compared with 2007.  Among RNs who worked full-time in 2007, 91.5 percent continued to work full-time in 2008. Another 5.8 percent worked part-time in 2008. Among RNs who worked part-time in 2007, 82.9 percent continued to work part-time in 2008, while 11.2 percent changed to full-time work.    Employment changes of RNs who were employed in both 2007 and 2008 are described in Table 330 and Appendix A, Table 37. Many RNs change positions and employers from year to year.  Among RNs who worked full-time in 2007, 11.6 percent changed employer by 2008. Another 6.5 percent worked with the same employer but held a different position. Among RNs who worked part-time in 2007, 9.7 percent changed employers. These data suggest that part-time RNs are slightly less likely to change employers or positions than are full-time RNs.    Appendix A, Table 38 presents the employment settings of RNs in 2008 as compared with 2007. Among RNs employed in hospital settings in 2008, 90.8 percent had been employed in a hospital in 2007. However, other settings draw many RNs from hospitals. For example, while 82.5 percent of RNs employed in home health in 2008 had worked in that setting in 2007, 7.9 percent had worked in a hospital in 2007. Among RNs employed in ambulatory care in 2008, 8.2 percent had worked in a hospital in 2007.  3-51  The Employment of Registered Nurses  3  Figure 3-23.  Comparison of employment status of registered nurse population in 2007 and 2008  Not employed 2007 or  2008 12.3% New graduate  (2007/2008) 2.5% Employed 2008 only 2.4%  Employed 2007 only 2.9%  Employed 2007 and  2008 79.9%  Source: 2008 National Sample Survey of Registered Nurses  Table 3-29.  Employment status in 2008, compared with status in 2007  Year 2007 employed in nursing full-time (number) 1,753,305 110,737 52,628 Year 2007 employed in nursing full-time (percent) 91.5 5.8 2.7 Year 2007 emp
