A Question of Nursing Ethics By Genevieve M. Clavreul, RN, PhD (Raconte@AOL.com)
There is a French saying “qui vole un oeuf, vole un boeuf,” which translates, “if one can steal an egg, one can steal a cow.” This phrase came to mind as I read recent news coverage about 11 nursing school students caught cheating during their comprehensive nursing school exam at the Prairie View A&M University School of Nursing in Texas. Ethics is one of the cornerstones of our profession, and a cheating scandal like this should concern all nurses, healthcare professionals, patients, and their families.An article in the Houston Chronicle reported how a group of final year nursing students sat for a comprehensive nursing exam, their last step towards graduation. The students were permitted breaks throughout the four to five-hour exam. During the test taking, several nursing students reported to the monitors that they observed others texting on their cell phones during the exam.11 students were identified as participants in this cheating scheme, which included texting others who had completed the exam. They were called before the student court for their punishment. They were prohibited from graduating but would be allowed to return the following school year. After completing an ethics course, they could re-take the comprehensive exam. So far, 0 of the 11 have announced their intentions to return to school.Was it 'Just Cheating on a Test'? Does the punishment fit the crime? I think not. You may wonder why I take it so seriously-some say it was, after all, “just cheating on a test.” It's not like they altered medical records, forged prescriptions, or failed to follow procedures that led to a negative outcome for a patient. So why don't I think an ethics course should suffice? Consider the following. In this class at A&M, there were approximately 56 nursing students, all in their final year of their Bachelor of Science in Nursing (BSN) studies. If 11 were caught cheating, that means approximately 20 percent of the class was involved. Since BSN nursing programs typically take four to six years to complete, one can conclude that most, if not all, the students involved in this cheating scandal were not newbies. Indeed, these were seasoned students who, in addition to their academic studies, were involved in the clinical aspects of the program. If they felt that cheating on the final exam was acceptable, did they also treat their clinical and patient care in the same cavalier manner? A blogger recently posted in response to the A&M scandal that cheating was so commonplace now that she was not surprised to learn about the nursing students. However, a majority of other bloggers, many of them RNs, were not so forgiving. Many expressed concern at what appeared to be a rather light punishment for what many, myself included, viewed as a serious breach of integrity and ethics.There have been calls for sanctions against the A&M School of Nursing. In addition, many called for the Texas Board of Nurse Examiners (BNE) to prohibit these students from sitting for the NCLEX-RN altogether, or to place some type of prohibition on their license for an indeterminate number of years, or to issue a list of the offenders to all the other 49 State Boards of Nursing.
Philippine Nursing Board Scandal: Some of you may remember a past column “A Breach of Integrity,” where I discussed a 2006 scandal involving the sale of test answers in the Philippines. In this incident, an unknown number of graduate nursing students accessed the answers to the Philippine Board of Nursing exam. Nearly a year passed before the Philippine government ordered a mandatory re-test of the suspect class. They did so only after the Chief Nursing Officer (CNO) organization and several others applied pressure for a re-test.The final straw seemed to be when the CNO organization issued a written recommendation that no person who sat for the suspect exam should be hired. After this edict, the Philippine government accepted the earlier concerns of various parties and held a re-test. (This article is archived on WorkingNurse.com.)
Why I Believe a Stronger Punishment is Needed Unfortunately, it will take a lot of pressure before A&M steps up and does the right thing. Here are some reasons why I believe stronger punishment is needed.
o It was a well-coordinated cheating effort. This wasn't the spontaneous act of a student sneaking a peak at the test of the student in the next seat. It involved the active participation of students cheating on the exam and those who already completed it and agreed to share the answers. I hardly think one course of ethics would help correct the lapse that occurred.o Deterrent effect. We must also consider the impact on those who may contemplate cheating in the future. Will this punishment serve as enough of a deterrent? 11 A&M students cheated and an unknown number of Filipino nursing school graduates bought answers to their RN licensure exam. These examples illustrate that we must be vigilant.
o The effect on other nurses and patients. Can you imagine being an RN, wondering if the A&M graduate you are working alongside was one of the 11 caught cheating? Or worse still, one who had cheated but wasn't caught? I recently saw another blog post suggesting that before booking a procedure, patients should be allowed to ask whether any of the RNs had attended Prairie View A&M School of Nursing as a way to choose their medical facility.
Excusing Poor Behavior Nursing has displayed somewhat contradictory behavior, usually in the name of the nursing shortage. It isn't uncommon to make excuses when nurses exhibit poor, unacceptable or even dangerous behavior. Often, such behaviors are brushed off due to the nurse being overworked or the hospitals understaffed. Though these are often the realities of nursing, many RNs resist the urge to cut corners and most display the highest of work ethics. For this reason, a cavalier attitude toward the A&M cheating scheme should not be allowed to take root and flourish in either our nursing schools or workforce. Since RNs are entrusted with the health and lives of others, we should be held to the highest level of ethical standards. As the story of the A&M 11 travels the country by word of mouth, printed word, and the internet, in all likelihood, it will take on a life of its own. This makes it imperative that both Prairie View A&M School of Nursing and the Texas BNE take decisive action. In my opinion, A&M's actions seem to fall far short; especially in light of an additional Houston Chronicle article that reports that one of the students alleged that the nursing school faculty encouraged the cheating. At this time, there are no additional reports as to whether or not the BNE or another accreditation body will take action against either the school or the 11 students. My mother's favorite saying “qui vole un oeuf, vole un boeuf” seems to have played out in the case of Prairie View A&M School of Nursing cheating scandal, as it would appear that the cow was indeed stolen.
Geneviève M. Clavreul RN, PhD, is a healthcare management consultant who has experience as a director of nursing and as a teacher of nursing management.
Thursday, June 26, 2008
Monday, June 9, 2008
PARADIGM BYTES
PARADIGM BYTES
Newsletter for Paradigm 97
June 10, 2008
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 Paradigm97 chatroom 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.
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.
~~**~~**~~**~~**~~**~~
Please drop in . the Paradigm97 chatroom 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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SNIPPET
As we all know, nurses make a difference in patients’ lives every day. But some nurses also impact their colleagues’ lives by giving them the knowledge and tools they need to improve nursing practice. The four nurses interviewed in this story made changes in their own practices that, because of their ingenuity, eventually influenced nursing practice across the nation and beyond. These RNs are inspirations to any nurse who thinks there might be a better way to care for patients — and that they know what it is.... http://www.nurse.com/topstory.html
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The right tool for the job (Part One of Four} Early in her career as a researcher, Barbara J. Braden, RN, PhD, FAAN, realized pressure ulcers were an unending challenge for acute care and long-term healthcare facilities and there was a need for better prevention and treatment. In 1984, while researching the link between poor nutrition and pressure ulcers as the project director of the Creighton University (Omaha, Neb.) Teaching Nursing Home Project — which was funded by the Robert Wood Johnson Foundation — Braden developed the Braden Scale. The scale provides better validity and reliability than other pressure-ulcer risk tools and calculates the risk for pressure ulcers using indicators such as sensory perception, moisture, activity, mobility, nutrition, and friction.Braden initially believed her new scale would only be used as a screening tool for her own research. But within five years of her research being published in 1987, it was adopted by U.S. hospitals and long-term care facilities and went international. It has since been translated into about 20 languages. “Its use has spread wildly beyond my expectations,” says Braden, who is dean of the University College and Summer Sessions at Creighton.The Braden Scale also has been widely studied in tertiary care hospitals, Veterans Administration medical centers, and skilled nursing facilities by domestic and international researchers. Its success is tied with its ability to provide more consistent assessment of the risk level for pressure ulcers and, therefore, helps nurses determine patients’ turning schedules and other details of care.“Most studies report anywhere from a 60% to an 80% decrease in facility-acquired pressure ulcers [after implementation of the Braden Scale],” says Braden.Braden’s current goal is to raise awareness and decrease the risk for the early development of pressure ulcers in settings including the ED and OR, where patients who are immobile can lie on hard or minimally padded surfaces or gurneys for long periods of time. “I believe many problems start in the ED,” she says. “For example, patients should be cleared from backboards within 20 minutes.” She also is pushing for better skin assessments in the ED as well as the OR. “If the patient is in the ED or OR for more than two hours, staff should perform a Braden Scale and decide if they need to transfer the person to another surface,” she says.Braden also would like to expand the scale to include other factors that are more difficult to measure, such as age, that contribute to the risk for pressure ulcers.
SNIPPET
As we all know, nurses make a difference in patients’ lives every day. But some nurses also impact their colleagues’ lives by giving them the knowledge and tools they need to improve nursing practice. The four nurses interviewed in this story made changes in their own practices that, because of their ingenuity, eventually influenced nursing practice across the nation and beyond. These RNs are inspirations to any nurse who thinks there might be a better way to care for patients — and that they know what it is.... http://www.nurse.com/topstory.html
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The right tool for the job (Part One of Four} Early in her career as a researcher, Barbara J. Braden, RN, PhD, FAAN, realized pressure ulcers were an unending challenge for acute care and long-term healthcare facilities and there was a need for better prevention and treatment. In 1984, while researching the link between poor nutrition and pressure ulcers as the project director of the Creighton University (Omaha, Neb.) Teaching Nursing Home Project — which was funded by the Robert Wood Johnson Foundation — Braden developed the Braden Scale. The scale provides better validity and reliability than other pressure-ulcer risk tools and calculates the risk for pressure ulcers using indicators such as sensory perception, moisture, activity, mobility, nutrition, and friction.Braden initially believed her new scale would only be used as a screening tool for her own research. But within five years of her research being published in 1987, it was adopted by U.S. hospitals and long-term care facilities and went international. It has since been translated into about 20 languages. “Its use has spread wildly beyond my expectations,” says Braden, who is dean of the University College and Summer Sessions at Creighton.The Braden Scale also has been widely studied in tertiary care hospitals, Veterans Administration medical centers, and skilled nursing facilities by domestic and international researchers. Its success is tied with its ability to provide more consistent assessment of the risk level for pressure ulcers and, therefore, helps nurses determine patients’ turning schedules and other details of care.“Most studies report anywhere from a 60% to an 80% decrease in facility-acquired pressure ulcers [after implementation of the Braden Scale],” says Braden.Braden’s current goal is to raise awareness and decrease the risk for the early development of pressure ulcers in settings including the ED and OR, where patients who are immobile can lie on hard or minimally padded surfaces or gurneys for long periods of time. “I believe many problems start in the ED,” she says. “For example, patients should be cleared from backboards within 20 minutes.” She also is pushing for better skin assessments in the ED as well as the OR. “If the patient is in the ED or OR for more than two hours, staff should perform a Braden Scale and decide if they need to transfer the person to another surface,” she says.Braden also would like to expand the scale to include other factors that are more difficult to measure, such as age, that contribute to the risk for pressure ulcers.
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Part Two of Four A social healthcare movement The concept that infant mortality is a direct consequence of social injustices is a driving force in the career of Ruth Watson Lubic, RN, CNM, EdD, FAAN, FACNM, founder of the Washington, D.C., Developing Families Center (DFC) and the Family Health and Birth Center (FHBC). In 2000, the DFC/FHBC opened in the nation’s Capitol, which had the highest infant mortality rate in the country. “I’m here because of the health disparities — it was bearing heavily on my conscience,” says Lubic. The birth center serves an underserved African-American population and provides cost-effective and comprehensive maternal services by nurse-midwives in conjunction with hospital-based obstetrical care.FHBC has broken new ground in the freestanding birth center model by developing what Lubic dubs a “social healthcare movement.” Through the DFC, prenatal care, deliveries, health education, and well-woman and NP well-child health care are integrated with social and educational services. Through its partner, the Healthy Babies Project, the center provides social support. A third partner, the United Planning Organization, provides infant and child development services in the same building.“Many women in the community have low self-esteem, and there is no better place to break that cycle than in the birthing process,” says Lubic. “We’re showing that if you spend time with women, listen to them, and make relationships with them, they can overcome a lot of their challenges through giving birth rather than being delivered [by someone else].”Lubic proved she was right. After 5 1/2 years of operation, FHBC’s cesarean section, preterm birth, and low birth-weight rates were lower than the rates of those of the African-American population in D.C., of all D.C. births, and the overall U.S. African-American rates, according to data from the University of North Carolina School of Public Health. Because of the low rates of these complications, the FHBC saved more than $1.1 million in 2005 for the healthcare system, a figure greater than its 2005 operating budget, Lubic says. Lubic is currently spearheading an effort with staffers in both the U.S. Senate and House of Represenatives to get an administrative ruling to award a Medicaid facility fee across the board for the nation’s birth centers, 42 of which serve 50% or greater of medically underserved populations in 19 states. Many centers do not get any reimbursement from Medicaid. Click here to view our video interview with Ruth Watson Lubic.
(Parts three and four of four will be in the July issue)
Part Two of Four A social healthcare movement The concept that infant mortality is a direct consequence of social injustices is a driving force in the career of Ruth Watson Lubic, RN, CNM, EdD, FAAN, FACNM, founder of the Washington, D.C., Developing Families Center (DFC) and the Family Health and Birth Center (FHBC). In 2000, the DFC/FHBC opened in the nation’s Capitol, which had the highest infant mortality rate in the country. “I’m here because of the health disparities — it was bearing heavily on my conscience,” says Lubic. The birth center serves an underserved African-American population and provides cost-effective and comprehensive maternal services by nurse-midwives in conjunction with hospital-based obstetrical care.FHBC has broken new ground in the freestanding birth center model by developing what Lubic dubs a “social healthcare movement.” Through the DFC, prenatal care, deliveries, health education, and well-woman and NP well-child health care are integrated with social and educational services. Through its partner, the Healthy Babies Project, the center provides social support. A third partner, the United Planning Organization, provides infant and child development services in the same building.“Many women in the community have low self-esteem, and there is no better place to break that cycle than in the birthing process,” says Lubic. “We’re showing that if you spend time with women, listen to them, and make relationships with them, they can overcome a lot of their challenges through giving birth rather than being delivered [by someone else].”Lubic proved she was right. After 5 1/2 years of operation, FHBC’s cesarean section, preterm birth, and low birth-weight rates were lower than the rates of those of the African-American population in D.C., of all D.C. births, and the overall U.S. African-American rates, according to data from the University of North Carolina School of Public Health. Because of the low rates of these complications, the FHBC saved more than $1.1 million in 2005 for the healthcare system, a figure greater than its 2005 operating budget, Lubic says. Lubic is currently spearheading an effort with staffers in both the U.S. Senate and House of Represenatives to get an administrative ruling to award a Medicaid facility fee across the board for the nation’s birth centers, 42 of which serve 50% or greater of medically underserved populations in 19 states. Many centers do not get any reimbursement from Medicaid. Click here to view our video interview with Ruth Watson Lubic.
(Parts three and four of four will be in the July issue)
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MEDICAL NEWS
One in Every 20 Healthcare Workers is a MRSA Carrier GENEVA, April 15 -- One in every 20 healthcare workers carries methicillin-resistant Staphylococcus aureus (MRSA), researchers here said. But the vast majority is without symptoms and only 5.1% have full-blown clinical infections, according to Stephan Harbarth, M.D., of the University Hospitals of Geneva, and Werner Albrich, M.D., of University Hospital Bern.
One implication is that screening efforts aimed at symptomatic infections are likely to miss a large proportion of colonized healthcare workers who might transmit the bacteria, they wrote in a literature review in the May issue of Lancet Infectious Diseases.
Instead, they said, "aggressive screening and eradication policies" should be used in an outbreak and in situations where MRSA has not reached highly endemic levels.
The researchers looked at 127 studies published from January 1980 through March 2006, to see how likely healthcare workers are to be infected or colonized by MRSA and to assess their role in MRSA transmission.
On the basis of the published evidence, they said, healthcare workers are usually vectors, rather than the main sources of MRSA transmission, implying that "good hand hygiene practices remain essential to control the spread of MRSA." http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/tb/9117
MEDICAL NEWS
One in Every 20 Healthcare Workers is a MRSA Carrier GENEVA, April 15 -- One in every 20 healthcare workers carries methicillin-resistant Staphylococcus aureus (MRSA), researchers here said. But the vast majority is without symptoms and only 5.1% have full-blown clinical infections, according to Stephan Harbarth, M.D., of the University Hospitals of Geneva, and Werner Albrich, M.D., of University Hospital Bern.
One implication is that screening efforts aimed at symptomatic infections are likely to miss a large proportion of colonized healthcare workers who might transmit the bacteria, they wrote in a literature review in the May issue of Lancet Infectious Diseases.
Instead, they said, "aggressive screening and eradication policies" should be used in an outbreak and in situations where MRSA has not reached highly endemic levels.
The researchers looked at 127 studies published from January 1980 through March 2006, to see how likely healthcare workers are to be infected or colonized by MRSA and to assess their role in MRSA transmission.
On the basis of the published evidence, they said, healthcare workers are usually vectors, rather than the main sources of MRSA transmission, implying that "good hand hygiene practices remain essential to control the spread of MRSA." http://www.medpagetoday.com/InfectiousDisease/GeneralInfectiousDisease/tb/9117
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FROM THE MEMBERS
JANNA RN@AOL.com (Cindy) has written the following:
" I've left hospital nursing and basically, what I could really benefit from is networking with other RN's about the latest ways to handle certain situations such as wounds, specific emergencies etc. because I'm doing school nursing and need to be on top of things."
Please write her/ network with her especially anyone who is a school nurse.......or you think you can help her. That is what we are all here for ......support of one another !!! Thank you .
FROM THE MEMBERS
JANNA RN@AOL.com (Cindy) has written the following:
" I've left hospital nursing and basically, what I could really benefit from is networking with other RN's about the latest ways to handle certain situations such as wounds, specific emergencies etc. because I'm doing school nursing and need to be on top of things."
Please write her/ network with her especially anyone who is a school nurse.......or you think you can help her. That is what we are all here for ......support of one another !!! Thank you .
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INTERESTING READING
Please remember that the REUTERS articles may be good for only 30 days
Delays in Treatment: Gathering complete patient information to avoid delays Treatment delays account for 286 of the 3,811 sentinel events reported to The Joint Commission as of the end of June 2006, according to the Joint Commission’s Sentinel Event Statistics (for more information, see http://www.jointcommission.org/SentinelEvents/Statistics/). Inadequate assessment, untimely transmittal of information, and lack of coordination of care are just some of the root causes leading to treatment delays. When a patient is admitted, caregivers need to quickly access and assemble all relevant information from the patient's record. Staff must identify when this does not occur and track instances when access to documentation is delayed and why. A medical records system must allow for confidential communication and the ability to access information when the main system breaks down. Lack of access to key information can result in an incomplete assessment.... http://www.medinfonow.com/min/ct/5/65124/fuwluz/KAAK/853/default.aspx
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Drug found helpful in problem gamblers NEW YORK (Reuters 6/4 ) - In a study of pathological gamblers, the urge to gamble and gambling-related behaviors diminished among those who took naltrexone -- a drug frequently prescribed for the treatment of alcoholism and drug dependence.
Nearly 40 percent of the pathological gamblers who took naltrexone were able to abstain from all gambling for at least 1 month. Similar abstention occurred among just 10.5 percent of those treated with an inactive placebo, Dr. Jon E. Grant of the University of Minnesota in Minneapolis and colleagues report in the Journal of Clinical Psychiatry.... (Since it appears to help that addiction, why not cigarette addition???) http://www.reuters.com/article/healthNews/idUSCOL47055920080604?feedType=nl&feedName=ushealth1100
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Well, I am not certain, but isn't the following (at the very least) an OOPS.......or a DUH or does it fall in the OMG category?
Bladder and dementia therapy may be incompatible NEW YORK (Reuters 6/4 ) - In a study of elderly nursing home patients, those who took medications for dementia called cholinesterase inhibitors and medications for incontinence called anticholinergics at the same time had a 50 percent faster decline in function than those who were being treated only for dementia.
"Over a year's time, the decline would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity," study chief Dr. Kaycee M. Sink, of Wake Forest University, Winston-Salem, North Carolina said in a university-issued statement. These two drug classes "cancel each other out should not be used in combination," Sink added in comments to Reuters Health....
http://www.reuters.com/article/healthNews/idUSTON47359520080604?feedType=nl&feedName=ushealth1100
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HERE COME THE LAWYERS>>. HOT ON THE HEELS OF THE HEPARIN ISSUES ! Department of Health & Human Services Warning Letter 4/21/08 (This subject also appeared in our May issue) Click Here For Breaking News About Heparin!
The Heparin recall and injury lawyers at our firm are currently evaluating potential lawsuits on behalf of people injured by Baxter Heparin. As of March 2008, Baxter Heparin had been linked to hundreds of serious and sometimes life-threatening reactions, including at least four deaths. Our Baxter Heparin injury lawyers are offering free consultations to victims of the tainted drug and their families. The Baxter Heparin injury lawyers at our firm will work hard to make sure people injured by this defective drug receive the compensation they deserve.
If any of us were involved with a heparin problem..... please get your thoughts/ facts gathered together ! http://www.yourlawyer.com/topics/overview/heparin?gclid=CNKf_pbg4JMCFQIOuwodISiSig
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This article is directed toward patient teaching........but is good review for all of us.
High blood pressure patients advised to use home monitors DALLAS, May 22 — People with hypertension should routinely monitor their blood pressure at home to help manage the disease, according to a new joint scientific statement from the American Heart Association, American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association.
The statement is published online in Hypertension: Journal of the American Heart Association, the Journal of the American Society of Hypertension and the Journal of Clinical Hypertension and printed in the June issue of Journal of Cardiovascular Nursing.
“High blood pressure is notoriously difficult to treat to goal – many patients fail to reach target levels despite treatment, and studies show home monitoring can help,” said Thomas G. Pickering, M.D., D.Phil., chair of the statement writing group. “Blood pressure measurement and tracking could be improved with home monitoring by the patients themselves, in much the way people with diabetes monitor their blood sugar levels with home glucose monitors.” http://www.eurekalert.org/pub_releases/2008-05/aha-hbp051908.php
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TODAY'S RANDOM FACT -The human heart creates enough pressure to squirt blood 30 ft.
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Common drugs hasten the decline in elderly: study ( 5/3) - Elderly people who took commonly prescribed drugs for incontinence, allergy or high blood pressure walked more slowly and were less able to take care of themselves than others not taking the drugs, U.S. researchers said on Saturday.
They said people who took drugs that block acetylcholine -- a chemical messenger in the nervous system critical for memory -- functioned less well than their peers.
"These results were true even in older adults who have normal memory and thinking abilities," said Dr. Kaycee Sink of Wake Forest University School of Medicine in North Carolina, who led the study of 3,000 people of whom 40 percent were taking more than one anticholinergic drug.... http://www.reuters.com/article/healthNews/idUSN0230858220080503?feedType=nl&feedName=ushealth1100
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Cultural and Linguistic Competence and Patient Safety: Understanding the cultures and diversity of individuals Patient demographics are more diverse than ever, and health care providers need to provide care in a way that is culturally and linguistically appropriate to their patients. Some cultures focus on the spiritual or nutritional aspects of care; others rely on traditional remedies. Some cultures prohibit the mixing of sexes so that only same-gender individuals may provide care. These beliefs directly affect the patient’s willingness to be treated and follow treatment programs. Many health care organizations have made an effort to recruit staff representing the communities the organization serves. Staff members who practice or are familiar with the values, beliefs, traditions, customs, and cultures present in the hospital’s community can be recruited through development of relationships with cultural groups in the area. http://www.medinfonow.com/min/ct/5/64991/fuwluz/KAAK/834/default.aspx
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Blood Transfusion Errors: Labeling, storing, and dispensing properly According to the U.S. Food and Drug Administration’s database, a leading cause of blood transfusion error fatalities is ABO incompatibility. Since ABO typing is a well-established science where mismatch can be prevented, these errors are among the most preventable of all health care errors.The Joint Commission found that the most common problem resulting in blood transfusion errors was that pretransfusion testing specimens were mislabeled. Staff should use at least two patient identifiers (not the patient’s room number) whenever taking blood samples or administering blood products. Further, any blood specimen containers should be labeled in the presence of the patient and immediately matched to the patient using the two designated identifiers. Incorrect specimen labeling, improper product dispensing, and inadequate checks to match the patient to the blood product can all result in blood transfusion errors. http://www.medinfonow.com/min/ct/5/64725/fuwluz/KAAK/797/default.aspx
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Nurses develop clinical guideline from BP measurement research Christiana Care Health System nurses in Delaware developed a clinical practice guideline and Internet-based educational module to teach nurses and techs how to take proper blood pressure measurements after their research project showed different readings resulted from the use of two different parts of the arm. The nurses also created a practice alert about noninvasive blood pressure monitoring based on their research. http://include.nurse.com/apps/pbcs.dll/article?AID=/20080602/PA01/106020031
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NEW YORK (Reuters 5/12) - Child safety seats should be centered in the back seat Positioning child safety seats in the center of the back seat could cut infants' and toddlers' injury risks by nearly half, a new study suggests.
In a study of car crash data from 16 U.S. states, researchers found that children younger than 3 years old were 43 percent less likely to be injured when their seat was fastened in the center of the back seat rather than one of the side seats.
Experts already recommend that parents position car seats in the center of the rear seat, and the current findings bolster that advice, according to Michael J. Kallan and colleagues at the University of Pennsylvania and Children's Hospital of Philadelphia.
Unfortunately, only 28 percent of children in their study were sitting in that position at the time of the car accident, the researchers report in the journal Pediatrics....
http://www.reuters.com/article/healthNews/idUSKEN96664420080512?feedType=nl&feedName=ushealth1100
INTERESTING READING
Please remember that the REUTERS articles may be good for only 30 days
Delays in Treatment: Gathering complete patient information to avoid delays Treatment delays account for 286 of the 3,811 sentinel events reported to The Joint Commission as of the end of June 2006, according to the Joint Commission’s Sentinel Event Statistics (for more information, see http://www.jointcommission.org/SentinelEvents/Statistics/). Inadequate assessment, untimely transmittal of information, and lack of coordination of care are just some of the root causes leading to treatment delays. When a patient is admitted, caregivers need to quickly access and assemble all relevant information from the patient's record. Staff must identify when this does not occur and track instances when access to documentation is delayed and why. A medical records system must allow for confidential communication and the ability to access information when the main system breaks down. Lack of access to key information can result in an incomplete assessment.... http://www.medinfonow.com/min/ct/5/65124/fuwluz/KAAK/853/default.aspx
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Drug found helpful in problem gamblers NEW YORK (Reuters 6/4 ) - In a study of pathological gamblers, the urge to gamble and gambling-related behaviors diminished among those who took naltrexone -- a drug frequently prescribed for the treatment of alcoholism and drug dependence.
Nearly 40 percent of the pathological gamblers who took naltrexone were able to abstain from all gambling for at least 1 month. Similar abstention occurred among just 10.5 percent of those treated with an inactive placebo, Dr. Jon E. Grant of the University of Minnesota in Minneapolis and colleagues report in the Journal of Clinical Psychiatry.... (Since it appears to help that addiction, why not cigarette addition???) http://www.reuters.com/article/healthNews/idUSCOL47055920080604?feedType=nl&feedName=ushealth1100
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Well, I am not certain, but isn't the following (at the very least) an OOPS.......or a DUH or does it fall in the OMG category?
Bladder and dementia therapy may be incompatible NEW YORK (Reuters 6/4 ) - In a study of elderly nursing home patients, those who took medications for dementia called cholinesterase inhibitors and medications for incontinence called anticholinergics at the same time had a 50 percent faster decline in function than those who were being treated only for dementia.
"Over a year's time, the decline would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity," study chief Dr. Kaycee M. Sink, of Wake Forest University, Winston-Salem, North Carolina said in a university-issued statement. These two drug classes "cancel each other out should not be used in combination," Sink added in comments to Reuters Health....
http://www.reuters.com/article/healthNews/idUSTON47359520080604?feedType=nl&feedName=ushealth1100
*************************
HERE COME THE LAWYERS>>. HOT ON THE HEELS OF THE HEPARIN ISSUES ! Department of Health & Human Services Warning Letter 4/21/08 (This subject also appeared in our May issue) Click Here For Breaking News About Heparin!
The Heparin recall and injury lawyers at our firm are currently evaluating potential lawsuits on behalf of people injured by Baxter Heparin. As of March 2008, Baxter Heparin had been linked to hundreds of serious and sometimes life-threatening reactions, including at least four deaths. Our Baxter Heparin injury lawyers are offering free consultations to victims of the tainted drug and their families. The Baxter Heparin injury lawyers at our firm will work hard to make sure people injured by this defective drug receive the compensation they deserve.
If any of us were involved with a heparin problem..... please get your thoughts/ facts gathered together ! http://www.yourlawyer.com/topics/overview/heparin?gclid=CNKf_pbg4JMCFQIOuwodISiSig
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This article is directed toward patient teaching........but is good review for all of us.
High blood pressure patients advised to use home monitors DALLAS, May 22 — People with hypertension should routinely monitor their blood pressure at home to help manage the disease, according to a new joint scientific statement from the American Heart Association, American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association.
The statement is published online in Hypertension: Journal of the American Heart Association, the Journal of the American Society of Hypertension and the Journal of Clinical Hypertension and printed in the June issue of Journal of Cardiovascular Nursing.
“High blood pressure is notoriously difficult to treat to goal – many patients fail to reach target levels despite treatment, and studies show home monitoring can help,” said Thomas G. Pickering, M.D., D.Phil., chair of the statement writing group. “Blood pressure measurement and tracking could be improved with home monitoring by the patients themselves, in much the way people with diabetes monitor their blood sugar levels with home glucose monitors.” http://www.eurekalert.org/pub_releases/2008-05/aha-hbp051908.php
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TODAY'S RANDOM FACT -The human heart creates enough pressure to squirt blood 30 ft.
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Common drugs hasten the decline in elderly: study ( 5/3) - Elderly people who took commonly prescribed drugs for incontinence, allergy or high blood pressure walked more slowly and were less able to take care of themselves than others not taking the drugs, U.S. researchers said on Saturday.
They said people who took drugs that block acetylcholine -- a chemical messenger in the nervous system critical for memory -- functioned less well than their peers.
"These results were true even in older adults who have normal memory and thinking abilities," said Dr. Kaycee Sink of Wake Forest University School of Medicine in North Carolina, who led the study of 3,000 people of whom 40 percent were taking more than one anticholinergic drug.... http://www.reuters.com/article/healthNews/idUSN0230858220080503?feedType=nl&feedName=ushealth1100
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Cultural and Linguistic Competence and Patient Safety: Understanding the cultures and diversity of individuals Patient demographics are more diverse than ever, and health care providers need to provide care in a way that is culturally and linguistically appropriate to their patients. Some cultures focus on the spiritual or nutritional aspects of care; others rely on traditional remedies. Some cultures prohibit the mixing of sexes so that only same-gender individuals may provide care. These beliefs directly affect the patient’s willingness to be treated and follow treatment programs. Many health care organizations have made an effort to recruit staff representing the communities the organization serves. Staff members who practice or are familiar with the values, beliefs, traditions, customs, and cultures present in the hospital’s community can be recruited through development of relationships with cultural groups in the area. http://www.medinfonow.com/min/ct/5/64991/fuwluz/KAAK/834/default.aspx
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Blood Transfusion Errors: Labeling, storing, and dispensing properly According to the U.S. Food and Drug Administration’s database, a leading cause of blood transfusion error fatalities is ABO incompatibility. Since ABO typing is a well-established science where mismatch can be prevented, these errors are among the most preventable of all health care errors.The Joint Commission found that the most common problem resulting in blood transfusion errors was that pretransfusion testing specimens were mislabeled. Staff should use at least two patient identifiers (not the patient’s room number) whenever taking blood samples or administering blood products. Further, any blood specimen containers should be labeled in the presence of the patient and immediately matched to the patient using the two designated identifiers. Incorrect specimen labeling, improper product dispensing, and inadequate checks to match the patient to the blood product can all result in blood transfusion errors. http://www.medinfonow.com/min/ct/5/64725/fuwluz/KAAK/797/default.aspx
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Nurses develop clinical guideline from BP measurement research Christiana Care Health System nurses in Delaware developed a clinical practice guideline and Internet-based educational module to teach nurses and techs how to take proper blood pressure measurements after their research project showed different readings resulted from the use of two different parts of the arm. The nurses also created a practice alert about noninvasive blood pressure monitoring based on their research. http://include.nurse.com/apps/pbcs.dll/article?AID=/20080602/PA01/106020031
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NEW YORK (Reuters 5/12) - Child safety seats should be centered in the back seat Positioning child safety seats in the center of the back seat could cut infants' and toddlers' injury risks by nearly half, a new study suggests.
In a study of car crash data from 16 U.S. states, researchers found that children younger than 3 years old were 43 percent less likely to be injured when their seat was fastened in the center of the back seat rather than one of the side seats.
Experts already recommend that parents position car seats in the center of the rear seat, and the current findings bolster that advice, according to Michael J. Kallan and colleagues at the University of Pennsylvania and Children's Hospital of Philadelphia.
Unfortunately, only 28 percent of children in their study were sitting in that position at the time of the car accident, the researchers report in the journal Pediatrics....
http://www.reuters.com/article/healthNews/idUSKEN96664420080512?feedType=nl&feedName=ushealth1100
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Health Literacy.........three questions the patient needs to ask Health literacy — the ability to read, understand, and effectively use basic medical instructions and information — is the strongest predictor of a person's health, according to The Partnership for Clear Health Communication (PCHC).But the average American reads at the eighth- or ninth-grade level, considerably below the reading level of most medical instructions and patient information. PCHC estimates 90 million people in the U.S. have difficulty understanding and acting on health information, putting their health at risk.PCHC, of the National Patient Safety Foundation, launched the Ask Me 3 program to help improve health literacy through clear communication between patients and healthcare providers. Advocate Lutheran General Hospital in Park Ridge, Ill., the sixth largest hospital in the Chicago metropolitan area, successfully tested the program and is about to expand its use hospital-wide. Advocate Illinois Masonic Hospital in Chicago also is considering using the program. Ask Me 3 is based on three questions patients need to ask their healthcare providers. The questions originally were intended for outpatients to use in physicians' offices, but they work well in any healthcare setting.
Health Literacy.........three questions the patient needs to ask Health literacy — the ability to read, understand, and effectively use basic medical instructions and information — is the strongest predictor of a person's health, according to The Partnership for Clear Health Communication (PCHC).But the average American reads at the eighth- or ninth-grade level, considerably below the reading level of most medical instructions and patient information. PCHC estimates 90 million people in the U.S. have difficulty understanding and acting on health information, putting their health at risk.PCHC, of the National Patient Safety Foundation, launched the Ask Me 3 program to help improve health literacy through clear communication between patients and healthcare providers. Advocate Lutheran General Hospital in Park Ridge, Ill., the sixth largest hospital in the Chicago metropolitan area, successfully tested the program and is about to expand its use hospital-wide. Advocate Illinois Masonic Hospital in Chicago also is considering using the program. Ask Me 3 is based on three questions patients need to ask their healthcare providers. The questions originally were intended for outpatients to use in physicians' offices, but they work well in any healthcare setting.
1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?
Jean Mau, RN, APN, conducted two research studies at Lutheran General using the Ask Me 3 program. The first month-long study was with patients in the cardiovascular unit. Mau reported a marked increase in patients' understanding of instructions and a decrease in instances of heart failure during the pilot....
http://include.nurse.com/apps/pbcs.dll/article?AID=/20080421/IL02/104210006&source=nletter-
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Just checked....the following is still available. NEW YORK (Reuters 4/16 ) - Health insurer WellPoint Inc said on Tuesday it is developing a system that will use its 35 million-member database to monitor and help to more quickly identify potential safety problems of approved medicines. WellPoint's Safety Sentinel System, being developed in collaboration with U.S. health regulators and other government and academic institutions, should in theory be able to uncover health risks that might crop up once drugs are being used by the general population more quickly than the FDA, doctors or drugmakers.... http://www.reuters.com/article/healthNews/idUSN1445413220080415?feedType=nl&feedName=ushealth1100
http://include.nurse.com/apps/pbcs.dll/article?AID=/20080421/IL02/104210006&source=nletter-
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Just checked....the following is still available. NEW YORK (Reuters 4/16 ) - Health insurer WellPoint Inc said on Tuesday it is developing a system that will use its 35 million-member database to monitor and help to more quickly identify potential safety problems of approved medicines. WellPoint's Safety Sentinel System, being developed in collaboration with U.S. health regulators and other government and academic institutions, should in theory be able to uncover health risks that might crop up once drugs are being used by the general population more quickly than the FDA, doctors or drugmakers.... http://www.reuters.com/article/healthNews/idUSN1445413220080415?feedType=nl&feedName=ushealth1100
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Mouth test could predict lung cancer, study finds ( Reuters 4/13) - Damage to cells lining the mouth can predict similar damage in the lungs that eventually leads to lung cancer in smokers, U.S. researchers reported on Sunday.
They hope it may be possible to some day swab the mouths of smokers to predict who is developing lung cancer -- saving painful and dangerous biopsies of the lung.
The process may also lead to tests that will predict other cancers, said Dr. Li Mao, an expert in head, neck and lung cancer at the University of Texas M.D. Anderson Cancer Center in Houston.... http://www.reuters.com/article/healthNews/idUSN1327574420080413?feedType=nl&feedName=ushealth1100
*********************Men Can Take Five Steps to Better Heart A man may reduce his risk for heart disease by revving up his healthy lifestyle practices, according to findings published in Circulation. Researchers studied almost 43,000 male health-professionals for 16 years and identified five key steps men can take.
Factor in These Top Five PracticesAmong the men ages 40 to 75 studied, those whose lifestyles included these healthy practices had the lowest risk for heart disease:1. Not smoking 2. Eating a healthy diet3. Exercising daily 4. Drinking alcohol in moderation5. Staying a healthy weight
http://www.regardinghealth.com/sil/RHO/2008/04/Article.aspx?bmkEMC=37935
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Most Uninsured Families Lack Sufficient Assets To Cover Cost Sharing In Consumer-Directed Health Plans Relatively few uninsured households have enough financial assets to cover the cost sharing in consumer-driven health plans tied to Health Savings Accounts (HSAs), according to a new study by Kaiser Family Foundation researchers published today as a Health Affairs Web Exclusive.The study shows that most uninsured households do not have overall financial assets great enough to cover the relatively high deductibles associated with consumer-driven plans.... Article by Kaiser researchers Paul Jacobs and Gary Claxton: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.3.w214
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Presliced fruit sure saves time. But here's what you miss out on when you buy it: vitamin C. Research shows that presliced fruit may have less vitamin C by the time you eat it than if you'd bought whole fruit and sliced it yourself.Kiwifruit, pineapple, and cantaloupe seem particularly prone to vitamin C loss, according to John La Puma, MD, author of ChefMD's Big Book of Culinary Medicine. (Browse the book online.)
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Eating four of these a week can cut your kidney-cancer risk in half. Yep, we're talking bananas. They're bursting with phenolic compounds that appear to thwart renal-cancer cells. And that's not all the monkey's favorite fruit brings to your body . . . Phenols, Potassium, and More Phenols -- plant-based substances linked to all sorts of health benefits, from cancer prevention to heart health -- aren't the only goodies that bananas have to offer. No doubt you already know about the super potassium stores in the yellow-skinned fruit (450 milligrams in one banana!). But they're also a good source of B vitamins like B6 and folate, plus calcium, magnesium, and vitamin C. Reference: Fruits, vegetables and risk of renal cell carcinoma: a prospective study of Swedish women. Rashidkhani, B., Lindblad, P., Wolk, A., International Journal of Cancer 2005 Jan 20;113(3):451-455.
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Geriatric nurses must use wide range of skills (CanWest News Service) (5/22) Geriatric nurse Judy Bianco says it is difficult to entice nurses to gerontology, but once they gain some experience they end up loving the specialization. Bianco says geriatric nurses focus on bio-psycho-social care for the patient in relationship to the family and community and often serve as advocates for their elderly patients. http://working.canada.com/resources/story.html?id=60e2f8f4-2c61-4144-9cf8-c978f00244fd *****************
Recently, six nurses were written up when dilaudid went missing from the Pyxis. It appears, that someone was waiting for the nurses to finish, then walked in before the automatic 60 second log outinterval. 10 here, 15 there, a large number of carpuject doses were missing over a one day period.They examined the schedule, saw who was on and had access to the Pyxis, and it was a long list of people. So, do the six nurses voluntarily submit to drug testing since the meds were taken under their usernames?The theft of narcotics is usually a reportable event, meaning the Drug Enforcement Agency (DEA) will be notified. Looks like it is going to be one helluva mess, for a few nurses forgetting to hit "exit" and log out of the Pyxis when they were done. Given the prevalence of drug abuse, their hands may be tied.Diversion of Controlled Substances: A Catalyst for Change, National Association for Healthcare Quality (NAHQ):"Controlled substance diversion by healthcare professionals is an event many healthcareprofessionals believe could never happen in their institution. Most employees believe they know coworkers well enough and would be able to identify a substance abuser. Employees in pediatric settings appear especially naïve because of the misconception that a coworker would never intentionally withhold a child's pain medication for personal use. However, drug diversion is more common than most people know. Approximately 15% of healthcare professionals will struggle with chemical dependency during their career (National Council of State Boards of Nursing [NCSBN], 2001). Nearly 30% of addiction problems begin with the abuse of a prescription drug (Briefings on Patient Safety, 2002). Stress and chronic illnesses, including migraine headaches, surgery, and back injury, are two of the main reasons why narcotics are diverted (Hospital Security and Safety Management, 1997)." NAHQ 4700 W. Lake Ave. - Glenview, IL 60025 800/966-9392 - 847/375-4720 - Fax 877/218-7939http://www.nahq.org/journal/ce/article.html?article_id=217
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Beyond evidence-based nursing: tools for practice Aim This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions.
Background As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach.
Evaluation This article summarizes nursing’s simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making.
Key issue I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale.
Conclusion Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more.
Implications for nursing management This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions....
ANNEMARIE JUTEL RN, PhD (2008) Beyond evidence-based nursing: tools for practice Journal of Nursing Management 16 (4) , 417–421 doi:10.1111/j.1365-2834.2008.00861.x http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2834.2008.00861.x
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Pain assessment in the cognitively impaired and noncommunicative is cutting edge science at Adventist Rehabilitation Hospital of Maryland. The patient nods when you ask him if he's in pain. He had a motor vehicle accident 2 weeks ago and fractured several ribs, for which you medicated him an hour ago. However, because this patient suffered a brain injury during his accident and has lost much of his ability to communicate, how will you know whether his pain is now better or worse? His expression is flat; does that mean his pain is tolerable or is that simply a result of his brain injury? Should you call the doctor and recommend a stronger dose? And how will the next shift be able to compare their assessment to yours?
New Tools If a patient at Adventist Rehabilitation Hospital of Maryland, Rockville, has been diagnosed with stroke, brain injury, cancer or disease of the brain, they benefit from the latest science has to offer in pain assessment techniques. Based on a nursing-led project, the facility has adopted two new evidence-based pain assessment tools that don't require cognitively impaired patients to use numbers to communicate their pain level.... http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?cc=114276
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TODAY'S RANDOM FACT... Despite their hump... camels have a straight spine.
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Glaxo says cervical cancer vaccine works for longer LONDON (Reuters 5/14) - GlaxoSmithKline said on Wednesday new data showed its Cervarix vaccine generated sustained, high levels of neutralizing antibodies against the two most common cervical cancer-causing virus types for 6.4 years.
Glaxo said on Wednesday the data, from an extended follow-up study, showed the longest duration of sustained neutralizing antibody levels reported against both virus types HPV 16 and 18 with a cervical cancer vaccine to date.
Experts believe that neutralizing antibodies -- so-called because they have the ability to neutralize cancer-causing virus types and prevent them from infecting cells in the cervix -- are essential for cervical cancer protection. (Reporting by Mark Potter, Editing by Dan Lalor) http://www.reuters.com/article/healthNews/idUSWLB155420080514?feedType=nl&feedName=ushealth1100
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Sitting too long may be dangerous for young infants NEW YORK (Reuters 5/13) - "Do not leave infants less than one month old in a sitting position for a long period of time," suggests Dr. Aurore Cote, because this may place them at increased risk for sudden infant death.
Cote, from McGill University Health Center in Montreal, and colleagues report that deaths among infants in a sitting position accounted for about 3 percent of the infant deaths they reviewed as part of their study.... http://www.reuters.com/article/healthNews/idUSKEN37119120080513?feedType=nl&feedName=ushealth1100
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Disruptive Care Provider Behavior: Ensuring civility in the health care workplace Disruptive behavior is not only a job satisfaction issue, it is also a patient safety issue. It is behavior that interferes with patient care and safety by breaking down the communication that is essential to safe care. It can range from physical intimidation and unpleasant behavior to refusal to cooperate. Disruptive behavior makes staff refrain from needed interactions. It is important to have a strong policy on disruptive behavior. The keys are to clearly define disruptive behavior and refuse to tolerate it. Because many people are unaware of the full extent of disruptive behavior or may be reluctant to report it, leadership will need to work initially to uncover problems. Leadership must also make sure people throughout the organization are aware of and understand the disruptive-behavior policy. The involvement of leadership will not only help you find out about behavior problems, it helps you be a part of the solution once they are uncovered.... http://www.medinfonow.com/min/ct/5/65257/fuwluz/KAAK/878/default.aspx © 2007 Joint Commission on Accreditation of Healthcare Organizations
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Low Levels of Vitamin D Spell Trouble for Breast Cancer... FRIDAY, May 16 (HealthDay News) -- Women with breast cancer who have a vitamin D deficiency at the time of diagnosis are more likely to have a recurrence or to die from their disease, a new study shows.
Surprisingly, the researchers also found that only 24 percent of the patients had adequate levels of vitamin D when they were diagnosed.
"This study found that vitamin D deficiency is very common among women with breast cancer, and it suggests that vitamin D deficiency is linked to poorer outcomes in these women," Dr. Nancy Davidson, director of the breast cancer program at the Johns Hopkins Kimmel Cancer Center, said during a May 6 press conference. Davidson is president of the American Society of Clinical Oncology (ASCO).
Nevertheless, the evidence isn't strong enough to suggest women with breast cancer take more of the vitamin.... http://www.washingtonpost.com/wp-dyn/content/article/2008/05/16/AR2008051601472.html
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New scans prompt mastectomies for breast patients (Reuters 5/15/08) - Breast cancer patients who get newer scans called magnetic resonance imaging are more likely to opt for mastectomies, U.S. researchers reported on Thursday. The patients who get mastectomies are not living any longer than those who get less radical surgery, the researchers said in preliminary results released ahead of a meeting later this month of the American Society of Clinical Oncology.... http://www.reuters.com/article/healthNews/idUSN1532730020080516?feedType=nl&feedName=ushealth1100
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FDA defends safety of baby bottle chemical WASHINGTON (Reuters 5/15) - The U.S. Food and Drug Administration said on Wednesday said it sees no reason to tell consumers to stop using products such as baby bottles made with a controversial chemical found in many plastic items.
Norris Alderson, the FDA's associate commissioner for science, said although the regulatory agency is reviewing safety concerns about the chemical bisphenol A, or BPA, "a large body of available evidence" shows that products such as liquid or food containers made with it are safe.... http://www.reuters.com/article/healthNews/idUSN1342348720080515?feedType=nl&feedName=ushealth1100
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New treatment seen boosting stroke survival CHICAGO (Reuters 5/14) - Adding just a small dose of a clot-busting drug to standard treatment for strokes caused by bleeding in the brain dramatically reduced death and disability among victims, U.S. researchers said on Wednesday.
Normally, only about 20 percent of people survive this type of stroke, known as an intracerebral hemorrhage, which accounts for 17 percent of all strokes.
But when doctors used a clot-busting drug plus a catheter to clear out blood from the brain in a study of 50 patients, more than 80 percent of the stroke victims survived.
"Getting the blood out of the middle of the brain significantly improved their chances of survival," said Dr. Daniel Hanley of the Johns Hopkins University School of Medicine, who presented his findings at the European Stroke Conference in Nice, France.
The clot-busting drug tissue plasminogen activator or tPA is typically reserved for breaking up blood clots in the more common type of stroke known as ischemic stroke, which is caused when a blood clot impedes blood flow to the brain.... http://www.reuters.com/article/healthNews/idUSN1453829120080514?feedType=nl&feedName=ushealth1100
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Green tea may shield brain from sleep apnea effects NEW YORK (Reuters 5/19) - Compounds found in green tea may help ward off the neurological damage that can come with the breathing disorder sleep apnea, a new animal study hints.
Researchers found that when they added green tea antioxidants to rats' drinking water, it appeared to protect the animals' brains during bouts of oxygen deprivation designed to mimic the effects of obstructive sleep apnea (OSA).... http://www.reuters.com/article/healthNews/idUSPAT94474720080519?feedType=nl&feedName=ushealth1100
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Stress in pregnancy raises risks for baby CHICAGO (Reuters 5/18) - Women who are stressed about money, relationships and other problems during pregnancy may give birth to babies who are predisposed to allergies and asthma, U.S. researchers said on Sunday.
The findings, presented at a meeting of the American Thoracic Society in Toronto, suggest a mother's stress during pregnancy may have lasting consequences for her child.
"This research adds to a growing body of evidence that links maternal stress such as that precipitated by financial problems or relationship issues to changes in children's developing immune systems, even during pregnancy," Dr. Rosalind Wright of Harvard Medical School in Boston said in a statement... http://www.reuters.com/article/healthNews/idUSN1652878520080518?feedType=nl&feedName=ushealth1100
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TODAY'S RANDOM FACT... The cat's clavicle, or collarbone, does not connect with other bones but is buried in the muscles of the shoulder region. This lack of a functioning collarbone allows them to fit through any opening the size of their head.
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U.S. seeks new hepatitis blood donation rules (Reuters 5/20)- U.S. health officials are seeking to relax blood donation rules for some people who initially tested positive for hepatitis B, which could clear hundred of thousands of new donors, according to documents released on Tuesday.
People whose blood showed signs of the liver-swelling virus after repeated tests are currently banned from ever donating blood, even if medical tests later showed they were not infected.
But in a draft proposal, the U.S. Food and Drug Administration (FDA) said that a new, more specific test could help determine whether donors who initially fail a first test are truly infected and suggested they be allowed to give blood after an 8-week waiting period... http://www.reuters.com/article/healthNews/idUSN2031039220080520?feedType=nl&feedName=ushealth1100
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U.S. Panel mulls minimum breast cancer hospital stay (Reuters 5/21) - A congressional panel on Wednesday said it has bipartisan support for a bill requiring health insurers to pay for a minimum 48-hour hospital stay after breast cancer treatment, to combat what critics call "drive-through" surgeries.
About 20 U.S. states have such a minimum insurance requirement for women undergoing mastectomies or lumpectomies to treat breast cancer. Advocates of the bill say federal legislation is needed to equalize coverage across the nation... http://www.reuters.com/article/healthNews/idUSN2140144220080521?feedType=nl&feedName=ushealth1100
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Study cites Pfizer smoking drug risk, shares fall (Reuters 5/21) - Hundreds of patients taking Pfizer Inc's anti-smoking drug Chantix have reported serious accidents, vision problems and heart trouble, researchers said on Wednesday, sending shares of the world's largest drugmaker to their lowest level since 1997.
U.S. aviation regulators responded quickly to the research, saying they would prohibit use of the drug by private and commercial pilots. "It's prudent to deem the drug no longer acceptable for use," said Federal Aviation Administration spokesman Les Dorr. Hundreds of patients taking Pfizer Inc's anti-smoking drug Chantix have reported serious accidents, vision problems and heart trouble, researchers said on Wednesday, sending shares of the world's largest drugmaker to their lowest level since 1997... http://www.reuters.com/article/healthNews/idUSWBT00902620080521?feedType=nl&feedName=ushealth1100
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For the Home Health nurses: Soap Sheets from Magellans. (From a nurse on the List serve; I did not write this. I sounds excellent. Hopefully, paper towels are available)There are 50 sheets in a small dispenser and they're dry. They're easy to use and the dispenser is about the size of a small box of matches and not as thick. I carry them in my pocket and because I do hospice care in people's homes and believe it or not, sometimes they don't even have soap to wash thehands with, this is great. The soap is antibacterial too.To use, you pick out a sheet and put your hands along with the sheet under running water. The sheet dissolves and becomes soap that has no aroma. It has a pleasant soapy feel to it. For a total of $14.84 (a bit pricey, I admit), you get two dispensers. I ordered them online from Magellan's out of Santa Barbara, CA. but the toll free number is 1-800-962-4943
Mouth test could predict lung cancer, study finds ( Reuters 4/13) - Damage to cells lining the mouth can predict similar damage in the lungs that eventually leads to lung cancer in smokers, U.S. researchers reported on Sunday.
They hope it may be possible to some day swab the mouths of smokers to predict who is developing lung cancer -- saving painful and dangerous biopsies of the lung.
The process may also lead to tests that will predict other cancers, said Dr. Li Mao, an expert in head, neck and lung cancer at the University of Texas M.D. Anderson Cancer Center in Houston.... http://www.reuters.com/article/healthNews/idUSN1327574420080413?feedType=nl&feedName=ushealth1100
*********************Men Can Take Five Steps to Better Heart A man may reduce his risk for heart disease by revving up his healthy lifestyle practices, according to findings published in Circulation. Researchers studied almost 43,000 male health-professionals for 16 years and identified five key steps men can take.
Factor in These Top Five PracticesAmong the men ages 40 to 75 studied, those whose lifestyles included these healthy practices had the lowest risk for heart disease:1. Not smoking 2. Eating a healthy diet3. Exercising daily 4. Drinking alcohol in moderation5. Staying a healthy weight
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Most Uninsured Families Lack Sufficient Assets To Cover Cost Sharing In Consumer-Directed Health Plans Relatively few uninsured households have enough financial assets to cover the cost sharing in consumer-driven health plans tied to Health Savings Accounts (HSAs), according to a new study by Kaiser Family Foundation researchers published today as a Health Affairs Web Exclusive.The study shows that most uninsured households do not have overall financial assets great enough to cover the relatively high deductibles associated with consumer-driven plans.... Article by Kaiser researchers Paul Jacobs and Gary Claxton: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.3.w214
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Presliced fruit sure saves time. But here's what you miss out on when you buy it: vitamin C. Research shows that presliced fruit may have less vitamin C by the time you eat it than if you'd bought whole fruit and sliced it yourself.
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Eating four of these a week can cut your kidney-cancer risk in half. Yep, we're talking bananas. They're bursting with phenolic compounds that appear to thwart renal-cancer cells. And that's not all the monkey's favorite fruit brings to your body . . . Phenols, Potassium, and More Phenols -- plant-based substances linked to all sorts of health benefits, from cancer prevention to heart health -- aren't the only goodies that bananas have to offer. No doubt you already know about the super potassium stores in the yellow-skinned fruit (450 milligrams in one banana!). But they're also a good source of B vitamins like B6 and folate, plus calcium, magnesium, and vitamin C. Reference: Fruits, vegetables and risk of renal cell carcinoma: a prospective study of Swedish women. Rashidkhani, B., Lindblad, P., Wolk, A., International Journal of Cancer 2005 Jan 20;113(3):451-455.
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Geriatric nurses must use wide range of skills (CanWest News Service) (5/22) Geriatric nurse Judy Bianco says it is difficult to entice nurses to gerontology, but once they gain some experience they end up loving the specialization. Bianco says geriatric nurses focus on bio-psycho-social care for the patient in relationship to the family and community and often serve as advocates for their elderly patients. http://working.canada.com/resources/story.html?id=60e2f8f4-2c61-4144-9cf8-c978f00244fd *****************
Recently, six nurses were written up when dilaudid went missing from the Pyxis. It appears, that someone was waiting for the nurses to finish, then walked in before the automatic 60 second log outinterval. 10 here, 15 there, a large number of carpuject doses were missing over a one day period.They examined the schedule, saw who was on and had access to the Pyxis, and it was a long list of people. So, do the six nurses voluntarily submit to drug testing since the meds were taken under their usernames?The theft of narcotics is usually a reportable event, meaning the Drug Enforcement Agency (DEA) will be notified. Looks like it is going to be one helluva mess, for a few nurses forgetting to hit "exit" and log out of the Pyxis when they were done. Given the prevalence of drug abuse, their hands may be tied.Diversion of Controlled Substances: A Catalyst for Change, National Association for Healthcare Quality (NAHQ):"Controlled substance diversion by healthcare professionals is an event many healthcareprofessionals believe could never happen in their institution. Most employees believe they know coworkers well enough and would be able to identify a substance abuser. Employees in pediatric settings appear especially naïve because of the misconception that a coworker would never intentionally withhold a child's pain medication for personal use. However, drug diversion is more common than most people know. Approximately 15% of healthcare professionals will struggle with chemical dependency during their career (National Council of State Boards of Nursing [NCSBN], 2001). Nearly 30% of addiction problems begin with the abuse of a prescription drug (Briefings on Patient Safety, 2002). Stress and chronic illnesses, including migraine headaches, surgery, and back injury, are two of the main reasons why narcotics are diverted (Hospital Security and Safety Management, 1997)." NAHQ 4700 W. Lake Ave. - Glenview, IL 60025 800/966-9392 - 847/375-4720 - Fax 877/218-7939http://www.nahq.org/journal/ce/article.html?article_id=217
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Beyond evidence-based nursing: tools for practice Aim This commentary shares my views of evidence-based nursing as a framework for practice, pointing out its limitations and identifying a wider base of appraisal tools required for making good clinical decisions.
Background As the principles of evidence-based nursing take an increasingly greater hold on nursing education, policy and management, it is important to consider the range of other decision-making tools which are subordinated by this approach.
Evaluation This article summarizes nursing’s simultaneous reliance on and critique of evidence-based practice (EBP) in a context of inadequate critical reasoning. It then provides an exemplar of the limitations of evidence-based practice and offers an alternative view of important precepts of decision-making.
Key issue I identify means by which nurses can develop skills to engage in informed and robust critique of practices and their underpinning rationale.
Conclusion Nurses need to be able to locate and assess useful and reliable information for decision-making. This skill is based on a range of tools which include, but also go beyond EBP including: information literacy, humanities, social sciences, public health, statistics, marketing, ethics and much more.
Implications for nursing management This essay prompts nursing managers to reflect upon whether a flurried enthusiasm to adopt EBP neglects other important decision-making skills which provide an even stronger foundation for robust nursing decisions....
ANNEMARIE JUTEL RN, PhD (2008) Beyond evidence-based nursing: tools for practice Journal of Nursing Management 16 (4) , 417–421 doi:10.1111/j.1365-2834.2008.00861.x http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2834.2008.00861.x
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Pain assessment in the cognitively impaired and noncommunicative is cutting edge science at Adventist Rehabilitation Hospital of Maryland. The patient nods when you ask him if he's in pain. He had a motor vehicle accident 2 weeks ago and fractured several ribs, for which you medicated him an hour ago. However, because this patient suffered a brain injury during his accident and has lost much of his ability to communicate, how will you know whether his pain is now better or worse? His expression is flat; does that mean his pain is tolerable or is that simply a result of his brain injury? Should you call the doctor and recommend a stronger dose? And how will the next shift be able to compare their assessment to yours?
New Tools If a patient at Adventist Rehabilitation Hospital of Maryland, Rockville, has been diagnosed with stroke, brain injury, cancer or disease of the brain, they benefit from the latest science has to offer in pain assessment techniques. Based on a nursing-led project, the facility has adopted two new evidence-based pain assessment tools that don't require cognitively impaired patients to use numbers to communicate their pain level.... http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?cc=114276
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TODAY'S RANDOM FACT... Despite their hump... camels have a straight spine.
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Glaxo says cervical cancer vaccine works for longer LONDON (Reuters 5/14) - GlaxoSmithKline said on Wednesday new data showed its Cervarix vaccine generated sustained, high levels of neutralizing antibodies against the two most common cervical cancer-causing virus types for 6.4 years.
Glaxo said on Wednesday the data, from an extended follow-up study, showed the longest duration of sustained neutralizing antibody levels reported against both virus types HPV 16 and 18 with a cervical cancer vaccine to date.
Experts believe that neutralizing antibodies -- so-called because they have the ability to neutralize cancer-causing virus types and prevent them from infecting cells in the cervix -- are essential for cervical cancer protection. (Reporting by Mark Potter, Editing by Dan Lalor) http://www.reuters.com/article/healthNews/idUSWLB155420080514?feedType=nl&feedName=ushealth1100
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Sitting too long may be dangerous for young infants NEW YORK (Reuters 5/13) - "Do not leave infants less than one month old in a sitting position for a long period of time," suggests Dr. Aurore Cote, because this may place them at increased risk for sudden infant death.
Cote, from McGill University Health Center in Montreal, and colleagues report that deaths among infants in a sitting position accounted for about 3 percent of the infant deaths they reviewed as part of their study.... http://www.reuters.com/article/healthNews/idUSKEN37119120080513?feedType=nl&feedName=ushealth1100
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Disruptive Care Provider Behavior: Ensuring civility in the health care workplace Disruptive behavior is not only a job satisfaction issue, it is also a patient safety issue. It is behavior that interferes with patient care and safety by breaking down the communication that is essential to safe care. It can range from physical intimidation and unpleasant behavior to refusal to cooperate. Disruptive behavior makes staff refrain from needed interactions. It is important to have a strong policy on disruptive behavior. The keys are to clearly define disruptive behavior and refuse to tolerate it. Because many people are unaware of the full extent of disruptive behavior or may be reluctant to report it, leadership will need to work initially to uncover problems. Leadership must also make sure people throughout the organization are aware of and understand the disruptive-behavior policy. The involvement of leadership will not only help you find out about behavior problems, it helps you be a part of the solution once they are uncovered.... http://www.medinfonow.com/min/ct/5/65257/fuwluz/KAAK/878/default.aspx © 2007 Joint Commission on Accreditation of Healthcare Organizations
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Low Levels of Vitamin D Spell Trouble for Breast Cancer... FRIDAY, May 16 (HealthDay News) -- Women with breast cancer who have a vitamin D deficiency at the time of diagnosis are more likely to have a recurrence or to die from their disease, a new study shows.
Surprisingly, the researchers also found that only 24 percent of the patients had adequate levels of vitamin D when they were diagnosed.
"This study found that vitamin D deficiency is very common among women with breast cancer, and it suggests that vitamin D deficiency is linked to poorer outcomes in these women," Dr. Nancy Davidson, director of the breast cancer program at the Johns Hopkins Kimmel Cancer Center, said during a May 6 press conference. Davidson is president of the American Society of Clinical Oncology (ASCO).
Nevertheless, the evidence isn't strong enough to suggest women with breast cancer take more of the vitamin.... http://www.washingtonpost.com/wp-dyn/content/article/2008/05/16/AR2008051601472.html
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New scans prompt mastectomies for breast patients (Reuters 5/15/08) - Breast cancer patients who get newer scans called magnetic resonance imaging are more likely to opt for mastectomies, U.S. researchers reported on Thursday. The patients who get mastectomies are not living any longer than those who get less radical surgery, the researchers said in preliminary results released ahead of a meeting later this month of the American Society of Clinical Oncology.... http://www.reuters.com/article/healthNews/idUSN1532730020080516?feedType=nl&feedName=ushealth1100
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FDA defends safety of baby bottle chemical WASHINGTON (Reuters 5/15) - The U.S. Food and Drug Administration said on Wednesday said it sees no reason to tell consumers to stop using products such as baby bottles made with a controversial chemical found in many plastic items.
Norris Alderson, the FDA's associate commissioner for science, said although the regulatory agency is reviewing safety concerns about the chemical bisphenol A, or BPA, "a large body of available evidence" shows that products such as liquid or food containers made with it are safe.... http://www.reuters.com/article/healthNews/idUSN1342348720080515?feedType=nl&feedName=ushealth1100
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New treatment seen boosting stroke survival CHICAGO (Reuters 5/14) - Adding just a small dose of a clot-busting drug to standard treatment for strokes caused by bleeding in the brain dramatically reduced death and disability among victims, U.S. researchers said on Wednesday.
Normally, only about 20 percent of people survive this type of stroke, known as an intracerebral hemorrhage, which accounts for 17 percent of all strokes.
But when doctors used a clot-busting drug plus a catheter to clear out blood from the brain in a study of 50 patients, more than 80 percent of the stroke victims survived.
"Getting the blood out of the middle of the brain significantly improved their chances of survival," said Dr. Daniel Hanley of the Johns Hopkins University School of Medicine, who presented his findings at the European Stroke Conference in Nice, France.
The clot-busting drug tissue plasminogen activator or tPA is typically reserved for breaking up blood clots in the more common type of stroke known as ischemic stroke, which is caused when a blood clot impedes blood flow to the brain.... http://www.reuters.com/article/healthNews/idUSN1453829120080514?feedType=nl&feedName=ushealth1100
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Green tea may shield brain from sleep apnea effects NEW YORK (Reuters 5/19) - Compounds found in green tea may help ward off the neurological damage that can come with the breathing disorder sleep apnea, a new animal study hints.
Researchers found that when they added green tea antioxidants to rats' drinking water, it appeared to protect the animals' brains during bouts of oxygen deprivation designed to mimic the effects of obstructive sleep apnea (OSA).... http://www.reuters.com/article/healthNews/idUSPAT94474720080519?feedType=nl&feedName=ushealth1100
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Stress in pregnancy raises risks for baby CHICAGO (Reuters 5/18) - Women who are stressed about money, relationships and other problems during pregnancy may give birth to babies who are predisposed to allergies and asthma, U.S. researchers said on Sunday.
The findings, presented at a meeting of the American Thoracic Society in Toronto, suggest a mother's stress during pregnancy may have lasting consequences for her child.
"This research adds to a growing body of evidence that links maternal stress such as that precipitated by financial problems or relationship issues to changes in children's developing immune systems, even during pregnancy," Dr. Rosalind Wright of Harvard Medical School in Boston said in a statement... http://www.reuters.com/article/healthNews/idUSN1652878520080518?feedType=nl&feedName=ushealth1100
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TODAY'S RANDOM FACT... The cat's clavicle, or collarbone, does not connect with other bones but is buried in the muscles of the shoulder region. This lack of a functioning collarbone allows them to fit through any opening the size of their head.
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U.S. seeks new hepatitis blood donation rules (Reuters 5/20)- U.S. health officials are seeking to relax blood donation rules for some people who initially tested positive for hepatitis B, which could clear hundred of thousands of new donors, according to documents released on Tuesday.
People whose blood showed signs of the liver-swelling virus after repeated tests are currently banned from ever donating blood, even if medical tests later showed they were not infected.
But in a draft proposal, the U.S. Food and Drug Administration (FDA) said that a new, more specific test could help determine whether donors who initially fail a first test are truly infected and suggested they be allowed to give blood after an 8-week waiting period... http://www.reuters.com/article/healthNews/idUSN2031039220080520?feedType=nl&feedName=ushealth1100
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U.S. Panel mulls minimum breast cancer hospital stay (Reuters 5/21) - A congressional panel on Wednesday said it has bipartisan support for a bill requiring health insurers to pay for a minimum 48-hour hospital stay after breast cancer treatment, to combat what critics call "drive-through" surgeries.
About 20 U.S. states have such a minimum insurance requirement for women undergoing mastectomies or lumpectomies to treat breast cancer. Advocates of the bill say federal legislation is needed to equalize coverage across the nation... http://www.reuters.com/article/healthNews/idUSN2140144220080521?feedType=nl&feedName=ushealth1100
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Study cites Pfizer smoking drug risk, shares fall (Reuters 5/21) - Hundreds of patients taking Pfizer Inc's anti-smoking drug Chantix have reported serious accidents, vision problems and heart trouble, researchers said on Wednesday, sending shares of the world's largest drugmaker to their lowest level since 1997.
U.S. aviation regulators responded quickly to the research, saying they would prohibit use of the drug by private and commercial pilots. "It's prudent to deem the drug no longer acceptable for use," said Federal Aviation Administration spokesman Les Dorr. Hundreds of patients taking Pfizer Inc's anti-smoking drug Chantix have reported serious accidents, vision problems and heart trouble, researchers said on Wednesday, sending shares of the world's largest drugmaker to their lowest level since 1997... http://www.reuters.com/article/healthNews/idUSWBT00902620080521?feedType=nl&feedName=ushealth1100
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For the Home Health nurses: Soap Sheets from Magellans. (From a nurse on the List serve; I did not write this. I sounds excellent. Hopefully, paper towels are available)There are 50 sheets in a small dispenser and they're dry. They're easy to use and the dispenser is about the size of a small box of matches and not as thick. I carry them in my pocket and because I do hospice care in people's homes and believe it or not, sometimes they don't even have soap to wash thehands with, this is great. The soap is antibacterial too.To use, you pick out a sheet and put your hands along with the sheet under running water. The sheet dissolves and becomes soap that has no aroma. It has a pleasant soapy feel to it. For a total of $14.84 (a bit pricey, I admit), you get two dispensers. I ordered them online from Magellan's out of Santa Barbara, CA. but the toll free number is 1-800-962-4943
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HUMOR SECTION
Sitting alongside the road, waiting to catch speeders, a State Trooper sees a car puttering along at 22 miles per hour . He thinks to himself, this car is as dangerous as the speeding cars. so he turns on his lights and pulls the driver over. Approaching the car...he notices that there are five elderly ladies--two in the front seat and three in the back...Wide eyed and white as ghosts.
The driver, obviously confused...says to him..." Officer, I don't understand. I was going the exact speed limit. What seems to be the problem?"
The trooper trying to contain a chuckle, explains to her that 22 was the route number, not the speed limit. A bit embarrassed...the woman grinned and thanked the Officer for pointing out her error.
The Officer asked.... "But before you go, Ma'am....I have to ask if everyone in this car is OK? These women seem awfully shaken."
HUMOR SECTION
Sitting alongside the road, waiting to catch speeders, a State Trooper sees a car puttering along at 22 miles per hour . He thinks to himself, this car is as dangerous as the speeding cars. so he turns on his lights and pulls the driver over. Approaching the car...he notices that there are five elderly ladies--two in the front seat and three in the back...Wide eyed and white as ghosts.
The driver, obviously confused...says to him..." Officer, I don't understand. I was going the exact speed limit. What seems to be the problem?"
The trooper trying to contain a chuckle, explains to her that 22 was the route number, not the speed limit. A bit embarrassed...the woman grinned and thanked the Officer for pointing out her error.
The Officer asked.... "But before you go, Ma'am....I have to ask if everyone in this car is OK? These women seem awfully shaken."
"Oh, they'll be all right in a minute, Officer We just got off Route 127."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
http://www.snopes.com/
http://www.nurse.com/ Pay Only $34.99 for a full year of CONTACT HOURS
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
http://www.snopes.com/
http://www.nurse.com/ Pay Only $34.99 for a full year of CONTACT HOURS
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
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MEDICAL RECALLS
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MEDICAL RECALLS
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Tumor Necrosis Factor (TNF) Blockers (marketed as Remicade, Enbrel, Humira, and Cimzia) FDA issued an Early Communication About an Ongoing Safety Review to inform healthcare professionals that the Agency is investigating a possible association between the use of Tumor Necrosis Factor (TNF) blockers and the development of lymphoma and other cancers in children and young adults. FDA is investigating approximately 30 reports of cancer in children and young adults. Until the evaluation is completed, healthcare providers, parents, and caregivers should be aware of the possible risk of lymphoma and other cancers in children and young adults when deciding how to best treat these patients. http://www.fda.gov/medwatch/safety/2008/safety08.htm#TNF
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Trasylol (aprotinin injection) [UPDATE 05/14/2008] Following publication of the Blood conservation using antifibrinolytics: A randomized trial in a cardiac surgery population (BART) study in the May 14, 2008 online issue of The New England Journal of Medicine, Bayer Pharmaceuticals notified the FDA of their intent to remove all remaining supplies of Trasylol from hospital pharmacies and warehouses. Under a limited use agreement, access to Trasylol is limited to investigational use of the drug according to the procedures described in a special treatment protocol. The protocol allows treatment for certain patients who are at increased risk of blood loss and transfusions during coronary artery bypass graft surgery and who have no acceptable alternative therapy. Physicians using Trasylol in this situation must also verify that the benefits of the drug clearly outweigh the risks for their patients.
11/05/2007] FDA announced that, at the agency's request, Bayer Pharmaceuticals Corp. has agreed to a marketing suspension of Trasylol (aprotinin injection), a drug used to control bleeding during heart surgery, pending detailed review of preliminary results from a Canadian study that suggested an increased risk for death. FDA requested the suspension in the interest of patient safety based on the serious nature of the outcomes suggested in the preliminary data. FDA has not yet received full study data but expects to act quickly with Bayer, the study's researchers at the Ottawa Health Research Institute, and other regulatory agencies to undertake a thorough analysis of data to better understand the risks and benefits of Trasylol. Until FDA can review the data from the terminated study it is not possible to determine and identify a population of patients undergoing cardiac surgery for which the benefits of Trasylol outweigh the risks. However, understanding that individual doctors may identify specific cases where benefit outweighs risk, FDA is committed to exploring ways for those doctors to have continued, limited access to Trasylol. There are not many treatment options for patients at risk for excessive bleeding during cardiac surgery. Thus, FDA is working with Bayer to phase Trasylol out of the marketplace in a way that does not cause shortages of other drugs used for this purpose.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Trasylol
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FDA is aware of reports of infants born with serious congenital anomalies, including microtia and cleft lip and palate, following exposure to mycophenolate mofetil (MMF) during pregnancy. MMF, the active drug substance in CellCept, is an ester of the active metabolite mycophenolic acid (MPA), the active drug substance in Myfortic. In most cases, the mothers were taking MMF following an organ transplant to prevent organ rejection. However, some mothers taking MMF were being treated for immune-mediated conditions such as systemic lupus erythematosus (SLE) and erythema multiforme. Treatment began before their pregnancies and continued into the first trimester or until the pregnancy was detected. MMF and MPA increase the risk of spontaneous abortion in the first trimester and can cause congenital malformations in the offspring of women who are treated during pregnancy. FDA is continuing to work with the manufacturers of these drug products to develop and implement means to mitigate the risks of fetal exposure. See the FDA Healthcare Professional Information Sheet containing considerations and recommendations for clinicians prior to prescribing MMF or MPA to women of childbearing potential. http://www.fda.gov/medwatch/safety/2008/safety08.htm#MMF
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Mommy's Bliss Nipple Cream FDA informed consumers not to use or purchase Mommy's Bliss Nipple Cream, marketed by MOM Enterprises, Inc., because the product contains potentially harmful ingredients that may cause respiratory distress or vomiting and diarrhea in infants. The product is promoted to nursing mothers to help soothe and heal dry or cracked nipples. Potentially harmful ingredients in the product are chlorphenesin and phenoxyethanol. Chlorphenesin relaxes skeletal muscle and can depress the central nervous system and cause slow or shallow breathing in infants. Phenoxyenthanol, a preservative that is primarily used in cosmetics and medications, can also depress the central nervous system and may cause vomiting and diarrhea, which can lead to dehydration in infants. Mothers and caregivers should seek immediate medical attention if their child shows signs and symptoms of decreases in appetite, difficulty in awakening, limpness of extremities or a decrease in an infant's strength of grip and a change in skin color. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Bliss
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Viril-ity Power (VIP) Tablets International Pharmaceuticals, Ltd. and FDA notified consumers and healthcare professionals that the company is recalling all supplement products sold under the brand name of Viril-ity Power (VIP) Tablets. The product is being recalled because one lot was found to contain a potentially harmful undeclared ingredient, hydroxyhomosildenafil, an analog of sildenafil. Sildenafil is the active ingredient in Viagra, an FDA-approved drug used for erectile dysfunction. The undeclared ingredient may interact with nitrates found in some prescription drugs (such as Nitroglycerin) and may lower blood pressure to life-threatening levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take such nitrates. Consumers who have Viril-ity Power (VIP) Tablets should stop using it immediately and contact their healthcare professional if they experience any problems that may be related to taking this product. http://www.fda.gov/medwatch/safety/2008/safety08.htm#VIP
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FDA alerted consumers and healthcare professionals not to buy or use Xiadafil VIP Tablets sold in bottles of 8 tablets (Lot #6K029) or blister cards of 2 tablets (Lot# 6K029-SEI). The product is marketed as a dietary supplement and is promoted and sold over the internet for sexual enhancement and to treat erectile dysfunction (ED). The product contains a potentially harmful, undeclared ingredient that may dangerously affect a person's blood pressure and can cause other life-threatening side effects. Xiadafil VIP Tablets contain hydroxyhomosildenafil, an analog of sildenafil, the active ingredient in Viagra, an FDA approved prescription drug for ED. The undeclared ingredient may interact with nitrates found in some prescription drugs and can lower blood pressure to life-threatening levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates. Consumers who have used the product should discontinue use immediately and consult their healthcare professional if they have experienced any adverse events that they believe may be related to the use of this product. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Xiadafil
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Trasylol (aprotinin injection) [UPDATE 05/14/2008] Following publication of the Blood conservation using antifibrinolytics: A randomized trial in a cardiac surgery population (BART) study in the May 14, 2008 online issue of The New England Journal of Medicine, Bayer Pharmaceuticals notified the FDA of their intent to remove all remaining supplies of Trasylol from hospital pharmacies and warehouses. Under a limited use agreement, access to Trasylol is limited to investigational use of the drug according to the procedures described in a special treatment protocol. The protocol allows treatment for certain patients who are at increased risk of blood loss and transfusions during coronary artery bypass graft surgery and who have no acceptable alternative therapy. Physicians using Trasylol in this situation must also verify that the benefits of the drug clearly outweigh the risks for their patients.
11/05/2007] FDA announced that, at the agency's request, Bayer Pharmaceuticals Corp. has agreed to a marketing suspension of Trasylol (aprotinin injection), a drug used to control bleeding during heart surgery, pending detailed review of preliminary results from a Canadian study that suggested an increased risk for death. FDA requested the suspension in the interest of patient safety based on the serious nature of the outcomes suggested in the preliminary data. FDA has not yet received full study data but expects to act quickly with Bayer, the study's researchers at the Ottawa Health Research Institute, and other regulatory agencies to undertake a thorough analysis of data to better understand the risks and benefits of Trasylol. Until FDA can review the data from the terminated study it is not possible to determine and identify a population of patients undergoing cardiac surgery for which the benefits of Trasylol outweigh the risks. However, understanding that individual doctors may identify specific cases where benefit outweighs risk, FDA is committed to exploring ways for those doctors to have continued, limited access to Trasylol. There are not many treatment options for patients at risk for excessive bleeding during cardiac surgery. Thus, FDA is working with Bayer to phase Trasylol out of the marketplace in a way that does not cause shortages of other drugs used for this purpose.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Trasylol
********************
FDA is aware of reports of infants born with serious congenital anomalies, including microtia and cleft lip and palate, following exposure to mycophenolate mofetil (MMF) during pregnancy. MMF, the active drug substance in CellCept, is an ester of the active metabolite mycophenolic acid (MPA), the active drug substance in Myfortic. In most cases, the mothers were taking MMF following an organ transplant to prevent organ rejection. However, some mothers taking MMF were being treated for immune-mediated conditions such as systemic lupus erythematosus (SLE) and erythema multiforme. Treatment began before their pregnancies and continued into the first trimester or until the pregnancy was detected. MMF and MPA increase the risk of spontaneous abortion in the first trimester and can cause congenital malformations in the offspring of women who are treated during pregnancy. FDA is continuing to work with the manufacturers of these drug products to develop and implement means to mitigate the risks of fetal exposure. See the FDA Healthcare Professional Information Sheet containing considerations and recommendations for clinicians prior to prescribing MMF or MPA to women of childbearing potential. http://www.fda.gov/medwatch/safety/2008/safety08.htm#MMF
**************************
Mommy's Bliss Nipple Cream FDA informed consumers not to use or purchase Mommy's Bliss Nipple Cream, marketed by MOM Enterprises, Inc., because the product contains potentially harmful ingredients that may cause respiratory distress or vomiting and diarrhea in infants. The product is promoted to nursing mothers to help soothe and heal dry or cracked nipples. Potentially harmful ingredients in the product are chlorphenesin and phenoxyethanol. Chlorphenesin relaxes skeletal muscle and can depress the central nervous system and cause slow or shallow breathing in infants. Phenoxyenthanol, a preservative that is primarily used in cosmetics and medications, can also depress the central nervous system and may cause vomiting and diarrhea, which can lead to dehydration in infants. Mothers and caregivers should seek immediate medical attention if their child shows signs and symptoms of decreases in appetite, difficulty in awakening, limpness of extremities or a decrease in an infant's strength of grip and a change in skin color. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Bliss
*****************
Viril-ity Power (VIP) Tablets International Pharmaceuticals, Ltd. and FDA notified consumers and healthcare professionals that the company is recalling all supplement products sold under the brand name of Viril-ity Power (VIP) Tablets. The product is being recalled because one lot was found to contain a potentially harmful undeclared ingredient, hydroxyhomosildenafil, an analog of sildenafil. Sildenafil is the active ingredient in Viagra, an FDA-approved drug used for erectile dysfunction. The undeclared ingredient may interact with nitrates found in some prescription drugs (such as Nitroglycerin) and may lower blood pressure to life-threatening levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take such nitrates. Consumers who have Viril-ity Power (VIP) Tablets should stop using it immediately and contact their healthcare professional if they experience any problems that may be related to taking this product. http://www.fda.gov/medwatch/safety/2008/safety08.htm#VIP
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FDA alerted consumers and healthcare professionals not to buy or use Xiadafil VIP Tablets sold in bottles of 8 tablets (Lot #6K029) or blister cards of 2 tablets (Lot# 6K029-SEI). The product is marketed as a dietary supplement and is promoted and sold over the internet for sexual enhancement and to treat erectile dysfunction (ED). The product contains a potentially harmful, undeclared ingredient that may dangerously affect a person's blood pressure and can cause other life-threatening side effects. Xiadafil VIP Tablets contain hydroxyhomosildenafil, an analog of sildenafil, the active ingredient in Viagra, an FDA approved prescription drug for ED. The undeclared ingredient may interact with nitrates found in some prescription drugs and can lower blood pressure to life-threatening levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates. Consumers who have used the product should discontinue use immediately and consult their healthcare professional if they have experienced any adverse events that they believe may be related to the use of this product. http://www.fda.gov/medwatch/safety/2008/safety08.htm#Xiadafil
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NURSING HINTS CORNER
(Even tho we, as professionals, are "experts" with the glucose meters......it would behoove us to read this article AND to give copies to our patients. We know they become careless with the usage ...and seldom wash their hands prior to taking the testing. F.)
Getting the Most Out of Blood Glucose Meters Keeping glucose levels under control can help people with diabetes feel better and also lower the risk of blindness, kidney disease, and nerve damage. Very high or very low blood sugar can have serious consequences. Although blood glucose meters are fairly simple to operate, many things can go wrong if the user isn't careful. Here are some tips that can help people with diabetes get accurate results from their glucose meters.... http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=76#5
NURSING HINTS CORNER
(Even tho we, as professionals, are "experts" with the glucose meters......it would behoove us to read this article AND to give copies to our patients. We know they become careless with the usage ...and seldom wash their hands prior to taking the testing. F.)
Getting the Most Out of Blood Glucose Meters Keeping glucose levels under control can help people with diabetes feel better and also lower the risk of blindness, kidney disease, and nerve damage. Very high or very low blood sugar can have serious consequences. Although blood glucose meters are fairly simple to operate, many things can go wrong if the user isn't careful. Here are some tips that can help people with diabetes get accurate results from their glucose meters.... http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=76#5
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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/ .
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
This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
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This ad is from Wendie (whowland1@mac.com) The eLifeCard can save your life when seconds count! Carry this life-saving card in your wallet in case of emergency at home, at work, at school, traveling, or on vacation! NEW online estate planning system membership makes it possible for you to buy, upload, change and securely store your health care directive, allergies and medication lists, emergency contacts, and more. Exceptional package of other benefits. Give yourself and your family the gift of peace of mind. For FREE information, email name & phone number. All responses kept confidential and answered promptly.
Wendie Howland, CEO Miracle Group TFN Affiliate #10136 508-564-9556 (office) 915-990-1367 (fax) http://www.thefoundationnetwork.com/
This ad is from Wendie (whowland1@mac.com) The eLifeCard can save your life when seconds count! Carry this life-saving card in your wallet in case of emergency at home, at work, at school, traveling, or on vacation! NEW online estate planning system membership makes it possible for you to buy, upload, change and securely store your health care directive, allergies and medication lists, emergency contacts, and more. Exceptional package of other benefits. Give yourself and your family the gift of peace of mind. For FREE information, email name & phone number. All responses kept confidential and answered promptly.
Wendie Howland, CEO Miracle Group TFN Affiliate #10136 508-564-9556 (office) 915-990-1367 (fax) http://www.thefoundationnetwork.com/
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NEW MEMBERS
WELCOME TO:
imsueh@yahoo.com (Sue) 5/12/08
ann.hoover@sgmc.org (Ann) 5/13/08
Ryan.Shrode@kci1.com (Ryan) 5/22/08
cks081@yahoo.com (Kay) 6/2/08
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
NEW MEMBERS
WELCOME TO:
imsueh@yahoo.com (Sue) 5/12/08
ann.hoover@sgmc.org (Ann) 5/13/08
Ryan.Shrode@kci1.com (Ryan) 5/22/08
cks081@yahoo.com (Kay) 6/2/08
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
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NOTICE:
Please, when you "move" from one ISP to another, REMEMBER to give me your new e-mail 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, okay?
RNFrankie@AOL.com
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
NOTICE:
Please, when you "move" from one ISP to another, REMEMBER to give me your new e-mail 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, okay?
RNFrankie@AOL.com
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
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DISCLAIMER:
DISCLAIMER:
The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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TWO THOUGHTS FOR THE DAY
The difficulties, hardships and trials of life, the
TWO THOUGHTS FOR THE DAY
The difficulties, hardships and trials of life, the
obstacles one encounters on the road to fortune are
positive blessings. They knit the muscles more firmly,
and teach self-reliance.
Peril is the element in which power is developed.
--W. Mathews
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A general dissolution of the principles and manners will
more surely overthrow the liberties of America than the
whole force of the common enemy.
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