PARADIGM BYTES
Newsletter for Paradigm 97
November 24, 2006
Newsletter for Paradigm 97
November 24, 2006
Our NEW website......still brand new.... All due to Chris (Raconte's daughter) THANK YOU.
http://paradigm97.blogspot.com/
I will try to have the newsletter posted Q two weeks.
http://paradigm97.blogspot.com/
I will try to have the newsletter posted Q two weeks.
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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Please drop in ...the chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PST (Please note that these times are per time zone..... e.g. same time in essence).
Now, the Paradigm97 chatroom is always there....door open, lights on, waiting for visitors to come in. Check your Buddy List.....and invite your friends in for a little chat Let me know if you want others involved.
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SNIPPET
Facts on Leukemia and Lymphoma
Leukemia and lymphoma are cancers that originate in bone marrow or lymphatic tissues as the result of a genetic injury to the DNA of a single cell. This cell becomes malignant and begins to multiply continuously. This accummulation of abnormal cells eventually interferes with the production of normal blood cells.
Facts
According to a published report by the Leukemia & Lymphoma Society:
Approximately 785,829 people in America are living with blood cancers.
Every five minutes someone is diagnosed with this disease; an estimated 118,310 new cases are expected this year.
Every 10 minutes someone dies from this disease; approximately 53,920 deaths are anticipated in 2006.
Leukemia is the second most prominent type of blood cancer today. In addition to its high incidence rate, leukemia causes more deaths than any other cancer among children and young adults under the age of 20. Leukemia can be divided into four categories:
Myelogenous or Lymphocytic leukemias, each of which can be acute or chronic. Myelogenous and lymphocytic speak specifically to the cell type involved.
Acute leukemia is more rapidly progressing as it affects immature cells.
Chronic leukemia is more slowly progressing, allowing more mature productive cells to be made.
Signs and symptoms of leukemia are: easy bruising and bleeding (due to a platelet deficiency), paleness or easy fatigue (due to anemia) and recurrent infections or poor healing of open wounds (due to inadequate white cell count).
There is no definite cause of leukemia; anyone, regardless of ethnicity or gender, can develop it. Research has found that chronic exposure to benzene and high doses of irradiation can be possible causes of the disease.
Lymphoma
Lymphoma is the most prominent type of blood cancer today. It is the general term for cancers that originate in the lymphatic system. Fifty-six percent of blood cancers diagnosed today are lymphomas. Among those are two different types: Hodgkin Lymphoma and Non-Hodgkin Lymphoma.
Hodgkin Lymphoma is characterized by the presence of a special cell called the Reed-Sternberg cell. Incidence rates of this type of cancer are higher in adolescents and young adults than in other age demographics.
Non-Hodgkin Lymphoma is comprised of a more diverse group of cancers that can be classified as low, intermediate or high grade, or indolent or aggressive. The different categories tell whether each type is more or less favorable. It is the sixth most common cause of cancer deaths among both males and females.
Symptoms of this disease include painless swelling of the lymph nodes in the neck, armpit or groin; reoccurring fatigue and high fever; night sweats; persistent itching; and weight loss. Other less common symptoms can include indigestion and abdominal pain, loss of appetite and bone pain. http://view.exacttarget.com/?ffcb10-fe9913727563067c76-fdf017777d610d7871157070-ff021572746207&WT.mc_id=EM_22Sept06+Awareness_LeukemiaLymphoma&WT.dcsvid=2020453645
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FORGOTTEN HISTORY
Sandy Koufax
By Denis Mueller
He straddled two different time periods. Sandy Koufax began his career in the pre-television
era and finished it in the age of celebrity. He was also the best pitcher in the modern era. But what makes Koufax different, aside from a plus ninety mile an hour fastball and a curve that fell from a table, was his humility. He walked away from the spotlight at the top of his game while enduring tremendous pain from an arm problem and never saying a word about it.
Sandy Koufax came from the streets of Brooklyn and was an all around athlete who excelled at every sport he tried. His true love was basketball and at 6' 2'' his slender, but muscular frame, was made for the game. Baseball was almost and afterthought but Koufax showed enough to gain a scholarship at the University of Cincinnati. There he pitched only three games when he was signed by the Brooklyn Dodgers.
The Dodgers were a veteran team who did not take kindly at first to the gifted young man. Sure he threw the ball hard but he was a just likely to heave one over the batter's head as hit the strike zone. As a bonus baby, the Dodgers were obliged to keep him on the roster so Sandy did not appear in many games. In 1958, the Dodgers moved to Brooklyn and Koufax left his Brooklyn home for the sun baked landscape of L.A.
At first he was just as erratic as he had been in Brooklyn but in 1961 things began to change. By 1962, he had conquered his early wildness and began to assemble a record that showed dominance unheard of before or since. During the next six years, until and arthritic elbow forced him to retire, Koufax compiled a record of 111-37. During this time he also pitched several no-hitters and a perfect game. His E.R.A. in post season play
was 0.95, how about that for numbers?
In 1963, he was 25-3 and the light hitting Los Angles Dodgers were the champions of the world.
He also was Jewish and his demur on the mound, his coolness, made being Jewish cool. With the
move to Los Angles baseball itself was no longer a game played in eastern cities. Television and the rise of the mass media created new superstars and Koufax was one of the first in the modern sports era.
But he was a different type of hero. Koufax, while not running away from it, never craved the spotlight, or money, for that manner. It was all about being the best he could be. In the 1965 World Series the pain was too much and Sandy decided to abandon his curveball and go entirely with his heater. "F... 'em, we'll blow
them away," said Koufax. He sure did and using only his fastball Koufax made the
hard hitting Minnesota Twins look like a bunch of little leaguers.
By 1966, the pain was too much and despite going 27-9 Sandy knew the end was near. The pain
was enormous but he never complained so he retired at the top of his game. What made him so
special was not only his ability, which was considerable, but the way he carried himself. He was a
gentleman, a leader, a friend of minorities and pretty much the type of person that you wished your daughter would marry.
I have never seen anyone quite like him. He walked away from fame and the public eye but remains in our consciousness. I can still here Dodger announcer proclaim, "Sandy is going entirely with his fastball," while blowing the hard-hitting Twins away. It is not often we see such excellence in sports, or elsewhere for that matter, but Sandy was special and one of the great joys of my life was watching him pitch. He was a true hero.
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Medical News
REUTERS ALERT Neglected Nurses Fight Their Own War BAGHDAD, 19 November (IRIN) - Nissrin Muhammad, 36, sees death every day and worries how her children would survive if she were killed. The only means this widowed mother-of-five has to support her family is to continue working in the dangerous and deteriorating conditions of a public hospital in the capital, Baghdad. Nissrin works 13 hours a day to feed her children. Spending her days tending to sick and bullet-ridden bodies, she is increasingly worried that the day will come when she will be the one lying on the operating table. http://www.alertnet.org/thenews/newsdesk/IRIN/109e7b581d8d47d1e88f4c05018eb463.htm
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National Politics & Policy House Panel Approves Bill That Would Reauthorize National Breast and Cervical Screening Program for Low-Income, Uninsured Women The House Committee on Energy and Commerce on Wednesday approved 45-0 a bill (HR 5472) that would reauthorize CDC's National Breast and Cervical Cancer Early Detection Program -- which offers screening services to low-income women without insurance -- through fiscal year 2011, CQ Today reports (Hopkins, CQ Today, 9/28). The program provides Pap tests and other screenings for qualified women ages 18 to 64 and mammograms for qualified women ages 40 to 64. http://www.kaisernetwork.org:80/daily_reports/rep_index.cfm?DR_ID=40085
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FROM A MEMBER
This is from Sue Stones @ aol.com ..England.
I read Raconte's Nurse-Patient Ratio article with great interest, particularly as I too work in NICU and have done for the last 15 years. I work as a "Sister" in the UK - our Equivalent of a charge nurse. Like the US we have standards to go by (BAPM) but i know very few units can meet the nurse to patient ratio successfully as not only are we short staffed but we also have a severe lack of skilled nurses on each shift. What is frustrating is we have very keen newly qualifed nurses taking up posts on the unit - we, despite our best efforts don't have the time or resources to supervise and train them - we get frustrated, they get frustrated then look else where for jobs - and the cycle starts again.
A typical shift for me occured last week. I was sister in charge (we always have to take out own caseload too). I had 16 babies, including four intensive care (one in the terminal stages), 5 high dependency. These incuded babies from other units in the region. One nurse (currently doing her specialist training) was allocated a high dependency a special care and the palliative care baby. I had a baby on CPAP, another who had regular A and Bs and three special care babies and the other two nurses took the rest. As well as my own caseload and taking charge, I also had to support the nurse looking after the terminal baby as this was her first one (the baby sadly died that afternoon).
This is a typical shift. There are some shifts when you find yourself being the only experienced nurse on shift with three juniors. Recruitment attempts for experienced staff seems almost futile and there just aren't any out there and even recruitment itself is barred by the powers that be-- due to cutbacks. Its a totally frustrating situation and most days I leave work wondering why the heck I do it. But I know the answer to that - because I am passionate about my actual job AND I am the sole wage earner and have not trained to do anything else.
FROM A MEMBER
This is from Sue Stones @ aol.com ..England.
I read Raconte's Nurse-Patient Ratio article with great interest, particularly as I too work in NICU and have done for the last 15 years. I work as a "Sister" in the UK - our Equivalent of a charge nurse. Like the US we have standards to go by (BAPM) but i know very few units can meet the nurse to patient ratio successfully as not only are we short staffed but we also have a severe lack of skilled nurses on each shift. What is frustrating is we have very keen newly qualifed nurses taking up posts on the unit - we, despite our best efforts don't have the time or resources to supervise and train them - we get frustrated, they get frustrated then look else where for jobs - and the cycle starts again.
A typical shift for me occured last week. I was sister in charge (we always have to take out own caseload too). I had 16 babies, including four intensive care (one in the terminal stages), 5 high dependency. These incuded babies from other units in the region. One nurse (currently doing her specialist training) was allocated a high dependency a special care and the palliative care baby. I had a baby on CPAP, another who had regular A and Bs and three special care babies and the other two nurses took the rest. As well as my own caseload and taking charge, I also had to support the nurse looking after the terminal baby as this was her first one (the baby sadly died that afternoon).
This is a typical shift. There are some shifts when you find yourself being the only experienced nurse on shift with three juniors. Recruitment attempts for experienced staff seems almost futile and there just aren't any out there and even recruitment itself is barred by the powers that be-- due to cutbacks. Its a totally frustrating situation and most days I leave work wondering why the heck I do it. But I know the answer to that - because I am passionate about my actual job AND I am the sole wage earner and have not trained to do anything else.
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INTERESTING READING
Please remember that the REUTERS' articles are good for 30 days only
Sandy Summers sent this in to a List Serve....I thought it was very appropriate to go with Sue Stones letter in this issue under "From a Member"....also Raconte's article on the website.
Why don't the facilites use research such as the following?
Nurse shortage boosts death rates Patients in hospitals with more nurses per patient fared better Nursing shortages are linked to an increase in patient death rates, a study of English hospitals has found. Scientists discovered mortality was 26% higher for the hospitals with the worst staffing levels compared with those with more nurses per patient.
The Royal College of Nursing said the study, published in the International Journal of Nursing Studies, showed it was essential to retain nursing posts. But the Department of Health said nurse numbers had risen in recent years.
Professor Anne Marie RaffertyTo establish the link between nursing levels and patient outcomes, UK researchers analysed just under 120,000 patient records and compared them with information from 4,000 nurses from 30 hospital trusts in England.
The data was taken between 1998-99. They found the patient-to-nurse ratios varied from 6.9 to 14.3 across the trusts. And patients in the hospitals where nurses had the highest workloads were more likely to suffer complications and/or die than those in hospitals with better staffing ratios. The researchers also discovered the nurses caring for the most patients were 71% more likely to suffer "burn out", and 91% more likely to be unsatisfied with their jobs compared with the nurses with a lighter workload.
Professor Anne Marie Rafferty, lead researcher on the study and a health services researcher from Kings College London, said: "We calculate that some 246 fewer deaths would have occurred in these 30 trusts had all the patients been treated in hospitals with the most favourable staffing levels.
"The number of lives that could potentially be saved through investments in nursing throughout NHS hospitals could be thousands every year."
Short-termism The research forms part of a collaboration between five countries:
US, Scotland, Germany, Canada and England, and is called the International Hospital Outcomes Study.
The scientists said the findings in England closely mirror those of the US and Canadian components, which were published recently.
The delay between the time the data was collected and the date of publication of this latest paper was because of the length of time taken to design how the study should be carried out, Professor Rafferty said.
Dr Beverly Malone, general secretary for the Royal College of Nursing, said: "This new independent research backs up what nurses have always known: that nurse numbers really do matter and that nurses make a life and death difference to how well their patients recover.
"That is why we must not allow nursing posts to be sacrificed to ease financial deficits. This is short-termism in the extreme and will end up costing the health service more in the long run as patients with complications that should have been picked up in the first place are re-admitted."
A Department of Health spokeswoman said: "Patient safety is always a top priority for the NHS and we now have around an extra 89,000 nurses working in the NHS delivering high quality care for patients than we did in 1997.
"Nursing ratios are a complex subject which has yet to gain a definitive consensus within the nursing profession
and we welcome this addition to this debate."
Liberal Democrat health spokesman Steve Webb said: "This is further evidence of the damage that will be done to patient care if the NHS financial crisis results in even more frontline staff cuts." http://news.bbc.co.uk/1/hi/health/6077690.stm
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Islet-cell transplants aren't -- yet -- a cure for diabetes, an international clinical trial shows. The trial tested the Edmonton protocol, a revolutionary technique for transplanting insulin-making pancreas cells from cadavers to desperately ill diabetes patients. A few years ago, it seemed that the technique -- in which islet cells are infused into the liver -- could free most patients from the need for insulin shots.
It does, find Edmonton protocol inventor James Shapiro, MD, PhD, and colleagues. But now it's clear that only some 10% of study patients remained insulin-free after five years. Even so, the transplanted cells kept many of the patients from having life-threatening blood-sugar crashes.ept. 27, 2006 -- Islet-cell transplants aren't -- yet -- a cure for diabetes, an international clinical trial shows.
The trial tested the Edmonton protocol, a revolutionary technique for transplanting insulin-making pancreas cells from cadavers to desperately ill diabetes patients. A few years ago, it seemed that the technique -- in which islet cells are infused into the liver -- could free most patients from the need for insulin shots.
It does, find Edmonton protocol inventor James Shapiro, MD, PhD, and colleagues. But now it's clear that only some 10% of study patients remained insulin-free after five years. Even so, the transplanted cells kept many of the patients from having life-threatening blood-sugar crashes. http://www.webmd.com:80/content/article/127/116853
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Wound healing complications in lower limb amputation - Judy Harker describes a number of problems associated with amputation wound healing and highlights the importance of multidisciplinary team working.
http://www.worldwidewounds.com/2006/september/Harker/Wound-Healing-Complications-Limb-Amputation.html
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Boost your body's defenses with at least 6 servings per week of . . . the color green? That's right. It's green-clad lutein and zeaxanthin to the rescue! No, they're not superheroes from another planet. But they are able to put a serious hurt on your risk for deadly cancers. This dynamic carotenoid duo is found in green veggies, such as kale, collard greens, and broccoli. Try them steamed, with some shredded Parmesan cheese on top, or chop 'em up and toss in a stir-fry or soup.
Lutein and zeaxanthin are powerful cancer fighters, and you need them to protect against non-Hodgkin's lymphoma (NHL), a deadly cancer that's on the rise. How do they work their cancer-fighting magic? They pull double duty. First, they work as antioxidants to wipe out tissue-damaging free radicals. Second, they help repair damaged DNA so it can't set the stage for cancer.
Leafy greens are a great source of lutein and zeaxanthin, but they don't corner the market. You also can find these nutrients in orange and yellow veggies, such as winter squash, pumpkin, and sweet yellow corn References
Vegetables, fruit, and antioxidant-related nutrients and risk of non-Hodgkin lymphoma: a National Cancer Institute-Surveillance, Epidemiology, and End Results population-based case-control study. Kelemen, L. E., Cerhan, J. R., Lim, U., Davis, S., Cozen, W., Schenk, M., Colt, J., Hartge, P., Ward, M. H., American Journal of Clinical Nutrition 2006 Jun;83(6):1401-1410.
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Your inner voice may cheerlead you into thinking longer walks equal more pounds lost, but research shows it may not be so. Long walks may be best for someone more fit, but shorter strolls -- about 30 minutes 5 days a week -- could be all you need in the first 3 months of a walking program to achieve the weight-loss benefit you seek.
Once you're feeling stronger, and the walking is easier, add minutes and intensity to reach your next goal. That'll give your inner voice something to cheer about.
INTERESTING READING
Please remember that the REUTERS' articles are good for 30 days only
Sandy Summers sent this in to a List Serve....I thought it was very appropriate to go with Sue Stones letter in this issue under "From a Member"....also Raconte's article on the website.
Why don't the facilites use research such as the following?
Nurse shortage boosts death rates Patients in hospitals with more nurses per patient fared better Nursing shortages are linked to an increase in patient death rates, a study of English hospitals has found. Scientists discovered mortality was 26% higher for the hospitals with the worst staffing levels compared with those with more nurses per patient.
The Royal College of Nursing said the study, published in the International Journal of Nursing Studies, showed it was essential to retain nursing posts. But the Department of Health said nurse numbers had risen in recent years.
Professor Anne Marie RaffertyTo establish the link between nursing levels and patient outcomes, UK researchers analysed just under 120,000 patient records and compared them with information from 4,000 nurses from 30 hospital trusts in England.
The data was taken between 1998-99. They found the patient-to-nurse ratios varied from 6.9 to 14.3 across the trusts. And patients in the hospitals where nurses had the highest workloads were more likely to suffer complications and/or die than those in hospitals with better staffing ratios. The researchers also discovered the nurses caring for the most patients were 71% more likely to suffer "burn out", and 91% more likely to be unsatisfied with their jobs compared with the nurses with a lighter workload.
Professor Anne Marie Rafferty, lead researcher on the study and a health services researcher from Kings College London, said: "We calculate that some 246 fewer deaths would have occurred in these 30 trusts had all the patients been treated in hospitals with the most favourable staffing levels.
"The number of lives that could potentially be saved through investments in nursing throughout NHS hospitals could be thousands every year."
Short-termism The research forms part of a collaboration between five countries:
US, Scotland, Germany, Canada and England, and is called the International Hospital Outcomes Study.
The scientists said the findings in England closely mirror those of the US and Canadian components, which were published recently.
The delay between the time the data was collected and the date of publication of this latest paper was because of the length of time taken to design how the study should be carried out, Professor Rafferty said.
Dr Beverly Malone, general secretary for the Royal College of Nursing, said: "This new independent research backs up what nurses have always known: that nurse numbers really do matter and that nurses make a life and death difference to how well their patients recover.
"That is why we must not allow nursing posts to be sacrificed to ease financial deficits. This is short-termism in the extreme and will end up costing the health service more in the long run as patients with complications that should have been picked up in the first place are re-admitted."
A Department of Health spokeswoman said: "Patient safety is always a top priority for the NHS and we now have around an extra 89,000 nurses working in the NHS delivering high quality care for patients than we did in 1997.
"Nursing ratios are a complex subject which has yet to gain a definitive consensus within the nursing profession
and we welcome this addition to this debate."
Liberal Democrat health spokesman Steve Webb said: "This is further evidence of the damage that will be done to patient care if the NHS financial crisis results in even more frontline staff cuts." http://news.bbc.co.uk/1/hi/health/6077690.stm
****************************
Islet-cell transplants aren't -- yet -- a cure for diabetes, an international clinical trial shows. The trial tested the Edmonton protocol, a revolutionary technique for transplanting insulin-making pancreas cells from cadavers to desperately ill diabetes patients. A few years ago, it seemed that the technique -- in which islet cells are infused into the liver -- could free most patients from the need for insulin shots.
It does, find Edmonton protocol inventor James Shapiro, MD, PhD, and colleagues. But now it's clear that only some 10% of study patients remained insulin-free after five years. Even so, the transplanted cells kept many of the patients from having life-threatening blood-sugar crashes.ept. 27, 2006 -- Islet-cell transplants aren't -- yet -- a cure for diabetes, an international clinical trial shows.
The trial tested the Edmonton protocol, a revolutionary technique for transplanting insulin-making pancreas cells from cadavers to desperately ill diabetes patients. A few years ago, it seemed that the technique -- in which islet cells are infused into the liver -- could free most patients from the need for insulin shots.
It does, find Edmonton protocol inventor James Shapiro, MD, PhD, and colleagues. But now it's clear that only some 10% of study patients remained insulin-free after five years. Even so, the transplanted cells kept many of the patients from having life-threatening blood-sugar crashes. http://www.webmd.com:80/content/article/127/116853
****************************
Wound healing complications in lower limb amputation - Judy Harker describes a number of problems associated with amputation wound healing and highlights the importance of multidisciplinary team working.
http://www.worldwidewounds.com/2006/september/Harker/Wound-Healing-Complications-Limb-Amputation.html
******************************
Boost your body's defenses with at least 6 servings per week of . . . the color green? That's right. It's green-clad lutein and zeaxanthin to the rescue! No, they're not superheroes from another planet. But they are able to put a serious hurt on your risk for deadly cancers. This dynamic carotenoid duo is found in green veggies, such as kale, collard greens, and broccoli. Try them steamed, with some shredded Parmesan cheese on top, or chop 'em up and toss in a stir-fry or soup.
Lutein and zeaxanthin are powerful cancer fighters, and you need them to protect against non-Hodgkin's lymphoma (NHL), a deadly cancer that's on the rise. How do they work their cancer-fighting magic? They pull double duty. First, they work as antioxidants to wipe out tissue-damaging free radicals. Second, they help repair damaged DNA so it can't set the stage for cancer.
Leafy greens are a great source of lutein and zeaxanthin, but they don't corner the market. You also can find these nutrients in orange and yellow veggies, such as winter squash, pumpkin, and sweet yellow corn References
Vegetables, fruit, and antioxidant-related nutrients and risk of non-Hodgkin lymphoma: a National Cancer Institute-Surveillance, Epidemiology, and End Results population-based case-control study. Kelemen, L. E., Cerhan, J. R., Lim, U., Davis, S., Cozen, W., Schenk, M., Colt, J., Hartge, P., Ward, M. H., American Journal of Clinical Nutrition 2006 Jun;83(6):1401-1410.
*****************************
Your inner voice may cheerlead you into thinking longer walks equal more pounds lost, but research shows it may not be so. Long walks may be best for someone more fit, but shorter strolls -- about 30 minutes 5 days a week -- could be all you need in the first 3 months of a walking program to achieve the weight-loss benefit you seek.
Once you're feeling stronger, and the walking is easier, add minutes and intensity to reach your next goal. That'll give your inner voice something to cheer about.
In a 12-week study of significantly overweight women, those who walked for 30 minutes 5 days per week lost weight at a rate similar to that of women who walked for 60 minutes 5 days per week. Researchers speculate that greater health benefits from longer walks probably start to kick in after 12 weeks. Your weight and fitness level will likely determine how your body responds to exercise programs of varying degrees of intensity and duration.
Dose-response effect of walking exercise on weight loss. How much is enough? Bond Brill, J., Perry, A. C., Parker, L., Robinson, A., Burnett, K., International Journal of Obesity and Related Metabolic Disorders 2002 Nov;26(11):1484-1493.
*************************
ALEXANDRIA, VA -- October 2, 2006 -- In response to growing concern and confusion about Lyme disease, the Infectious Diseases Society of America (IDSA) has updated its Clinical Practice Guidelines on the disease, in order to provide guidance to physicians and patients based on the latest scientific evidence. The guidelines were originally published in 2000.
The most significant changes in the updated version include:
-- The addition of information on human granulocytic anaplasmosis (HGA) and babesiosis, two diseases transmitted by the same tick that transmits Lyme disease;
-- Recommendations of a single dose of an antibiotic for certain high-risk patients who have been bitten by a tick but do not have symptoms of Lyme disease;
-- Expanded discussion and definition of so-called "chronic" or post-Lyme syndromes.
http://www.docguide.com/news/content.nsf/news/852571020057CCF6852571FB00569D15?OpenDocument&id=D82277BEB625E4E185256E3700509F48&c=&count=10
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When you talk with patients about their diet—specifically when you provide patient education pertaining to healthy diet choices—you may include grapefruit and grapefruit juice on the list of healthy food and beverage choices. Why not? It’s high in vitamin C and lycopene, relatively low in calories, has no fat and very low sodium. But did you know that grapefruit and grapefruit juice can potentially cause serious drug-food interactions with some of the most commonly prescribed drugs.
Interactions between grapefruit juice and medications have been recognized since the 1980s. The U.S. Food & Drug Administration now requires all prospective new drugs that are thought to interact with this enzyme system to be tested for interactions with grapefruit juice. In addition, a warning about grapefruit juice is included in the "food-drug interactions" that come with numerous medications. Nevertheless, many health care providers and patients know little to nothing about the associated risks—some of which may be life threatening depending on a variey of factors, including age, genetics and metabolism. http://w3.rn.com/news_features.asp?articleID=15640
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Tetralogy of Fallot (ToF) occurs in approximately 1 in 3600 live births and accounts for 3.5% of infants born with congenital heart disease. Surgical repair was first introduced in the 1950s and there is now a large population of adults with repaired tetralogy. Many of the short term aspects of management have been resolved, although whether symptomatic neonates should undergo primary repair or first be palliated remains debatable. In 2001, independently validated data pooled from all 13 centres performing cardiac surgery in the United Kingdom indicated a 97% survival one year after operation.1 Other reports indicate that of patients alive 30 days after operation there is a 98% 20 year survival, and of those operated on as children 30 year survival is above 90%.2
http://www.mdlinx.com/readArticle.cfm?art_id=1649367 ( to get the full article.... subscribe to HEART magazine)
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Medical News Today, Tue, 21 Nov 2006 4:07 PM PST Potentially deadly influenza outbreaks in nursing homes are less likely to occur when large numbers of staff and residents get flu shots, according to a study issued on 15-Nov-2006 by the RAND Corporation http://www.medicalnewstoday.com/medicalnews.php?newsid=56861&nfid=rssfeeds
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HUMOR SECTION
Dose-response effect of walking exercise on weight loss. How much is enough? Bond Brill, J., Perry, A. C., Parker, L., Robinson, A., Burnett, K., International Journal of Obesity and Related Metabolic Disorders 2002 Nov;26(11):1484-1493.
*************************
ALEXANDRIA, VA -- October 2, 2006 -- In response to growing concern and confusion about Lyme disease, the Infectious Diseases Society of America (IDSA) has updated its Clinical Practice Guidelines on the disease, in order to provide guidance to physicians and patients based on the latest scientific evidence. The guidelines were originally published in 2000.
The most significant changes in the updated version include:
-- The addition of information on human granulocytic anaplasmosis (HGA) and babesiosis, two diseases transmitted by the same tick that transmits Lyme disease;
-- Recommendations of a single dose of an antibiotic for certain high-risk patients who have been bitten by a tick but do not have symptoms of Lyme disease;
-- Expanded discussion and definition of so-called "chronic" or post-Lyme syndromes.
http://www.docguide.com/news/content.nsf/news/852571020057CCF6852571FB00569D15?OpenDocument&id=D82277BEB625E4E185256E3700509F48&c=&count=10
****************************
When you talk with patients about their diet—specifically when you provide patient education pertaining to healthy diet choices—you may include grapefruit and grapefruit juice on the list of healthy food and beverage choices. Why not? It’s high in vitamin C and lycopene, relatively low in calories, has no fat and very low sodium. But did you know that grapefruit and grapefruit juice can potentially cause serious drug-food interactions with some of the most commonly prescribed drugs.
Interactions between grapefruit juice and medications have been recognized since the 1980s. The U.S. Food & Drug Administration now requires all prospective new drugs that are thought to interact with this enzyme system to be tested for interactions with grapefruit juice. In addition, a warning about grapefruit juice is included in the "food-drug interactions" that come with numerous medications. Nevertheless, many health care providers and patients know little to nothing about the associated risks—some of which may be life threatening depending on a variey of factors, including age, genetics and metabolism. http://w3.rn.com/news_features.asp?articleID=15640
****************************
Tetralogy of Fallot (ToF) occurs in approximately 1 in 3600 live births and accounts for 3.5% of infants born with congenital heart disease. Surgical repair was first introduced in the 1950s and there is now a large population of adults with repaired tetralogy. Many of the short term aspects of management have been resolved, although whether symptomatic neonates should undergo primary repair or first be palliated remains debatable. In 2001, independently validated data pooled from all 13 centres performing cardiac surgery in the United Kingdom indicated a 97% survival one year after operation.1 Other reports indicate that of patients alive 30 days after operation there is a 98% 20 year survival, and of those operated on as children 30 year survival is above 90%.2
http://www.mdlinx.com/readArticle.cfm?art_id=1649367 ( to get the full article.... subscribe to HEART magazine)
********************************
Medical News Today, Tue, 21 Nov 2006 4:07 PM PST Potentially deadly influenza outbreaks in nursing homes are less likely to occur when large numbers of staff and residents get flu shots, according to a study issued on 15-Nov-2006 by the RAND Corporation http://www.medicalnewstoday.com/medicalnews.php?newsid=56861&nfid=rssfeeds
VVVVVVVVVVVVVVV
HUMOR SECTION
A cat died and went to Heaven. God met her at the gates and said, "You have been a good cat all these years. Anything you want is yours for the asking."
The cat thought for a minute and then said, "All my life I lived on a farm and slept on hard wooden floors. I would like a real fluffy pillow to sleep on."
God said, "Say no more." Instantly the cat had a huge fluffy pillow.
A few days later, six mice were killed in an accident and they all went to Heaven together. God met the mice at the gates and made the same offer that He had made to the cat. The mice said, "Well we have had to run all of our lives: from cats, dogs, and even people with brooms! If we could just have some little roller skates, we would not have to run again." God answered, "It is done." All the mice had beautiful little roller skates.
About a week later, God decided to check on the cat. He found her sound asleep on her fluffy pillow. God gently awakened the cat and asked, " Is everything okay? How have you been doing? Are you happy?".
The cat replied, " Oh, it is WONDERFUL. I have never been so happy in my life. The pillow is so fluffy, and those little Meals on Wheels you have been sending over are delicious!!!"
The cat thought for a minute and then said, "All my life I lived on a farm and slept on hard wooden floors. I would like a real fluffy pillow to sleep on."
God said, "Say no more." Instantly the cat had a huge fluffy pillow.
A few days later, six mice were killed in an accident and they all went to Heaven together. God met the mice at the gates and made the same offer that He had made to the cat. The mice said, "Well we have had to run all of our lives: from cats, dogs, and even people with brooms! If we could just have some little roller skates, we would not have to run again." God answered, "It is done." All the mice had beautiful little roller skates.
About a week later, God decided to check on the cat. He found her sound asleep on her fluffy pillow. God gently awakened the cat and asked, " Is everything okay? How have you been doing? Are you happy?".
The cat replied, " Oh, it is WONDERFUL. I have never been so happy in my life. The pillow is so fluffy, and those little Meals on Wheels you have been sending over are delicious!!!"
VVVVVVVVVVVVVVVVVVVV
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
A website offering free CEU s: http://www.medscape.com/cmecenterdirectory/nurses
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com/
Nearly One Third of Older Adults Fall, Some to their Deaths (CME/CE)
ATLANTA -- Accidental falls account for an estimated 1.8 million annual emergency department visits for older Americans, and falls are the leading cause of trauma deaths in this age group, according to CDC investigators. http://www.medpagetoday.com/PrimaryCare/Geriatrics/dh/4549
Contact hours are just a click away with ADVANCE's popular Learning Scope. Check out our most recent CE offerings, Incident Reports. You can also take a host of discounted and free CEs!Group discounts are available to facilities that want to offer their nurses an easy way to earn CE credit. Call Terri Castrinoes for details at 800-355-5627, ext. 1446; or e-mail her at tcastrinoes@merion.com.
ZZZZZZZZZZZZZZZZZZ
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
A website offering free CEU s: http://www.medscape.com/cmecenterdirectory/nurses
Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com/
Nearly One Third of Older Adults Fall, Some to their Deaths (CME/CE)
ATLANTA -- Accidental falls account for an estimated 1.8 million annual emergency department visits for older Americans, and falls are the leading cause of trauma deaths in this age group, according to CDC investigators. http://www.medpagetoday.com/PrimaryCare/Geriatrics/dh/4549
Contact hours are just a click away with ADVANCE's popular Learning Scope. Check out our most recent CE offerings, Incident Reports. You can also take a host of discounted and free CEs!Group discounts are available to facilities that want to offer their nurses an easy way to earn CE credit. Call Terri Castrinoes for details at 800-355-5627, ext. 1446; or e-mail her at tcastrinoes@merion.com.
ZZZZZZZZZZZZZZZZZZ
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:
RNFrankie@bellsouth.net
A - Z Guide on Health Topics http://www.webmd.com/a_to_z_guide/health_topics.htm
Click here: Insertion and Management of Nasogastric Tubes for Adults
http://www.joannabriggs.edu.au/protocols/protnasotube.php
Sent in by BAcello (Barbara) This is an excellent, simple program!
Susan Harwood Preventing TB in Long Term Care
http://www.aed.org/Health/International/upload/PreventingTB.pdf
****************************************************************
***************************************************
*
Medical Recalls
*
**************************************************
****************************************************************
FDA notified healthcare professionals of a newly published clinical study showing that patients treated with an erythropoiesis-stimulating agent (ESA) and dosed to a target hemoglobin concentration of 13.5 g/dL are at a significantly increased risk for serious and life threatening cardiovascular complications, as compared to use of the ESA to target a hemoglobin concentration of 11.3 g/dL. The "Correction of Hemoglobin and Outcomes in Renal Insufficiency" study, published November 16, 2006 in the New England Journal of Medicine, reports the adverse cardiovascular complications as a composite of the occurrence of one of the following events: death, myocardial infarction, hospitalization for congestive heart failure, or stroke.
The study findings underscore the importance of following the currently approved prescribing information for Procrit, Epogen, and Aranesp, including the dosing recommendation that the target hemoglobin not exceed 12 g/dL.
http://www.fda.gov/medwatch/safety/2006/safety06.htm#erythropoiesis
**************************
Roche and FDA notified healthcare professionals of revisions to the PRECAUTIONS/Neuropsychiatric Events and Patient Information sections of the prescribing information for acute illness Tamiflu, indicated for the treatment of uncomplicated distress due to influenza infection in patients 1year and older who have been symptomatic for no more than 2 days and for the prophylaxis of influenza in patients 1 year and older. There have been postmarketing reports, mostly from Japan, of self-injury and delirium with the use of Tamiflu in patients with influenza. People with the flu, particularly children, may be at an increased risk of self-injury and confusion shortly after taking Tamiflu and should be closely monitored for signs of unusual behavior. A healthcare professional should be contacted immediately if the patient taking Tamiflu shows any signs of unusual behavior.
http://www.fda.gov/medwatch/safety/2006/safety06.htm#tamiflu
*****************************
LifeScan and FDA notified healthcare professionals and the public of counterfeit blood glucose test strips being sold in the United States for use with various models of the One Touch Brand Blood Glucose Monitors used by people with diabetes to measure their blood glucose. The counterfeit test strips potentially could give incorrect blood
glucose values--either too high or too low--which might result in a patient taking either too much or too little insulin and lead to serious injury or death . http://www.fda.gov/medwatch/safety/2006/safety06.htm#LifeScan
********************************
Ibuprofen May Reduce Protective Effects of Aspirin — The US Food and Drug Administration (FDA) has notified healthcare professionals and consumers that taking ibuprofen for pain relief may interfere with the benefits of aspirin taken for heart disease. Ibuprofen can interfere with the antiplatelet effect of low-dose aspirin (81 mg/day), which may render aspirin less effective when used for cardioprotection and stroke prevention, according to an alert from MedWatch, the FDA's safety information and adverse event reporting program.
http://www.medscape.com/viewarticle/544497?src=mp
In a note to healthcare professionals, the FDA gives the following advice: With occasional use of ibuprofen, there is likely to be minimal risk from any attenuation of the antiplatelet effect of low-dose aspirin, because of the long-lasting effect of aspirin on platelets.
*************************************
This may be a repeat ...sorry. Heartland Repack Services and FDA notified healthcare professionals of a voluntary recall of all products containing a lot number beginning with "K" (example: K12345). Drugs repackaged by Heartland Repack Services are distributed through their own pharmacy services to Omnicare nursing homes and other institutional facilities. Omnicare is responsible for 1.4 million nursing home and healthcare patients in 47 states and Canada. These product lots are distributed in 30, 60, 90 count size boxes and 250 count bags. Both the boxes and bags contain unit dose
strips of five tablets per strip. This recall was initiated because there is the potential for mislabeling and packaging mix-up. Due to incomplete accounting of product subject to this recall, on October 20, 2006 Heartland Repack Services issued a follow-up notice of the July 2006 recall.
http://www.fda.gov/medwatch/safety/2006/safety06.htm#heartland
*******************************
Vaccine Mix-ups: Adacel (Tdap) and Daptacel (DTaP)
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#6
Danger in Administering Azathioprine and Mercaptopurine Together
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#5
Drug Name Confusion: Mucomyst and Mucinex
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#4
Increased Risk of Infectious Disease Transmission from Human Tissues recovered by Donor Referral Services
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#3
Safety Information on Alaris SE Infusion Pumps
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#2
New Studies on Antidepressants in Pregnancy
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#1
zzzzzzzzzzzzzzzzzzz
NURSING HINTS CORNER
Arm position and Blood pressure:
We all know that stress and "white coatitis" can cause an increase in blood pressure and now according to the January 6th Annals of Internal Medicine, blood pressure readings can be up to 10% higher depending on the positioning of the patient's arm
Blood pressure readings taken on arms parellel or extended in the SAME direction as the body are up to 10 % higher than the readings taken when the person's elbow is at a right angle to the body with the elbow flexed at heart level.
The study's investigators from the University of California, San Diego (UCSD) School of Medicine and the Medical College of Wisconsin noted that because blood pressure values determine methods of treatment, a designated and consistent arm position should be adhered to when measuring blood pressure.
It also was found, in a previous study, that 73% of healthcare workers failed to use proper blood pressure cuff positions and arm positions (with slightly flexed elbow and held at heart level) as defined by the American Heart Association.
ADVANCE for Nurses, July 7, 2004,p. 47 (WWW.advanceweb.com )
Always on the lookout for interesting websites / links. Please send them to:
RNFrankie@bellsouth.net
A - Z Guide on Health Topics http://www.webmd.com/a_to_z_guide/health_topics.htm
Click here: Insertion and Management of Nasogastric Tubes for Adults
http://www.joannabriggs.edu.au/protocols/protnasotube.php
Sent in by BAcello (Barbara) This is an excellent, simple program!
Susan Harwood Preventing TB in Long Term Care
http://www.aed.org/Health/International/upload/PreventingTB.pdf
****************************************************************
***************************************************
*
Medical Recalls
*
**************************************************
****************************************************************
FDA notified healthcare professionals of a newly published clinical study showing that patients treated with an erythropoiesis-stimulating agent (ESA) and dosed to a target hemoglobin concentration of 13.5 g/dL are at a significantly increased risk for serious and life threatening cardiovascular complications, as compared to use of the ESA to target a hemoglobin concentration of 11.3 g/dL. The "Correction of Hemoglobin and Outcomes in Renal Insufficiency" study, published November 16, 2006 in the New England Journal of Medicine, reports the adverse cardiovascular complications as a composite of the occurrence of one of the following events: death, myocardial infarction, hospitalization for congestive heart failure, or stroke.
The study findings underscore the importance of following the currently approved prescribing information for Procrit, Epogen, and Aranesp, including the dosing recommendation that the target hemoglobin not exceed 12 g/dL.
http://www.fda.gov/medwatch/safety/2006/safety06.htm#erythropoiesis
**************************
Roche and FDA notified healthcare professionals of revisions to the PRECAUTIONS/Neuropsychiatric Events and Patient Information sections of the prescribing information for acute illness Tamiflu, indicated for the treatment of uncomplicated distress due to influenza infection in patients 1year and older who have been symptomatic for no more than 2 days and for the prophylaxis of influenza in patients 1 year and older. There have been postmarketing reports, mostly from Japan, of self-injury and delirium with the use of Tamiflu in patients with influenza. People with the flu, particularly children, may be at an increased risk of self-injury and confusion shortly after taking Tamiflu and should be closely monitored for signs of unusual behavior. A healthcare professional should be contacted immediately if the patient taking Tamiflu shows any signs of unusual behavior.
http://www.fda.gov/medwatch/safety/2006/safety06.htm#tamiflu
*****************************
LifeScan and FDA notified healthcare professionals and the public of counterfeit blood glucose test strips being sold in the United States for use with various models of the One Touch Brand Blood Glucose Monitors used by people with diabetes to measure their blood glucose. The counterfeit test strips potentially could give incorrect blood
glucose values--either too high or too low--which might result in a patient taking either too much or too little insulin and lead to serious injury or death . http://www.fda.gov/medwatch/safety/2006/safety06.htm#LifeScan
********************************
Ibuprofen May Reduce Protective Effects of Aspirin — The US Food and Drug Administration (FDA) has notified healthcare professionals and consumers that taking ibuprofen for pain relief may interfere with the benefits of aspirin taken for heart disease. Ibuprofen can interfere with the antiplatelet effect of low-dose aspirin (81 mg/day), which may render aspirin less effective when used for cardioprotection and stroke prevention, according to an alert from MedWatch, the FDA's safety information and adverse event reporting program.
http://www.medscape.com/viewarticle/544497?src=mp
In a note to healthcare professionals, the FDA gives the following advice: With occasional use of ibuprofen, there is likely to be minimal risk from any attenuation of the antiplatelet effect of low-dose aspirin, because of the long-lasting effect of aspirin on platelets.
*************************************
This may be a repeat ...sorry. Heartland Repack Services and FDA notified healthcare professionals of a voluntary recall of all products containing a lot number beginning with "K" (example: K12345). Drugs repackaged by Heartland Repack Services are distributed through their own pharmacy services to Omnicare nursing homes and other institutional facilities. Omnicare is responsible for 1.4 million nursing home and healthcare patients in 47 states and Canada. These product lots are distributed in 30, 60, 90 count size boxes and 250 count bags. Both the boxes and bags contain unit dose
strips of five tablets per strip. This recall was initiated because there is the potential for mislabeling and packaging mix-up. Due to incomplete accounting of product subject to this recall, on October 20, 2006 Heartland Repack Services issued a follow-up notice of the July 2006 recall.
http://www.fda.gov/medwatch/safety/2006/safety06.htm#heartland
*******************************
Vaccine Mix-ups: Adacel (Tdap) and Daptacel (DTaP)
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#6
Danger in Administering Azathioprine and Mercaptopurine Together
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#5
Drug Name Confusion: Mucomyst and Mucinex
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#4
Increased Risk of Infectious Disease Transmission from Human Tissues recovered by Donor Referral Services
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#3
Safety Information on Alaris SE Infusion Pumps
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#2
New Studies on Antidepressants in Pregnancy
http://www.accessdata.fda.gov/psn/transcript.cfm?show=57#1
zzzzzzzzzzzzzzzzzzz
NURSING HINTS CORNER
Arm position and Blood pressure:
We all know that stress and "white coatitis" can cause an increase in blood pressure and now according to the January 6th Annals of Internal Medicine, blood pressure readings can be up to 10% higher depending on the positioning of the patient's arm
Blood pressure readings taken on arms parellel or extended in the SAME direction as the body are up to 10 % higher than the readings taken when the person's elbow is at a right angle to the body with the elbow flexed at heart level.
The study's investigators from the University of California, San Diego (UCSD) School of Medicine and the Medical College of Wisconsin noted that because blood pressure values determine methods of treatment, a designated and consistent arm position should be adhered to when measuring blood pressure.
It also was found, in a previous study, that 73% of healthcare workers failed to use proper blood pressure cuff positions and arm positions (with slightly flexed elbow and held at heart level) as defined by the American Heart Association.
ADVANCE for Nurses, July 7, 2004,p. 47 (WWW.advanceweb.com )
XXXXXXXXXXXXXXXXXXXXXXXXXX
ADVERTISEMENTS
from the members This ad is from Decubqueen (Gerry)..........
Accu-Ruler
Accurate 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/.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
This ad is from: GShort @AOL.com (Gwen) These are great little cakes !
http://www.delightfulgreetingcakes.com/worldsgreatest.php
<<<<<<<<<<<<<<<<<<<<>>>>>>>>>>>>>>>>>>>
ADVERTISEMENTS
from the members This ad is from Decubqueen (Gerry)..........
Accu-Ruler
Accurate 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/.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
This ad is from: GShort @AOL.com (Gwen) These are great little cakes !
http://www.delightfulgreetingcakes.com/worldsgreatest.php
<<<<<<<<<<<<<<<<<<<<>>>>>>>>>>>>>>>>>>>
NEW MEMBERS
No new members this issue
Please send the prospective members' screen names and first names to me: RNFrankie@bellsouth.net
++++++++++++++++++++++++++++
NOTICE: I attempt to send newsletters to your current 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.......lol
So please send me your new name/address, ok? rnfrankie@bellsouth.net
YYYYYYYYYYYYY
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)
Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN@AOL.com (Sue) E thru I section,
rnfrankie @bellsouth.net (Frankie) J thru K section,
Jntcln@AOL.com (Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section
Schulthe@AOL.com (Susan) R thru T section
Sandy1956@AOL.com (Sandy) U thru Z section.
lllllllllllllllll
Paradigm 97 Co-Founders:
MarGerlach @AOL.com (Marlene) and RNFrankie @bellsouth.com (Frankie)
**********************************
No new members this issue
Please send the prospective members' screen names and first names to me: RNFrankie@bellsouth.net
++++++++++++++++++++++++++++
NOTICE: I attempt to send newsletters to your current 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.......lol
So please send me your new name/address, ok? rnfrankie@bellsouth.net
YYYYYYYYYYYYY
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)
Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN@AOL.com (Sue) E thru I section,
rnfrankie @bellsouth.net (Frankie) J thru K section,
Jntcln@AOL.com (Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section
Schulthe@AOL.com (Susan) R thru T section
Sandy1956@AOL.com (Sandy) U thru Z section.
lllllllllllllllll
Paradigm 97 Co-Founders:
MarGerlach @AOL.com (Marlene) and RNFrankie @bellsouth.com (Frankie)
**********************************
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.
THOUGHT FOR THE DAY
When will our consciences grow so tender that we will act
to prevent human misery rather than avenge it?
--ELEANOR ROOSEVELT
Hope to hear from you ..... Frankie
(RNFrankie@bellsouth)
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.
THOUGHT FOR THE DAY
When will our consciences grow so tender that we will act
to prevent human misery rather than avenge it?
--ELEANOR ROOSEVELT
Hope to hear from you ..... Frankie
(RNFrankie@bellsouth)
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