Tuesday, June 9, 2009

PARADIGM 97 Newsletter


PARADIGM BYTES
Newsletter for Paradigm 97
June 10, 2009

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%20/
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.

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SNIPPETS
I know the following is a very controversial issue. I would like to present it as a personal experience with Autism in my family and not open up a wide discussion of the pros and cons, but just present the facts as known to us and let each of you decide for yourselves how you feel about this issue."
A friend forwarded this letter to me, as an open letter, requesting me to email it to others for feedback. It was from one of her young (20 yo) male relatives , who currently is teaching Autistic children. He wrote:



"I just wanted to pass along a quick book recommendation. I recently picked up "Autism's False Prophets" By Paul Offit. It presents a chronicle of how the MMR vaccine became linked as a potential cause of Autism. It also explores the lack of any scientific evidence that a link exists. I know the background of the controversy and know personally many parents who still believe that MMR caused their children to develop Autism. This book sheds light on the bad "scientific" practices that lead to the controversy and has lead to the rise in Measles and several deaths stemming from unvaccinated children getting Measles. It presents a really interesting account of how easily families effected by Autism have been taken advantage of by questionable practices. What is more amazing to me is that there are documented cases of children being killed either by treatment or by a lack of immunization and knuckleheads like Jenny Mc Carthy are still given airtime to spread unsupported positions about vaccines. These parents are a bunch of knuckleheads. (Having personally watched the damage caused by the unsupported treatments she advocates, I have a strong dislike for her) Anyway, it is a really interesting book even if you have no interest in Autism. It is a great lesson in how public myths are spread and can lead to severe harm. As for the rise in Autism, no research has identified the reasons. "

My daughter wrote the following in response:

To Whom It May Concern:

I did receive this forwarded letter. Initially, I believed it was sent with some 'sarcastic' good intentions, but found it doesn't have facts to back it up. I do. Please do some research at the University of Michigan. A grant was awarded to Dr. Sighn approx 1998-1999. My son was part of his U.S. nationwide testing (Bryan; southeast sector) trying to see why there was an abrupt increase in Autism diagnoses; beyond the normal rise in population growth. WHY was Autism becoming the number one neurological disability in children...one of the most disabling ones, too!!

My son was a bright, above-average developing child who spoke two languages; had just started three word sentences by 22 months. Bryan altered after receiving a vaccination (MMR 12/1989) within six months of chemotherapy (6/1990-12/1990). No...his chemotherapy (Actinomycin D & Vincristin) was treating his 'Wilms tumor' NOT brain cancer; thereby not crossing the blood/brain barrier.

At age 2.5yrs, Bryan's first symptom was hyperactivity; which shortened his ability to sleep. His pediatrician, Dr Marcadis, said it was due to having three operations on top of six months of chemotherapy; a normal traumatic regression. He assured me that there wasn't any other reason because my son was so advanced for his age! His diagnosis was proven wrong a year later when Bryan started losing his ability to speak; lowered to two-and one word sentence replies in both English/Spanish. Then he lost his hand-eye coordination; he could no longer catch and hit a ball. These were abilities that he had already mastered! I went to everyone...WHY and WHAT is this happening to my child!!
He was diagnosed by Dr Tuchman,a Pediatric Neurologist out of Miami/Coral Springs, as being severely-moderately Autistic by 3/1992. Because, he ran all the chromosomal/diagnostic tests and everything came out negative...leaving Bryan with several of the 'umbrella' s/s of Autism. Now, Dr. Isaac Marcadis will tell you today...that there was NO WAY possible for my son to be born with Autism...though, throughout his early education all of his teachers and educational specialist kept telling me he MUST have been. See, these 'professionals' never witnessed my advanced son...ONLY the injured one. In addition, I was told by a WPB Pediatric Neurologist, after a 20 minute consult, to institutionalize him at age seven...that he would never go beyond infancy in his learning abilities. WHY put my young family through this trauma...of caring for him at home. Then the LAZY, UNPROFESSIONAL Teachers and support therapist documented that his ability to learn was equal to his ability to speak!! Refusing Occupational Therapy four times; from Pre K to 3rd grade!!! Again, I had to listen to these ignorant 'professionals' that he was born this way...and that I was either just too ignorant of the disability or I was in DENIAL. My argument was that my son can still understand English and Spanish...he must have the ability to learn!! They just wanted to put him into a corner and take his state/federal educational funds; glorified babysitting at school. I WAS the one who taught him addition, subtraction, multiplication and now, division- (but, remember they are always right...my son doesn't have the capacity to learn)

In 1993, Bryan was running amuck over-focused onto a red ball-that he carried everywhere, oblivious to most interactive communication, flapped his arms/hands in excitement, and was placed on hyperactivity medication due to his inability to sleep at night. He had lost ALL of his ability to talk; NOW MUTE...having to point and grunt at things to get his needs met. Periodically, he was able to get a word out; approximately 10 words a month...then this ability left him. It was like I had a child displaying ALL the S/S of Alzheimers!!!!

In 1999, Dr Sighn found that Bryan had an extraordinary high measle titer (yes: at age 11 years), and had developed an antibody that was attacking his protective sheaths of the brain's nervous system. Dr Sighn's study found a total of two different antibodies that were harming 60% of these children; they either had one or both....and of the 60% ... 80% of them had extraordinary high measles titers. He pleaded with the College and other public/private U.S. research labs to continue his study...but, no one wanted to fund the Autistic studies; he was told he had to leave the children and go research Alzheimers instead. How ironic, when Bryan was 3.5 years old, I was told Autism was rare 1:100,000...NOW...1:99 boys will have this disorder....So, please tell me what has changed so abruptly in our genetics or society to harm these children?? To equal your sarcastic 'soap box' comment... THANK GOD, the 'professionals' have finally removed their past reasoning for AUTISM. If you were unaware of it....they used to state that it was all the MOTHER's fault; for not giving their children attention and love. But, YOU ARE right....your highly educated "friend" must know the reason for Autism and has found this one author that supports him.

REALLY, you think by giving these babies tripled the amount of vaccinations that we had received - starting the day after birth...has NO effect? DID you know, that NO Doctor is testing their immune system prior to their injections!! AND aren't we breast feeding our babies for the first few months to a year in order for them to benefit from our immune system??? OH, and LET US NOT FORGET that the Drug companies are pushing these new vaccinations; by paying millions of dollars annually to our politicians in order to make their profits !!!

SO this is MY soap box regarding Autism...VERY tired of having people with little knowledge saying that vaccinations have no influence on a developing babies immune system...or on their life!! MY suggestion is for you to spent time at the Special Olympics- as I have...and meet those children and their parents who have been awarded thousands of dollars from the US government because of the vaccinations doing permanent/debilitating harm/death to their child (BTW; I have NOT requested nor received these compensations). Ask them what they think of these MIRACLE Drugs!!! YES, I have !! I'm sure you will say...the good of the drug outweighs the bad...unless it was YOUR child!! Now, most reasonable people would say...that yes, vaccinations are good...limited amounts given later in life...not the day after birth! I have had Pediatricians actually tell me that the reason for the early vaccinations were because of a study showing that parents are noncompliant after the age of two years...my answer; give the vaccinations at school like we used to. The schools already have school nurses; utilize them!!

In YOUR mind; all of these millions of parents of autistic children are clueless!! I cannot even comprehend HOW YOU can compare Autism to mental retardation-ask any Pediatric Neurologist- THERE IS A BIG DIFFERENCE!!! LOOK at the facts...treat Autism as a pandemic! What other insult on the human body has afflicted so many children? Maybe...think twice of who writes the book...who finances the author...what agenda does that author have? Maybe, have an open mind...wasn't too long ago that our tobacco industry paid billions of dollars to hide the facts of cigarette smoke...and what did our government do about it? Did they SAY these companies were poisoning its citizens??? Or did it takes decades for the payoffs to be rescinded and the TRUTH to come out??

I would love for you to LIVE a day in my life...watch what my son has HAD to endure all of his life! ** But, I guess I will be considered another "KNUCKLEHEAD" and you will remain ANNOYED!!

Margaret Hutchison-Padron RN (yes, Frankie's daughter!!)

** I remember those early days......I lived on the West coast, she lives on the East coast. It was a very terrible time for her. I wrote her:
Ohh, Peggy.............I can't stop crying after reading your letter. It brings me home to all the terrible stuff done to Bryan and to you all......being in a class without a signing tutor for months........being in a class with an alleged pedophile for a year with no help from the school despite all the S/S of HIV. who used the same bathroom as the children did , who really really liked a classmate of Bryan's...etc.......Bryan and other children.taken out of class and put to work folding pizza boxes........and stuffing envelopes (to learn how to work....OMG). The days and nights you spent watching your child "go away".....and I wasn't there......no support from anyone except from me by phone.
I think it is very important for people--- esp those in our profession--- to experience a first hand knowledge of the devastation of autism.
I love you.........Mom

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NURSING and MEDICAL NEWS

(Reuters 5/19/09) - The U.S. Justice Department said on Monday that it and 16 states had joined two whistleblower lawsuits filed against Wyeth which allege the drugmaker failed to pay hundreds of millions of dollars in rebates to Medicaid. The lawsuits accuse Wyeth of giving hospitals steep discounts on the drugs Protonix Oral and Protonix IV, which reduce stomach acid, with the goal of winning the retail business of the same patients once they were released from the hospital.... http://www.reuters.com/article/healthNews/idUSTRE54H61S20090519?feedType=nl&feedName=ushealth1100
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Nurse Re-entry information Conditions and requirements for re-entering the nursing workforce differ for each state and vary according to the number of years a nurse has been considered inactive. In most states, nurses must undergo a refresher or re-entry program to re-qualify for licensure. If you are a former nurse considering returning to the workforce, first contact the licensing body in your state to confirm the specific requirements for re-entry. Information is available at the National Council of State Boards of Nursing. To locate refresher courses and re-entry programs in your region, visit http://sdm3.rm04.net/ctt?kn=16&m=2560130&r=MTY4MzkyMTc3MzgS1&b=0&j=NzI5ODUwOTQS1&mt=1&rt=0. For information on the Registered Nurse Re-Entry Program at Weber State University, visit www.weber.edu/.
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This article was originally in a Nursing magazine that made reference to a similar article in Newsweek. The article appeared in Newsweek on March 9, 2009. It tells about the real work that nurses do and Mr. Aldler writes about "the power of nursing". "The Nurse Will See You Now" www.newsweek.com/id/187004
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Nursing Gains a Voice at the Federal Level Nearly 10 weeks into her new job heading up the U.S. Health Resources and Services Administration, Mary K. Wakefield, RN, PhD, FAAN, is juggling many responsibilities: improving care for the disadvantaged and underserved across the country, distributing stimulus funds, and visibly providing the voice of nurses in the healthcare reform debate.... Http://www.nurse.com/
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Nurses' codes of ethics in practice and education: a review of the literature The purpose of this review was to provide an overview of the empirical literature on nurses' codes of ethics in practice and education covering the time from 1980 to August 2007. The focus was on methodological issues, main domains of interest and findings of the studies. The aim of the review was to identify knowledge gaps and to provide recommendations for further research. Research on the codes of ethics in nursing is scarce. The main domains of interest were education, nurses' knowledge and use of the codes, the content and functions of the codes, and moral behaviour and values related to the codes. Education of the codes was important, and it had a positive impact on students' moral behaviour measured by an instrument based on the codes. Nurses' knowledge and use of the codes was deficient.... .
Scand J Caring Sci; 2009; 23; 380-394 http://www.mdlinx.com/readArticle.cfm?art_id=2710526
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For the whole story, free registration The Bottom Line on Happiness While the CMS and hospitals continue to sharpen their focus on high patient-satisfaction scores, new research indicates there isn’t any correlation between how happy patients are and a hospital’s expenses and profitability, or mortality and complication rates. https://home.modernhealthcare.com/clickshare/authenticateUserSubscription.do?CSProduct=modernhealthcare&CSAuthReq=1:173348963480125:AIDIDAID=20090601/REG/905299991ID=:01BA5AC6525E9609B9E3024F6C3E0E3B&AID=20090601/REG/905299991&title=The%20bottom%20line%20on%20happiness&ID=&CSTargetURL=http%3A%2F%2Fwww.modernhealthcare.com%2Fapps%2Fpbcs.dll%2Fexec%3Fname%3DMHCPayPerArticleResponse%26nocache%3D1%26AssignSessionID%3D173348963480125%26AID%3D20090601%2FREG%2F905299991


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This is a review of NURSE JACKIE television series......by Sandy Summers June 8, 2009 -- Tonight's series premiere of Showtime's "dark comedy" Nurse Jackie is a brutal subversion of the unskilled angel stereotype. The first significant nurse-focused show to emerge from Hollywood in more than 15 years, Nurse Jackie may be the strongest--though not most positive--fictional TV portrayal of a modern nurse that we have ever seen. Jackie Peyton is a New York City ED nurse. Like esteemed TV physicians Greg House (Fox's House ) and John Carter (NBC's ER ), Jackie is a high-functioning drug addict. But she is also a tough, life-saving nurse who works at the center of patient care, and the show is unusually alert to what nurses experience.... http://www.truthaboutnursing.org/news/2009/jun/08_jackie.html

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INTERESTING READING

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

Bipolar patients often relapse: study (Reuters Health 5/18/09) Results of a study suggest that bipolar disorder has a high relapse rate. In the study, researchers found evidence that three fourths of the hospitalizations for treatment of bipolar disorder are repeat admissions.... http://www.reutershealth.com/archive/2009/05/18/eline/links/20090518elin026.html
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(Reuters 5/18/09) A study found that women smokers have lung damage earlier in life than men smokers and also can have reduced lung function with less smoking exposure than men. The lead researcher said anatomy, such as smaller airways, and hormones might play a role in the differences. ... http://www.reuters.com/article/healthNews/idUSTRE54H5UA20090518
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Acupuncture eases a side effect of radiation (Reuters 5/5/09) - When people with head or neck cancer are treated with radiation, a common side effect is dry mouth, and now researchers have shown that the problem can be relieved by acupuncture.
Excessive dryness of the mouth is technically termed xerostomia. Dr. Mark Chambers and colleagues from The University of Texas M. D. Anderson Cancer Center, Houston, conducted a pilot study to see if radiation-induced xerostomia resulting from radiation therapy for cancer in the head and neck region can be reversed using acupuncture.... http://www.reuters.com/article/healthNews/idUSTRE54467R20090505?feedType=nl&feedName=ushealth1100
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Acupuncture real or fake, helps aching backs: Study CHICAGO (Reuters 5/11/09) - Acupuncture brought more relief to people with back pain than standard treatments, whether it was done with a toothpick or a real needle, U.S. researchers said on Monday in a study that raises new questions about how acupuncture works.... http://www.reuters.com/article/healthNews/idUSTRE54A5QE20090511?feedType=nl&feedName=ushealth1100
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American Geriatrics Society (AGS 2009) Short-Term Opioid Therapy in Older Adults Effective, Non-addicting Elderly patients with chronic pain benefit from a short-term regimen of opioids, with little chance of overuse, according to geriatric researchers. A review of 35 studies found the treatment to be safe and effective at reducing pain and disability, even though it did decrease mental functioning. The study showed benefits regardless of the drug used; morphine was no more effective than a lower potency opioid.... http://www.medscape.com/viewarticle/702345
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Random tidbit: In most of the Middle and Far East, it is considered an insult to point your feet (particularly the soles) at another person or to display them in any way, for example, by resting with your feet up.
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LONDON (Reuters 5/19) - Instead of using a blood test to determine whether a man has prostate cancer, doctors might one day more accurately diagnose the condition using a new technique that measures a different compound, researchers said.... http://www.reuters.com/article/healthNews/idUSTRE54H6I820090519?feedType=nl&feedName=ushealth1100
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Brief counseling boosts breast self-exam rates (Reuters 5/4/09 ) - Women who take part in a quick counseling session on breast self-examination (BSE), reinforced with a couple of follow-up calls, are more likely to perform the exams regularly, new research in the journal Health Promotion shows.
http://www.reuters.com/article/healthNews/idUSTRE54403N20090505?feedType=nl&feedName=ushealth1100
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(Reuters 5/5/09) - The order in which vaccine injections are given affects infants' pain response, new research shows. During routine childhood immunization, infants given an injection of DPTaP-Hib vaccine before pneumococcal vaccine (PCV) experience less pain than those given the vaccines in the opposite order.... http://www.reuters.com/article/healthNews/idUSTRE54403920090505?feedType=nl&feedName=ushealth1100
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Random tidbit: In most Asian countries, a business card is seen as an extension of the person it represents; therefore, to disrespect a card -- by folding it, writing on it, or just shoving it into your pocket without looking at it -- is to disrespect the person who gave it to you.
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NEW YORK (Reuters Health 5/18/09) - Chemotherapy antidote may be lifesaving In cancer patients accidentally overexposed with the chemotherapy drug 5-fluorouracil (5-FU), the drug vistonuridine (Wellstat Therapeutics Corp) may be lifesaving, according to research to be reported June 1 at the American Society of Clinical Oncology's annual meeting in Orlando....
http://www.reuters.com/article/healthNews/idUSTRE54H5SP20090518?feedType=nl&feedName=ushealth1100
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RANDOM FACT The Baby Ruth candy bar was actually named after Grover Cleveland's baby daughter, Ruth.
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Breast cancer risk elements and nurse practitioners' knowledge, use, and perceived comfort level of breast cancer risk assessment - Excluding skin cancer, breast cancer is the leading cause of cancer and second leading cause of cancer death among women in the United States. Breast cancer risk assessment is important in identifying women who may be at high risk for developing the disease. At the front line in health care, NPs can play a vital role in assessing women's risk for breast cancer. Edwards QT et al. ... http://www3.interscience.wiley.com/journal/122371603/abstract?CRETRY=1&SRETRY=0
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RANDOM FACT The U.S. national anthem, the Star Spangled Banner, actually has four verses. Americans traditionally only sing the first verse.
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Outpatient management of asthma in children age 5–11 years: Guidelines for practice Watts B - Recent research has revealed that children suffering from asthma in the United States are underdiagnosed and their asthma is poorly controlled. Compelling evidence supports that children classified as having persistent asthma following NAEPP-EPR3 guidelines benefit from daily inhaled corticosteroid therapy, yet many are misclassified and undertreated.... http://www3.interscience.wiley.com/journal/122371598/abstract
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Defining Professionalism From the Perspective of Patients, Physicians, and Nurses Academic Medicine, 05/05/09 Green M et al. - This study demonstrates that it is possible and instructive to define professionalism in terms of tangible behaviors. Focusing on behaviors rather than attributes may facilitate discussion, assessment, and modeling of professionalism in both medical education and clinical care. ... http://journals.lww.com/academicmedicine/Abstract/2009/05000/Defining_Professionalism_
From_the_Perspective_of.11.aspx (please copy and paste this address)
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Infantile Botulism: Clinical Manifestations, Treatment, and the Role of the Nurse Practitioner

Abstract Clostridium botulinum, a toxin most commonly found in soil and honey products, is the main source of infantile botulism. Botulinum toxin is one of the most deadly substances that can attack the neuromuscular system, resulting in a wide range of sequelae. A high index of suspicion is crucial in promptly diagnosing and treating infantile botulism because of the potential for abrupt progression into respiratory failure. This article discusses the epidemiology, pathophysiology, and clinical manifestations of infantile botulism, as well as the valuable role the nurse practitioner plays in preventing this disease within the pediatric population.... http://www.npjournal.org/article/PIIS1555415509000427/abstract?rss=yes
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Chew More and Weigh Less Next time you grab a handful of nuts to snack on, count to 40. A recent study revealed that when people ate a small serving of almonds, 40 chews quelled hunger better than 10 or even 25 crunches of the same amount of nuts. The Magic Number Not only did the extra chews help curb hunger best, but also the feelings of fullness lasted longest when people gave the nuts the extra chews. And the practice may work with other foods, too, because researchers suspect it may simply be the mere act of chewing that switches on your brain’s satiety center.... http://www.realage.com/ct/eat-smart/food-and-nutrition/tip/8671
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Women Bullying Women at Work By MICKEY MEECE It's a taboo topic in the workplace sisterhood: Women who bully usually pick on other women.http://www.nytimes.com/2009/05/10/business/10women.html?th&emc=th

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New Roche drug helps shrink breast cancer tumors
ZURICH (Reuters 5/28/09) - A new drug from Roche Holding AG helped shrink the tumors of 25 percent of women with HER2-positive breast cancer, according to data from a mid-stage clinical trial, the Swiss company said on Thursday. ... http://www.reuters.com/article/healthNews/idUSTRE54R11Z20090528?feedType=nl&feedName=ushealth1100
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Information Number via GOOGLE
Thank you , Laregis @AOL.com (Laura) I did try this......and it works !!! What was reliable and free now cost a pretty penny to get someone at a call center that didn't have an up to date directory of the area in question and didn't know the territory from a hole in the ground. Didn't make a difference whether the personnel were actually in the US , Bombay or Brussels . FREE information calls from now on !Just leave it up to Google to come up with something like this!!!Here's a number worth putting in your cell phone, or your home phone speed dial:
1-800-goog411
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TIDBIT A history of the biohazard label.
http://www.shippinglabels.com/BIO/BioHazard_Symbol.asp
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The Role of Coping and Temperament in the Adjustment of Children with CancerJournal of Pediatric Psychology, 05/19/09 Miller KS et al. - Results partially support the utility of an integrated model including cancer-related stress, coping, and NA in identifying children at risk for internalizing symptoms during treatment. Additional research is needed to inform interventions for this population. ... http://jpepsy.oxfordjournals.org/cgi/content/abstract/jsp037
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RANDOM FACT Like fingerprints, everyone's tongue print is different.
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Predictors of Postpartum Depression: An Update
Nursing Research: September/October 2001 - Volume 50 - Issue 5 - pp 275-285 Articles
Background: Approximately 13% of women experience postpartum depression. Early recognition is one of the most difficult challenges with this mood disorder because of how covertly it is suffered.
Objectives: The purpose of this meta-analysis was to update the findings of an earlier meta-analysis of postpartum depression predictors that had synthesized the results of studies conducted mostly in the 1980s.... Http://journals.lww.com/nursingresearchonline/Abstract/2001/09000/Predictors_of_Postpartum_
Depression__An_Update.4.aspx (please copy and paste this address)
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Sent in by BAcello@AOL.com Barbara (thank you)
Red Flags Rule guidance published The Federal Trade Commission (FTC) published guidance April 7 to help organizations comply with the May 1 enforcement deadline on the Red Flags Rule, which forces facilities to implement a documented identity theft prevention program.The report offers four steps to complete compliance with the rule: Include reasonable policies and procedures to identify the "red flags" signaling potential identity theft; Design your program to detect red flags that you have identified;Spell out appropriate actions you'll take when you detect red flags; and Address how you will re-evaluate your program periodically Read the complete FTC report.http://www.ftc.gov/bcp/edu/pubs/business/idtheft/bus23.pdf
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Prospectively Validated Dosing Nomograms for Maximizing the Pharmacodynamics of Vancomycin Administered by Continuous Infusion in Critically Ill Patients Pea F et al. - Two dosing nomograms based on CLCr were created to target the vancomycin Css at 15 and 20 mg/liter in critically ill patients. These nomograms could be helpful in improving the vancomycin treatment of MRSA infections, especially in the presence of borderline-susceptible pathogens and/or of pathophysiological conditions which may enhance the clearance of vancomycin, while potentially avoiding the increased risk of nephrotoxicity observed with the use of high intermittent doses of vancomycin. ... http://aac.asm.org/cgi/content/abstract/53/5/1863
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RANDOM TIDBITS There are over 60 communities throughout the United States that have their own form of local currency. California has the most communities with their own currency, including many popular colleges like Berkeley and Santa Barbara. ***********
A quarter has 119 grooves on its edge, one more than a dime. The reason the mint started using ridges was to prevent counterfeit and devaluing of the coin.
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Protein may be key to preventing aneurysms: study
CHICAGO (Reuters 5/11/09) - There may be a way to prevent abdominal aortic aneurysms, dangerous bulges in the body's main artery that can kill suddenly and unexpectedly, U.S. scientists report ... http://www.reuters.com/article/healthNews/idUSTRE54A0Q620090511?feedType=nl&feedName=ushealth1100

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HUMOR SECTION
Subject: Children Writing About the Ocean...
1) - This is a picture of an octopus. It has eight testicles. (Kelly, age 6)

2) - Oysters' balls are called pearls. (Jerry, age 6)

3) - If you are surrounded by ocean, you are an island. If you don't have ocean all round you, you are incontinent. (age 7)

4) - Sharks are ugly and mean, and have big teeth, just like Emily Richardson. She's not my friend any more. (Kylie, age 6)

5) - A dolphin breaths through an asshole on the top of its head. (Billy, age 8)

6) - My uncle goes out in his boat with 2 other men and a woman and pots and comes back with crabs. (Millie, age 6)

7) - When ships had sails, they used to use the trade winds to cross the ocean. Sometimes when the wind didn't blow the sailors would whistle to make the wind come. My brother said they would have been better off eating beans. (William, age 7)

8) - Mermaids live in the ocean. I like mermaids. They are beautiful and I like their shiny tails, but how on earth do mermaids get pregnant? (Helen, age 6)

9) - I'm not going to write about the ocean. My baby brother is always crying, my Dad keeps yelling at my Mom, and my big sister has just got pregnant, so I can't think what to write. (Amy, age 6)

10) - Some fish are dangerous. Jellyfish can sting.. Electric eels can give you a shock. They have to live in caves under the sea where I think they have to plug themselves in to chargers. (Christopher, age 7)

11) - When you go swimming in the ocean, it is very cold, and it makes my willy small. (Kevin, age 6)

12) - Divers have to be safe when they go under the water. Divers can't go down alone, so they have to go down on each other. (Becky, age 8)

13) - On vacation my Mom went water skiing. She fell off when she was going very fast. She says she won't do it again because water fired right up her big fat ass. (Julie, age 7)

14) - The ocean is made up of water and fish. Why the fish don't drown I don't know. (Bobby, age 6)
15) - My dad was a sailor on the ocean. He knows all about the ocean. What he doesn't know is why he quit being a sailor and married my mom. (James, age 7)

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Are You Prepared for a H1N1 (Swine) Flu Pan… CE566
Cholesterol — The Good, the Bad, and the… CE337-60
How To Stay Safe While Administering Chemot… CE554
Novice to Expert: Through the Stages to Suc… CE556
Aging Immune Systems Makes Older Adults Mor… CE494

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

Click here: Dismantling the Arguments of the Hospital Industry Against a Minimum Safe Standard of Care

Click here: Internal and External Urinary Catheters: A Primer for Clinical Practice Ostomy Wound Management

http://www.solutionsoutsidethebox.net/

This website (for registering the CELL PHONES) was sent in by Laregis@AOL.com (Laura) who sends in a prodigious amount of articles for the Newsletter. Thank you !
https://www.donotcall.gov/

The Cochrane Mural....Check out the horse's eye.
http://www.muralmosaic.com/Cochrane.html

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

The National Nurse's new website: http://nationalnurse.org/

Any time you want to check a rumor ... this is the link:
http://www.snopes.com/


This site has passed the Snopes.com test
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3


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MEDICAL RECALLS
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You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm

Respironics, Inc. SmartMonitor 2 Infant Apnea Monitor, Models 4002 and 4003 Respironics and FDA notified healthcare professionals of a Class I recall of SmartMonitor 2 Infant Apnea Monitor, Models 4002 and 4003, used for the continuous monitoring of respiration and heart rate of infant patients in the home or in the hospital. The monitors may fail to sound an alarm during periods of temporary interruption of breathing or low heart rates. The affected products were manufactured from January 16, 2008 through November 13, 2008 and distributed from January 17, 2008 through December 31, 2008. http://www.fda.gov/medwatch/safety/2009/safety09.htm#SmartMonitor
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Antiepileptic Drugs FDA notified healthcare professionals that it approved updated labeling for antiepileptic drugs used to treat epilepsy, psychiatric disorders, and other conditions (e.g., migraine and neuropathic pain syndromes).... http://www.fda.gov/medwatch/safety/2008/safety08.htm#Antiepileptic
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A Food and Drug Administration report released Wednesday recommends stronger warnings and dose limits on drugs containing the painkiller acetaminophen, citing an increased risk of liver injury. ...
The recommendations also call for limiting the maximum adult daily dose to no more than 3,250 milligrams. The current recommendation stands at 4,000 milligrams per day. Other recommendations include limiting tablet strength for immediate release formulations and limiting options in liquid formulations for children. http://hosted.ap.org/dynamic/stories/U/US_FDA_ACETAMINOPHEN_WARNING?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2009-05-27-17-58-32
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Simponi (golimumab) Centocor Ortho Biotech and FDA reminded healthcare professionals of the risk of serious fungal infections associated with TNF-αlpha blockers, including Simponi [golimumab]. FDA has reported that histoplasmosis and other invasive fungal infections are not consistently recognized in patients taking other TNF-αlpha blockers including Cimzia (certolizumab pegol), Enbrel (etanercept), Humira (adalimumab), and Remicade (infliximab). This has resulted in delays in appropriate antifungal treatment, sometimes even resulting in death. It is important that all adverse events potentially associated with Simponi be reported so that the adverse event profile reported in the prescribing information can be updated appropriately as post-approval experience is gathered. Centocor encourages reporting adverse events to Centocor at 1-800-457-6399 or to the FDA MedWatch program at 1-800-332-1088. ... http://www.fda.gov/medwatch/safety/2009/safety09.htm#Simponi
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Digoxin, USP 0.125 mg, Digoxin, USP 0.25 mg (Caraco brand) [UPDATED 05/12/2009] AS Medication Solutions, LLC, a drug repackage company, announced today that all tablets of Caraco brand Digoxin, USP, 0.25 mg, distributed prior to March 31, 2009, which are not expired and are within the expiration date of August, 2011, are being voluntarily recalled to the consumer level. The tablets are being recalled because they may differ in size and therefore could have more or less of the active ingredient, digoxin. Caraco Pharmaceutical Laboratories, Ltd manufactured the recalled tablets. The recalled product is a scored round biconvex white tablet imprinted with “441”, with an NDC number of 54569-5758-0 (30-count). Consumers with the product that are within expiration should return these products to their pharmacy or place of purchase.... http://www.fda.gov/medwatch/safety/2009/safety09.htm#Digoxin
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Fun Express Water-based Face Paints for Children FDA is notifying consumers and healthcare professionals of the recall of cosmetic “Face Paint” items labeled as distributed by Oriental Trading Co., Omaha, Neb., due to adverse event reports of skin reactions in children, including rashes, itchiness, burning sensation, and swelling where the face paints were applied. All exposures occurred on the same day at an organized event in children exposed to various colors of the face paint. Significant microbial contamination was indicated in most of the products in testing by an FDA laboratory. These items were distributed nationwide. See the News Release for a listing of affected products.... http://www.fda.gov/medwatch/safety/2009/safety09.htm#Paints

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NURSING HINTS CORNER Will be back next issue
Handy Hints.........
Handy Hint: to keep boiling eggs from cracking, here's a tip from a book published in the 1940s, and it works every time.Take a pin and pierce the shell of the rounded end of each egg. With a perforated spoon, lower them into water boiled with a few drops of vinegar.Also, to keep the yolks from getting a black covering, bring the water back to a boil after adding the eggs, then turn down to a bare simmer for 20 minutes. When done, cool them in the pan with cold water and ice cubes. They'll cool fast and you'll get perfect eggs every time. Use a hand potato masher to make egg salad.

About the ink stain in the dryer, hair spray will help take ink off clothing. The best thing to remove ball point ink is rubbing alcohol. It will also remove permanent marker ink from smooth surfaces if the ink is fairly fresh.

Concerning ink in the dryer. I used a little WD40 on a rag, and a little denatured alcohol for the stubborn spots. Then I cleaned the drum with Windex. (I did not write this article)WARNING: be sure to allow the dryer to air out for a couple of hours as denatured alcohol is flammable. The fumes will dissipate after an hour or so. This may seem extreme, but so is ink in the drum!

Handy Hints Unclog your drains almost instantly! Drop a couple of Alka-Seltzer tablets down the opening, then pour in a cup of vinegar. Wait a few minutes and then run the hot water at full force to clear the clog. This is also a good way to eliminate kitchen drain odors. (This works !)
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ADVERTISEMENTS from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford. By using the following code: Paradigm10 , you will get 10% off of their first order. ( I have ordered through Gerry...and it was very satisfactory. )
Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
No new members this issue Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
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NOTICE:
I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.......lol So please send me your new name/address, ok? RNFrankie@AOL.com
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
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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 v
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THOUGHT FOR THE DAY

"Health is not only to be well, but to use well
every power we have."
Florence Nightingale, 1893


Hope to see you online or hear from you---write me..... Frankie

RNFrankie@AOL.com