Saturday, February 11, 2012

A Followup to the J&J article

Sarah (perrycare44@COMCAST.NET) wrote as a followup on the J&J thread: When I spoke with the lady on the phone

she was pretty focused on students. It seemed to me that students have been defined as the future. The picture I got was one of

them not being able to do much about jobs, or what hospitals do,so they are putting their efforts and their money into students.

I tried to get my point across about the fact that I couldn't really tell much from the website or their published annual reports. I had

seen the two most recent annual reports, which seemed to be talking about very soft things and reporting their survey
information in vague terms e.g. "almost half" of RNs, blah blah blah. I tried to point out to her that if nursing education

is really their focus then they might think about using data to report on their the results of the project.

For her part, she expressed regret that I had used a negative report in talking about J&J on this listserv. She directed

me to the Peter Beurhaus reports, which are archived and which I ought to be able to find in an internet search,
if I wanted the hard data. She expressed the point of view of J&J as a company that does not do a lot of chest thumping about the great things they are doing.

I still encourage the students on the list to go to the RWJF website and the the
NSNA website to look for some of the $18million dollars in scholarship money
that J&J has raised. Sarah

Friday, February 10, 2012

From NurseNet.... All about J&J

perrycare44@COMCAST.NET (Sarah) wrote:

About a week or so ago I sent a request to J&J for Progress reports, the two latest ones, about their "Future of Nursing" campaign. They have arrived and I was almost shocked to see how little they have to report. What they call progress amounts to a lot feel good reports of distribution of pamphlets, T-shirts, advertising and facebook sorts of things. If I were not a nurse I might feel good about J&J and what they are doing for nursing. But I am a nurse, so I was looking for something tangible. I thought I had found it when they talked about the money they raised for scholarships. So I went to the www.discovernursing.com website, as directed, and found stories about scholarships, links to other scholarship sites and nothing (perhaps I didn't pursue it hard enough) that linked me to a site where I could actually learn about how to apply for a scholarship. The website is not exactly well-maintained. Every page started with a "sorry" message telling me that if the graphics aren't working I should click on the link, which took me to another page that said "sorry". So, I'm not sure if the sorry messages would have once led me to more information, but today they do not. At any rate, J&J says they have raised more than $15 million in nursing scholarships, but I can't find the links to apply. I encourage students on the list to visit the site and see if they can find some money. If you find it, please apply for some of it.
One article in the report says that nursing satisfaction has improved since 2002, but does not indicate how they know that. There are no numbers in this article. In fact there are no numbers in this book except as they relate to how many dollars, how many visits to J&J websites, how many t-shirts (100K) or bumper stickers (350K) they have distributed. But when they talk about nurses and their evaluation of their chosen profession they talk about nurses in magnet hospitals being more likely to recommend nursing as a profession (how much more?) and nurses in understaffed hospitals being less satisfied (how much less?). And nurses have not really changed in the way they rate their relationships with doctors and other nurses (about half call that relationship very good or excellent) since 2002.

So after looking at their material I still have basically the same question I had in the first place -- what has the campaign done for nursing? Well, besides developing an iPhone app called Happy Nurse.
I always have thought J&J were in our corner....shows just how wrong I have been !
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PARADIGM BYTES
Newsletter for Paradigm 97
February 10, 2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT


We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.

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SNIPPET
FATIGUE:
The link between health care worker fatigue and adverse events is well documented, with a substantial number of studies indicating that the practice of extended work hours contributes to high levels of worker fatigue and reduced productivity. These studies and others show that fatigue increases the risk of adverse events, compromises patient safety, and increases risk to personal safety and well-being. While it is acknowledged that many factors contribute to fatigue, including but not limited to insufficient staffing and excessive workloads, the purpose of this Sentinel Event Alert is to address the effects and risks of an extended work day and of cumulative days of extended work hours.The impact of fatigue
Fatigue resulting from an inadequate amount of sleep or insufficient quality of sleep over an extended period can lead to a number of problems, including:
• lapses in attention and inability to stay focused
• reduced motivation
• compromised problem solving
• confusion
• irritability
• memory lapses
• impaired communication
• slowed or faulty information processing and judgment
• diminished reaction time
• indifference and loss of empathy6

Contributing factors to fatigue and risks to patients
Shift length and work schedules have a significant effect on health care providers’ quantity and quality of sleep and, consequently, on their job performance, as well as on the safety of their patients and their individual safety. This fact has been borne out in numerous studies. Findings from a groundbreaking 2004 study of 393 nurses over more than 5,300 shifts – the first in a series of studies of nurse fatigue and patient safety – showed that nurses who work shifts of 12.5 hours or longer are three times more likely to make an error in patient care.7 Additional studies show that longer shift length increased the risk of errors and close calls and were associated with decreased vigilance,7 and that nurses suffer higher rates of occupational injury when working shifts in excess of 12 hours.8 Still, while the dangers of extended work hours (more than 12 hours) are well known, the health care industry has been slow to adopt changes, particularly with regard to nursing.
“An overwhelming number of studies keep saying the same thing – once you pass a certain point, the risk of mistakes increases significantly,” says Ann Rogers, Ph.D., R.N., FAAN, a nationally renowned sleep medicine expert with Emory University’s Nell Hodgson Woodruff School of Nursing. “We have been slow to accept that we have physical limits and biologically we are not built to do the things we are trying to do.”

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FROM A MEMBER

(This was submitted by Wendie (whowland@howlandhealthconsulting.com) who writes: " Seems this increases the evidence for physical (as opposed to strictly psychological) mechanisms for PTSD."

Stellate Ganglion Blockade Shows Promise as Effective, Durable Treatment for PTSD April 30, 2010 — Case reports of immediate, durable, and significant reductions in symptoms of posttraumatic stress disorder (PTSD) are now appearing in the literature following the use of stellate ganglion block (SGB) in severe PTSD unresponsive to medical intervention. A report of 2 PTSD patients who were successfully treated with SGB was published online April 20 in Pain Practice.
Sean Mulvaney, MD, Consortium for Health and Military Performance, Uniformed Service University, Bethesda, Maryland, and colleagues reported the successful use of SGB in 2 patients with symptoms of PTSD. Before receiving the SGB, pretreatment scores on the Posttraumatic Stress Disorder Checklist (PCL) were 76 of a maximum score of 85 for the first patient and 54 in the second patient.
After SGB blockade with ropivacaine delivered at the level of the sixth cervical vertebra on the right side, 1 patient indicated that global feelings of anxiety improved from a pre-SGB level of 8 of 10 to a 2 of 10 after the procedure. Post-SGB PCL scores for the second patient decreased to 24, with the minimum score being 17. ...
http://www.medscape.com/viewarticle721079
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MEDICAL NEWS

UMDNJ, Settle Lawsuit Regarding Moral Objections to Assisting at Abortions

Twelve New Jersey nurses working on the same-day services (SDS) unit of the University Hospital in Newark, New Jersey, filed suit on October 31, 2011, against the University of Medicine and Dentistry of New Jersey (UMDNJ), alleging that the institution's officials demanded that the nurses assist in abortions, despite their religious and moral objections, or their employment would be terminated. In what was to be a public hearing of oral arguments and rebuttals for both sides on December 22, 2011, the attorneys instead reached a settlement in New Jersey's U.S. District Court. ...
http://journals.lww.com/ajnonline/Fulltext/2012/02000/Nurses,_UMDNJ,_Settle_Lawsuit_Regarding_Moral.7.aspx

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INTERESTING READING


Please remember that the REUTERS articles usually good for only 30 days


The Relationship Between Body Mass Index and 30-Day Mortality Risk, by Principal Surgical Procedure.
To examine the relationship between body mass index (BMI) calculated as weight in kilograms divided by height in meters squared) and 30-day mortality risk among patients in the participant use data file database
of the American College of Surgeons National Surgical Quality Improvement Program. Obesity is a prevalent chronic disease in the
United States, and general and vascular surgeons are caring for an increasing population of obese patients.

Multivariable logistic regression analysis was used to assess the statistical significance of the relationship between BMI and mortality, with adjustments for patient-level differences in overall mortality risk and principal operating procedures. Odds ratios with 95% CIs were calculated to measure the relative difference in mortality by BMI quintile, with reference to the middle quintile of the BMI. The overall significance of the BMI and of the other covariates was measured using the Wald χ(2) test statistic. A separate multivariable logistic regression model was developed to assess the significance of the interaction between BMI and primary procedure. ... http://www.ncbi.nlm.nih.gov/pubmed/22106249

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(Thank you, Barbara) The Norovirus is behind 18% of outbreaks in U.S. hospitals A study in the American Journal of Infection Control found that norovirus was the most common cause of infection outbreaks, causing 18.2% of all outbreaks in U.S. hospitals in 2008 and 2009. Researchers
noted that 65% of hospital unit closures over the same period were attributed to norovirus. The three next most common causes of outbreaks were Staphylococcus aureus, Acinetobacter spp and Clostridium difficile.
Nurse.com (1/31) http://news.nurse.com/article/20120131/NATIONAL02/102130001

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Study endorses HPV testing for all women over 30 New DNA tests looking for the virus responsible for most cases of cervical cancer make sense for all women aged 30 or over, since they can prevent more cases of cancer than smear tests alone, Dutch researchers said on Thursday.
Results of a five-year study involving 45,000 women provided the strongest evidence yet in favor of using human papillomavirus (HPV) testing, Chris Meijer and colleagues from the VU University Medical Centre in Amsterdam reported in The Lancet Oncology.
Most cases of infection with the sexually transmitted virus are cleared naturally by the immune system, but persistent infection with certain HPV strains can lead to cervical cancer.

In recent years, tests for these "high-risk" strains have been developed by companies including Roche and Qiagen.
The new tests are known to work well in detecting HPV, but the Dutch study is the first to show they are better than Pap smears alone over two screening rounds set five years apart. ... http://in.reuters.com/article/2011/12/15/us-hpv-idINTRE7BE00320111215
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RANDOM FACTS: The Conquistadors that conquered South America and Mexico during the 1500's came from Spain bringing horses and early guns known as Arquebus'; neither of which had yet reached the Americas.
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Before they were demolished, the Incas of South America made the grave mistake of underestimating the Conquistadors, who's 150 or so explorers were dwarfed by 80,000 Inca warriors. The Inca chief considered them fools for wearing cooking pots on their heads (actually steel helmets).
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Infant acetaminophen in new concentration. The new 160mg/5mL (32mg/mL) infant acetaminophen concentration has been arriving in hospitals, retail pharmacies, and stores, although manufacturers may not be providing notification about the change. Last spring,manufacturers announced a voluntary reformulation of the former 80 mg/0.8mL (100mg/mL) infant drops. All liquid acetaminophen for children under the age of 12 is now in the 160mg/5mL (32mg/mL) strength to make it easier for parents and caregivers to avoid dosing errors. http://www.ismp.org/newsletters/nursing/issues/NurseAdviseERR201112.pdf
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I am a Nurse To most of us, we believe it is a natural call on duty. To many of us, it is more than an art or a science, it is a way of life. To a few in the wrong career, it is a job that makes their ends meet. Nursing takes more than just scoring a 4.0 GPA in prerequisites, tough school work and sleepless nights preparing care plans for patient, night before clinical/practical days.
Guinness book of world record has ranked bachelors of nursing as one of the toughest courses I the world, above medicine, engineering and architecture. This just explains that nurses are not average performers but high functioning scholars. Beyond being high functioning, nurses must have strong social, political, cultural and religious skills that equip them with skills to deal with all lows and highs of life.
Nursing pub is a place where nurses from all over the world share stories, experiences, and tips to the world about who we are. Besides stories, nurses at nursing pub offer health tips, answer public questions that may help make better health related decisions. ... (In my opinion, this article says it all)
http://nursingpub.com/i-am-a-nurse
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Understanding Acute Myocardial Infarction Biomarkers Heart attack, MI & AMI are common terms you might have heard all being associated to the heart. Each nursing or any medical care provider ought to be able to recognize myocardial infarction and take action as soon as possible because it is a life threatening emergency. Time and speed saves heart muscle damage.
Acute myocardial infarction (AMI) is a medical emergency requiring immediate hospitalization; patients suspected of having AMI should be admitted immediately to the coronary or intensive care unit for evaluation and potentially life-saving treatment. (Do you know how AMI is treated? Please tell us in comments section below)
The clinical presentation of AMI is characterized by chest pain, ECG changes, and serial elevation of cardiac biomarkers. (Do you know specific ECG/EKG changes indicate myocardial infarction? Tell us in comments section)
Serum cardiac enzymes and specific cardiac biomarkers may be elevated, indicating cardiac muscle damage, ischemia, necrosis, thereby aiding in the diagnosis of AMI. ...
http://nursingpub.com/understanding-acute-myocardial-infarction-biomarkers
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Mutations in 2 Genes Linked to Rare Autism-Related Disorder --- Research sheds light on Joubert syndrome, which causes physical and mental disabilities
THURSDAY, Jan. 26 (HealthDay News) -- Newly discovered mutations in two adjacent genes cause a rare genetic brain condition called Joubert syndrome, according to a new study.
People with Joubert syndrome have malformation or underdevelopment of the cerebellum and brainstem, resulting in a range of physical and mental disabilities such as poor muscle control and mental retardation.
As many as four in 10 people with Joubert syndrome meet the criteria for an autism diagnosis and other neurocognitive disorders, according to background information in a news release about the research.
In the study, a team led by University of California, San Diego School of Medicine researchers found that mutations in two adjacent genes -- TMEM216 and TMEM138 -- cause Joubert syndrome. ...
http://www.nlm.nih.gov/medlineplus/news/fullstory_121239.html
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HIV ‘saliva’ test as effective as blood test, study finds
Canadian researchers who analyzed data from five global databases found that a saliva test was as effective as the standard blood test in diagnosing HIV virus among high-risk populations, and was about 97% accurate among low-risk populations. The oral bluid test can produce results in about 20 minutes compared with about two weeks for the traditional blood test.
A rapid oral test that collects mouth fluids to diagnose HIV is nearly as accurate as traditional blood tests and could help to curb the global HIV/AIDS epidemic, a new study has found.
In a study published Tuesday in The Lancet Infectious Diseases, a group of researchers, led by the Research Institute of the McGill University Health Centre, compared field research studies from five global databases of two rapid test methods — blood tests and an oral fluid test, OraQuick HIV ½.
Researchers found that the oral test was just as effective as the blood test in detecting the virus among high-risk adult populations (injection drug users, men who have sex with men and people having unprotected sex) — and about 97 per cent effective for low-risk populations.
“If you’re really talking about bringing the virus to its knees . . . the oral test is one more way for people to find out their status,” said Dr. Nitika Pant Pai, a McGill medical scientist and the study’s lead author. ...

http://www.thestar.com/news/article/1121379
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RANDOM FACTS: Rainforests only cover about 7% of Earth's surface, but they are home to 50% of the plant and animal species on
the planet. Also: Burning rainforests accounts for roughly 30% of the carbon dioxide releases in the air.
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FDA approves new treatment for most common type of skin cancer Today, Erivedge (vismodegib) was approved by the U.S. Food and Drug Administration to treat adult patients with basal cell carcinoma, the most common type of skin cancer. The drug is intended for use in patients with locally advanced basal cell cancer who are not candidates for surgery or radiation and for patients whose cancer has spread to other parts of the body (metastatic).
Erivedge, reviewed under the agency’s priority review program, is the first FDA-approved drug for metastatic basal cell carcinoma. Erivedge was reviewed under the FDA’s priority review program that provides for an expedited six-month review of drugs that may offer major advances in treatment. The drug is being approved ahead of the March 8, 2012 prescription user fee goal date.
Basal cell carcinoma is generally a slow growing and painless form of skin cancer that starts in the top layer of the skin (epidermis). The cancer develops on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation.
Erivedge is a pill taken once a day and works by inhibiting the Hedgehog pathway, a pathway that is active in most basal cell cancers and only a few normal tissues, such as hair follicles.
“Our understanding of molecular pathways involved in cancer, such as the Hedgehog pathway, has enabled the development of targeted drugs for specific diseases,” said Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research. “This approach is becoming more common and will potentially allow cancer drugs to be developed more quickly. This is important for patients who will have access to more effective therapies with potentially fewer side effects.”
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm289545.htm
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RANDOM FACT: According to a study by the American Journal of Public Health, adults who watch three hours of TV a day are more likely to be obese than those who keep it under an hour.
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RANDOM FACT: Soft drinks represent the largest single source of added sugars in the American diet. The average American will drink 54 gallons of soft drink a year.
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First patients shown to improve with embryonic stem cells (Reuters)
- Before treatment, the 51-year-old graphic artist was legally blind, unable to read a single letter on a standard eye chart. She has suffered from Stargardt's disease, the most common form of macular degeneration in young patients, since she was a teenager, and it was getting progressively worse.
A second patient, aged 78, suffered from dry macular degeneration -- the leading cause of blindness in the elderly -- and could not even see well enough to go shopping. ...
http://www.reuters.com/article/2012/01/24/us-stemcells-idUSTRE80M21R20120124?feedType=nl&feedName=ushealth1100
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FDA approves Kalydeco to treat rare form of cystic fibrosis Breakthrough therapy targets defective protein
The U.S. Food and Drug Administration today approved Kalydeco (ivacaftor) for the treatment of a rare form of cystic fibrosis (CF) in patients ages 6 years and older who have the specific G551D mutation in the Cystic Fibrosis Transmembrane Regulator (CFTR) gene.
CF is a serious genetic disorder affecting the lungs and other organs that ultimately leads to an early death. It is caused by mutations (defects) in a gene that encodes for a protein called CFTR that regulates ion (such as chloride) and water transport in the body. The defect in chloride and water transport results in the formation of thick mucus that builds up in the lungs, digestive tract and other parts of the body leading to severe respiratory and digestive problems, as well as other complications such as infections and diabetes.
CF, which affects about 30,000 people in the United States, is the most common fatal genetic disease in the Caucasian population. About 4 percent of those with CF, or roughly 1,200 people, are believed to have the G551D mutation.
“Kalydeco is an excellent example of the promise of personalized medicine – targeted drugs that treat patients with a specific genetic makeup,” said FDA Commissioner Margaret A. Hamburg, M.D. “The unique and mutually beneficial partnership that led to the approval of Kalydeco serves as a great model for what companies and patient groups can achieve if they collaborate on drug development.”
The FDA reviewed and approved Kalydeco in approximately three months under the agency’s priority review program that is designed to expedite the review of drugs. The priority review program uses a six-month review, instead of the standard 10 months, for drugs that may offer significant advances in treatment over available therapy. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm289633.htm
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MIAMI, Jan. 31 (UPI) -- Drinking diet soft drinks on a daily basis might increase the risk stroke, heart attack and vascular death, U.S. researchers said.
Hannah Gardener and colleagues from the University of Miami Miller School of Medicine and at Columbia University Medical Center in New York also found regular soft drink consumption and a more moderate intake of diet soft drinks do not appear to be linked to a higher risk of vascular events.
http://www.upi.com/Health_News/2012/01/31/Diet-soda-linked-to-stroke-heart-attack/UPI-44911328067236/#ixzz1l9VXba1u
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RANDOM FACTS: Adding three of four sugar cubes to a suitcase before storage will help prevent musty odors.
and
A spoonful of sugar added to a vase of water will prolong the life of freshly cut flowers.
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Researchers Spot Potential Bile Duct Cancer Drug Targets --- Mutations in two genes found in tumors appear to fuel their growth THURSDAY, Jan. 26 (HealthDay News) -- Researchers who identified a new genetic signature associated with bile duct cancer say their discovery could lead to targeted treatment for the deadly cancer.
The team at the Massachusetts General Hospital Cancer Center screened samples from 287 patients with gastrointestinal tumors and found that growth-enhancing mutations in two genes (IDH1 and IDH2) may account for nearly one-fourth of bile duct tumors that develop in the liver. Mutations in IDH1 were found in 13 percent of all bile duct tumors and in 23 percent of those within the liver itself. Mutations in IDH2 were less common. ... http://www.nlm.nih.gov/medlineplus/news/fullstory_121243.html
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CDC: Cancer Screening Below Target Rates
Jan. 26, 2012 -- Screening rates for breast, cervical, and colorectal cancer remain below target levels in the United States and are especially low among Asians and Hispanics, the CDC reports.
Screening rates for breast and cervical cancer have remained relatively stable over the past decade, with about 3 out of 4 eligible women receiving mammograms and 4 out of 5 having Pap tests to screen for cervical cancer. Target rates set by federal officials in the Healthy People 2020 initiative are 81% and 93%, respectively, for breast and cervical cancer screening. ... http://www.webmd.com/cancer/news/20120126/cdc-cancer-screening-below-target-rates
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Rate of Leg, Foot Amputations Among Diabetics Drops: CDC TUESDAY, Jan. 24 (HealthDay News) -- The rate of leg and foot amputations among diabetes patients aged 40 and older fell by 65 percent between 1996 and 2008, a new U.S. government study shows.
The analysis of data from the National Hospital Discharge Survey found that the rate of non-traumatic lower-limb amputations among adults with diagnosed diabetes was 3.9 per 1,000 in 2008, compared with 11.2 per 1,000 in 1996, according to the U.S. Centers for Disease Control and Prevention.
Non-traumatic lower-limb amputations are the result of circulatory problems that are common among people with diabetes, as opposed to traumatic amputations caused by injuries.
In 2008, the rate of diabetes-related leg and foot amputations was higher for men than women (6 versus 1.9 per 1,000) and higher for blacks than for whites (4.9 versus 2.9 per 1,000). Adults aged 75 and older had the highest rate (6.2 per 1,000) of all age groups. ... (I believe that nurses play a very large role in the observance and reporting of potential leg and foot wounds; they also play a vital role with the wound care of these wounds.)
http://www.nlm.nih.gov/medlineplus/news/fullstory_121142.html
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Examining Our Biases About Mental Illnesses “There's nothing really wrong with him, it's just anxiety.” How many times have you heard someone say this—or said it yourself? Mental health problems are among the most marginalized health conditions in the United States. They're viewed as less “real” than physical illnesses; there's no tumor to be palpated, no abnormality to be spotted on an X-ray. Emotional and psychological problems are often thought to be under a person's control in a way that, say, multiple sclerosis or cancer is not. And because mental health problems can be construed as signs of weakness, sufferers may hide their symptoms. People who suffer from a mental illness need to feel comfortable seeking care and to trust that they'll be treated with skill, compassion, and respect. This is vital: studies consistently find that mental illnesses, particularly depression, take a terrible toll on health. Such illnesses have been associated with an increased risk of stroke, coronary artery disease, and dementia, as well as increased mortality in people with cancer, diabetes, or chronic kidney disease and following a myocardial infarction or coronary artery bypass surgery. ... http://journals.lww.com/ajnonline/Fulltext/2012/02000/Examining_Our_Biases_About_Mental_Illnesses.1.aspx
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RANDOM FACT: Hawaii is the most isolated population center on the face of the earth. Hawaii is 2,390 miles from California; 3,850 miles from Japan; 4,900 miles from China; and 5,280 miles from the Philippines.

Also: Honolulu's zenith star, (the star that rises directly above it) is Arcturus. The Hawaiians called it Hokule'a. (Hoe koo lay uh.)

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The effects of psychoeducation and telephone counseling on the adjustment of women with early-stage breast cancer☆

Background
Throughout the illness trajectory, women with breast cancer experience issues that are related to physical, emotional, and social adjustment. Despite a general consensus that state-of-the-art treatment for breast cancer should include educational and counseling interventions to reduce illness or treatment-related symptoms, there are few prospective, theoretically based, phase-specific randomized, controlled trials that have evaluated the effectiveness of such interventions in promoting adjustment. ... http://www.appliednursingresearch.org/article/S0897-1897%2809%2900109-8/abstract?elsca1=etoc&elsca2=email&elsca3=0897-1897_201202_25_1&elsca4=saunders
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Chlamydia trachomatis Testing Sensitivity in Midstream Compared With First-Void Urine Specimens

Abstract

Traditionally first-void urine specimens are used to test for Chlamydia trachomatis. In contrast, midstream urine specimens are traditionally recommended for microscopy and culture of presumptive bacterial urinary tract infections. The ability to test for both C trachomatis and urinary tract infection on a single midstream urine specimen would greatly aid clinical practice, as an urinary tract infection is an extremely common complaint in primary care. This study set out to determine how well positive C trachomatis results obtained on first-void specimens would correlate with positive findings in matched midstream specimens. ...
http://www.annfammed.org/content/10/1/50.full

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RANDOM FACTS: At the age of thirty-five, Martin Luther King, Jr., was the youngest man to have received the Nobel Peace Prize.

Martin Luther King Jr. Day was not officially observed in all 50 states until January, 2000.
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Owner and Employee of Miami Home Health Company Plead Guilty in $22 Million Health Care Fraud Scheme
WASHINGTON – The owner and an employee of a Miami health care agency pleaded guilty for their participation in a $22 million home health Medicare fraud scheme, the Department of Justice, the FBI and the Department of Health and Human Services (HHS) announced today.
Marietha Morales, 38, pleaded guilty on Jan. 24, 2012, before U.S. District Judge Seitz to one count of conspiracy to commit health care fraud and Eduardo Saborit-Dominguez, 48, pleaded guilty today before Judge Seitz to one count of conspiracy to violate the Anti-Kickback Statute. Sentencing for both defendants is scheduled for May 23, 2012. The charge of conspiracy to commit health care fraud carries a maximum prison sentence of 10 years.
According to the court documents, Morales was the president and Saborit-Dominguez was an employee of Prime Home Health Services Inc., a Florida home health agency that purported to provide home health care and physical therapy services to eligible Medicare beneficiaries. ...
http://www.stopmedicarefraud.gov/HEATnews/florida/index.html#jan-26-2012 ***********
Headache affects 50 percent of HIV/AIDS patients in the United States, and many of those headaches are severe, a new study says. (HealthDay News)
Researchers who interviewed 200 HIV/AIDS clinic patients from Montgomery, Ala., found that 27.5% experienced chronic migraines, compared with 2% of the general population. About 27.5 percent of the 200 HIV/AIDS patients in the study suffered "chronic migraine," a rare condition in which a person has migraine symptoms (with or without other headaches) for 15 or more days a month. This condition occurs in only 2 percent of the general population.
"This translates into a 13-fold increased risk of chronic migraine among patients with HIV disease," study author Todd Smitherman, an assistant professor of psychology at the University of Mississippi, said in a university news release.
"The strongest predictor of headache was the severity of HIV disease, such that patients with more advanced disease had more frequent, more severe and more disabling migraines," he added.
The frequency and severity of migraines increased with the advancement of HIV/AIDS. Researchers advised care providers to monitor headache symptoms in patients with HIV. ... http://consumer.healthday.com/Article.asp?AID=659604

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RANDOM FACTS: Macaroni and Cheese is the #1 cheese recipe in America. In any given twelve-week period, approximately one-third of the population of the U.S. will eat mac and cheese at least once. Bonus Fact: The average American ate 30 lbs of cheese in the year 2000, up from 11 lbs in 1970.

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HUMOR SECTION
Farmer Joe decided his injuries from the accident were serious enough to take the trucking company (responsible for the accident) to court. In court, the trucking company''s fancy lawyer was questioning farmer Joe. "Didn't you say, at the scene of the accident, ' I'm fine?'" questioned the lawyer.

Farmer Joe responded, "we.., I'll tell you what happened. I had just loaded my favorite mule....Bessie into the..." " I didn't ask for any details," the lawyer interrupted, just answer the question. Did you not say, at the scene of the accident, 'I'm fine'!"

Farmer Joe said, "Well I had just got Bessie into the trailer and I was driving down the road..."
The lawyer interrupted again and said, "Judge, I am trying to establish the fact that, at the scene of the accident, this man told the Highway Patrolman on the scene that he was just fine. Now several weeks after the accident he is trying to sue my client. I believe his is a fraud. Please tell him to simply answer the question."

By this time the Judge was fairly interested in Farmer Joe's answer and said to the lawyer, "I'd like to hear what he has to say about his favorite mule Bessie."

Joe thanked the Judge and proceeded, "Well, as I was saying, I had just loaded Bessie, my favorite mule, into the trailer and was driving her down the highway when this huge semi-truck and trailer ran the stop sign and smacked my truck right in the side. I was thrown into one
ditch and Bessie was thrown into the other. I was hurting real bad and didn't want to move. However, I could hear ole Bessie moaning and groaning. I knew she was in terrible shape just by her groans.

Shortly after the accident, a Highway Patrolman came on the scene. He could hear Bessie moaning and groaning so he went over to her. After he looked at her, he took out his gun and shot her between the eyes.

Then the Patrolman came across the road with this gun in his hand and looked at me. He said, "your mule was in such bad shape I had to shoot her. How are you feeling?"
It was then that I said, "I'm fine" ."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member. Please follow me on Twitter as DrRobertHess.

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

Free CEs http://www.myfreece.com/welcome.asp

https://nursing.advanceweb.com/CE/TestCenter/Main.aspx

This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ !

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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.

This is an excellent nursing site, check it out: http://nursingpub.com/

An interesting website: http://www.uptodate.com/home/clinicians/index.html

Back issues of the ISMP newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.

Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance
info@sharedgovernance.org www.sharedgovernance.org

Decubqueen's website: www.accu-ruler.com

http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2

http://www.nationalnurse3.blogspot.com/

RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm

H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html

Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263

The Nursing Site http://thenursingsite.com .

http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.snopes.com

http://www.solutionsoutsidethebox.net/ Raconte's website

http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
National Do Not Call Registry

If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood

Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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MEDICAL RECALLS
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North American Rescue, LLC Announces A Follow-Up to the Recall of Crickit® Convenience Kits Because of Possible Health Risk Related to Nationwide Recall of Triad Povidone Iodine Prep Pads February 6, 2012 – Greer, SC, February 6, 2012-Under the direction of the FDA, North American Rescue, LLC (NAR) today announces the market recall of the NAR Surgical Crichothyroidotomy Kit or Crickit®, due to potential contamination of the povidone iodine prep pads, manufactured by Triad Group. This recall is a follow up to the recall initiated on May 5, 2011. North American Rescue, LLC has successfully contacted 97% of our customers and requested they contact our customer service department for return instructions. North American Rescue, LLC requests all recipients who have further distributed these devices to forward this communication to their customers to facilitate the removal of all affected product.
This is North American Rescue’s final attempt to reach out to customers who may still be in possession of these devices.
The Crickit® Kit component may be found inside a larger kit, the NAR Medic Trauma Pack Kits, available in 4 colors for which the codes are listed below. Only the Crickit® component is being recalled. Please see the attached lot numbers for the affected Crickit® Kits. The affected lot numbers for the Medic Trauma Pack Kits can be found on the North American Rescue website www.narescue.com. Please note that this product has been discontinued and therefore is no longer included in the Medic Trauma Pack Kits. ... http://www.fda.gov/Safety/Recalls/ucm290639.htm?source=govdelivery
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St. Jude Medical, Riata and Riata ST Silicone Endocardial Defibrillation Leads: Class 1 Recall - Failures with Lead Insulation
FDA notified healthcare professionals of a Class I Recall of the St. Jude Medical Riata and Riata ST Silicone Endocardial Defibrillation Leads. The silicone insulation covering these defibrillation leads is at risk of premature abrasion. When abrasion occurs, the conductors inside the leads can come out (externalized) of the insulation. Leads with externalized conductors may develop electrical dysfunction and not work as intended. In the event the device does not work as intended, should a life-threatening heart rhythm occur, pacing or defibrillation therapy may not be delivered as intended. This may result in serious adverse events, including death.
The recall includes the following model numbers:

Riata (8F) Silicone Endocardial Defibrillation Leads
Models: 1560, 1561, 1562, 1570, 1571, 1572, 1580, 1581, 1582, 1590, 1591, 1592
Riata ST (7Fr) Silicone Endocardial Defibrillation Leads
Models: 7000, 7001, 7002, 7010, 7011, 7040, 7041, 7042

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm284390.htm
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Bedford Laboratories Issues Guidance On 2011 Voluntary Recall Of PolymyxinBFor Injection USP And Vecuronium Bromide For Injection Related To Glass Particles
January 10, 2012 - Bedford Laboratories today issued updated guidance on the following nationwide voluntary product recalls originally issued on August 2, 2011:


Polymyxin B for Injection USP, 500,000 Units per vial – NDC #55390-139-10
Lot 1942980 – Exp. Date August 2013 and Lot 1895027 – Exp. Date June 2013
Vecuronium Bromide for Injection, 10 mg per vial – NDC #55390-037-10
Lot 1865067 – Exp. Date May 2012
Vecuronium Bromide for Injection, 20 mg per vial – NDC #55390-039-10
Lot 1865069 – Exp. Date February 2012


The recalls were initiated on August 2, 2011 after the discovery of a visible glass particle in a limited number of vials within the lots listed above to the user level. To date, there have been no reports of adverse events for the lots being recalled.

Polymyxin B is indicated in the treatment of acute infections caused by susceptible strains of Pseudomonas aeruginosa. Polymyxin B sulfate is a drug of choice in the treatment of infections of the urinary tract, meninges, and bloodstream caused by susceptible strains of Ps. aeruginosa. It may also be used topically and subconjunctivally in the treatment of infections of the eye caused by susceptible strains of Ps. aeruginosa.

Vecuronium Bromide is indicated as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation.
http://www.fda.gov/Safety/Recalls/ucm286953.htm
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Bedford Laboratories Issues A Voluntary Nationwide Patient Level
Recall Of Acetylcysteine Solution, USP, LOT 1877093

Acetylcysteine Solution, USP, (Manufactured for Roxane Laboratories, Inc.) 20%, 30 mL per vial – NDC #0054-3026-02 – Lot 1877093 – Exp. Date June 2013
This voluntary recall was initiated on December 20, 2011 after the discovery of a single visible glass particle in a vial within the lot listed above. There have been no complaints or adverse events related to a piece of glass in vials of this lot. All other product parameters were within specifications.

Acetylcysteine for inhalation is usually delivered via a Nebulizer, but can also be delivered via direct instillation into a tracheostomy, or into the bronchial-pulmonary tree during bronchosopy. Glass particles can cause airway obstruction resulting in symptoms of choking, wheezing, difficulty breathing, coughing and potentially hemoptysis. Use of an inhaled product with glass particles has the potential to cause choking which could be life-threatening. Aerosolization of small glass particles in the airways could result in recurrent infections (due to obstruction of airways, and decreased clearance of airway secretions).

Acetylcysteine is indicated as adjuvant therapy for patients with abnormal, viscid, or inspissated mucous secretion. Acetylcysteine, administered orally, is indicated as an antidote to prevent or lessen hepatic injury which may occur following the ingestion of a potentially hepatotoxic quantity of acetaminophen.

The key component of this update is the extension of the recall to the patient level. This recall is limited to the one lot number listed above.

http://www.fda.gov/Safety/Recalls/ucm290204.htm?source=govdelivery
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Vitaflo USA Renastart: Recall - Possible Health Risk Due To Incorrectly Labeled Cans Vitaflo USA has announced a voluntary recall of Renastart 14.11 oz (400g) cans, Batch Number 12832, because some of the product shipped throughout the United States during the period December 29, 2011 through January 26, 2012 was incorrectly labeled. Some immediate consequences of using the incorrectly labeled product may result in high potassium blood levels (hyperkalemia) or high sodium levels in the blood (hypernatremia). All other Vitaflo products, including Renastart cans in batches other than 12832 and Renastart packed in sachets, are not affected.
BACKGROUND: Renastart is a powdered medical food used in the dietary management of pediatric renal disease, for patients one year and older. Renastart 14.11oz (400g) product in cans is sold only in the United States. Following a customer complaint regarding the way the product was dissolving, Vitaflo determined that a small number of cans of a different product may have been wrongly labeled as Renastart.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm289705.htm
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Pfizer Announces Voluntary Nationwide Recall of Lo/Ovral®-28 and Norgestrel/Ethinyl Estradiol Tablets Due to Possibility of Inexact Tablet Counts or Out of Sequence Tablets January 31, 2012 - NEW YORK, N.Y. – Pfizer Inc. announced today that it has voluntarily recalled 14 lots of Lo/Ovral®-28 (norgestrel and ethinyl estradiol)Tablets and 14 lots of Norgestrel and Ethinyl Estradiol Tablets (generic) for customers in the U.S. market. An investigation by Pfizer found that some blister packs may contain an inexact count of inert or active ingredient tablets and that the tablets may be out of sequence. The cause was identified and corrected immediately.

These products are oral contraceptives indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception. These tablets were manufactured and packaged by Pfizer Inc., commercialized by Akrimax Rx Products and labeled under the Akrimax Pharmaceuticals brand. This product is distributed to warehouses, clinics and retail pharmacies nationwide.

As a result of this packaging error, the daily regimen for these oral contraceptives may be incorrect and could leave women without adequate contraception, and at risk for unintended pregnancy. You can either go to the weblink for further info, or for a complete listing, please write me-- RNFrankie@AOL.com-- and I will send it to you. There are too many lot numbers to list on this page .

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm289803.htm

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Cephalon, Inc. issues a voluntary nationwide recall of Treanda® (bendamustine HCL) for Injection 25mg/Vial January 27, 2012 - Cephalon, Inc. is voluntarily recalling Treanda® (bendamustine HCL) for Injection 25mg/8mL; lot TB30111, expiration date 12/2012. This product lot is being recalled due to the presence of particulate matter found in a single vial, which has been identified as glass fragments.
Treanda® (bendamustine HCL) for Injection 25mg/8mL is indicated for the treatment of chronic lymphocytic leukemia (CLL). Efficacy relative to first-line therapies other than chlorambucil has not been established. Treanda® (bendamustine HCL) for Injection 25mg/8mL is indicated for the treatment of patients with indolent B-cell non-Hodgkin’s lymphoma (NHL) that has progressed during or within 6 months of treatment with rituximab-containing regimen.
This recall is being conducted in consideration of the potential safety issue and risk associated with administration of this product lot. Potential adverse events after intravenous administration of solutions containing particulates may present as an emboli and result in disruption of blood flow causing tissue/organ damage, especially in vulnerable patients such as those undergoing surgery, immunosuppressed individuals, and the elderly, as well as patients with micro or macrovasular disease, such as cardiac and renal disease, who may be more at risk since their vasculature and end organs are already compromised. To date, Cephalon, Inc. has not received any adverse events associated with the use of this product lot that could be attributed to particulate matter. ... http://www.fda.gov/Safety/Recalls/ucm289452.htm?source=govdelivery ******************
Tysabri (natalizumab): Drug Safety Communication - New Risk Factor for Progressive Multifocal Leukoencephalopathy (PML)
FDA notified healthcare profesisonals that testing positive for anti-JC virus (JCV) antibodies has been identified as a risk factor for progressive multifocal leukoencephalopathy (PML). PML is a rare but serious brain infection associated with use of Tysabri (natalizumab) for the treatment of multiple sclerosis (MS) or Crohn's disease.
A patient's anti-JCV antibody status may be determined using an anti-JCV antibody detection test that has been analytically and clinically validated, and has been ordered by a healthcare professional. The Stratify JCV Antibody ELISA test2 was cleared by FDA on January 20, 2012. Testing positive for anti-JCV antibodies means that a person has been exposed to JCV in the past. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm288602.htm
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NURSING HINTS CORNER

Calculating with Confidence

As a a busy nursing supervisor, I taped a small list of dosage calculations to the back of my identification badge. Now, when I am in a crunch, I have quick access to this information. I have taught my staff to do the same, which has saved time and boosted confidence in our unit.

Jacquieline Zobresky, RN, BA

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.174, Springhouse Corporation/www.springnetcom. ;


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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com

WELCOME TO:

MaureenTWebb@gmail.com (Maureen) January 17, 2012

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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.. So please send me your new name/address, okay? RNFrankie@AOL.com


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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)


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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)

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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.

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THOUGHT FOR THE DAY

"

July 4th, we will be celebrating out independence from the British. I hope that in a couple of years,
we will be able to celebrate our independence from the Chinese."

David Letterman



Feel free to write me...with suggestions and/or 'gentle" criticisms...... Frankie/Frances

RNFrankie@AOL.com

Saturday, January 14, 2012

Margaret Sanger

Margaret Higgens was born in Corning, New York, on 14th September 1883. She was the sixth of eleven children. Her mother also had seven more babies that died in childhood, before dying of cervical cancer. Educated at Claverack College, she became a trained nurse and married William Sanger, an architect, in 1902. After moving to Saranac for health reasons she gave birth to three children. Over the next 12 years she devoted herself to being a housewife and mother.
In her autobiography she wrote: "My own motherhood was joyous, loving, happy. I wanted to share these joys with other women. Since the birth of my first child I had realized the importance of spacing babies, but only a few months before had I fully grasped the significant fact that a powerful law denied and prevented mothers from obtaining knowledge to properly space their families."
When her three children were old enough to go to school she returned to work as a public health nurse in the slums of New York. Sanger joined the Socialist Party and became friends with other radicals such as John Reed, Upton Sinclair, Mabel Dodge, Robert Minor, Agnes Smedley, Kate Richards O'Hare, Eugene Debs, Elizabeth Flynn, Norman Thomas and Emma Goldman.
In July 1912 she was summoned to a Grand Street tenement. "My patient was a small, slight Russian Jewess, about twenty-eight years old, of the special cast of feature to which suffering lends a madonna-like expression. The cramped three-room apartment was in a sorry state of turmoil. Jake Sachs, a truck driver scarcely older than his wife, had come home to find the three children crying and her unconscious from the effects of a self-induced abortion." When Sadie Sachs died Margaret Sanger made a pledge to devote her life to making reliable contraceptive information available to women. She began her campaign by writing a column for the New York Call entitled "What Every Girl Should Know."
Upset by the poverty she experienced as a nurse in New York she founded a radical feminist magazine, The Woman Rebel. As Sanger later observed in her autobiography: "During these years in New York more and more my calls began to come from the Lower East Side, as though I were being magnetically drawn there by some force outside my control. I hated the wretchedness and hopelessness of the poor, and never experienced that satisfaction in working among them that so many noble women have found. My concern for my patients was now quite different from my earlier hospital attitude. I could see that much was wrong with them that did not appear in the physiological or medical diagnosis. A woman in childbirth was not merely a woman in childbirth. My expanded outlook included a view other background, her potentialities as a human being, the kind of children she was bearing, and what was going to happen to them."

After the death of a patient during childbirth Sanger decided to devote her life to making reliable contraceptive information available to women. She published the Birth Control Review and persuaded Lou Rogers and Cornelia Barns to be co-art editors of the journal.
The main theme of her articles was that "no woman can call herself free who doesn't own and control her own body."
After advice about birth-control appeared in her newspaper in1915, she was charged with publishing an "obscene and lewd article".

The Masses gave its full support to Sanger's campaign. Floyd Dell was assistant editor at the journal: "The Masses published articles in defense of of Margaret Sanger, and the magazine was immediately flooded with thousands of letters from women, asking for information about the methods of birth control, and giving the best as well as the most heart-breaking reasons for needing such information. These letters, as associate editor, I answered, saying that we were forbidden by law to give the information; then, as a private individual, I carefully turned over all these letters to other private individuals, who mailed this information to the women; and in this law-breaking I cheerfully and conscientiously participated. I believed then, as I do now, that it is a moral duty to violate evil laws."
Margaret Sanger fled to Britain and it was while she was in London she met Marie Stopes. She later recalled: "She then explained to me that, owing to her previous unfortunate marriage she had no experience in matters of contraception nor any occasion to inform herself of their use. Could I tell her exactly what methods were used? I replied that it would give me the greatest pleasure to bring to her home such devices as I had in my possession. Accordingly, we met again the following week for dinner in her home, and inspected and discussed the French pessary which she stated she then saw for the first time. I gave her my own pamphlets, all of which contained contraceptive information."
After hearing Sanger's story Marie Stopes decided to start a birth-control campaign in Britain. She knew it would be dangerous as several people in Britain, including Richard Carlile, Charles Bradlaugh and Annie Besant, had been sent to prison for advocating birth-control.
In December 1914 Sanger sent a letter to Havelock Ellis. As Phyllis Grosskurth, the author of Havelock Ellis (1980), has pointed out: "He invited her to tea the following week and was startled to find her so pretty and so comparatively young. At first she was overwhelmed by his patriarchal beauty and his refusal to make small talk. She was also surprised - as many others were on first meeting him - by his thin, high voice, so unexpected in a man of his size."
Sanger fell in love with Ellis. She wrote in An Autobiography (1938): "I was at peace, and content as I had never been before... I was not excited as I went back through the heavy fog to my own dull little room. My emotion was too deep for that. I felt as though I had been exalted into a hitherto undreamed-of world."
Soon afterwards Sanger tried to turn it into a sexual relationship. Havelock Ellis wrote to her explaining "What I felt, and feel, is that by just being your natural spontaneous self you are giving me so much more than I can hope to give you. You see, I am an extremely odd, reserved, slow undemonstrative person, whom it takes years and years to know. I have two or three very dear friends who date from 20 or 25 years back (and they like me better now than they did at first) and none of recent date."
Sanger returned to New York City and on 16th October, 1916, with the help of Kitty Marion, she opened a family planning and birth control clinic in the Brownsville neighborhood of Brooklyn. It was raided nine days later by the police and Sanger served 30 days in prison. In 1917 she published What Every Mother Should Know.
In 1921 Sanger founded the American Birth-Control League. Later that year her friend Marie Stopes also opened the first of her birth-control clinics in Holloway on 17th March 1921. Guy Aldred and Rose Witcop, joined the campaign and when they published a pamphlet written by Margaret Sanger, they were found guilty of selling an obscene publication. The case drew much press coverage and the couple were supported financially by John Maynard Keynes, Dora Black and Bertrand Russell. Later that year this group was joined by Katharine Glasier, Susan Lawrence, Margaret Bonfield, Dorothy Jewson and H. G. Wells to establish the Workers' Birth Control Group.

Margaret Sanger continued her campaign and in 1927, Sanger helped organize the first World Population Conference in Geneva. The following year she resigned as the president of the American Birth-Control League and devoted her energies to the Birth Control Clinical Research Bureau. She also published two books on the subject: Motherhood in Bondage (1928) and My Fight for Birth Control (1931).
In 1932 Margaret Sanger became president of the Birth Control International Information Center. The dissemination of birth control information by doctors was finally legalized in the United States in 1937. Her memoirs, The Autobiography of Margaret Sanger was published in 1938.
Margaret Sanger died in Tucson, Arizona, on 6th September 1966. http://www.spartacus.schoolnet.co.uk/Jsanger.htm

January Paradigm 97 Newsletter:

PARADIGM BYTES
Newsletter for Paradigm 97
January 12, 2012

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT


We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.

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SNIPPETS

Contact: Lauren Wilson, Communications Director
2468 Rayburn House Office Building Washington DC 20515
Phone: (202) 225-8885 Fax: (202) 226-1477 www.house.gov/ebjohnson

CONGRESSWOMAN EDDIE BERNICE JOHNSON INTRODUCES THE NATIONAL NURSE ACT OF 2011, HR 3679

Washington, DC – (Friday, December 16) – Yesterday, Congresswoman Eddie Bernice Johnson (D-TX) introduced the National Nurse Act of 2011, HR 3679. The bill, co-led by Congressman Peter King (R-NY), has garnered eighteen original co-sponsors. It would designate the Chief Nurse Officer of the U.S. Public Health Service as the “National Nurse for Public Health.”
The National Nurse would function alongside the Surgeon General and focus on health promotion, improving health literacy, and decreasing health disparities.

“The National Nurse Act of 2011 is an important piece of legislation that would establish a focal point for promoting health and disease prevention. There are currently 3.4 million nurses, making the demographic the largest sector of healthcare workers in the United States.

“As the first registered nurse in Congress, I believe that having a National Nurse focused on prevention activities will help reduce illnesses and decrease the costs for care and services,” said Congresswoman Johnson.

The National Nurse Act of 2011 is currently endorsed by dozens of prominent nursing organizations and key stakeholders.

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U.S. Representative Eddie Bernice Johnson is the highest-ranking Texan on the House Committee on Transportation & Infrastructure and a senior member of the Science Committee. She represents the 30th Congressional District of Texas, which, includes Downtown Dallas, Fair Park, Oak Lawn, Turtle Creek, Old East Dallas, Pleasant Grove, & South Oak Cliff; all of Balch Springs, DeSoto, Hutchins, Lancaster & Wilmer and parts of Cedar Hill, Duncanville, Ferris, Glenn Heights and Ovilla.



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INTERESTING READING

Please remember that the REUTERS articles usually good for only 30 days

522 Million People Could Have Diabetes By 2030, Experts Say Many Cases Still Preventable
GENEVA - The International Diabetes Federation predicts that at least one in 10 adults could have diabetes by 2030, according to its latest statistics.
In a report issued on Monday, the advocacy group estimated that 552 million people could have diabetes in two decades' time based on factors like aging and demographic changes. Currently, the group says that about one adult in 13 has diabetes.
The figure includes both types of diabetes as well as cases that are undiagnosed. The group expects the number of cases to jump by 90 per cent even in Africa, where infectious diseases have previously been the top killer. Without including the impact of increasing obesity, the International Diabetes Federation said its figures were conservative. ... http://www.huffingtonpost.ca/2011/11/14/522-million-people-could-_n_1091753.html?ncid=webmail1#s446200&title=Diabetes

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Quiz Time

An important advance in treating combat-related pain during patient military evacuation flights is:
a. use of morphine
b. use of nonsteroidal anti-inflammatory drugs
c. use of Reiki
d. use of regional anesthesia
(Answer at end of Newsletter)
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ED nurses continue to be victims of workplace violence, according to new report

The latest data from the “Emergency Department Violence Surveillance Study,” an ongoing survey study from the Emergency Nurses Association (ENA), show rates of physical violence and verbal abuse against nurses did not decrease from May 2009 to January 2011. In the 12 months from January 2010 to January 2011, more than half (53.4%) of nurses reported experiencing verbal abuse and more than one in ten (12.9%) reported experiencing physical violence over a seven-day period compared with 54% reporting verbal abuse and 11% reporting only physical violence in the first year of the study. The study also found that reporting policies (especially zero-tolerance policies) were associated with a lower odds of physical violence and verbal abuse. Read the ENA press release. and the report.
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HHS Unveils MLR Rule Dec 02, 2011

The Department of Health and Human Services today released its final medical loss ratio rule. The rule will ensure that health insurance companies spend at least 80 percent of consumers' health insurance premiums on medical care rather than on income, overhead and marketing expenses.
The Hill: "Insurance plans will soon have to give consumers more information about how their premium dollars are spent,
even if the spending meets new federal requirements. The disclosure requirements were included in final regulations on
the healthcare reform law's medical loss ratio (MLR) provision. The Health and Human Services Department finalized
its MLR rules Friday" (Baker, 12/2). There are some links to the interim rule & other info with the article.........
http://www.kaiserhealthnews.org/Daily-Reports/2011/December/02/mlr-rule.aspx

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Frequent red meat eaters at higher risk of stroke (Reuters Health)
- A high-protein diet might benefit health in some ways, but depending on what kind of protein a person consumes, it could raise their stroke risk too, suggests a large new study that finds eating lots of red meat ups the likelihood of having a stroke while poultry lowers it.
"The main message from this paper is that the type of protein or the protein package is really important for the risk of stroke. We have to consider protein in the context of the foods," said Dr. Frank Hu, a professor at the Harvard School of Public Health and one of the authors of the study. ...
http://www.reuters.com/article/2012/01/11/us-redmeat-stroke-idUSTRE80A20O20120111?feedType=nl&feedName=ushealth1100
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By MedPage Today Staff
Published: December 30, 2011
Injections That Are 'Soft as Silk' Silk Needle Threaded With Medicines

Instead of the "pinch" of a hypodermic needle to administer drugs, tiny biodegradable needles made of silk protein could be used to deliver precise doses painlessly, researchers suggested.
An engineering group described in Advanced Functional Materials how the microneedles could be made at room temperature and pressure with a water-based process, which wouldn't destroy sensitive biologic medications.
Even large-molecule drugs could be mixed with the silk protein solution, and adjusting the conditions under which they dried determined short or extended release of the medication.
Because the tip of the needles penetrate the skin without reaching nerves, they would be painless to use, the researchers noted.
"This is a very flexible technology that can be scaled up or down, shipped and stored without refrigeration and administered as easily as a patch or bandage," one of the researchers said in a press release. "We believe the potential is enormous."
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Spools and Tails May Be Keys to Schizophrenia Tx
Postmortem studies of brain tissue from patients with schizophrenia have revealed alterations of gene expression relating to low levels of histone acetylation – a finding that could open up new ways of treating the disease itself and not just the devastating symptoms.
Histones are intracellular proteins that serve as structural spools for DNA to wind around, forming chromatin, with "tails" that regularly undergo chemical modifications such as acetylation and methylation.
These epigenetic changes can determine which genes are activated and which are repressed, explained Elizabeth Thomas, PhD, of the Scripps Research Institute in La Jolla, Calif.
In a series of PCR assay experiments, the researchers found alterations in histone acetylation in the promoter region of several genes that have been linked to schizophrenia. They then studied the effects of a histone deacetylase inhibitor on mouse brain tissue, and found a reversal of the abnormal gene expression.
If the use of a histone deacetylase inhibitor such as valproic acid is found to have similar effects in the human brain, the effects could be normalization of histone acetylation patterns and gene expression, the researchers wrote in Translational Psychiatry.

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RANDOM FACTS: Fortune cookies actually originated in Japanese culture. You would find more Japanese-owned restaurants that served the still very popular American adaptation of Asian cuisine before WWII. When large populations of the Japanese-American citizens were put into internment camps, the fates of their restaurants were turned over to Chinese-Americans, and so we associate the famous cookie with the Chinese.

Bonus Fact: Actual Chinese cuisine is much different than what Americans know as Chinese food. However, the success of American-Asian food has necessitated vocational schools in China to teach potential immigrants the art of the cuisine. For example, Egg Foo Young is unheard of in traditional Chinese cuisine.
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Study Examines Changes in Resting Heart Rate Over Time
Although resting heart rate (RHR) has been long known to be associated with cardiovascular risk, change in RHR over time has not been well studied. A new paper from Norway published in JAMA demonstrates that an increase in RHR over 10 years helps predict the risk of all-cause and ischemic heart disease (IHD) death.
Javaid Nauman and colleagues analyzed data from 46,410 Norwegian adults without known cardiovascular disease who had their RHR measured at baseline and at 10 years. ...
http://www.forbes.com/sites/larryhusten/2011/12/21/study-examines-changes-in-resting-heart-rate-over-time/
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RANDOM FACT: Levi Strauss arrived in California during the Gold Rush trying to sell canvas tents to miners. However, he soon
learned that what the prospectors needed most was pants, and so he turned his tent business into a pants business;
eventually using imported denim in place of canvas.
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Bonus Fact: In 2005, an original pair of Levi's--aged more than 115 years--were sold to a collector for $60,000.
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A Taste of Nursing Research: An Interactive Program Introducing Evidence-Based Practice and Research to Clinical Nurses Abstract
Developing and implementing a program to introduce clinical nurses to research and evidence-based practice (EBP) should spark interest and participation. In this article, the authors describe and evaluate a staff development initiative not only to introduce the principles of EBP and research but also to give nurses the opportunity to participate in the research process and development of EBP questions.
http://journals.lww.com/jnsdonline/Abstract/2011/11000/A_Taste_of_Nursing_Research__An_Interactive.18.aspx

Brown, Christine R. BSN, RN, CCRN; Johnson, Ann S. BSN, RNC, NNP-BC; Appling, Susan E. MS, CRNP
Journal for Nurses in Staff Development - JNSD:
November/December 2011 - Volume 27 - Issue 6 - p E1–E5
doi: 10.1097/NND.0b013e3182371190
Articles: Online Only
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High lead exposure linked to hearing loss in youth
(Reuters Health) - Teens exposed to higher-than-normal levels of lead are more likely to have trouble hearing, suggests a new study that links the hearing problems to lead levels well below those considered "safe" by current standards.
But other heavy metals weren't clearly tied to hearing problems, researchers said. And with lead, the report found only a small proportion of adolescents had blood concentrations that might be linked to hearing loss.
"It looks like the levels in the blood of most kids are very low and people are avoiding (heavy metals)," said study author Dr. Josef Shargorodsky, from the Massachusetts Eye and Ear Infirmary and Brigham and Women's Hospital in Boston. ...

http://www.reuters.com/article/2011/12/22/us-high-lead-hearing-loss-idUSTRE7BL1T720111222?feedType=nl&feedName=ushealth1100
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Breast implants need lifetime of care: experts (Reuters) - The Internet and women's magazines are filled with enticing adverts for breast implant surgery, but experts and regulators have varying views on how long they last and possible risks.
The implants now at the centre of a worldwide health scare came from the now-defunct French company Poly Implant Prothese (PIP) and appear to have an abnormally high rupture rate. That risk, though typically low, is present in all implants. ... http://www.reuters.com/article/2011/12/27/us-breast-implants-idUSTRE7BQ0EC20111227?feedType=nl&feedName=ushealth1100
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Siemens recalls clinical pregnancy tests (Reuters) - Siemens has recalled 15 batches of clinical pregnancy tests because some of them incorrectly showed a positive result, a spokesman for the company said on Friday.
He said the recall affects several hundred hospitals around the world, which were told as early as mid-December to destroy pregnancy tests from the batches. Until the cause of the malfunction has been found, Siemens will not be supplying any such tests, he said.

http://www.reuters.com/article/2011/12/30/us-siemens-recall-idUSTRE7BT0CN20111230?feedType=nl&feedName=ushealth1100
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Analysis: Court tests liability of healthcare executives (Reuters) - After decades in relative obscurity, a legal doctrine that holds corporate officers liable for company wrongdoing is finding its way back into some high-profile healthcare prosecutions.
The "responsible corporate officer" doctrine allows for prison terms of up to one year for misdemeanor violations of the Federal Food, Drug and Cosmetic Act, but typically defendants have received only probation.
Recently, however, the government has sought to reinvigorate the doctrine, and some executives are facing stiffer penalties than they had ever imagined.
On Tuesday, the Department of Health and Human Services will seek to convince a federal appeals court to uphold a 12-year exclusion from government business for three former executives of Purdue Pharma. The executives had pleaded guilty in 2007 to a misdemeanor for misbranding the painkiller OxyContin. ...

http://www.reuters.com/article/2011/12/06/us-health-legal-idUSTRE7B50NA20111206?feedType=nl&feedName=ushealth1100
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Medtronic settles U.S. probe over doctor kickbacks
(Reuters) - Medtronic Inc has agreed to pay $23.5 million to settle allegations that it paid kickbacks to doctors to encourage them to use its pacemakers and defibrillators, the U.S. Justice Department said on Monday.
The company was accused of seeking physicians to participate in studies and registries and paying doctors fees of between $1,000 to $2,000 per patient for information and data collected as long as they used Medtronic's devices, according to the Justice Department.
Medtronic caused false claims to be submitted to the federal healthcare programs Medicare and Medicaid, the Justice Department said. The settlement resolves two whistleblower lawsuits against the company. ...

http://www.reuters.com/article/2011/12/13/us-medtronic-kickbacks-idUSTRE7BC2GV20111213?feedType=nl&feedName=ushealth1100
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The New York Times: Report Finds Most Errors At Hospitals Go Unreported
Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report (Pear, 1/6).
http://tinyurl.com/6makzby The 42 page study can be downloaded from: http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf (I don't think this is an accurate report....what do you think?)
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USA Today: Workplaces Ban Not Only Smoking, But Smokers Themselves
As bans on smoking sweep the USA, an increasing number of employers — primarily hospitals — are also imposing bans on smokers. They won't hire applicants whose urine tests positive for nicotine use, whether cigarettes, smokeless tobacco or even patches (Koch, 1/5).
http://tinyurl.com/729eovy
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Emergency Hospitalizations for Adverse Drug Events in Older Americans. A study in the New England Journal of Medicine found that 67% of emergency hospitalizations related to adverse drug events were caused by four medications or mediation classes alone or in combination: warfarin,insulins, oral antiplatelets, and oral hypoglycemic agency. Adverse drug events are important preventable causes of hospitalization in older adults, however nationally representative data on adverse drug events is scarce ...

http://www.nejm.org/doi/full/10.1056/NEJMsa1103053
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RANDOM FACT: Rather than wring every dime he could out of the popular "Matrix" movie series, Keanu Reeves signed away his back-end deal for the two sequels to the films' special-effects and costume-design teams -- an act of benevolence that cost him many millions.

Bonus Fact: Named after his uncle, Henry Keanu Reeves, the actor's first name roughly translates to "cool mountain breeze" in Hawaiian.

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HUMOR SECTION

The shopkeeper was dismayed when a brand new business much like his own opened up next door and erected a huge sign which read BEST DEALS.

He was horrified when another competitor opened up on his right, and announced its arrival with an even larger sign, reading LOWEST PRICES.

The shopkeeper was panicked, until he got an idea. He put the biggest sign of all over his own shop- it read...... MAIN ENTRANCE



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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member. Please follow me on Twitter as DrRobertHess.

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

Free CEs http://www.myfreece.com/welcome.asp

https://nursing.advanceweb.com/CE/TestCenter/Main.aspx

This site was sent in by FNPMSN@aol.com (Cindy) http://cmepain.com/ !

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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.

This is an excellent nursing site, check it out: http://nursingpub.com/

This information has recently been updated and is now available.
Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus (PDF - 168KB)


Back issues of the ISMP newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.

Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance
info@sharedgovernance.org www.sharedgovernance.org

Decubqueen's website: www.accu-ruler.com

http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2

http://www.nationalnurse3.blogspot.com/

RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm

H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html

Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263

The Nursing Site http://thenursingsite.com .

http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.snopes.com

http://www.solutionsoutsidethebox.net/ Raconte's website

http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
National Do Not Call Registry

If you're buying a used car, it is recommended having a mechanic inspect it first. And screen the car's VIN through the free database at carfax.com/flood

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm

Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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MEDICAL RECALLS
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CareFusion AVEA Ventilator: Recall - Failure May Lead to Lack of Ventilation
FDA notified healthcare professionals of a class I recall of CareFusion AVEA Ventilators. The AVEA ventilator can develop a failure where the ventilator activates a false extended high peak alarm, opens the safety valve and stops ventilating. Without health care professional intervention, patients may suffer life-threatening injury or death.
The AVEA ventilator is intended for continuous breathing support for the care of neonatal through adult patients who require mechanical ventilation. These ventilators are used in hospitals and other health care institutions. The recalled ventilators were manufactured between March 1, 2009 and June 30, 2011. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm285063.htm
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Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants: Drug Safety Communication - Use During Pregnancy and Potential Risk of Persistent Pulmonary Hypertension of the Newborn Including Celexa (citalopram); Lexapro (escitalopram); Prozac, Sarafem, Symbyax (fluoxetine); Luvox, Luvox CR (fluvoxamine); Paxil, Paxil CR, Pexeva (paroxetine); Zoloft (sertraline); Viibryd (vilazodone)

FDA notified healthcare professionals and the public on the use of selective serotonin reuptake inhibitor (SSRI) antidepressants by women during pregnancy and the potential risk of a rare heart and lung condition known as Persistent Pulmonary Hypertension of the Newborn (PPHN). The initial Public Health Advisory in July 2006 on this potential risk was based on a single published study. Since then, there have been conflicting findings from new studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.
FDA has reviewed the additional new study results and has concluded that, given the conflicting results from different studies, it is premature to reach any conclusion about a possible link between SSRI use in pregnancy and PPHN. FDA will update the SSRI drug labels to reflect the new data and the conflicting results.
BACKGROUND: SSRIs are marketed under various brand and generic drug names, and are used to treat depression and other psychiatric disorders. There are no adequate and well-controlled studies of SSRIs in pregnant women.
PPHN occurs when a newborn baby does not adapt to breathing outside the womb. Newborns with PPHN may require intensive care support including a mechanical ventilator to increase their oxygen level. If severe, PPHN can result in multiple organ damage, including brain damage, and even death.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm283696.htm


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NURSING HINTS CORNER

X marks the spot.
Locating pedal and posttibial pulses can be time-consuming. After I find them, I use a felt-tip pen to mark and X over a palpable pulse and a D over a pulse that is detectable by a Doppler ultrasound stethoscope only. This not only helps the nurse on the next shift, but it also allows us to determine quickly if the pulse has worsened or improved. Christine Ozoro, RN, BSN.

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.119, Springhouse Corporation/www.springnetcom.

~**~~**~~**~~**~~**~~ ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.

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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com


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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number. So please send me your new name/address, okay? RNFrankie@AOL.com


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EDITORIAL STAFF:

GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)


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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)

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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.

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THOUGHT FOR THE DAY

The bitterest tears shed over graves are for words left
unsaid and deeds left undone.

Harriet Beecher Stowe, Author

Drop me a line.... Frankie
RNFrankie@AOL.com

Answer to Quiz Time:

Correct answer: d. Regional anesthesia is now used to manage combat-related pain during air transport to the next level of care and for postoperative pain. Regional analgesia is a preventive strategy that yields improved analgesia, outcomes, and patient satisfaction.