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Take Note – June 2007


Nursing V.P. receives Lifetime Achievement Award from AONE 
Linda Burnes Bolton, DrPH, RN, FAAN, Vice President and Chief Nursing Officer at Cedars-Sinai Health System in Los Angeles, has received the American Organization of Nurse Executives (AONE) 2007 Lifetime Achievement Award. Burnes Bolton has been the chief nursing officer at Cedars-Sinai since 1994. She has been a staff nurse, clinical nurse specialist, public member of government advisory boards, healthcare executive, community and public health nurse, university faculty, and consultant.

Burnes Bolton has dedicated her career to improving access to health care for all members of society and to advancing nursing practice. As founder of the Geri and Richard Brawerman Nursing Institute at Cedars-Sinai, she oversees development of educational programs in collaboration with nursing schools to increase the supply of nurses, supports research and innovation to improve clinical outcomes, and creates outreach programs to inform students about nursing careers.

To honor Burnes Bolton, the AONE Institute for Patient Care Research and Education is accepting donations in her name for the 2007 calendar year. To make a donation, visit


New study fails to shed light on whether timing of HRT initiation affects CHD risk  
Does starting hormone replacement therapy (HRT) closer to menopause carry less cardiovascular risk than starting it later? A new data analysis from the Women’s Health Initiative provides no clear answer.

It links HRT to a nonsignificant decrease in risk for coronary heart disease (CHD) in women who started therapy within 10 years of menopause—but also to an increased CHD risk in women who started therapy 10 to 19 years, or 20 or more years after menopause. On the other hand, the study found HRT was associated with a statistically significant increased risk of stroke, regardless of age or time since menopause. Also, researchers noted a greater risk of myocardial infarction in women in their 60s and 70s who still had hot flashes and night sweats, even if they weren’t taking HRT; those taking HRT had an even higher risk. The authors believe their findings support current recommendations that HRT be used for short-term relief of moderate or severe vasomotor symptoms but not for longer-term CHD prevention.


Reduction in breast cancer incidence plateaus in 2004 
Breast cancer rates in the United States, which had fallen steeply in 2003, stayed low but didn’t decrease significantly further in 2004. Theses statistics, from an analysis of data from the National Cancer Institute (NCI), support the hypothesis that the drop in breast cancer incidence stemmed from decreased HRT use after results of the Women’s Health Initiative were published.

The NCI analysis, published in the New England Journal of Medicine, revealed that breast cancer rates fell by 6.7% in 2003 compared with 2002, but didn’t decrease significantly in 2004. The drop occurred only in women age 50 or older, and was much more dramatic for estrogen-receptor–positive than estrogen-receptor–negative tumors. Researchers believe the data are most consistent with a direct effect of HRT on preclinical disease, but cautioned that “this conclusion does not rule out some contribution from changes in screening mammography.”


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