PARADIGM BYTES
Newsletter for Paradigm 97
November 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/ 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
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)
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.
***~~~***~~~***~~~***
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
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.
~~~~~~~~~~~~~~
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
~~**~~**~~**~~**~~**~~
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
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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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
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
***********************
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
*****************
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.
"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.
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
**********************
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
************************
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
****************
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.)
*****************
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
***********************
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
**********************
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
************************
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
***************************
RANDOM FACT The average human head has about 100,000 hairs
**********************
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
*****************
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
***********************
RANDOM FACT Drunk driving causes approximately one-third of all traffic fatalities in the United States.
***************
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
***************
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
********************
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
*************************
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
********************
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 .
******************
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
**********************
RANDOM FACT The average cat sleeps about 2/3 of the day
~~**~~**~~**~~**~~**~~
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.
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
*****************
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
***********************
RANDOM FACT Drunk driving causes approximately one-third of all traffic fatalities in the United States.
***************
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
***************
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
********************
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
*************************
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
********************
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 .
******************
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
**********************
RANDOM FACT The average cat sleeps about 2/3 of the day
~~**~~**~~**~~**~~**~~
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'?'
\\\\\\\\\\\\\\\\\\\\\\\
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/ !
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
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/ !
~~**~~**~~**~~**~~**~~
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
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:
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:
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?
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/
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.
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
***********************
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
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
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)
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.
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.
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.
