Saturday, December 8, 2007

PARADIGM BYTES December 8, 2007


PARADIGM BYTES
Newsletter for Paradigm 97
December 8, 2007

Wishing you all the very best and beautiful Christmas.....and a great New Year. Keep in mind that on January 20th......we wil "celebrate" our Eleventh year together ! Wow.


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/
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 AOL chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PST Now, the Paradigm Chatroom..{.here is the link: Click here: PARADIGM97 } is always there....door open, lights on, waiting for you 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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MEDICAL NEWS

The Robert Wood Johnson Foundation is Seeking Executive Nurse LeadersNotice from The Center for the Health Professions (UCSF). The application deadline is February 1, 2008 for the 2008 cohort. Up to 20 fellowships will be awarded in this grant cycle
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CAPPS Introduces Legislation on Hospital Nurse Staffing Levels Congresswoman Lois Capps introduced legislation today aiming to require health care facilities to adopt nurse staffing levels sufficient to promote high quality patient care.
The Registered Nurse Safe Staffing Act would require Medicare-participating hospitals to implement staffing systems that ensure a certain number of registered nurses on each shift and in each unit of the hospital.
Capps, D-Santa Barbara, co-authored HR 4138 with Ginny Brown-Waite, D, Florida. Capps' district covers parts of San Luis Obispo County.
“This legislation encourages nurses and hospitals to work together to make sure the right number of nurses are there to provide the excellent care that each and every patient deserves,” Capps said in a prepared statement. California already has some of the strictest nursing staffing ratios in the nation. http://www.sanluisobispo.com/breakingnews/story/192206.html
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Veto Costs Nursing Programs $18M
President Bush vetoed legislation containing funding for the Title VIII Nursing Workforce Development Programs, which are considered the main sources of federal support for nursing recruitment, education and retention. The House of Representatives failed to pass the FY 2008 Labor, Health and Human Services, and Education Appropriations Act by a veto-proof margin. The final vote was 277-141.
The legislation (H.R. 3043) contained an $18 million increase in funding for the Title VIII programs. The Nov. 14 veto brings fiscal year 2008 funding for the programs to $167.7 million. Bush's initial proposal was to cut an unprecedented $44 million from nursing workforce development, according to the American Nurses Association.
In FY 2006, the Health Resources and Services Administration (HRSA) was forced to turn away 85 percent of the applicants for the Nurse Education Loan Repayment Program, and 96 percent of the applicants for the Nursing Scholarship program due to inadequate funding. That resulted in 10,000 applicants being turned away from programs designed to direct RNs into facilities with the most critical nursing shortages, ANA said in the prepared statement.
HRSA projects that, absent aggressive intervention, the supply of nurses in America will fall 36 percent (more than 1 million nurses) below requirements by the year 2020. http://nursing.advanceweb.com/SpecialPages/NW/NationalNews.aspx?#ID101598
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FROM THE MEMBERS

This was sent in by Decubqueen @AOL.com (Gerry). She writes with well deserved pride:
" Accu-Ruler was voted #3 in the category of Most Innovative on Microsoft's Startup Nation's home based 100 businesses. I am very happy that we were chosen for this category as it wasn't based on popularity votes, as was one category, but by the product itself. They wrote up a small blurb on us with one sentence that wasn't true. They mentioned that we've grown so much that we are now outsourcing. That is not true. We still manufacture them, we just have a few more employees than we did, and one works from home, but she is only about 5 minutes away. So I guess if they count that as outsourcing, then we are outsourcing. In any case, I am proud and happy that this business was chosen and took the 3rd position in the top 10 of Most Innovative.
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This is from MagicianNKitchen@AOL.com (Faye). She writes: I have multiple diagnosis: spinal stenosis w entrapment neuropathy, severe osteo arthritis, degenerative joint disease w/ multiple replaced joints, entrapped radial nerve status post mumford procedure (which is the removal of the head of the clavicle) and decompression of the shoulder joint. I have been left with chronic left arm pain, fibromyalgia. Secondary to inflammatory disease process: chronic interstitial cystitis, severe sleep apnea (requiring Cpap and O2), mitral valve prolapsed (monitoring every 6 months). Not to mention chronic depression, however, personally I would never consider any means to end my life. I feel that is a permanent solution to temporary problems.
For chronic pain control, I personally require 150 mgm of Fenyanyl/hr, w Dilaudid 3-12 mgms q 4-12 hrs for breakthrough pain, in addition medication muscle relaxation, depression, etc. I would go back to work in a heartbeat, however, there isn't a workman's comp carrier that will cover an employee that requires narcotics for pain control. Also, it is a personal decision I made many years ago that even if we are not making day to day life and death decisions, a nurse on medication for chronic pain control has no place in a medical setting.
Thankfully I had the forethought to protect a portion of my salary via long term disability that augments my social security disability. It was very difficult to be medically retired at the age of 40, and at the age of 57 those feelings haven't changed.(If anyone has any suggestions to help with the pain, or know how she could get employment while she has such pain requiring the above medications.....Let her know). I would appreciate hearing from you all on this .... She is a gourmet Kosher chef !
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INTERESTING READING

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

The immunity conveyed by vaccinations lasts much longer than had been thought, researchers said, and Americans may be getting booster doses that aren't needed.In some cases, mainly those that involve replicating viral antigens, immunity is lifelong, Mark Slifka, Ph.D., and colleagues at the Oregon Health & Science University here, reported in the Nov. 8 issue of the New England Journal of Medicine. "Surprisingly, we found that immunity following vaccination with tetanus and diphtheria was much more long-lived than anyone realized and that antibody responses following viral infections were essentially maintained for life," Dr. Slifka said.... http://www.medpagetoday.com/InfectiousDisease/Vaccines/tb/7289
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News on Nursing in the Media Baby We Were Born to Care
November 2007 -- Johnson & Johnson has begun running a new set of television ads as part of its massive Campaign for Nursing's Future, whose stated goal is to address the nursing shortage. The two new 30-second spots do not abandon the emotional, soft-focus helping imagery that marred the Campaign's previous ads, particularly in the use of more gooey lite music with lyrics about being "born to care." But both ads also do important things the Center urged the company to do in its analysis of the previous ads. They make clear that nurses save lives and improve outcomes, even offering some specific examples, like defibrillation. One ad pays tribute to nurse educators. And both continue the Campaign's admirable focus on promoting workforce diversity. We thank J&J for ads that do a better job of showing the public that nurses are not just angelic hand-holders. http://www.nursingadvocacy.org/media/commercials/jnj_2007.html
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This is from BAcello (Barbara).........from University of Iowa's Geriatric EducationSome of the resources available on the IGEC web site include:• E‐Learning The Iowa Geriatric Education Center offers online learning opportunities for licensed and certified healthcare professionals and trainees. These include GeriaSims (interactive "virtual patient" simulations on the care of older adults), GeriaFlix (multidisciplinary presentations on geriatric topics in a streaming digital video format with synchronized slides), a program on Best-Practice Geriatric Oral Health Training, and the Train-the-Preceptor Program in Functional Assessment, as well as interactive, story-based Internet modules designed for CNAs.• Publications Archive Includes the Info-Connect series – informational pamphlets designed to provide practical information for long-term care providers about topics of key importance. New brochures are added regularly. The archive also includes the previous 12 months' issues of E-NEWS.• Geriatric Assessment Tools A collection of tools that are a standardized means of obtaining information from older adults as part of a comprehensive assessment visit. The tools are organized into categories such as depression, dementia and delirium, functional assessment, pain, and oral health.• Ask the Expert A searchable database of previously asked questions about issues in caring for older adults. If your question is not in the database, you can submit it to an interdisciplinary panel of experts using a simple online form.• Geriatric Lecture Series Information General information about the Geriatric Lecture Series, including a schedule of topics, presenter information, and CEU/CME forms. http://www.healthcare.uiowa.edu/igec/
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No website given for this article......just the Journal. Vitamin E Could Help Diabetics Ward Off MIs
Vitamin E supplements can significantly reduce the risk of myocardial infarction (MI) and related deaths for diabetics who carry a particular version of a gene, according to researchers at the Technion-Israel Institute of Technology and the Clalit Health Services in Israel.
After 18 months of treatment, people with the haptoglobin (Hp) 2-2 gene who took 400 International Units (IU) of vitamin E daily had more than 50 percent fewer MIs, strokes and related deaths than Hp 2-2 patients who took a placebo pill. Forty percent of individuals with diabetes carry the Hp 2-2 gene.
The full study appeared in the Nov. 21 online edition of the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
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Tell Us What You Think About Proposed Standard Revisions to the Joint Commission’s Standards - Patient Rights and Responsibilities (RI)
As part of the Standards Improvement Initiative (SII), The Joint Commission is asking for feedback on proposed revisions to the current Patient Rights and Responsibilities (RI) chapter for the Ambulatory Health Care, Critical Access Hospital, Home Care, Hospital, and Office-Based Surgery programs.
The revised Patient Rights and Responsibilities (RI) chapter applies to individuals from the following areas:
* Case Manager, Care Manager, Social Services Professional
Physician
Nurse (including nursing administrator)
Administrator (not including nursing administrator)
Chaplain
Attorney
Patient Advocate
Translator
Interpreter
Performance Improvement Professional
Governing Body Member
Individuals from these areas are recommended to review the RI chapter. Please forward this e-mail to people from these areas who may be responsible for the implementation of the RI standards. Feedback on proposed revisions to the Patient Rights and Responsi-bilities (RI) chapter will be gathered for 6 weeks, beginning on November 19, 2007.
To review the revised chapter and provide feedback, click on the following link or copy and paste the link into the address bar of your internet browser: http://www.jointcommission.org/Standards/SII/.
At this site, you will:
1. Select the program you represent (you may provide feedback for more than one program, but you will need to repeat this process for each program you select)
2. Read the revised standards and their supporting materials
3. Follow the instructions for providing feedback via mail, email, or online survey
Thank you in advance for your time and thoughtful comments http://www.jointcommission.org/Standards/SII/
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Interesting Question: Since we are not relieved from duty to eat, should our employer pay us for the 30 minutes docked from our paychecks for meals? For the Answer, go to: http://include.nurse.com/apps/pbcs.dll/article?AID=/20071018/ALL05/71016004/-1/section
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The U.S. is in desperate need of more nurses. And many young people would like to become nurses. So why is the nurse shortage worse than ever?
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The problem is there aren’t enough educational programs to train nurses. And there aren’t enough teachers of nursing.For this reason, Dr. Cindy Mailloux recently went to Washington and joined nurse educators from across the country to urge their legislators to designate more funding for nurse education.Dr. Mailloux is the chairman of the nursing department at Misericordia University.“By increasing our legislators’ awareness, we’re hoping funding can be found to meet the needs of the profession and improve the quality of care patients receive,” said Mailloux.Specifically, Mailloux and her colleagues are asking their U.S. senators to support Nursing Workforce Development programs under Title VIII, the largest source of federal funding for nursing education.To their credit, both Pennsylvania senators, Alren Specter and Bob Casey, through their aids, indicated support for more funding for nursing education. http://www.zwire.com/site/news.cfm?newsid=19044840&BRD=2259&PAG=461&dept_id=456222&rfi=6
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LOS ANGELES (Dec. 4) - Dennis Quaid and his wife sued the makers of heparin Tuesday after their newborn twins were inadvertently given massive doses of the blood thinner at a hospital. The product liability lawsuit, filed in Chicago, seeks more than $50,000 in damages. It claims that Baxter Healthcare Corp., based in Deerfield, Ill., was negligent in packaging different doses of the product in similar vials with blue backgrounds. The lawsuit also says the company should have recalled the large-dosage vials after overdoses killed three children at an Indianapolis hospital last year. ...The lawsuit was first reported by CelebTV.com, which obtained the court documents. A call to Baxter Healthcare Corp. seeking comment wasn't immediately returned. The Quaids' children, Thomas Boone and Zoe Grace, and a third patient were at Cedars-Sinai Medical Center on Nov. 18 when they were mistakenly given vials of heparin that were 1,000 times stronger than the usual dosage.... http://news.aol.com/entertainment/movies/movie-news-story/ar/_a/dennis-quaid-and-wife-sue-drug-maker/20071204155509990001
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(Please, Members, write me your opinion about the establishment of an Office of the National Nurse. I would very much appreciate hearing from you on this topic !)

Florida Nurse Practitioner Network Endorses ONN InitiativeLast weekend, the National Nursing Network Organization received word that the Florida Nurse Practitioner Network, representing over 9,000 nurse practitioners from all specialties and settings in Florida, has given their full support for the initiative to establish an Office of the National Nurse. Florida has the second highest NP population in the country.Christopher Saslo, DNS ARNP-BC, President of the FNPN, wrote, “Our organization has discussed this and we are happy to provide the endorsement of your organization for its intent to improve the visibility and collegiality among professional organizations during these times of need for better and available health care. ”If you are interested in pursuing an endorsement from a professional organization, nursing or non-nursing related, please contact teri@nationalnurse.info Health care is everybody’s business. Publications About the ONN Thank you to the following state nursing associations who made the decision to publish a brief article in their Fall/Winter newsletters about the National Nurse proposal. These include, but may not be limited to West Virginia, Virginia, Kentucky, Nevada, and Maryland. Supporters Respond to Article in Nursing Spectrum A number of supporters wrote to members of the National Nursing Network Organization, with their comments about the article that appeared in Nursing Spectrum, NurseWeek, and on line at http://nurse.com/ Here is the link to this article http://include.nurse.com/apps/pbcs.dll/article?AID=/20071203/DC02/312030001
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Group sounds Alarm on Infant Formula Cans NEW YORK (CNN) -- Mothers sit propped against pillows and gym mats at the "Real Birth" baby clinic in New York City. It's a sea of unwashed hair, women of various ages and professions, complicit smiles and apologies for not looking more put together. The diverse women share a common drive: the desire to breast-feed their babies. They believe it's the best nutrition, but they have difficulty, for reasons ranging from low milk production to adopted babies to problems with some babies latching on.
"Breast-feeding was my absolute first choice," says Helen Niblock, cradling her newborn and watching tentatively as she puts 5-week-old Emma on a scale. "I actually cried when they told me that I had to give her formula in the hospital."
Niblock gives Emma Enfamil from a can to supplement her diet. But a research group says the cans that contain the formula are lined with a toxic, potentially harmful chemical. http://www.cnn.com/2007/HEALTH/12/04/bpa.formula/index.html
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Childhood Obesity Brings Heavy Heart Burden in Adulthood COPENHAGEN, Dec. 5 -- Overweight and obesity in childhood and adolescence substantially increase future risk of heart attack and other cardiac events, researchers found, confirming fears that the most serious consequences of the obesity epidemic are yet to come.Boys overweight by 11.2 kg (25 lb) at age 13 had a 33% higher risk of coronary heart disease events in adulthood than those at a normal weight at that age, according to a large longitudinal cohort study in the Dec. 6 issue of the New England Journal of Medicine.
Action Points --->
Explain to interested parents and patients that overweight and obesity in childhood have been shown to have serious long-term health consequences.
Inform parents and patients that previous studies have found that childhood overweight and obesity have an impact on adult health regardless of adult body mass index (BMI). ...
http://www.medpagetoday.com/PrimaryCare/PreventiveCare/tb/7596
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Handwashing more useful than drugs in Virus control HONG KONG (Reuters) - Physical barriers, such as regular handwashing and wearing masks, gloves and gowns, may be more effective than drugs to prevent the spread of respiratory viruses such as influenza and SARS, a study has found.
The findings, published in the British Medical Journal, came as Britain announced it was doubling its stockpile of antiviral medicines in preparation for any future flu pandemic.
Trawling through 51 studies, the researchers found that simple, low-cost physical measures should be given higher priority in national pandemic contingency plans. . . http://news.yahoo.com/s/nm/20071128/hl_nm/virus_prevention_washing_dc
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Robert Wood Johnson Foundation Gives AARP Foundation $10 Million for New Center to Address the Nursing Workforce Crisis Threatening Patient Care. The Robert Wood Johnson Foundation (RWJF) today announced an effort to address the 1.1-million nurse workforce shortage crisis that is currently poised to strike America’s health care system by 2020.
The newly created Center to Champion Nursing in America will work to improve patient care for all Americans by pursuing an aggressive agenda to elevate the visibility of the nursing shortage while identifying actionable solutions to improve the quality of patient care. The Center is made possible by a $10-million grant to the AARP Foundation from RWJF.
Specifically, the Center to Champion Nursing will address the nursing shortage by pressing for:
Greater state and federal funding to support expanded nursing education, particularly addressing severe faculty shortages at nurse training institutions across the country.
Places for nurse leaders on the governing boards of hospitals and other health care organizations to provide critically needed perspective on improving quality and safety of care.
An educational movement based on new research to inform the public and policy-makers about nurse workforce issues and the link between a trained and adequate nursing workforce and high quality health care. ...
http://www.rwjf.org/newsroom/newsreleasesdetail.jsp?productid=23991&typeid=160
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Exercise Can Ease Fibromyalgia Pain Researchers in Boston have found regular walks and stretching exercises can help ease the chronic pain of fibromyalgia. In a study of 207 women between the ages of 18 and 75 diagnosed with fibromyalgia, researchers from Brigham and Women’s Hospital and Harvard University assigned one group to a twice-weekly aerobic and stretching program for 16 weeks. Another group added mild strength training, while a third group attended a 2-hour education course every two weeks. A fourth group combined all of the approaches. The study found an exercise program that included progressive walking and flexibility movements, with or without strength training, improved physical, emotional, and social function. http://include.nurse.com/apps/pbcs.dll/article?AID=/20071207/ALL01/71128021/-1/frontpage
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The following journals are available for a free trial. Please click on the trial you are interested in to register for free access.
American Journal of Men's Health - Register for Free Online Access to Volume 1 of American Journal of Men's Health. [First issue: March 2007] (Access ends 31 December, 2007)
British Journal of Visual Impairment - Free Online Access to the British Journal of Visual Impairment (Access ends 31 December, 2007)
Criminology, Criminal Justice & Interpersonal Violence - Register for free online access to SAGE journals in Criminology, Criminal Justice & Interpersonal Violence Access ends 15th December 2007
Cultural Sociology - Free Online Access to Volume 1 of Cultural Sociology [First issue March 2007] (Access ends 31 December, 2007)
Discourse & Communication - Free Online Access to Volume 1 of Discourse & Communication [First issue February 2007] (Access ends 31 December, 2007)
Emotion Review - Register now to be offered free online access to the the complete first Volume of Emotion Review (published from 2009)
Journal of Mixed Methods Research - Free Online Access to Volume 1 of Journal of Mixed Methods Research [First issue January 2007] (Access ends 31 December, 2007)
Media, War & Conflict - Free Online Access to Volume 1 of Media, War & Conflict [First issue April 2008] (Access ends 31 December, 2008)
Memory Studies - Free Online Access to Volume 1 of Memory Studies [First issue January 2008] (Access ends 31 December, 2008]
Theology and Biblical Studies free trial - Thank you for your interest in the SAGE Theology and Biblical Studies free access trial running until January 31, 2008. Simply register and you will have free online access to 10 theology and biblical studies journals including deep backfile....
Therapeutic Advances in Cardiovascular Disease FREE Trial - Free Online Access to Volume 1 Therapeutic Advances in Cardiovascular Disease [First issue October 2007] (Access ends 31 December, 2007)
Therapeutic Advances in Respiratory Disease FREE Trial - Free online access to Vol.1 and vol.2 Therapeutic Advances in Respiratory Disease [First issue available from Oct 2007] (Access ends 31 December, 2008) [IMG]Thank you for your interest in Therapeutic Advances in Respiratory Disease vol.1 and vol.2...
Therapeutic Advances in Respiratory Disease FREE Trial - Vol. 1 and Vol. 2 Therapeutic Advances in Respiratory Disease [First issue Oct 2007] (Access ends 31 December, 2008) [IMG]Thank you for your interest in Therapeutic Advances in Respiratory Disease vol. 1 and vol. 2 free trial. By registering below,... http://online.sagepub.com/cgi/freetrial
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Analysis: Deaths From Drug Reactions Up CHICAGO (AP) — Reports of dangerous side effects and deaths from widely used medicines almost tripled between 1998 and 2005, an analysis of U.S. drug data found.
The number of deaths and serious injuries from prescription and over-the-counter drugs climbed from 34,966 to 89,842 during the study of reports to the Food and Drug Administration.
Potent narcotic painkillers including Oxycontin, sold generically as oxycodone, were among 15 drugs most often linked with deaths in the study. Drugs frequently linked with serious nonfatal complications included insulin, the arthritis drugs Vioxx and Remicade, and the antidepressant Paxil.
The report adds to recent criticism of FDA oversight on drug safety, including its handling of serious problems connected with Vioxx, which was removed from the market in 2004. http://ap.google.com/article/ALeqM5jmQAzlPOONNMP_7Xdv6iZl4putsw
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Even Wider Reperfusion Wiindow Not Enough for Stroke Patients
ANN ARBOR, Mich., Nov. 2 -- Most stroke patients in "real-world" communities are still missing the boat for reperfusion therapy by failing to get to the hospital quickly, and an expanded opportunity would be of limited value.Only 31% of stroke patients arrived at the hospital within the three-hour window for use of tissue plasmin-ogen activator (tPA) and a total of 44% arrived within six hours, according to a population-based study conducted in a city with no academic medical center.... http://www.medpagetoday.com/Neurology/Strokes/tb/7211
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Does your bowl of fruit salad, steamy oatmeal, or creamy yogurt need a little more oomph? For extra texture and a heart-health boost, sprinkle on some toasted walnuts. You'll add a nice crunch quality and also help lower your cholesterol. Just 8 to 13 nuts a day may be all you need in order to drop your LDL (that's the bad stuff) by 6 percent. Helping Your Heart Two WaysWhen men and women with moderately high cholesterol replaced some of the monounsaturated fat in their diets with as few as 8 to 13 walnuts a day, their cholesterol dropped and their blood vessels dilated more readily -- allowing blood to flow more freely through arteries that supply the heart and brain. (What else can you eat to help lower your cholesterol? Find out here.) Good and Plenty What's in walnuts that keeps your arteries in the clear? Quite a lot -- like cell-protecting antioxidants, inflammation-fighting fatty acids, and healthy amounts of L-arginine -- an amino acid that helps control blood pressure. Kick up the crunch quotient in your afternoon snack with this seriously yummy Apricot-Walnut Cereal Bar recipe.
References: A walnut diet improves endothelial function in hypercholesterolemic subjects: a randomized crossover trial. Ros, E., Nunez, I., Perez-Heras, A., Serra, M., Gilabert, R., Casals, E., Deulofeu, R., Circulation 2004 Apr 6;109(13):1609-1614.
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Nurses aren't Valued by the Hospital
Is the recent cut in pay to the pay-without-benefits nurses at Mercy Medical Center in Des Moines a way to retain experienced bedside nurses, or a way to recruit new nurses to the hospital?With the severe nurse shortage, and the prediction of the loss of up to 40 percent of bedside nurses within the next five to seven years, Mercy would be better off to use funds to provide benefits and pay that would attract and retain highly trained, experienced nurses instead of building a new hospital, buying a coffee-shop franchise or putting big-screen TVs in patient rooms.
The timing seems particularly relevant as these cuts were announced after Mercy recently pushed for "Magnet" status, a recognition from the American Nurses Association to recognize excellence in nursing and those institutions that provide environments that reward nurses. Is this the way nurses are valued and rewarded at Mercy - by cutting their hard-earned pay and benefits?If asked, most patients and their families would prefer a caring and knowledgeable nurse over waterfalls and terrazzo tile floors.
Many nurses will leave the hospital to work where there is less stress, better conditions and better compensation. We pay plumbers and painters more money and benefits than the bedside nurse responsible for your health while hospitalized. http://desmoinesregister.com/apps/pbcs.dll/article?AID=/20071107/OPINION04/711070344/1035/OPINION
They had a place for comments...this is what I wrote........
As a Registered Nurse with many years' experience, I truly believe that this article expresses (one of the ) major reasons for the Nursing Shortage!!!It is so shortsighted of the administrators of most hospitals to consider nurses as overhead ! There have been many studies published to prove that pressure ulcers, failures in health , poor recoveries from procedures are all related to the shortage of nurses everywhere. Why don't hospitals put two and two together for the correct answer?
RNFrankie@AOL.com
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Nurse, Fetch me The Ball -- Today, nurses persuaded Seattle's Group Health to withdraw ads for its "Ask the Doc" service that included the tag line: "Nurse, hand me my laptop." The ads, posted on websites such as MSN.com, promoted Group Health's program of having patients communicate with advanced practitioners by e-mail, instead of having to come in to the office for simple follow-ups or questions. We commend Group Health for using such a cost-effective care delivery system, and we get the "joke"--laptops are the new stethoscopes. But the ads' regressive text and imagery suggest that: (1) nurses are nameless handmaidens who fetch and carry items for physicians, rather than autonomous professionals who follow an independent practice model; (2) nurses' role in advanced care technology consists mainly of handing it to physicians, though in reality nurses are on the cutting edge of such technology; and (3) nurses lack substantive health information, and their role is to help patients reach the physicians who do have the expertise. In fact, nurses are the main patient educators, and nurses at Group Health itself regularly communicate with patients by email. We applaud Carolyn Elliott, Stephanie Hitzroth, Shari Hirshberg and their nursing colleagues for persuading Group Health to do the right thing.... http://www.nursingadvocacy.org/news/2007/nov/15_ghc.html
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Measuring central venous pressure Cole, E., et al. - Central venous pressure measurement is often associated with intensive and critical care settings. However, with increasing numbers of critically ill patients being cared for on medical and surgical wards, it is essential that nursing staff are able to record central venous pressure measurement accurately and recognise normal and abnormal parameters as highlighted in this article...
Nursing Standard Online, 11/06/07 http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2030026/?user_id=157159&email=rnfrankie@aol.com&news_id=399
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Organizational factors that support the implementation of a Nursing Best Practice Guideline Marchionni, C., et al. - There is beginning evidence in the literature that culture and leadership are key elements influencing guideline implementation. In this pilot work on two inpatient units where a nursing best practice guideline was implemented, a supportive organizational culture and key people leading change were present. Implications for further studies are offered [more...]
Journal of Nursing Management, 11/05/07 http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2027274/?user_id=157159&email=rnfrankie@aol.com&news_id=399
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ORLANDO, Nov. 5 — Heart failure patients are more likely to comply with important non-medication interventions, such as fluid and salt restrictions and regular weighing, when they have intensive support from a heart failure nurse and multidisciplinary team than if they do not, researchers reported at the American Heart Association’s Scientific Sessions 2007.
Although previous studies have examined medication adherence among heart failure patients, limited information is available on these patients’ adherence to the complex nonpharmacologic regimen of sodium restriction, fluid restriction and daily weighing.
“We examined the effect of education and counseling by heart failure nurses on adherence to nonpharmacologic treatments because these are so important to the patients’ survival,” said Martje H.L. van der Wal, R.N., Ph.D., study lead author and a cardiology nurse researcher at the department of cardiology of the University Medical Center Groningen, University of Groningen, in The Netherlands.
Researchers referred to the Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH) study, representing data from 17 Dutch hospitals and 1,023 heart failure patients (average age 71). ... http://www.eurekalert.org/pub_releases/2007-11/aha-hfp102407.php
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Urinary Incontinence in Women Subak, L., et al. - The purpose of this study was to estimate the direct costs of routine care for urinary incontinence (UI) in community-dwelling, racially diverse women...Women pay a mean of >250 per year out-of-pocket for UI routine care. Effective incontinence treatment may decrease costs [more...]
American Journal of Obstetrics and Gynecology, 12/05/07
Cite this article as: Subak L, Van Den Eeden S, Thom D, Creasman JM, Brown JS. Urinary incontinence in women: direct costs of routine care. Am J Obstet Gynecol 2007;197:596.e1-596.e9.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W9P-4PP7R97-1&_user=10&_coverDate=12%2F31%2F2007&_rdoc=15&_fmt=summary&_orig=browse&_srch=doc-info(%23toc%236688%232007%23998029993%23675508%23FLA%23display%23Volume)&_cdi=6688&_sort=d&_docanchor=&_ct=64&_acct=C000050221&_version=1&_urlVersion=0&_userid=
10&md5=7dbd546f6983a0e8a4fa46cea98fdada
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Poverty, Mental Health, and Women: Implications for Psychiatric Nurses in Primary Care Settings. Groh, C.J. - Poverty is one of the most consistent correlates of depression as well as other mental health disorders. Although poverty has negative health outcomes for men and women, the greater burden falls to women. Thus, the focus of this article is on the experiences of women and the complex intersection between the social and economic correlates of poverty and mental illness. A case study is presented that illustrates these intersections. The article concludes with suggestions to improve the mental health of poor women
Journal of the American Psychiatric Nurses Association, 12/04/07 http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2069035/?user_id=157159&email=rnfrankie@aol.com&news_id=410
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Company actively recruiting nurses with disabilities!!!
Bender Consulting Services, Inc. is a for-profit company that focuses on employing professionals with disabilities in the areas of information technology, finance/accounting, human resources, engineering, and general business. President and CEO, Joyce A. Bender, is the host of the international talk radio show, Disability Matters with Joyce Bender. She received the 2003 Bush Administration New Freedom Initiative Award, and the 1999 President’s Award, the highest honor bestowed by the President of the United States upon an American who furthers the employment and empowerment of people with disabilities. For more information, please visit www.benderconsult.com.
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SEATTLE, Nov. 1 /PRNewswire/ -- Redsense Medical's blood loss detection device for monitoring venous needle dislodgement has been granted FDA approval, and is now available for sale in the United States. The Swedish company's patented Redsense blood loss detection system is the world's first such device. Having met Europe's rigorous health & safety standards, the device has already been granted CE approval. With the FDA's approval, Redsense is the first clinically-tested, reliable blood loss monitoring system available in the U.S.
About 1.5 million patients worldwide receive over 200 million dialysis treatments every year. The size of the market is forecast to increase due to an aging population and the rise of diseases such as diabetes type II.
Medical professionals have long been aware of the risk of venous needle dislodgement during dialysis treatment. In the U.S. alone, 7 to 10 patients needlessly die each year due to needle dislodgement. It is feared that the true death rate is 3 to 4 times higher than reported. The total number of serious incidents is estimated to be in the thousands.... http://sev.prnewswire.com/medical-pharmaceuticals/20071101/LATH03901112007-1.html
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How should we screen for breast cancer? Mammography, Ultrsonography, MRI Nemec, C.F., et al. - Of the imaging techniques currently available to evaluatewomen for breast disease, mammography remains the mainstay of breast cancer screening, but recent guidelines have included magnetic resonance imaging (MRI) for the screening of some women at high risk. Whole-breast ultrasonography for screening has not been established as useful and so should not be offered routinely to patients [more...] Cleveland Clinic Journal of Medicine, 12/05/07 http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2070063/?user_id=157159&email=rnfrankie@aol.com&news_id=410
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A noninvasive Continence Management System: Development and Evaluation of a Novel Toileting Device for Women Macaulay, M., et al. - This paper describes a project to develop and clinically evaluate a novel toileting device for women called the Non-Invasive Continence Management System (NICMS). The NICMS device is designed to provide an alternative toileting facility that overcomes problems some women experience when using conventional female urinals...Conclusion: Significant further development is required for it to work reliably and to provide an acceptable device in terms of reliability, size, weight, noise, and aesthetics [more...] Journal of Wound, Ostomy, and Continence Nursing, 12/05/07 http://www.jwocnonline.com/pt/re/jwocn/abstract.00152192-200711000-00010.htm;jsessionid=HZJDxfLT4pT0XlFtCPL7rY5pFpnM6yTr6vSxHBpKZKkSv8L9J5Mq!-1288052477!181195628!8091!-1
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How to do a Head to Toe Assessment By Kathy Quan RN BSN
This article describes the basics of a head-to-toe assessment which is a vital aspect of nursing. It should be done each time you encounter a patient for the first time each shift (or visit, for home care, clinic or office nurses).
This assessment includes assessment of the physical, emotional and mental aspects of all body systems as well as the environmental and social issues affecting the patient. The nurse needs to observe for all of these factors and ask questions as needed. http://thenursingsite.com/Articles/Head%20to%20toe%20assessment.html
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ADVANCE for Nurses is thrilled to welcome you to Nurse POV Forums, part of the Nurse POV: Online Community. Our new forum offers posts covering timely questions, advice and opinions about the nursing field; connecting professionals nationwide. We have provided tags to assist in locating topics of interest, a profile page to make uniquely your own and a list of our most active discussions to keep you abreast of the latest discussions. We look forward to hearing more about the nursing field from your Point of View (POV). http://community.advanceweb.com/forums/9/ShowForum.aspx
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NANO Breakthru in Cancer Detection: Study PARIS (AFP) - A nano-scale tool that distinguishes soft cancerous cells from stiffer normal ones could save lives by making it easier to diagnose cancer, according to a study released Sunday.
Using atomic force microscopes, a team of US scientists showed for the first time that the surface of living cancer cells were more than 70 percent softer than their healthy counterparts.
This measurable difference in elasticity held true across lung, breast and pancreatic cancers, and could provide a powerful means of detecting malignant cells that might otherwise escape notice, said the study, published in the British journal Nature Nanotechnology.
http://health.yahoo.com/news/afp/healthsciencediseasecancernanotechnology.html;_
ylt=AlGTWs8gzSd7YvuEeTT6Ma2z5xcB
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My computer "sorta" crashed and I lost my "medical Jokes" folder. Please send me jokes!!!
A seagull in Scotland has developed the habit of stealing chips from a neighborhood shop.The seagull waits until the shopkeeper isn't looking, and then walks into the store and grabs a snack-size bag of cheese Doritos.
Once outside, the bag gets ripped open and shared by his other bird friends.The seagull's shoplifting started early this month when he first swooped into the store in Aberdeen , Scotland , and helped himself to a bag of chips.
Since then, he's become a regular. He always takes the same type of chips. Customers have begun paying for the seagull's stolen bags of chips because they think it's so funny and enjoy watching him everyday.

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

A website offering free CEU s: http://www.medscape.com/cmecenterdirectory/nurses
CE 450 / 1.0 hr Post-Polio Syndrome Five years ago, Ann Madden took care of her house and garden and belonged to a walking group. Today, at age 63, she uses a wheelchair to compensate for her muscle weakness and balance problems. She has trouble sleeping, is in constant pain, and has problems concentrating, especially when she’s tired. On the days that she wakens refreshed, she feels exhausted by midmorning. These are some of the symptoms experienced by people who had polio as children or young adults decades ago. Between 12 million and 20 million people worldwide have a polio-associated disability.1 In the United States, an estimated 440,000 polio survivors are now experiencing or at risk of post-polio syndrome.2 The Salk and Sabin polio vaccines, which became widely available in the United States in the 1950s and 1960s,3 have eradicated polio in developed countries. As a result, today many healthcare providers know little about polio infection and its consequences.
http://www.nurse.com/ce/course.html? CCID=4181
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.
http://www.snopes.com/

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

Nutrition in Fruits: http://www.peertrainer.com/DFcaloriecounterB.aspx?id=2253

Helping Uninsured Patients
http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?CC=RNFRANKIe99124

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MEDICAL RECALLS
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Stories in the December 2007 edition include:
First Rapid Test for Bacterial Contamination in Platelets
http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#1
Recall of Sprint Fidelis Cardiac Leads http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#2
Possibility of Pancreatitis in Patients Taking Byetta http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#3
Severe Adverse Events with Ultrasound Micro-bubble Contrast Agents http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#4
Possible Link between Bisphosphonates and Atrial Fibrillation http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#5
Preventing Meningitis in Children with Cochlear Implants http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#6
Warning on Unapproved Antitussives Containing Hydrocodone http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#7
Caution on Viracept in Children and Pregnant Women http://www.accessdata.fda.gov/psn/transcript.cfm?show=70#8
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FDA provided final recommendations for users of Vail Enclosed Bed Systems that updates the Agency's 2005 Preliminary Public Health Notification. Users of the bed systems were warned that the bed poses a health risk because patients can become entrapped in them and suffocate. Because of the suffocation risk, FDA advises hospitals, nursing homes, and consumers who have a Vail enclosed bed system to stop using it and move the patient to an alternate bed. Consumers who are using Vail beds at home should consult with their physicians about other options. See the Public Health Notification for safety precautions recommended by the manufacturer if continued use of the Vail bed is the only option.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Vail
************************** FDA, Centers for Disease Control and Prevention, Environmental Protection Agency, and the Occupational Safety and Health Administration issued a Public Health Notification, "Avoiding Hazards with Using Cleaners and Disinfectants on Electronic Medical Equipment". The notification describes the hazards of using excess cleaning and disinfecting liquids on certain electronic medical equipment and recommends ways to avoid these hazards. The problems included equipment fires and other damage, equipment malfunctions, and healthcare worker burns. Refer to the link below for recommendations on how to avoid hazards and appropriate equipment management.
[November 01, 2007 - Public Health Notification - FDA]
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FDA notified healthcare professionals and patients of the Agency's request that manufacturers update the prescribing information for desmopressin to include important new safety information about severe hyponatremia and seizures. Certain patients, including children treated with the intranasal formulation of the drug for primary nocturnal enuresis (PNE), are at risk for developing severe hyponatremia that can result in seizures and death. As such, desmopressin intranasal formulations are no longer indicated for the treatment of primary nocturnal enuresis and should not be used in hyponatremic patients or patients with a history of hyponatremia. PNE treatment with desmopressin tablets should be interrupted during acute illnesses that may lead to fluid and/or electrolyte imbalance. All desmopressin formulations should be used cautiously in patients at risk for water intoxication with hyponatremia.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Desmopressin
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Novartis and FDA informed healthcare professionals and patients that use of Myfortic Delayed Release Tablets during pregnancy is associated with increased risks of pregnancy loss and congenital malformations. The pregnancy category for Myfortic has been changed to Category D (Positive evidence of fetal risk). This change is a result of postmarketing data from the United States National Transplantation Pregnancy Registry and additional postmarketing data collected in women exposed to systemic mycophenolate mofetil (MMF) during pregnancy. MMF is converted to the active ingredient in Myfortic, following oral or intravenous administration. A patient who is planning a pregnancy should not use Myfortic unless she cannot be successfully treated with other immunosuppressant drugs. http://www.fda.gov/medwatch/safety/2007/safety07.htm#Myfortic
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NURSING HINTS CORNER
If you suspect I.V. infiltration in a patient with difficult veins, turn on a flashlight and hold it against his skin, directly over the suspicious site. If I.V. fluid has infiltrated into the tissue, the beam will highlight the size of the infiltration. If no fluid has infiltrated, only a small halo will appear around the flashlight (beam). Using this trick can save you from having to do extra checks. Then, if necessary, you can stop the I.V. before the infiltration gets worse.
Betty Woodfin, RN

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.166,
Springhouse Corporation/www.springnetcom.
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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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This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
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NEW MEMBERS
No new members this issue. 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 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@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)

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 @AOL.com (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 sectionSandy1956@AOL.com (Sandy) U thru Z section.
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.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
“Apprehension, uncertainty, waiting, expectation,
fear of surprise, do a patient more harm than any exertion.”
Florence Nightingale

Hope to see you online..... Frankie
(RNFrankie@AOL.com)