Thursday, December 10, 2009

December Issue


PARADIGM BYTES
Newsletter for Paradigm 97
December10, 2009

Hope you have a wonderful Christmas/ Hanukah holiday and a great 2010.

PARADIGM DEFINED:1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT

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

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SNIPPET
Buyer beware: Estrogen supplements not as effective as claimed WEST LAFAYETTE, Ind. - Connie Weaver Dietary supplements claiming to help postmenopausal women with bone health may not be doing what they say, according to new research from Purdue University."We found that some plant-derived isoflavones have a modest effect on suppressing bone loss during post-menopause, but more concerning is many dietary supplements that claim to have the power of estrogen do not," said Connie Weaver, distinguished professor of foods and nutrition. "It's buyer beware. Some of the supplements in our study claimed to be substitutes for estrogen, yet they weren't effective at all or weren't as effective as some of the current treatments for osteoporosis."

Women who are menopausal or postmenopausal produce less estrogen, and that leads to bone loss. More than 2 million women in the United States reach menopause each year, according to the National Women's Health Resource Center.Estrogen hormone replacement therapy was the traditional treatment, but it is no longer recommended for the long term because of links to stroke, embolism and breast cancer. Some individuals have harmful side effects with long-term use of bisphosphonates, the current main class of osteoporosis treatment drugs.

"This is a reminder that it's better to build up a good healthy skeleton than to rely on a drug to fix it later," Weaver said. "Healthy bones can be maintained by a good diet that is rich in calcium and regular exercise that includes strength training."

Weaver, who also is co-director of the Botanicals Research Center for Age Related Diseases, and her team looked at four popular isoflavones: soy cotyledon, soy germ, red clover and kudzu. These plant-derived phytoestrogens are claimed to protect bone health from estrogen loss, which can lead to osteoporosis and even fractures.

The researchers compared the four isoflavones to a traditional bisphosphonate treatment, risedronate and estrogen plus progesterone. These traditional therapies decreased bone loss 22 percent to 24 percent, but only soy isoflavones from the cotyledon and germ significantly decreased bone loss by 9 percent and 5 percent, respectively. The findings are available online and will be published in the October edition of the Journal of Clinical Endocrinology and Metabolism.

The findings also indicate that the soy cotyledon was more effective because of its higher genistein content. Weaver's team is currently evaluating the role of genistein more closely.

"Before, we might have assumed that any isoflavone was equally effective, but we found that for a supplement to work it was because of the genistein content specifically," she said.

This work was funded by the National Institutes of Health and supplements were supplied by the dietary and health companies Cognis, Frutarom and Novagen. Weaver also is on the advisory board of Pharmative and Wyeth Global Nutrition. The Botanicals Research Center for Age Related Diseases is a partnership between Purdue and the University of Alabama-Birmingham. jcem.endojournals.org

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FROM THE MEMBERS

(This is from ME) Dear Colleagues: I give up-- I have subscribed to ISMP Nurse Advise-ERR for a long time. It is in PDF form, and despite all my efforts--including buying Nitro-- I can not copy it properly for the newsletter. So, reluctantly, I will provide it in the following format. It is an excellent read. Please check it out. Back issues of the newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp. (This includes this month's presentation)

--- Plain D5W or hypotonic saline solutions post-op could result in acute hyponatremia
and death in healthy children
--- False belief regarding influenza vaccines
--- Influenza vaccines mixed-up
--- Medication patch slips into wrong ADC pocket
--- All is not as it seems…Dose not necessarily missing
November 2009 edition of Nurse Advise-ERR®, a peer-reviewed newsletter published by the Institute for Safe Medication Practices (ISMP). To open, read, and print the PDF file, you will need Adobe Acrobat Reader installed on your computer. Please check your version of the Reader; older versions may not allow you to view or print some pages. If you do not have the Reader, or you need to update it, click on this link (www.adobe.com/products/acrobat/readstep2.html) for a free download. Although the newsletter is produced in color, it prints clearly in black and white if color printers are not available.
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Thank you Roz (Rozalfaro@AOL.com) for sending this article in: Why Checklists for Reducing Infections Aren't always Used (Wall Street Journal) The list prescribed steps doctors and nurses in the intensive-care unit should take when performing a common procedure—inserting a catheter into a vein just outside the patient's heart, to allow easy delivery of intravenous drugs and fluids.
The steps are simple: washing hands; cleaning the patient's skin with a disinfectant called chlorhexidine; wearing a cap and gown and using a surgical drape during the procedure; inserting the catheter through parts of the body other than the groin, when possible; and removing unnecessary catheters.
The Michigan study, which included more than 100 ICUs, found that putting the checklist in place lowered the rate of bloodstream infections related to catheter use by 66%.
But putting the checklist into practice is more complicated than it sounds.... http://online.wsj.com/article/SB10001424052970204488304574429422345973600.html?mod=dist_smartbrief
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CHousm@AOL.com Connie asked the following question: "As you know there is a problem with MDRO's everywhere. I am wanting to know how other hospitals are handling the isolation of pts who may have been diagnosed with a MDRO such as MRSA several years ago, but never cleared. To be cleared, I understand that the patient must be symptom free for at least 12 months and have had 3 negative cultures. I work in a Day Surgery Unit, where we have 9 private rooms and the rest are shared rooms. Our patients may come in, be placed in a multi patient room and then tell us that they have had MRSA. We then, according to policy, have to move them to a private room and isolate them. This means an isolation clean on the cubical that the patient was in (what are his roommates thinking), and isolation protocol. We follow the protocol, though the surgeons and OR staff do not always. Infection control has verbally said we do not need to do the full isolation, but our policy says we do have to. What are other hospitals doing and how are they handling this issue? Thank you for any advice ". Connie Housman, RN
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Sandy Summers writes re: "Dr. Lung Love": Have you guys seen this public service announcement created by the Lung Cancer Alliance (LCA) non profit? It's designed to educate young people about the symptoms of lung cancer. And I give them credit for using such an edgy technique. But they employ the naughty nurse stereotype to get their message out.

I've placed at least 10 calls to the CEO of the LCA, and our members have sent at least 40 letters, but she's apparently above talking with little nurses... And they refuse to pull the video as well. It's still being promoted at their website. Here's our analysis at: http://www.truthaboutnursing.org/news/2009/nov/02_lunglove.html Please help us ratchet up the pressure on the LCA. We have a form letter at our site. So it takes less than a minute to send them a letter.

Thank you! Sandy Summers, RN, MSN, MPH Executive Director

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Donna Maheady writes: "Can you include this piece in your next newsletter?

"Mid-career change for a woman with a disability...finance to nursing!"

http://www.cleveland.com/healthfit/index.ssf/2009/11/mid-career_change_to_nursing_a.html

Thanks for your consideration, Donna Donna Maheady, Ed.D., ARNP(561) 627-9872, (561) 776-9254 (Fax), (561) 776-9442 (TTY)Founder and President www.ExceptionalNurse.com
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The following was sent in by Wendie whowland1@mac.com . Thank you, Wendie! What a wonderful service ! She writes: " This came to me from my life care planning network. DEFINITELY something to pass along! And if you know any cleaning services that might like to help out, please feel free to pass it to them! "
If you know any woman currently undergoing Chemo, please pass the word to her that there is a cleaning service that provides FREE housecleaning 1 time per month for 4 months while she is in treatment.All she has to do is sign up and have her doctor fax a note confirming the treatment.Cleaning for a Reason will have a participating maid service in her zip code area arrange for the service. (http://www.cleaningforareason.org/) Click on Maid services and then look for your state
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This is from Jenxl (Linda) who writes in response to Wendie's November Snippet about epidurals

"Call it an epidural, but if a woman has a HUGE headache after an epidural that gets less severe when she lies back down, there has most probably a hole been made and fluid has leaked.....hence a 'spinal headache' has occured....after an epidural". Linda B. Jenkins, RN jenxl@aol.com www.birthprep.com

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INTERESTING READING

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

This was sent in by Laregis (Laura) as a followup to the hand dryer report. Please read.
I thought you might find the following article from snopes.com interesting: http://www.snopes.com/medical/swineflu/handblower.asp
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Consumer ads pump up prescription drug costs NEW YORK (Reuters 11/24) - Medicaid pharmacy costs for the blood-thinning drug Plavix jumped at around the same time the drug's maker started advertising it to consumers -- even though the number of people prescribed the drug didn't change, new research shows. In the current issue of the Archives of Internal Medicine, Dr. Michael R. Law of the University of British Columbia in Vancouver and colleagues note that spending by government insurers for prescription drugs rose about 15 percent each year between 1994 and 2004. There's been an assumption that advertising drugs to consumers helps drive up prescription drug costs but there's little evidence to back this up....http://www.reuters.com/article/healthNews/idUSTRE5AN3VM20091124?feedType=nl&feedName=ushealth1100
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Antioxidants could help preserve muscle strength NEW YORK (Reuters 11/24 ) - In a study in older adults, dietary intake of vitamins C and E was linked with muscle strength, leading the researchers to suggest at a meeting in Atlanta this past weekend that a diet high in antioxidants could play an important role in preserving muscle function in older adults
"Muscle strength is really a marker of aging," one of the investigators, Dr. Anne Newman of the University of Pittsburgh, told Reuters Health. "Muscle strength starts declining when people are in their 40s, but it decreases dramatically after age 60." http://www.reuters.com/article/healthNews/idUSTRE5AN50B20091124?feedType=nl&feedName=ushealth1100
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RANDOM FACT A duck's quack doesn't echo and no one knows why.
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Disruptive behavior by doctors, nurses persists a year after crackdown One group of nurses banded together to try to get a physician unfairly disciplined, while another encouraged fellow nurses to disobey doctors' orders outright. A surgeon told his staff that monkeys could be trained to do what scrub nurses do, while another doctor told a patient that the nurse in the room didn't know what she was doing... http://www.ama-assn.org/amednews/2009/11/16/prl11116.htm
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Upping fiber intake could help defeat belly fat NEW YORK (Reuters Health) - Eating just a little bit more fiber could have a big impact in trimming the waistlines of America's young people, new research shows.
Latino adolescents and teens who increased their fiber intake over a two-year period had significant decreases in the amount of fat around their waists, while young people whose fiber intake fell saw their bellies expand, Dr. Jaimie N. Davis of the Keck School of Medicine at the University of Southern California in Los Angeles and her colleagues found.... http://www.reuters.com/article/healthNews/idUSTRE59S4ZW20091029?feedType=nl&feedName=ushealth1100
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The Healthcare system wastes up to $850 billion a year WASHINGTON (Reuters) - The U.S. healthcare system is just as wasteful as President Barack Obama says it is, and proposed reforms could be paid for by fixing some of the most obvious inefficiencies, preventing mistakes and fighting fraud, according to a Thomson Reuters report released on Monday....
http://www.reuters.com/article/healthNews/idUSTRE59P0L320091027?feedType=nl&feedName=ushealth1100
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RANDOM FACT The majority of suicides occur on a Monday
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Sebelius: Women should get mammograms by age 40 Women should continue getting regular mammograms starting at age 40, Health and Human Services Secretary Kathleen Sebelius said Wednesday, moving to douse confusion caused by a task-force recommendation two days earlier.... http://hosted.ap.org/dynamic/stories/U/US_MED_MAMMOGRAM_ADVICE?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2009-11-18-19-03-53
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I remember being very distressed over BPA long ago......and here is the nightmare, again .
The chemical Bisphenol A, which has been used for years in clear plastic bottles and food-can liners, has been restricted in Canada and some U.S. states and municipalities because of potential health effects. The Food and Drug Administration will soon decide what it considers a safe level of exposure to Bisphenol A (BPA), which some studies have linked to reproductive abnormalities and a heightened risk of breast and prostate cancers, diabetes, and heart disease....
http://www.walletpop.com/consumer-reports/insurance/article/concern-over-canned-foods/770756?icid=mainhtmlws-main-ndl1link3http%3A%2F%2Fwww.walletpop.com%2Fconsumer-reports%2Finsurance%2Farticle%2Fconcern-over-canned-foods%2F770756
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Examples of High BPA Levels - Progresso Vegetable Soup (67-134 ppb)- Campbell's Condensed Chicken Noodle Soup (54.5-102 ppb)- Canned Del Monte Fresh Cut Green Beans Blue Lake (35.9-191 ppb
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7 Ways to Pamper Dry Skin head to toe tips
http://yourtotalhealth.ivillage.com/7-ways-pamper-dry-skin.html?isEditPackage=true

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GENEVA (Reuters 11/26) - Tamiflu resistance in some H1N1 patients with badly weakened immune systems does not seem to reflect a major change in the virus' susceptibility to the frontline drug, the World Health Organization said on Thursday.
Nine people in Britain and the United States developed a Tamiflu-resistant form of swine flu while being treated in hospital mainly for blood cancers, said WHO flu expert Keiji Fukuda.... . http://www.reuters.com/article/healthNews/idUSTRE5AN24220091126?feedType=nl&feedName=ushealth1100
************************* RANDOM FACT A crocodile cannot stick its tongue out. (Poor thing )
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CDC stats show 3 major STDs still spreading in U.S. (Reuters11/16) - American squeamishness about talking about sex has helped keep common sexually transmitted infections far too common, especially among vulnerable teens, U.S. researchers reported Monday.CDC researchers said U.S. rates of chlamydia and gonorrhea were stable at unacceptably high levels in 2008, and cases of syphilis are increasing after the STD almost was eliminated. Data showed that girls ages 15 to 19 had the most chlamydia and gonorrhea cases of any age group.... http://www.reuters.com/article/healthNews/idUSTRE5AF14A20091116
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Largest crib recall in U.S. history announced-- Government safety regulators say more than 2.1 million drop-side cribs by Stork Craft Manufacturing are being recalled, the biggest crib recall in U.S. history. The Consumer Product Safety Commission says the recall involves 1.2 million cribs in the United States and almost 1 million in Canada, where Stork Craft is based. Nearly 150,000 of the cribs on recall carry the Fisher-Price logo.... http://www.msnbc.msn.com/id/34116399/ns/health-kids_and_parenting/
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Researchers said saline solution rinses for sinus problems could make people even more likely to get infections in the long-term by stripping the nose of good mucus needed for immune health. The study suggested avoiding long-term use of saline irrigation and using only when an infection is present. Yahoo!/HealthDay News (11/9) http://news.yahoo.com/s/hsn/20091110/hl_hsn/sinusrinsesmaydomoreharmthangood
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RANDOM FACT: No piece of normal-size paper can be folded in half more than 7 times.
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Report questions value of family health history NEW YORK (Reuters 11/2 ) - Getting a patient's family history is widely regarded as a standard element of good medical care. But a report published today concludes that there isn't much good evidence that obtaining such information improves doctors' ability to predict and manage disease.
In addition, the report's authors say the best way to collect family history data is unclear, as is the impact on patient outcomes and behaviors....
http://www.reuters.com/article/healthNews/idUSTRE5A15B820091102?feedType=nl&feedName=ushealth1100
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Postnatal HIV Transmission Seen After Infant Prophylaxis Stopped (Reuters 11/13)— A large study of infants uninfected with HIV at 14 weeks of age shows that transmission of the virus through breast milk occurs after extended antiretroviral prophylaxis is stopped.
The results suggest that infant prophylaxis is only effective while the prophylactic agents are being administered, Dr. Taha E. Taha, from Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues state. Thus, added preventive measures are required for the duration of infant breast-feeding. http://www.medscape.com/viewarticle/712323
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Feeling frazzled? Have another helping of the main course -- if the main course is turkey. Thankfully, skinless turkey is chock-full of B vitamins that help boost your energy and cinch stress -- something many of us could probably use today. And every day. Tallying the TalentsThink of the B vitamins in turkey -- niacin, B6, and B12 -- as your psyche's little bodyguards. These nutrients also help patch up DNA and keep your cells in good repair. And best of all, with turkey, your B vitamins get served up in one of the leanest meat sources around. A 3-ounce portion of skinless turkey breast has just 0.2 grams of saturated fat... http://www.realage.com/tips/breeze-through-today-with-this-festive-protein
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RANDOM FACT Wipe the blinds with a sheet of Bounce to prevent dust from resettling. *****************
Tired of looking like a wild animal? Under-eye circles could have many causes. Blame them on sun damage, allergies, genetics, lack of sleep . . . even caffeine and alcohol could play a role. But no matter the cause, our sister site -- RealBeauty.com -- has some simple drugstore tips to help dark circles fade away.... http://www.realage.com/tips/clear-up-raccoon-eyes-with-these-3-tricks
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This was submitted by KurtUllman Ullman@sprintmail.com
Why Females Live Longer Than Males: Is It Due to the Father's Sperm?ScienceDaily (Dec. 2, 2009) — Researchers in Japan have found that female mice produced by using genetic material from two mothers but no father live significantly longer than mice with the normal mix of maternal and paternal genes. Their findings provide the first evidence that sperm genes may have a detrimental effect on lifespan in mammals.http://www.sciencedaily.com/releases/2009/12/091201192105.htm
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How Long does hepatitis B vaccine protection last? NEW YORK (Reuters 11/2 ) The hepatitis B vaccine - given to protect against infection by a virus that can cause severe liver damage and cancer - may protect for more than two decades, according to a new study.
In 1981, Dr. Brian J. McMahon, from the Alaska Native Medical Center, Anchorage, and his colleagues gave more than 1500 Alaska Native adults and children over age 6 months three doses of hepatitis B vaccine. Before the hepatitis B vaccine was licensed for U.S. use in 1981, as many as one in 12 Alaskan Natives were infected.
In 2003, the team checked with almost 500 of those given the shots and had a response to them at the time to see who was still showing evidence of an immune system response. Blood tests found that more than half - 60 percent -- were still considered immune to the virus....
http://www.reuters.com/article/healthNews/idUSTRE5A153S20091102?feedType=nl&feedName=ushealth1100
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RANDOM FACT If you have 3 quarters, 4 dimes, and 4 pennies, you have $1.19. You also have the largest amount of money in coins without being able to make change for a dollar.
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No hospital savings with electronic records: study WASHINGTON (Reuters 11/20) - New electronic record systems installed in thousands of U.S. hospitals have done little to rein in skyrocketing healthcare costs, Harvard University researchers said in a study released on Friday.
A review of roughly 4,000 hospitals from 2003 to 2007 found that while many had moved away from the paper files that still dominate the U.S. healthcare system, administrative costs actually rose, even among the most high-tech institutions.... http://www.reuters.com/article/healthNews/idUSTRE5AJ0MQ20091120?feedType=nl&feedName=ushealth1100
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Nurses' Knowledge of Evidence-Based Guidelines for the Prevention of Surgical Site Infections Labeau SO et al. – Opportunities exist to improve ICU nurses' knowledge about SSI prevention recommendations. Current guidelines should support their ongoing training and education.... http://www3.interscience.wiley.com/journal/122685403/abstract?CRETRY=1&SRETRY=0
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Creating a Culture of Professional Development: A Milestone Pathway Tool for Registered Nurses Cooper E – This article introduces a milestone pathway tool for registered nurses designed to enhance professional development that is unique to the individual nurse and the specific nursing unit. This tool provides a unit–specific concept map, a milestone pathway template, and a personal professional development plan... http://www.jcenonline.com/view.asp?rID=50248
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RANDOM FACT: The first product to have a bar code scanned was Wrigley's gum.
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Expert nursing practice: a mathematical explanation of Benners 5th stage of practice development Journal of Advanced Nursing This paper is a theoretical discussion of a mathematical explanation for Benner's theory of practice development. Benner's practice development theory demonstrates how a nurse moves from a beginning, rule-based practice through to expert care. Her notion of expert practice as intuitive has not been well-accepted or understood in nursing. A new description of expert practice includes three types of intuitive practice (cognitive, transitional and embodied), the development of which are dependent on knowledge, experience and reflective time. Data sources. 
Lyneham J et al. – Having the intuitive component of expert practice further clarified from Benner's first vision confirms it as a valid component of practice. It is important to recognize that experience is a powerful component of practice and that it is essential to the development of expertise. Although this discussion has been nested within nursing practice, it has wide implications for medical, psychological and educational practice.... http://www.ingentaconnect.com/content/bsc/jan/2009/00000065/00000011/art00023;jsessionid= ckp1go3sbr1d.victoria
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Training the Trainers: Developing Today's Nurse Preceptors and Mentors By Susan Kreimer, MS, contributor Nurse Zone Oct. 22, 2009 - When Jan Hastings, MSN, RN, became a nurse 34 years ago, formal training for preceptors didn’t exist. “It was kind of an expectation that once you were comfortable in your role, that you would be able to precept,” said Hastings, manager of nursing education and professional development at Carle Foundation Hospital in Urbana, Ill. Nursing research later showed that “training is absolutely necessary to be a good preceptor.” ... http://www.nursezone.com/nursing-news-events/more-news.aspx?articleid=32760
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RANDOM FACT In a lifetime, an average person walks the equivalent of 5 equators .
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Size matters when it comes to AIDS defense WASHINGTON (Reuters) - Men with larger foreskins are more likely to become infected with the AIDS virus, researchers said Wednesday in a finding that helps explain why circumcision can protect men....http://www.reuters.com/article/healthNews/idUSTRE59R5RP20091029?feedType=nl&feedName=ushealth1100
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Kurt Ullman, a new member, writes: " Because disasters don’t discriminate, the Wisconsin Board for People with Developmental Disabilities has compiled nearly 100 useful emergency resources for those with special needs . The well-organized listings are searchable by disability, hazard, resource format, and audience". http://www.wi-bpdd.org/disasterpreperation/index.cfm

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Cut Fatty-Food Cravings with this Mineral: Give yourself the power to say no to waist-padding foods by adding this to your diet: a calcium and vitamin D supplement.
When female dieters did this in a recent study, they ate fewer fatty foods and lost four times more weight than the women who didn't take the supplement.... http://www.realage.com/tips/cut-fatty-food-cravings-with-this-mineral
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A Family of Seasonings That Trumps Tumors Slice them, dice them, roast them, caramelize them. However you manage to add them to your meals, it's a boon to cancer prevention. We're talking about the Allium family.
The what-ditty-what family? The Allium family -- that pungent, piquant group of plants that includes onions, garlic, leeks, chives, and shallots. Invite them to dinner tonight.... http://www.realage.com/tips/a-family-of-seasonings-that-trumps-tumors
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RANDOM FACT The average cat sleeps about 2/3 of the day
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Where can you go for one-stop shopping for healthy weight resources?
The We Can!™ (Ways to Enhance Children's Activity & Nutrition) Web site is full of science-based tips, tools, and training to help parents and caregivers and their families eat more nutritiously, increase physical activity, and reduce time spent sitting in front of the TV and/or computer screen.
What's on Our Site?
We Can! Parent Program online training for community leaders and health professionals
Resources for parents and youth
Resources to mobilize your community And much more http://wecan.nhlbi.nih.gov
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Touch influences what we hear, study finds Listening is more than a matter of being “all ears.' People can also hear with their skin, according to new research that deepens our understanding of the senses, showing they can work together but also override one another.... http://www.boston.com/news/local/massachusetts/articles/ 2009/11/26/touch_influences_what_we_hear_study_finds/
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Help for Tough Headaches Don't let migraines stop your life There are headaches—and then there are migraines. If you suffer from these skull-splitting episodes, discover 10 things that may be triggering them, what you can do to stop them before they start and the latest treatment options for getting migraine pain under control.
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RANDOM FACT Less than 3% of Nestlé's sales are for chocolate.
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RANDOM TIDBITS In one year, an acre of trees can absorb as much carbon as is produced by a car driven up to 8700 miles.
*** The amount of oxygen produced by an acre of trees per year equals the amount consumed by 18 people annually. One tree produces nearly 260 pounds of oxygen each year.
***The cottonwood tree seed is the seed that stays in flight the longest. The tiny seed is surrounded by ultra-light, white fluff hairs that can carry it on the air for several days. One of the tallest soft wood trees is the General Sherman, a giant redwood sequoia of California. General Sherman is about 275 ft high with a girth of 25 ft.
***Dendrochronology is the science of calculating a tree's age by its rings. Tree rings provide precise information about environmental events, including volcanic eruptions. *** Moon trees were grown from seeds taken to the moon by Stuart Roosa, Command Module pilot of the Apollo 14 mission of January 31, 1971. The effort included 400-500 seeds, which orbited the moon on the first few days of February 1971. NASA and the USFS wanted to see if being in space and in the moon's orbit would cause the seeds to grow differently than other seeds.
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This was sent by Matzori@AOL.com who writes: "This is the web page for the Advanced Nursing Practice in Acute and Critical Care (ANPACC) list serv. The purpose of this group is to enhance communication among clinical nurse specialists, nurse practitioners, educators, researchers, physicians, and others who are interested in advanced nursing practice in the clinical fields of acute and critical care. Discussion is focused exclusively on issues of concern to advanced practice nurses including clinical issues such as patient care problems, ethical dilemmas and case studies; research utilization; role issues; scope of practice; credentialling, certification and licensure; economic, legal and regulatory issues; effective collaboration; upcoming educational programs and career opportunities. The ANPACC list serv was started in 1997 and was initially co-sponsored by the Nursing Section of the Society ofCritical Care Medicine (SCCM) and the University of Pennsylvania, School of Nursing. The ANPACC list is currently supported by an unrestricted grant from the American Association CRNP PhD CCRN (jtv@nursing.upenn.edu)
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Academic Dishonesty in Nursing Schools: An Empirical Investigation McCabe DL – Academic dishonesty, whether in the form of plagiarism or cheating on tests, has received renewed attention in the past few decades as pervasive use of the Internet and a presumed deterioration of ethics in the current generation of students has led some, perhaps many, to conclude that academic dishonesty is reaching epidemic proportions. What is lacking in many cases, including in the nursing profession, is empirical support of these trends. This article attempts to provide some of that empirical data and supports the conclusion that cheating is a significant issue in all disciplines today, including nursing. Some preliminary policy implications are also considered....
http://www.journalofnursingeducation.com/showAbst.asp?thing=42262
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Dealing With Wound Pain Pain is a considerable problem for many wound patients. Some patients experience pain periodically during procedures such as wound cleansing, dressing changes or debridement, while others suffer pain constantly. Considerable research has already been devoted to the assessment and management of wound pain,1,2,3 but a great deal more work is needed before the problem can be managed satisfactorily....
http://www.woundeducators.com/wed/clinical-trials/179-the-future-of-wound-management--dealing-with-wound-pain.html
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Three genes linked to Lou Gehrig's disease HOUGHTON, Mich. - Michigan Technological University researchers say they have linked three genes to the most common type of amyotrophic lateral sclerosis. Professor Shuanglin Zhang, who led the research, said the discovery does not mean an end to ALS -- also known as Lou Gehrig's disease -- but it could provide scientists with valuable clues as they search for a cure. University officials said Zhang started showing symptoms of the disease four years ago and now breathes with support from a respirator. He works at home with the aid of a research assistant and his wife, Qiuying Sha, an assistant professor and member of his research team."It's very challenging to map genes for complex diseases, and while many statistical methods have been developed, most don't work well in practice," said Associate Professor Xiaofeng Zhu of Case Western Reserve University School of Medicine. "Zhang's group has developed a method to detect genes and gene-gene interaction in complex diseases and provided evidence that it works. "Their findings will need to be confirmed by other researchers, but I think this will be very useful for the investigators who are trying to find genes underlying complex diseases such as ALS," Zhu said. The research is detailed in the Proceedings of the National Academy of Sciences.
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there is a lot of "hoopla" over this guideline.. stay tuned. I could probably count on one hand the number of women who would "volunteer" for mammograms IF they didn't have to undergo them. CHICAGO (Reuters 11/17) – The new guidelines by the U.S. Preventive Services Task Force, an influential panel of independent experts, would sharply curtail the number of breast mammograms done in the United States, sparing women the worry of false alarms and the cost and trouble of extra tests.The U.S. Preventive Services Task Force has issued new guidelines suggesting that women in their 40s may not need to undergo routine mammograms and may decide for themselves when to start getting screened for breast cancer. Some medical groups and cancer experts said the recommendations could result in more breast cancer-related deaths. U.S. cancer experts argued the altered schedule may mean more women will die from breast cancer... 20091117/hl_nm/us_cancer_breast_screening;_ylt=A0LEapB5.AFLq.0Ah SaWSbYF;_ylu=X3oDMTMxNHFvaG5xBGFzc2V0A25tLzIwMDkxMTE3L3VzX2NhbmNlcl9icm Vhc3Rfc2NyZWVuaW5nBHBvcwMyNARzZWMDeW5fcGFnaW5hdGVfc3VtbWFyeV9saXN0BHN sawNu ZXd1c2d1aWRlbGk-
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Isis cholesterol drug meets all goals of key trial ORLANDO, Florida (Reuters 11/17) - An experimental drug for patients genetically disposed to extreme high cholesterol being developed by Isis Pharmaceuticals Inc and Genzyme Corp significantly lowered cholesterol in a pivotal late-stage study, according to data presented on Tuesday.
The drug, mipomersen, succeeded in attaining the main goal of the trial, cutting "bad" LDL cholesterol by 25 percent compared with just a 3 percent reduction from placebo in patients with a very rare condition known as homozygous familial hypercholesterolemia.... http://www.reuters.com/article/healthNews/idUSTRE5AG37C20091117?feedType=nl&feedName=ushealth1100
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RANDOM FACT: All swans in England are the property of the queen or king
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CHICAGO (Reuters 11/11/09) - A study of internal company documents suggests Pfizer Inc altered or omitted unfavorable study findings to expand its epilepsy drug Neurontin's market, U.S. researchers said on Wednesday, offering a look at how drugmakers influence scientific research. http://www.reuters.com/article/healthNews/idUSTRE5AA4TI20091111?feedType=nl&feedName=ushealth1100
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This was sent in by BAcello (Barbara) Thank you very much In fact, I bought to booklet.

International Pressure Ulcer Guidelines released Date: Thu, 22 Oct 2009 12:20:39 -0500
The European and US National Pressure Ulcer Advisory panels (EPUAP and NPUAP) are proud to announce the release of their International Pressure Ulcer Guidelines on October 22nd 2009.
The quick reference versions of both the pressure ulcer prevention and treatment guidelines will be freely available on the EPUAP website at http://www.epuap.org/ The full clinical practice guidelines will be available for purchase through the NPUAP website at
http://www.npuap.org/ Printed copies of the quick reference versions of the two guidelines can also be purchased through http://www.npuap.org/
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7 tips to improve your professional etiquette By Kathleen D. Pagana, PhD, RN Etiquette is more than just please and thank-you. Knowing how to present yourself in a professional manner helps you stand out and increases your chance for career success. ... http://www.nursingcenter.com//upload/static/403753/NMIEeNews_Bonus_Dec09.htm
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Free H1N1 patient handouts In response to the growing concern about the H1N1 flu epidemic, Anatomical Chart Company, in conjunction with NursingCenter.com, has developed a free educational handout for health professionals to use to help explain the H1N1 virus to patients. http://www.anatomical.com/article.asp?ai=1280&sid=&eid=&bhcd2=1259625323
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The Joint Commission and the CDC are offering a free podcast to help organizations improve the effectiveness of their influenza vaccination program.
The podcast and PowerPoint presentation includes:
Information on how health care workers can keep their patients safe during flu season
H1N1 situation update from the CDC
H1N1 vaccine recommendations and availability
Reasons why health care workers don’t get vaccinated
Tips to overcoming barriers to increase vaccination of health care workers
Additional resources http://www.jointcommission.org/PatientSafety/InfectionControl/H1N1_podcast.htm
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SNARE High Bp with This Creamy Breakfast: It's creamy, it's tangy, and it starts your day off right. And it's oh-so-good for your blood pressure. We're talking about low-fat yogurt. In a recent study, a diet that was rich in low-fat dairy seemed to help curb the risk of high blood pressure by as much as 31 percent.... http://www.realage.com/tips/snare-high-bp-with-this-creamy-breakfast
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Pill-Free Way to Help Knees Feel Fine You may be able to use your own body to help ease arthritis symptoms in your knees and other creaky joints.
How? Through regular practice of tai chi. This gentle martial art integrates fluid movements with deep breathing -- and research shows it may help reduce arthritis pain and disability by about 10 points on a 100-point scale.... http://www.realage.com/tips/pill-free-way-to-help-knees-feel-fine
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(Reuters 11/29) New WHO Guidelines urge phase-out of major HIV drug In sweeping changes to its guidelines, the WHO also recommended that people with HIV, including pregnant women, should start taking AIDS drugs earlier to live a longer and healthier life.
For the first time it advised HIV-positive women and their babies to take the drugs while breastfeeding to prevent mother-to-child transmission of the virus that causes AIDS. Stavudine, also known as d4T, is marketed as Zerit by U.S. drugmaker Bristol-Myers Squibb Co. Generic versions are made by Cipla Ltd, Aurobindo Pharma Ltd and Strides Arcolab Ltd, all of India. Stavudine, widely available in developing countries as a first-line therapy, is relatively cheap and easy to use, according to the U.N. agency.
But it causes a nerve disorder leading to numbness and burning pain in the hands and feet, and loss of body fat known as lipoatrophy or wasting, it said, conditions that are disabling and disfiguring... http://www.reuters.com/article/idUSTRE5AT00K20091130?feedType=nl&feedName=ushealth1100
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HUMOR SECTION

A man went to see his doctor because he was suffering from a miserable cold.
His doctor prescribed some pills, but they didn't help.
On his next visit the doctor gave him a shot, but that didn't do any good.
On his third visit the doctor told the man to go home and take a hot bath. As soon as he was finished bathing he was to throw open all the windows and stand in the draft. "But doc," protested the patient, "if I do that, I'll get pneumonia."
"I know," said his physician. "I can cure pneumonia."

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

Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /

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

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

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

Rheumatoid arthritis: A chronic inflammation By Catherine A. Olubummo, MS, MSN, RN, FNPBONUS: PowerPoint slides, click here.
Unraveling the mystery of ARDS By Laura Blume, BSN, RN, CCRN and Diane Byrum, MSN, RN, CCNS, CCRN, FCCM BONUS: PowerPoint slides, click here.

The following free CEU site is from BAcello (Barbara)
http://videolectures.nccam.nih.gov/ with free CEUs & CME for the following: Chapter I: Overview of Complementary and Alternative Medicine
Chapter II: Herbs and Other Dietary SupplementsChapter III: Mind-Body MedicineChapter IV: Acupuncture: an Evidence-Based AssessmentChapter V: Manipulative and Body-Based Therapies: Chiropractic and Spinal ManipulationChapter VI: Complementary and Alternative Medicine and AgingChapter VII: Integrative MedicineChapter VIII: Health and SpiritualityChapter IX: Studying the Effects of Natural ProductsChapter X: Neurobiological Correlates of Acupuncture

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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.
The Center for Medicare & Medicaid Services (CMS) released chapters 1, 3, and 5 of the new RAI User’s Manual for the MDS 3.o on November 24.http://www.cms.hhs.gov/NursingHomeQualityInits/25_NHQIMDS30.asp
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com

Click here: Bluefin Tuna in Atlantic Nearing Extinction, Conservation Group Says

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

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


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

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

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

The Nursing Site
http://thenursingsite.com .

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

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

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

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

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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MEDICAL RECALLS
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Stryker Operating Room System II Surgical Navigation System - Recall Stryker and FDA notified healthcare professionals of a recall of 23 Operating Room System II Surgical Navigation Systems because there is a potential for the navigation PC SPC-1 component to stop working which could result in the screen freezing, the system updating at a slow rate, or not responding at all. The Navigation System II is a computer aided surgery platform that surgeons can use to perform Hip, Knee, Spine, Neuro and ENT surgical procedures and contains a computer workstation with the navigation System II software and various components necessary to run the system.The potential harms associated with this failure are: delay in surgery, reschedule of the procedure resulting in an additional surgery, risk of infection, increased morbidity, potential neurological deficits, or injury due to the surgeon operating in an area where they did not intend to operate. Depending on the type of surgery, these failures could potentially lead to serious adverse health consequences, including death. Hospitals that have product that corresponds to the catalog numbers above should immediately quarantine the product, label it as a recalled product and stop using the product.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm192105.htm
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Meridia (sibutramine): Early Communication about cardiovascular events. FDA notified healthcare professionals and patients that it is reviewing preliminary data from a recent study suggesting that patients using sibutramine have a higher number of cardiovascular events (heart attack, stroke, resuscitated cardiac arrest, or death) than patients using a placebo (sugar pill). Sibutramine is marketed as Meridia, a prescription drug, in the United States. Meridia was approved by FDA in 1997 for the management of obesity, including weight loss and maintenance of weight loss, in conjunction with a reduced calorie diet. Meridia is only recommended for obese patients with an initial body mass index (BMI) ≥ 30 kg/m2, or BMI ≥ 27 kg/m2 with other risk factors (e.g., diabetes, high cholesterol, controlled high blood pressure).The analysis of these data is ongoing and FDA is making no conclusions about the preliminary findings at this time. These findings highlight the importance of avoiding the use of sibutramine in patients with a history of coronary artery disease (heart disease), congestive heart failure (CHF), arrhythmias, or stroke, as recommended in the current sibutramine labeling. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm191655.htm
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Byetta (exenatide) - Renal Failure FDA notified healthcare professionals of revisions to the prescribing information for Byetta (exenatide) to include information on post-marketing reports of altered kidney function, including acute renal failure and insufficiency. Byetta, an incretin-mimetic, is approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
From April 2005 through October 2008, FDA received 78 cases of altered kidney function (62 cases of acute renal failure and 16 cases of renal insufficiency), in patients using Byetta.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm188703.htm
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Cordis CROSSOVER Sheath Introducer - Recall Cordis and FDA notified healthcare professionals of a nationwide recall of all lots of the CROSSOVER Sheath Introducer, a long-coil reinforced,kink-resistant catheter sheath intended for use in arterial and venous procedures requiring the percutaneous introduction of therapeutic or diagnostic intravascular devices or fluids.
The recall was due to stretching or fracture of the sheath during use. In the event of a device fracture, separated segments of the device can embolize downstream in the bloodstream and impede blood flow distal to the point where it lodges, resulting in ischemia or infarct to the distal extremity. Since this device is coil reinforced, any separation of the cannula has the potential to expose portions of the coil creating the potential for vessel dissection or perforation. Unplanned open surgery may be required to remove the retained segments or control bleeding. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm188555.htm
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Pointe Scientific and FDA notified healthcare professionals of a nationwide recall of all size kits of Liquid Glucose Hexokinase Reagent catalog number G7517. The reagents have been found to fail linearity at >200mg/dL that results in inaccurate glucose values above this range. Distributors and testing laboratories who have received the Liquid Glucose Hexokinase Reagent (G7517) which is being recalled should destroy remaining inventory. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm188562.htm
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Synthes USA, Ti Synex II Vertebral Body Replacement - Class I Recall FDA notified healthcare professionals of a Class I Recall of all lots of the Synthes USA, Ti Synex II Vertebral Body Replacement, a device used in the T1-L5 portion of the spine to replace a collapsed, damaged, or unstable vertebral body. Reports of moderate to severe loss of vertebral body replacement height (caused by failure of the central body component) in situ at six to fifteen months post implantation were received. Potential adverse health issues that could be associated with this issue include neural injury, increased pain, spinal kyphosis if unrecognized, failure of supplementary fixation, and/or need for reoperation/revision surgery. Surgeons and hospitals in possession of the subject devices must stop implanting them immediately. This product was manufactured from June 8, 2007 through September 9, 2009 and distributed from July 2, 2007 through September 8, 2009. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190330.htm
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Dexferrum (iron dextran injection) - Labeling change American Regent and FDA notified healthcare professionals that anaphylactic-type reactions, including fatalities, have followed the parenteral administration of iron dextran injection. The Boxed Warning has been modified to recommend administering a test dose prior to the first therapeutic dose and observing for signs or symptoms of anaphylactic-type reactions during administration of Dexferrum. Fatal reactions have followed the test dose of iron dextran injection, even in situations where the test dose was tolerated. Patients with a history of drug allergy or multiple drug allergies may be at increased risk of anaphylactic-type reactions. It is recommended that resuscitation equipment and personnel trained in the detection and treatment of anaphylactic-type reactions be readily available during Dexferrum administration.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/ SafetyAlertsforHumanMedicalProducts
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FDA notified healthcare professionals of new safety information concerning an interaction between clopidogrel (Plavix), an anti-clotting medication, and omeprazole (Prilosec/Prilosec OTC), a proton pump inhibitor (PPI) used to reduce stomach acid. New data show that when clopidogrel and omeprazole are taken together, the effectiveness of clopidogrel is reduced. Patients at risk for heart attacks or strokes who use clopidogrel to prevent blood clots will not get the full effect of this medicine if they are also taking omeprazole. Separating the dose of clopidogrel and omeprazole in time will not reduce this drug interaction. Other drugs that are expected to have a similar effect and should be avoided in combination with clopidogrel include: cimetidine, fluconazole, ketoconazole, voriconazole, etravirine, felbamate, fluoxetine, fluvoxamine, and ticlopidine. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190848.htm
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RockHard Laboratories and FDA notified consumers that RockHard Weekend, a product sold as a dietary supplement, contains sulfoaildenafil, an analogue of sildenafil, an FDA-approved drug used as treatment for Erectile Dysfunction. The presence of sulfoaildenafil makes RockHard Weekend an unapproved drug. This undeclared drug ingredient may interact with prescription drugs known as nitrates, including nitroglycerin, and cause dangerously low blood pressure. RockHard Weekend is sold nationwide in single blisters, 3-count and 8-count bottles. RockHard Laboratories advises any customers in possession of RockHard Weekend to return any unused product for a full refund to the company directly. Customers can call 1.800.562.0543 for instructions on the return and refund process. ... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts
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Cardiovascular Systems, Inc. and FDA notified healthcare professionals of a nationwide recall of all lots of the ViperSheath Sheath Introducer on behalf of Thomas Medical due to reports about stretching or fracture of the sheath during use. In the event of a device fracture, separated segments of the device may require unplanned open surgery to remove the retained segments or control bleeding. Since this device is coil reinforced, any separation of the cannula (a flexible tube inserted into the body) has the potential to expose portions of the coil, creating the potential for vessel dissection or perforation.
The recall encompasses products distributed from March 25, 2009 to October 21, 2009, and includes the following lot ranges and catalog numbers:
Lot range: S28117 through S29174
Catalog numbers: VPR-ISH 5 X 85, VPR-ISH 6 X 85, VPR-ISH 7 X 85, VPR-ISH 5 X 45, VPR-ISH 6 X 45, VPR-ISH 7 X 45
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190967.htm
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IDS Sports and FDA notified consumers that five of the IDS's dietary supplement products (Bromodrol, Dual Action Grow Tabs, Grow Tabs, Mass Tabs, and Ripped Tabs TR) contain the following undeclared substances, which FDA considers to be steroids: “Madol,” “Turinabol,” “Superdrol,” and/or “Androstenedione.”
Acute liver injury is known to be a possible harmful effect of using steroid-containing products. In addition, steroids may cause other serious long-term adverse health consequences in men, women, and children.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190925.htm
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FDA notified healthcare professionals of a Preliminary Public Health Notification describing deaths and serious complications associated with the use of Negative Pressure Wound Therapy (NPWT) systems. FDA has received reports of six deaths and 77 injuries associated with NPWT systems over the past two years.... (as a wound care nurse, the placement of the NPWT is vital...never over an area which may cause bleeding of a vessel, etc. ) http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190704.htm
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GMP Herbal Products and FDA notified consumers and healthcare professionals of a recall of Pai You Guo, a weight loss dietary supplement, due to the presence of undeclared drug ingredients. FDA lab analyses of dietary supplements were found to contain undeclared sibutramine, an FDA-approved drug used as an appetite suppressant for weight loss; and phenolphthalein, a solution used in chemical experiments and a suspected cancer-causing agent that is not approved for marketing in the United States. The FDA has not approved the Pai You Guo products as a drug; therefore the safety and effectiveness of this product is unknown.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor Human MedicalProducts/ucm190531.htm
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Local Anesthetics, Continuously Infused (marketed as bupivacaine, chlorprocaine- chondrolysis. FDA notified healthcare professionals of 35 reports of chondrolysis (necrosis and destruction of cartilage) in patients given continuous intra-articular infusions of local anesthetics with elastomeric infusion devices to control post-surgical pain. The local anesthetics (with and without epinephrine) were infused for extended periods of time (48 to 72 hours) directly into the intra-articular space using an elastomeric pump. Joint pain, stiffness, and loss of motion were reported as early as the second month after receiving the infusion. In more than half of these reports, the patients required additional surgery, including arthroscopy or arthroplasty (joint replacement).
Local anesthetics are approved as injections for the production of local or regional anesthesia or analgesia.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190496.htm
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Genzyme Products, Marketed as Cerezyme, Fabrayzme, Myozyme, Aldurazyme, and Thyrogen FDA and Genzyme notified healthcare professionals about the potential for foreign particle contamination of several products that are used to treat rare, serious, and life-threatening diseases. The foreign particles include stainless steel fragments, non-latex rubber from the vial stopper, and fiber-like material from the manufacturing process and could potentially cause serious adverse events in patients. Cerezyme, Fabrazyme, Myozyme, and Thyrogen are supplied as lyophilized powders requiring reconstitution before administration; Aldurazyme is supplied as a liquid solution.... http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm190480.htm
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NURSING HINTS CORNER

Fan-tastic idea: Here is a simple way to pull up a patient in bed. I fold a sheet lingth-wise and place it on top of the fitten bottom sheet, starting at the head of the bed. Then I fanfold the excess at the foot of the bed. That way, one nurse can easily move a patient who has slipped down in the bed without running out of sheet. Carrie Brown, RN

Pillow prop When you are positioning a patient on his side in bed and you prop a pillow behind his back, does the pillow slip away? If so, untuck the drawsheet and place the pillow under the drawsheet. Then tuck the sheet back under the mattress. The pillow won't slip, and the patient will stay on his side. Betty Ann Ulmer, RN Actually, the patient is "tilted" not on the side....this way no pressure is placed on the hip bones, thus leading to pressure ulcers.
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.134, Springhouse Corporation/www.springnetcom. ~~**~~**~~**~~**~~**~~
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com

WELCOME TO:


Stw2010@gmail.com (Stacey) December 2, 2009


Vickicprn@yahoo.com (Vicki) December 2, 2009


rondamoore75@yahoo.com (Ronda) December 2, 2009

LisaCharger08@yahoo.com (Lisa) December 9, 2009


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

No Address changes this issue
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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) ~~**~~**~~**~~**~~**~~
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY

“If you have knowledge, let others light their candles with it.”

Winston Churchill

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

"Be kinder than necessary, for everyone you meet is fighting some kind of battle."

Friday, November 13, 2009

November Paradigm97 posting

MISSION STATEMENT

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

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SNIPPET

Wendie's answer to the question "Our facilities policy is that the patient has to lie down after an epidural; What is the incidence of the headache with no bedrest?" :

Wendie writes: "This policy indicates a confusion between epidural (outside the dura) injections and lumbar puncture (into the dura to remove fluid or to inject anesthetic agent). A spinal headache is the result of a leak of cerebrospinal fluid (CSF) out of the dura at the puncture site (or post-traumatic CSF losses, but that's a different problem). As you recall, the brain and cord are surrounded by this fluid, which is constantly manufactured in the brain. When there is a leak, the brain no longer floats inside the skull, and settles down on the dependent surface, causing meningeal irritation which is very painful (I have had this and it is NOT fun). As the fluid is being constantly produced, you can actually make the headache stop by bending forward at a 90-degree angle, thus allowing the fluid to accumulate in the front of the skull (not leaking down the spine to the hole) and floating the brain again. Not any way to spend a lot of time, though, LOL. Spinal headache is cured by allowing the hole to close, which it usually does if they use a small needle and keep the pt flat for awhile after the puncture, or spontaneously in up to three weeks. If it doesn't close, a blood patch can solve the problem; a needle is inserted in the area of the original puncture, and fresh blood without anticoagulant is drawn from the pt's arm and immediately injected around the area of the puncture. The clot seals the dural leak and the fluid reaccumulates. In a half an hour or so, the clot is fine, the fluid has reaccumulated, and all is well.

Epidurals do not make holes in the dura, so a "spinal headache" is not possible. Epidurals for back pain should never be done without fluoroscopy, to prevent misses. They used to be done all the time blind, in series of 3, mostly by anesthesiologists who did epidurals for labor and delivery. Studies showed that about 60% of the time they missed, which apparently wasn't such an issue in a time-limited thing like labor but is pretty wasteful for a patient with ongoing back pain. The 3 was traditional but increased the chances of getting it right, LOL. Some anesthesiologists still routinely schedule 3, but the repeats are not usually approved by payors (and ought not to be) without evidence of effectiveness. (I just had a pt who had the three scheduled but I canceled the 2nd and 3rd pending clinical evaluation of results-- and she was fine p the first alone, thus avoiding 2 more unpleasant and expensive procedures.) The pt usually stays flat for a half an hour or so to allow the local anes and steroid to stay in place, and to let the pt kinda get over the experience, but it has nothing to do c spinal headache".
( I may be wrong.......but I believe that the CSF is "manufactured" @ or about 10 CC/ hour. ......any corrections to my memory/assumption?---Frankie)
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FROM A MEMBER

GALLORN@AOL.com (Sue) wrote the following: Can you please forward to your friends and contacts my request for a diprivan policy. They want to start using in our ED and at present, there are no guidelines for administration. Thanks. Sue
Please help her if you have a policy or a link, Thank you.

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This website was sent in by Jahered@AOL.com JoAnn who writes: "There was an interesting article regarding the 1918 flu epidemic in the NY Times".
http://www.nytimes.com/2009/10/13/health/13aspirin.html?8au&emc=au

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MEDICAL NEWS

Three genes linked to Lou Gehrig's disease HOUGHTON, Mich. - Michigan Technological University researchers say they have linked three genes to the most common type of amyotrophic lateral sclerosis. Professor Shuanglin Zhang, who led the research, said the discovery does not mean an end to ALS -- also known as Lou Gehrig's disease -- but it could provide scientists with valuable clues as they search for a cure. University officials said Zhang started showing symptoms of the disease four years ago and now breathes with support from a respirator. He works at home with the aid of a research assistant and his wife, Qiuying Sha, an assistant professor and member of his research team."It's very challenging to map genes for complex diseases, and while many statistical methods have been developed, most don't work well in practice," said Associate Professor Xiaofeng Zhu of Case Western Reserve University School of Medicine. "Zhang's group has developed a method to detect genes and gene-gene interaction in complex diseases and provided evidence that it works. "Their findings will need to be confirmed by other researchers, but I think this will be very useful for the investigators who are trying to find genes underlying complex diseases such as ALS," Zhu said. The research is detailed in the Proceedings of the National Academy of Sciences.
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INTERESTING READING

Please remember that the REUTERS articles usually good for only 30 days
Beyond Office Sphygmomanometry Rafey M – To diagnose and manage hypertension optimally, we may need to do more than measure the patient’s blood pressure in the office using traditional sphygmomanometry. A variety of devices—some already available, validated, and reimbursable, some still in development – provide more information and give us a better picture of the patient’s true hypertensive status, degree of blood pressure control, and risk of end–organ damage.
Traditional office blood pressure measurements have diagnostic limitations, since they are only snapshots of a very dynamic variable.
Ambulatory 24–hour blood pressure monitoring is a useful and proven tool and can reveal nocturnal hypertension, a possible new marker of risk.
Automatic devices can be used in the clinician’s office to minimize the “white coat effect” and measure blood pressure accurately.
Pulse–wave analysis provides physiologic data on central blood pressure and arterial stiffness. This information may help in the early identification and management of patients at risk for end–organ damage. Cleveland Clinic Journal of Medicine
http://www.ccjm.org/content/76/11/657.full
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How adolescents who cut themselves differ from those who take overdoses Hawton K et al. – Analyses at both the individual and school level showed that the association between engaging in DSH (deliberate self harm) and exposure to DSH amongst peers was largely confined to girls who cut themselves. There are important differences between adolescents who cut themselves and those who take overdoses. Contagion may be an important factor in DSH by adolescents, especially in girls who cut themselves. These findings are relevant to the design of prevention and treatment programmes. European Child and Adolescent Psychiatry, 10/05/09 http://www.springerlink.com/content/914u12m86vl8r55x
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New prostate surgery not necessarily better: study
CHICAGO (Reuters 10/13/09) - Men who have less invasive prostate cancer surgery -- often done robotically -- are more likely to be incontinent and have erectile dysfunction than men who have conventional open surgery, U.S. researchers said on Tuesday. Many men, especially those who are wealthy and highly educated, favor minimally invasive surgery because they assume the high-tech approach will yield better results, but the evidence on that is mixed, the team reported in the Journal of the American Medical Association.... http://www.reuters.com/article/healthNews/idUSTRE59C5TE20091013?feedType=nl&feedName=ushealth1100
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Late-Dementia Suffering Often Unnecessary Oct. 14, 2009 -- Patients with advanced Alzheimer’s disease or other age-related dementias often suffer unnecessarily near the end of life probably because their condition is not recognized as fatal, researchers say.
The death rate among patients with advanced dementia in a newly published study was similar to that of patients with end-stage breast cancer or heart disease, lead researcher Susan L. Mitchell, MD, of Harvard Medical School’s Institute for Aging Research, tells WebMD.... http://www.webmd.com/alzheimers/news/20091014/late-dementia-suffering-often-unnecessary
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Try This Blossom for Lower Blood Pressure Tea brewed from lovely flower buds may help keepyour blood pressure in check -- if those buds are hibiscus. In a study, drinking 3 cups of hibiscus tea per day appeared to help lower systolic blood pressure by an average of seven points in people with prehypertension or mildly elevated blood pressure.
Assuming you don't load it up with sugar, brewed tea is one of the healthiest drinks around. And the flavonoids and polyphenols in hibiscus tea may be the reason for the blood-pressure-busting benefits observed in the study, which was funded jointly by the USDA and the tea industry. More research is needed to confirm the findings... http://www.realage.com/tips/try-this-blossom-for-lower-blood-pressure
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RANDOM FACT Female Mosquitos locate their victims primarily through scent.
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Your workouts might melt even more body fat if you eat this at breakfast: whole-grain cereal. Why? A small study suggests that eating healthy carbs in the morning may turbocharge your fat-burning furnaces when you exercise later on in the day.
Good Carbs, Bad Carbs The key here is the whole grain -- because the study showed that low-glycemic-index carbs (the high-fiber kind) were what moved the dial on fat burning.... http://www.realage.com/tips/burn-more-fat-with-this-wonder-breakfast
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HONG KONG (Reuters 10/09) - An India-made cholera vaccine that meets World Health Organization standards has proven to be safe and effective in young children in a part of India where the disease is endemic, a new study says. The researchers, who published their study results in The Lancet, hope the vaccine can soon be rolled out in developing countries where cholera remains endemic.... http://www.reuters.com/article/healthNews/idUSTRE59805E20091009?feedType=nl&feedName=ushealth1100
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Random Fact: The official name of Rhode Island is “Rhode Island and Providence Plantations”
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Why Outdoor Workouts Work Better Pounding away on a treadmill under fluorescent lights in a stuffy gym couldn't sound any less appealing. Until now. This workout choice may be holding your health back. That's what exercise guru Tina Vindum, author of Outdoor Fitness, believes. In her book, she references several studies that suggest exercising in a
natural environment is better for your mood and your health....
http://www.realage.com/tips/why-outdoor-workouts-work-better
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An Information Technology Infrastructure to Enable Evidence-Based Nursing Practice Nursing Administration Quarterly, 10/01/09 Pochciol JM et al. – The research–based nursing practice system is helping bridge the gap between evidence–based resources and practice by compiling the literature in one place and making it easily and readily accessible.... http://journals.lww.com/naqjournal/Abstract/2009/10000/An_
Information_Technology_Infrastructure_to_ Enable.8.aspx
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Erectile Dysfunction Severity as a Risk Predictor for Coronary Artery Disease The Journal of Sexual Medicine, 10/01/09 Salem S et al. – This study suggests that ED could be considered as a surrogate marker which can predict the occurrence of CAD, and severe ED could be regarded as an independent risk predictor in addition to the established ones.... http://www3.interscience.wiley.com/journal/122613867/abstract? CRETRY=1&SRETRY=0
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Random Fact: Just under 500,000 babies are born each year in the U.S. to teenage mothers
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"Nursing a Broken Heart "Sometimes that crushing chest pain associated with a heart attack is not a heart attack at all, but something else that has gone terribly wrong with the heart - because something has gone terribly wrong with life.
Takotsubo syndrome is also known as "broken heart syndrome" and "stressed-induced cardiomyopathy," and refers to left ventricular apical ballooning of the heart that temporarily causes a "stunning" or akinesis of the heart muscle, resulting in the inability of the heart to adequately pump blood. ... http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?CC=207377
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"Healthy" neighborhoods cut type 2 diabetes risk (Reuters 10/12) - If you are what you eat, you may also be a product of where you live: Living in a neighborhood where it's pleasant and easy to walk and fresh fruits and vegetables are close at hand can slash a person's risk of developing type 2 diabetes, new research shows.... http://www.reuters.com/article/healthNews/idUSTRE59B54U20091012?feedType=nl&feedName=ushealth1100
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RANDOM TIDBITS Monarch butterflies journey from the Great Lakes to the Gulf of Mexico, a distance of about 2,000 miles, and return to the north again in the spring.
*** Butterflies cannot fly if their body temperature is less than 86 degrees.
*** Many butterflies can taste with their feet to find out whether the leaf they sit on is good to lay eggs on to be their caterpillars' food or not. ***
Some moths never eat anything as adults because they don't have mouths. They must live on the energy they stored as caterpillars.
*** Butterflies and insects have their skeletons on the outside of their bodies, called the exoskeleton. This protects the insect and keeps water inside their bodies so they don’t dry out.
*** Some Case Moth caterpillars (Psychidae) build a case around themselves that they always carry with them. It is made of silk and pieces of plants or soil.
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Female Health's condom available, no U.S. retail yet WASHINGTON (Reuters 10/01/09) - Female Health Co's new version of its female condom is now available to state health agencies and nonprofit organizations, but the company is still trying to make it more widely available in stores.
The condom, known as FC2, will cost about 30 percent less than the original version at less than a dollar apiece, the company said on Thursday. Female Health Co's new version of its female condom is now available to state health agencies and nonprofit organizations, but the company is still trying to make it more widely available in stores...
http://www.reuters.com/article/healthNews/idUSTRE5905D620091001?feedType=nl&feedName=ushealth1100
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New Diabetes Drug Hits Target in Late Stage Study VIENNA (Reuters 10/02/09) - An experimental diabetes drug from Bristol-Myers Squibb and AstraZeneca met its main target in a late stage study, achieving significant reductions in glycosylated hemoglobin levels.
When added to the common diabetes pill metformin, dapagliflozin cut both levels of both glycosylated hemoglobin -- an indication of glucose levels -- and fasting plasma glucose in patients with type 2 diabetes after 24 weeks, hitting both its main and secondary targets.... http://www.reuters.com/article/healthNews/idUSTRE5911L620091002?feedType=nl&feedName=ushealth1100
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Foods dogs need to avoid...Most of us who live with pets know that chocolate and dogs do not mix. But there are many other harmful foods lurking in our pantries and fridges - seemingly innocent vegetables, fruits, and other edibles that may be delicious to us, but are dangerous, and even deadly, to our dogs... http://www.fetchdog.com/learn-connect/dog-resource-library/nutrition-supplements/Delicious-for-us-Dangerous-to-Dogs-Foods-to-Keep-Away-From-Your-Dog/D/300600/P/1:5:55:602/I/AR000010760?actn=addkeycodetocart&keycode=CHA7232&utm_source=aff&utm_ medium=homeagain&utm_campaign=LC_HAfs&emlsav=RNFRANKIE@AOL.COM
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Article questions effectiveness of N95 respirator masks The CDC recommends health care workers use the N95 respirator mask to prevent the spread of the H1N1 flu virus, but some Institute of Medicine committee members have questioned whether the masks are really that effective. The perspective in the New England Journal of Medicine said that there is no "convincing scientific data" showing the masks provide protection and that one study found more than 70% of health care workers removed their masks for at least part of their shift. Los Angeles Times/Booster Shots blog (9/30)
http://latimesblogs.latimes.com/booster_shots/2009/09/h1n1-swine-flu-n95-mask.html
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Surgical masks may be just as good as N95 respirators for protecting healthcare workers against the flu, according to a randomized clinical trial whose findings conflict with the only previous study....
http://www.medpagetoday.com/HospitalBasedMedicine/InfectionControl/16248
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THRIFTY TIP: How can you keep yourself from buying too much? Shop less frequently. Grocery shopping is no different, but the key is to shop smart in order to avoid spoilage. Try grocery shopping only once every two weeks. Cook two or three meals' worth of each recipe at the beginning of the two-week period, and immediately freeze the extra portions for the second week. Freeze any meat that you won't be eating within the next 48 hours.
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Nurses Bound by Ethics, Law to Maintain Privacy With nurses allegedly serving as sources to media outlets of private medical information on public figures, including Michael Jackson and Farrah Fawcett, the boundaries of protected health information have come into question. Nurses are bound by many legal and ethical mandates. One important mandate is to maintain the confidentiality and privacy of patient information. This mandate is found in many sources.The most recent underpinning of a patient’s privacy is the federal Health Insurance Portability and Accountability Act’s (HIPAA) Standards for Privacy of Individually Identifiable Health Information and its companion rule, The Security Rule. The final privacy rule, published Aug. 14, 2002, and the final security rule, effective April 20, 2005, established a set of national standards for the protection of certain health information... http://news.nurse.com/article/20091005/NATIONAL01/110050068/-1/frontpage
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HELPFUL HINTS: Clean all those dead bugs off your windshield by sprinkling baking soda onto a damp cloth and wipe down the glass. The abrasive baking soda whisks away insects easily without damaging your windshield. AND To clean a bottle with a narrow opening, etc...drop several grains of rice into the water/soapy water and shake thoroughly.
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Study associates H1N1 flu deaths with bacterial co-infections Reuters (9/30) A CDC study on 77 patients who died of the H1N1 flu virus found that 29% were also infected with a bacteria -- often Streptococcus pneumoniae, which can be prevented with a vaccine. Doctors may be missing these secondary infections in people very sick with the flu, the CDC said. The findings suggest that as with the other flu pandemics, "bacterial pneumonia is contributing to deaths associated with pandemic H1N1," health experts said. http://www.reuters.com/article/domesticNews/idUSTRE58T52D20090930
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Rituxan (rituximab) - PML Genentech and FDA notified healthcare professionals about a third case of progressive multifocal leukoencephalopathy [PML], the first case of PML in a patient with rheumatoid arthritis [RA] treated with Rituxan who has not previously received treatment with a TNF antagonist. Information to date suggests that patients with RA who receive Rituxan have an increased risk of PML. Physicians should consider PML in any patient being treated with Rituxan who presents with newonset neurologic manifestations. Consultation with a neurologist, brain MRI, and lumbar puncture should be considered as clinically indicated. http://www.fda.gov/Safety/MedWatch/SafetyInformation/ SafetyAlertsforHumanMedicalProducts
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Hyperbaric oxygen therapy is thought to offer a beneficial healing effect through a variety of underlying therapeutic mechanisms, including improved tissue oxygenation, and increased fibroblast proliferation and white blood cell killing capacity during periods of hyperoxia. It is also thought to stimulate angiogenesis during periods of relative hypoxia repair... http://www.woundeducators.com/wed/adjunctive-modalities/175-adjunctive-therapies--hyperbaric-oxygen-therapy.html
(I have seen this on those with serious injuries and on Diabetics' wounds, and it does work very well; the only real drawbacks are the 30 session requirement and the patient must be cooperative with schedules/ preparation, etc.)
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RANDOM FACT: "Go" is the shortest complete sentence in the English language ********************
Boys don't nurse August 20, 2009 -- Today the Times of India briefly reported that a court in Madras had upheld the Tamil Nadu government's decision to bar male candidates from a "diploma course nursing," apparently indefinitely, on the grounds that the course syllabus had been changed to include midwifery, and anyway, government hospitals will have enough "male nurses" till 2045.... http://www.truthaboutnursing.org/news/2009/aug/20_boys.html
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FDA probing nutrition claims on food packages WASHINGTON (Reuters 10/20/09) - U.S. regulators are examining the growing number of nutrition claims found on the front of food packages after complaints that they give a misleading picture of their health benefits, officials said in a warning to food companies on Tuesday. The Food and Drug Administration is trying to determine if any claims violate federal food labeling rules and "will take enforcement action against any egregious examples," FDA Commissioner Margaret Hamburg told reporters.... http://www.reuters.com/article/healthNews/idUSTRE59J5Z620091020?feedType=nl&feedName=ushealth1100
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NEW YORK (Reuters 10/20/09) - A single pill containing the pain relievers tramadol and acetaminophen is as effective as the drug gabapentin for treating diabetes-related nerve pain, according to study findings presented Tuesday at the 20th World Diabetes Congress in Montreal.... http://www.reuters.com/article/healthNews/idUSTRE59J5RV20091020?feedType=nl&feedName=ushealth1100
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Swine Flu sends most - 25 year olds to hospital..... WASHINGTON (Reuters 10/20/09) - Half of those hospitalized with the new H1N1 virus are under 25, a clear illustration that the pandemic is affecting the young disproportionately.

They said reports from 27 U.S. states show 53 percent of people sick enough to be hospitalized with H1N1 flu are under the age of 25, with only 7 percent of hospitalizations among people 65 and older...http://www.reuters.com/article/healthNews/idUSTRE59J58H20091021?feedType=nl&feedName=ushealth1100
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RANDOM FACT The average human head has about 100,000 hairs
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Today USA Today ran a very good report by Erin Thompson about a new study detailing the high level of abuse emergency nurses suffer. The article, "More than half of ER nurses have been assaulted on job," describes the results of an online survey of more than 3,000 ED nurses by the Emergency Nurses Association (ENA)... http://www.truthaboutnursing.org/index.html
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Explaining Fruit and Vegetable Intake Using a Consumer Marketing Tool Della LJ et al.36 (5): 895 Health Education & Behavior – The findings confirm the efficacy of using the TPB to explain variation in fruit and vegetable consumption as well as the validity of using a consumer–based algorithm to segment audiences for fruit and vegetable consumption messaging... http://heb.sagepub.com/cgi/content/abstract/36/5/895
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RANDOM FACT Drunk driving causes approximately one-third of all traffic fatalities in the United States.
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NEW YORK (Reuters 10/14 - Advanced dementia is a terminal illness and should be
viewed as such, researchers conclude in a report released Wednesday.
Infections and eating problems are common and often herald the final states of life for these patients.
Unfortunately, many of patients with advanced dementia suffer through burdensome medical interventions of questionable benefit as they approach the end-of-life. ... http://www.reuters.com/article/healthNews/idUSTRE59D5IY20091014?feedType=nl&feedName=ushealth1100
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In protecting against flu, face masks rank last WASHINGTON (Reuters 10/15) New guidelines on protecting hospital workers against the H1N1 swine flu stress keeping influenza patients away from others and put protective equipment such as face masks last. The new guidelines posted by the U.S. Centers for Disease Control and Prevention urge hospitals tovaccinate as many staff as possible against H1N1 and to bar entry to visitors with flu-like symptoms... http://www.reuters.com/article/healthNews/idUSTRE59D5LW20091015?feedType=nl&feedName=ushealth1100
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Enteral Nutrition in Nursing Home Residents: A 5-year (2001-2005) Epidemiological
Analysis Morello M et al. – Nursing home residents (NHRs) receiving enteral nutrition (EN) were mainly afflicted with neurodegenerative and cerebrovascular diseases, functional impairments, and a high incidence of pressure sores. The mortality rate was low compared with others reported in literature. The low EN use among NHRs in this study may suggest a limited use in advanced dementia and at end–stage of life....
http://ncp.sagepub.com/cgi/content/abstract/24/5/635
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CHICAGO (Reuters 10/13/09) - Men who have less invasive prostate cancer surgery -- often done robotically -- are more likely to be incontinent and have erectile dysfunction than men who have conventional open surgery, U.S. researchers said on Tuesday. Many men, especially those who are wealthy and highly educated, favor minimally invasive surgery because they assume the high-tech approach will yield better results, but the evidence on that is mixed, the team reported in the Journal of the American Medical Association....
http://www.reuters.com/article/healthNews/idUSTRE59C5TE20091013?feedType=nl&feedName=ushealth1100
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Thank you CKPPK (Cheri) for sending in this article: Hand Dryers This came from
someone who works in sales & distribution of cleaning and maintenance products for large industries.
Everyone in the cleaning industry has always been told that hand dryers in restrooms are not sanitary, they spread germs and bacteria around. I always thought that this just came from the paper companies because they are losing sales to the hand dryers. A couple of years ago, I was working with a rep, and noticed that after he washed his hands and noticed that there were no paper towels, only a hand dryer, he left the restroom with wet hands. I asked him about it. He said that hand dryers blow a lot of germs and bacteria around. He also told me to take a look under the hand dryer next time I was in a restroom. There is a filter underneath the hand
dryer that is supposed to be cleaned on a weekly basis. I looked at one and it looked like it hadn't been cleaned in years. It had layers and layers of caked on gunk (disgusting). Since then I will not use hand dryers in restrooms.

Now, this is where the story gets really interesting (and helps to prove this theory). The schools and universities that have had the H1N1 (swine flu) outbreak this year are being told by the health department that they have to take out all of their hand dryers and replace then with towel dispensers because the hand dryers are spreading disease .
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Gene therapy experiment restores sight in a few PHILADELPHIA (Reuters 10/25) - Nine-year-old Corey Haas can ride his bike alone now, thanks to an experimental gene therapy that has boosted his fading vision with a single treatment. The gene therapy helped improve worsening eyesight caused by a rare inherited disease called Leber congenital amaurosis, or LCA, which makes most patients blind by age 40.... http://www.reuters.com/article/healthNews/idUSTRE59N1T420091025?feedType=nl&feedName=ushealth1100
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RANDOM FACT The average cat sleeps about 2/3 of the day


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HUMOR SECTION
The following is a very good example about the need to learn foreign languages:

A mother mouse and a baby mouse are walking along, when all of a sudden, a cat attacks them. The mother mouse goes, "BARK!" and the cat runs away.
"See?" says the mother mouse to her baby. "Now do you see why it's important to learn a foreign language?"
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A SPANISH Teacher was explaining to her class that in Spanish, unlike English, nouns are designated as either masculine or feminine. 'House' for instance, is feminine: 'la Casa.''Pencil,' however, is masculine: 'el lapiz.' A student asked, 'What gender is 'computer'?'
Instead of giving the answer, the teacher split the class into two groups, male and female, and asked them to decide for themselves whether computer' should be a masculine or a feminine noun.. Each group was asked to give four reasons for its recommendation.
The men's group decided that 'computer' should definitely be of the feminine gender ('la computadora'), because: 1... No one but their creator understands their internal logic.
2. The native language they use to communicate with other computers is incomprehensible to everyone else;
3. Even the smallest mistakes are stored in long term memory for possible later retrieval; and
4. As soon as you make a commitment to one, you find yourself spending half your paycheck on accessories for it. (THIS GETS BETTER!)
The women's group, however, concluded that computers should be Masculine ('el computador'), because: 1. In order to do anything with them, you have to turn them on;
2. They have a lot of data but still can't think for themselves;
3. They are supposed to help you solve problems, but half the time they ARE the problem; and 4.. As soon as you commit to one, you realize that if you had waited a little longer, you could have gotten a better model.......................... The women won. ~~~***~~~***~~~*** ~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

H1N1 Influenza How you can protect your patients and yourself
Learning Scope #316 1 contact hourThis offering expires in 2 years: September 28, 2011
http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?CC=207466


Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /

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

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

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

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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com

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

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



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

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

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

The Nursing Site
http://thenursingsite.com .

http://www.snopes.com

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

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

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

This is a sampling of the offers on : Rozalfaro's website:
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

Beyond Office Sphygmometry http://www.ccjm.org/content/76/11/657.full.pdf

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MEDICAL RECALLS
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Philips Heartstart Fr2+ Automated External Defibrillators - Recall Philips and FDA notified healthcare professionals of the recall of 5,400 HeartStart FR2+ automated external defibrillators (AED) due to reports of a memory chip failure which could render the AED inoperable and prevent it from delivering therapy when indicated. The AEDs are used by trained responders and designated response teams to help treat sudden cardiac arrest.
The recalled units (models M3860A and M3861A, distributed by Philips; and models M3840A and M3841A, distributed by Laerdal Medical) were manufactured between May, 2007 and January, 2008. Philips is contacting customers to arrange for the return and replacement of all the recalled AEDs and set up a page on the Philips Web site -- www.philips.com/FR2PlusAction -- with a serial number look-up tool to allow customers to find out if their FR2+ is part of this recall, as well as instructions on what to do if it is. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedical Products/ucm185179.htm
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Heparin: Change in Reference Standard FDA notified healthcare professionals and patients of a change to heparin, effective October 1, 2009, which will include a new reference standard and test method used to determine the potency of the drug and able to detect impurities that may be present in heparin. The change, which will also harmonize the USP unit dose with the WHO International Standard unit dose, will result in approximately a 10% reduction in the potency of the heparin marketed in the United States.
This may have clinical significance in some situations, such as when heparin is administered as a bolus intravenous dose and an immediate anticoagulant effect is clinically important. Healthcare providers should be aware of the decrease in heparin potency as they monitor the anticoagulant effect of the drug; more heparin may be required to achieve and maintain the desired level of anticoagulation in some patients.
There will be simultaneous availability of heparin manufactured to meet the “old” and “new” USP monograph, with potential differences in potency. Products using the new “USP unit” potency definition are anticipated to be available on or after October 8. FDA is working with the manufacturers of heparin to ensure that an appropriate identifier is placed on heparin made under the new USP monograph. Most manufacturers will place an “N” next to the lot number. FDA is also working with the heparin manufacturers to study the impact of this variation in potency and will make the results available when the studies have concluded. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm184687.htm
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Neuron 6F 070 Delivery Catheter [Penumbra] Penumbra and FDA notified healthcare professionals about a voluntary field removal of the original version of Neuron 6F 070 Delivery Catheter due to reports that the catheter could kink or ovalize in certain anatomical situations, lead to difficulty in catheter advancement and/or delivery of other devices through the guide catheter. Continued usage of a kinked catheter could cause the catheter to break, which could result in a portion being retained in the patient, which could result in additional procedural time, patient injury or death. There are four injury reports to date, which may be potentially associated with this defect.
Facilities that have the older version of 6F Neuron 070 Delivery Catheter which is being recalled should stop using and return the device. Penumbra is notifying affected hospitals through detailed Field Removal notification letters requesting that affected product be returned to Penumbra. The affected product catalog numbers and lot numbers are provided in the firm press release. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm184742.htm
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Accusure Insulin Syringes (Qualitest Pharmaceuticals) - Recall Qualitest Pharmaceuticals and FDA notified healthcare professionals of a nationwide recall of Accusure Insulin Syringes. All syringes, regardless of lot number, are subject to this recall. These syringes were distributed between January 2002 and October 2009 to wholesale and retail pharmacies nationwide (including Puerto Rico). The syringes in these lots may have needles which detach from the syringe. If the needle becomes detached from the syringe during use, it can become stuck in the insulin vial, push back into to the syringe, or remain in the skin after injection. Consumers who have any Accusure insulin syringes should stop using them and contact Qualitest at 1-800-444-4011 for reimbursement. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts
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Unomedical Manual Pulmonary Resuscitator - Recall Unomedical and FDA notified healthcare professionals about the recall of the single-patient use Manual Pulmonary Resuscitator because of a malfunction which may impair the ability of the device to generate the positive pressure necessary to function properly and could potentially cause serious adverse health consequences or death. The recalled resuscitators were manufactured from July 2002 – March 2008 and the company set up a web page, http://www.unomedical.com/?pageid=H3160 with a list of affected lot numbers, guidance (diagram and photos) to allow customers to identify products subject to the recall in the event that the customer has already removed the primary product packaging, and instructions on what actions to take. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts



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NURSING HINTS CORNER

Preferred powder Often patients in our critical care units who are receiving steroids or have diabetes develop a yeast infection in the groin or under a pendulous breast. We apply powder to these areas to reduce moisture buildup and increase comfort.
But we've found that a cornstarch powder seems to make the infection worse, because the cornstarch and moisture from the skin act as a medium for yeast growth. Talcum powder, on the other hand, has a mineral base and doesn't promote yeast growth. Doris K. Putland, RN, CCRN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.160, Springhouse Corporation/www.springnetcom.
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ADVERTISEMENTS
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com

WELCOME TO:

francescarn08@gmail.com (Frances) October 26, 2009

SKevinH@bellsouth.net (Cindy) November 1, 2009

tinaisaac@hotmail.com (Tina) November 7, 2009
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NOTICE:
I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.......lol So please send me your new name/address, ok? RNFrankie@AOL.com
OLD ADDRESS: springns88@yahoo.com ( Barbara )

NEW ADDRESS: springns88@aol.com

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

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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY

The following quote was sent in by JuliaCR........thank you.

The democracy will cease to exist when you take away from those who are willing to work, and give to those who would not.
~ Thomas Jefferson


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