Tuesday, August 9, 2011

PARADIGM BYTES August 2011

PARADIGM BYTES
Newsletter for Paradigm 97
August 10,2011

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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SNIPPETS

Loretta Ford, a pioneer in shaping the role of Nurse Practitioners. In 1965, nurse leader Loretta Ford collaborated with physician Henry Silver in developing a model for the pediatric nurse practitioner with a focus on health and wellness. Their first training program aimed to ensure the NP was competent, safe and acceptable to patients. Since then, Ford has seen the number of NPs grow to 150,000 in the U.S. Nurse.com
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Lystra Gretter: Public Health Advocate and Professional Reformer
By David Yates
http://www.truthaboutnursing.org/press/pioneers/lystra_gretter.html When Lystra Eggert Gretter was inducted into the Michigan Women's Hall of Fame in 2004, she was honored for her "tireless" efforts in promoting nursing as a respectable profession in the late 19th and early 20th centuries. Gretter made many contributions to nursing. She shifted the model of nursing education from a one-year apprenticeship to a three-year academic pursuit. She created nurse-run hospital wards instead of allowing nursing students to run them. Gretter cut the work day to 8-hour shifts, to afford nurses and students more time to study and recreate. She wrote what is believed to be the first standardized textbook for nursing education and created one of the first professional nursing libraries. And Gretter was a founding member, at the end of the 19th Century, of groups that later became the American Nurses Association and the National League for Nursing. She established an early visiting nurses association. Noting that the public perception of nursing was that of "women's work," Gretter lobbied for more political power, including aligning nursing with suffragettes who sought the vote. And Gretter was "the moving spirit behind the creation of "The Florence Nightingale Pledge," an oath of ethics that many graduating nursing students still make today. Gretter also worked to advance public health generally. She established tuberculosis hospitals, lobbied for in-home nursing care and became a vocal public health advocate for Detroit's burgeoning poor and immigrant population. She also successfully introduced the first state-wide health inspections of school children and a free maternity/infant care clinic in Detroit. ...
http://www.truthaboutnursing.org/press/pioneers/lystra_gretter.html

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FROM THE MEMBERS

Check out Wendie's website........and support her endeavor !

The journal of nurse life care planning for June 2011 is up and available at www.AANLCP.org. Check it out, and the back issues too! Next issue is Sept ... Please let everyone know!
Wendie Howland, Editor (whowland@howlandhealthconsulting.com) ~~**~~**~~**~~**~~**~~
MEDICAL NEWS
HHS Proposes Changes to HIPAA Privacy Rule The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is proposing changes to the Health Insurance Portability and Accountability (HIPAA) Act Privacy Rule regarding the accounting of disclosures requirement. Pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act, the proposed rule would give people the right to get a report on who has electronically accessed their protected health information.
According to HHS, the proposed rule is an important step in promoting accountability across the health care system by ensuring that providers properly safeguard private health information. ...
http://www.mcnhealthcare.com/2011/06/01/hhs-proposes-changes-to-hipaa-privacy-rule
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INTERESTING READING

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

**Starting with this issue, I am inserting excerpts from an article "99 ways to save money". Hope you enjoy them. **

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Diabetes survey finds few follow through on lifestyle changes
A survey of 3,867 people with type 2 diabetes found that 87% knew obesity made their disease worse but only 70% said they had tried to lose weight, and only a third had maintained their goal weight for half a year. Researchers who reported the results at the American Diabetes Association conference found that 63% of people said their physician recommended they increase physical activity, but only 13% said they had been active during the past week. ... http://diabetes.webmd.com/news/20110629/survey-diabetes-patients-dont-change-lifestyle
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Archimedes' nasal-spray version of fentanyl gets FDA Okay The FDA approved Archimedes Pharma's fentanyl nasal spray Lazanda to relieve breakthrough pain in opioid-tolerant cancer patients aged 18 and older. It is indicated for patients aged 18 years and older who are already receiving opioid therapy but who have developed resistance to their regimen.Archimedes expects to launch the product this year through the FDA's Risk Evaluation and Mitigation Strategy program.
Fentanyl nasal spray is already available in 5 European countries, where it is marketed as PecFent (fentanyl pectin nasal spray).

"Lazanda is an important new option for patients with cancer who experience excruciating breakthrough pain," said Jeffrey H. Buchalter, chief executive officer of Archimedes Pharma, the manufacturer of the drug. ... http://www.medscape.com/viewarticle/745673
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Do not buy products made of palm oil! Palm oil plantations are replacing large areas of rainforest in many countries including Malaysia and Indonesia. Further, palm oil may increase the risk of cardiovascular disease due to the high concentration of saturated fats.


Palm Oil is a seed crop grown in many parts of the world, the majority being in Malaysia and Indonesia. It is a form of edible vegetable oil used in many food and non-food industries, including but not limited to, cookies, crackers, popcorn, frozen dinners, low-fat dairy, candy, soap and cosmetics. More recently, it has been used in biofuels.

Orangatans are found exclusively on the Indonesian islands of Borneo and Sumatra. The biggest threat to orangatans in the wild is from illegal logging of trees. The demand for palm oil is high and as a result these plantations are destroying the orangutan's natural habitat.

Sustainable yield palm oil is very important to the livelihood of millions of people in Indonesia. But when it is produced NON-sustainably, thousands of orangutans perish each year, due to clear cutting of rainforests and uncontrolled burns.

It's estimated an area the size of three football fields is cut down every day, displacing forest residents - including the already endangered orangatan.
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#1 Master the stick.....cars and trucks with stick shifts typically get two to five more miles/ gallon than those w' automatic transmissions according to Consumer Reports. They can cost $800 to $1,200 less in teh first place, and they need fewer and less expensive brake and transmission repairs.
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The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health (NIH), has an active and wide-ranging research portfolio in women's health. Research projects that focus on women's health issues are conducted and supported by the Institute's various Centers, Divisions, and Branches.

This site brings together a variety of information about women's health topics, and about ongoing research projects funded by and carried out by the NICHD that are related to these topics. ... http://www.nichd.nih.gov/womenshealth/ ;
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The Best Hospitals: What They Have in Common, What Makes Each Unique
By Jennifer Larson, contributor
July 29, 2011 - Every year, the U.S. News Media Group publishes a list of the top hospitals in the country, by medical specialty and by region, in U.S. News & World Report. As in previous years, the recently released 2011-2012 Best Hospitals rankings also spotlight the elite hospitals, with 17 listed on this year’s Honor Roll—the best of the best. ... http://www.nursezone.com/nursing-news-events/more-news.aspx?articleid=37486
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RANDOM FACT: To keep the unemployment rate steady at 9.6%, the US economy needs to create 100,000 jobs per month. This assumes average population growth of 1% and a flat labor force participation rate.
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Blood test targets oncology treatment Circulating tumor cell analysis may predict oncology patients' survival Oncology clinicians are testing a new tool to help determine patients' response to treatment, evaluate prognosis and make better-informed decisions — The CellSearch Circulating Tumor Cell Test.

"The value of counting circulating tumor cells is emerging, and its benefit is that it, hopefully, will be a biomarker for metastatic prostate cancer," said Anthony DeLaCruz, NP, MSN, OCN, a research nurse on the CTC numeration trial team at Memorial Sloan-Kettering Cancer Center in New York City. "The data to date that's been presented indicates changes in CTC count can predict overall survival and the patient's response to a particular treatment." ... http://news.nurse.com/article/20110725/NATIONAL01/307250018
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Johnson & Johnson said that it's reducing the maximum daily dose of its Extra Strength Tylenol pain reliever to lower risk of accidental overdose from acetaminophen, its active ingredient and the top cause of liver failure. (Maximum daily intake is 4 G)
(AP) -- The company's McNeil Consumer Healthcare Division said the change affects Extra Strength Tylenol sold in the U.S. - one of many products in short supply in stores due to a string of recalls. ... http://hosted.ap.org/dynamic/stories/U/US_TYLENOL_DOSING_CHANGE?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2011-07-29-03-29-07
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#81 Penny-wise superfoods... What foods give you the most vitamins and minerals for the least money? In descending order, the best vegetables are cabbage, collard greens, mustard greens, turnip greens, and carrots. Top fruits are watermelon, plums, oranges, apples, and strawberries.
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Screening has little impact on breast cancer deaths: study LONDON (Reuters) - Falling breast cancer death rates have little to do with breast screening but are down to better treatment and health systems, scientists said on Friday, in a study likely to fuel a long-running row over the merits of mammograms.
Researchers analyzed data from three pairs of countries in Europe and found that although breast cancer screening programs had been introduced 10 to 15 years earlier in some areas than in others, declines in death rates were similar.
The findings suggest that "improvements in treatment and in the efficiency of healthcare systems may be more plausible explanations" for falling deaths rates from breast cancer, they wrote in a study in the British Medical Journal. ... http://www.reuters.com/article/2011/07/29/us-cancer-breast-screening-idUSTRE76R7XR20110729?feedType=nl&feedName=ushealth1100
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Individual face-to-face support and quality of life in patients with breast cancer
Living with breast cancer significantly affects women's quality of life (QOL) creating a need for support that might persist throughout the breast cancer experience. The aim of this study was to assess the effect of individual face-to-face support on women's QOL and identify factors associated with their QOL. A two-group quasi-experimental design was used with a sample of 204 women who was assigned to the intervention (n = 112) or the control group (n = 92) in hospital after breast cancer surgery. ...

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-172X.2011.01948.x/abstract;jsessionid=DCD33A919F03FC2E808609ABF71D9CD4.d02t01?systemMessage=Wiley+Online +Library+will+be+disrupted+6+Aug+from+10-12+BST+for+monthly+maintenance
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Flu "super antibody" may bring universal shot closer (Reuters) - Scientists have found a flu "super antibody" called FI6 that can fight all types of influenza A viruses that cause disease in humans and animals and say their discovery may be a turning point in the development of new flu treatments.

Researchers from Britain and Switzerland used a new method aimed at beating "needle-in-a-haystack-type-odds" and managed to identify an antibody from a human patient which neutralizes both main groups of influenza A viruses. ... http://www.reuters.com/article/2011/07/28/us-flu-antibody-idUSTRE76R65F20110728?feedType=nl&feedName=ushealth1100
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Rethinking what is edible....
When most people think of healthy foods, they think of choices like colorful kiwi fruit and pineapple, perfectly juicy oranges, and bright, fresh broccoli and squash. Of course, missing from that picture are the parts of those superfoods that you may often discard, such as the skin of the kiwi and the hard core of the pineapple. But before you toss out these food parts, dietitians say, it’s time to reconsider what you’re cutting away. Many of these pared-off parts of fruits and veggies are positively brimming with antioxidants, and eating them can boost your health. ... Page 1 of 8
http://www.everydayhealth.com/diet-and-nutrition-pictures/rethinking-whats-edible.aspx?xid=aol_eh-nutr_1-_20110613&aolcat=DFT&ncid=webmail5
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(I find it very hard to accept "normal" patient to nurse levels in states such as Florida which are 7+ to 1 while California nurses are 5 to 1 !!!)
Contradicting Fears, California's Nurse-to-patient mandate did not reduce the skill level of the nursing workforce in Hospitals.
Matthew D. McHugh, Lesly A. Kelly, Douglas M. Sloane, and Linda H. Aiken

When California passed a law in 1999 establishing minimum nurse-to-patient staffing ratios for hospitals, it was feared that hospitals might respond by disproportionately hiring lower-skill licensed vocational nurses. This article examines nurse staffing ratios for California hospitals for the period 1997–2008. It compares staffing levels to those in similar hospitals in the United States. We found that California’s mandate did not reduce the nurse workforce skill level as feared. Instead, California hospitals on average followed the trend of hospitals nationally by increasing their nursing skill mix, and they primarily used more highly skilled registered nurses to meet the staffing mandate. In addition, we found that the staffing mandate resulted in roughly an additional half-hour of nursing per adjusted patient day beyond what would have been expected in the absence of the policy. Policy makers in other states can look to California’s experience when considering similar approaches to improving patient care. ... http://content.healthaffairs.org/content/30/7/1299.abstract
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RANDOM FACT: The number of atoms in a pound of iron is nearly five trillion trillion: 4,891,500,000,000,000,000,000,000 (this is something we all needed to know)
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Do tea, coffee drinkers have lower 'superbug' risk?

NEW YORK (Reuters Health) - People who regularly drink tea or coffee may be less likely to carry the antibiotic-resistant "superbug" MRSA in their nostrils, a new study suggests.

Researchers found that of more than 5,500 Americans in a government study, those who drank hot tea or coffee were about half as likely as non-drinkers to harbor MRSA bacteria in their nostrils.
A small segment of the population -- about one percent -- carries MRSA in the nose or on the skin but does not get sick.

For the new study, reported in the Annals of Family Medicine, researchers looked at whether coffee or tea drinkers were any less likely than other people to harbor MRSA in the nose.

The idea for the study came from the fact that, in both the lab dish and in humans, topically applied or inhaled tea extracts have shown some anti-MRSA activity, explained lead researcher Dr. Eric M. Matheson, of the University of South Carolina, Charleston.

Less research has been done on coffee compounds, he told Reuters Health, but there is some evidence of antibacterial powers there as well. ...
http://www.fox43.com/lifestyle/sns-rt-us-coffee-superbugtre76d424-20110714,0,1624574.story
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Copper kills 97 percent of Hospital ICU bacteria: study
(Reuters) - Antimicrobial copper surfaces in intensive care units (ICU) kill 97 percent of bacteria that can cause hospital-acquired infections, according to preliminary results of a multisite clinical trial in the United States.
The results also showed a 40 percent reduction in the risk of acquiring an infection.
The study, presented at the World Health Organization's 1st International Conference on Prevention and Infection Control (ICPIC) in Geneva, Switzerland, on Friday, backed what research teams at three U.S. hospitals suggested four years ago: replacing the most heavily contaminated touch surfaces in ICUs with antimicrobial copper will control bacteria growth and cut down on infection rates.
Hospital-acquired infections (HAIs) are the fourth leading cause of death in the United States behind heart disease, strokes and cancer. ...

http://www.reuters.com/article/2011/07/01/us-copper-antimicrobial-idUSTRE76031820110701?feedType=nl&feedName=ushealth1100
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Healthy Lifestyle Cuts Women's Sudden Cardiac Death Risk by 92%
By: MARY ANN MOON, Internal Medicine News Digital Network Middle-age and older women who avoid smoking, exercise regularly, follow a healthy diet, and maintain a healthy weight cut their risk of sudden cardiac death by 92%, compared with those who do not, according to a report in the July 6 JAMA.
If it is assumed that these four factors – smoking, lack of exercise, a poor diet, and obesity – play a causal role in sudden cardiac death (SCD), then approximately 80% of these deaths are preventable among women without diagnosed coronary heart disease, said Stephanie E. Chiuve, Sc.D., of the division of preventive medicine, Brigham and Women’s Hospital, Boston, and her associates. ... http://www.internalmedicinenews.com/newsletter/internal-medicine-news-e-newsletter/singleview40731/healthy-lifestyle-cuts-women-s-sudden-cardiac-death-risk-by-92/bde0adea93.html
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ABSTRACT: Addressing Men and Gender Diversity in Education: A Promising Solution to the HIV/AIDS Epidemic

DOI: 10.1080/07399332.2010.532577

Amir Biglar Beigi Ghajarieh & Karen Yip Cheng Kow
pages 314-327

To date, researchers investigating gender in relation to social issues underscore women and appear to sideline men. Focusing on women in studies concerning sociogender issues may exclude not only men from mainstream research, but also those who do not fit into the binary gender system, including gay, lesbian, bisexual, and transgender (GLBT) people. One area closely related to gender issues is the HIV epidemic. Mainstream discussions of men and other versions of masculinity and femininity including GLBT people in the gender-related studies of the HIV epidemic can decrease the vulnerability of individuals against HIV infections regardless of their biological sex. ... ( one copy : $34.00) http://www.tandfonline.com/doi/abs/10.1080/07399332.2010.532577

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Environment, not just genetics, at play in autism (Reuters) - Environmental factors may play a greater role in autism than previously thought, tipping the scale away from a strict focus on genetics, two studies released on Monday suggest.
In one, a team at Stanford University compared cases of autism in identical and fraternal twins and found that fraternal twins -- who share only half of the same genes -- have unusually high rates of autism, suggesting that factors other than genetics may be triggering the disease.
In another, researchers at health insurer Kaiser Permanente found mothers of children with autism were twice as likely to have been prescribed a common antidepressant during the year before their pregnancy than mothers of healthy children.
And the risk was even greater -- a threefold increase -- when the drug was taken in the first trimester of pregnancy.
The findings, released in the Archives of General Psychiatry, suggest that something in the birth environment -- drugs, chemicals or infections -- may be triggering autism in children who are already genetically predisposed to develop the disease. ...

http://www.reuters.com/article/2011/07/05/us-autism-environment-idUSTRE7634Y220110705?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Citrus Red No. 2 is often used to give Florida oranges their bright color. This dye has also been banned in food processing because studies have shown that it causes cancer.
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RANDOM FACT: More than 90 percent of samples of consumer apples, peaches, nectarines, and strawberries tested positive for detectible pesticides, even after being rinsed or peeled. (Yee Gods and little fishes...what next?)
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(The following article requires registration, take it from me, it was free and painless)

Guidelines for treating bladder cancer are largely ignored,
according to a study showing that only 1% of providers delivered the full gamut of recommended care to at least one patient in their practice. Guidelines for treating bladder cancer are largely ignored, according to a study showing that only 1% of providers delivered the full gamut of recommended care to at least one patient in their practice.

Only one bladder cancer patient out of 4,545 received the full number of recommended cystoscopies and cytologies as well as intravesical chemotherapy and immunotherapy, Karim Chamie, MD, MSHS, of the University of California Los Angeles, and colleagues found.

These results from the national Surveillance, Epidemiology and End Results (SEER) database linked with Medicare claims were reported online in Cancer. ... http://www.medpagetoday.com/HematologyOncology/OtherCancers/27501
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Once-daily AIDS pill can slash HIV infection risk
(Reuters) - AIDS drugs designed to treat HIV can also be used to reduce dramatically the risk of infection among heterosexual couples, two studies conducted in Africa showed for the first time on Wednesday.
The findings add to growing evidence that the type of medicines prescribed since the mid-1990s to treat people who are already sick may also hold the key to slowing or even halting the spread of the sexually transmitted disease.
The research involving couples in Kenya, Uganda and Botswana found that daily AIDS drugs reduced infection rates by an average of at least 62 percent when compared with placebo. ...
http://www.reuters.com/article/2011/07/13/us-aids-prevention-idUSTRE76C1TL20110713?feedType=nl&feedName=ushealth1100
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China downplays risk to children from lead poisoning: report (Reuters) - Chinese children suffering lead poisoning from polluting smelters and factories have been denied testing, effective treatment and even basic information by officials who downplayed health threats, a human rights advocacy group said on Wednesday.
The report from Human Rights Watch comes after China's latest lead pollution outbreak, when 103 children and scores of adults were poisoned by tinfoil-making workshops in eastern Zhejiang province. ...

http://www.reuters.com/article/2011/06/15/us-china-lead-pollution-idUSTRE75E14O20110615?feedType=nl&feedName=ushealth1100
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Pfizer, BI inhaler may raise risk of death: study
(Reuters) - A mist inhaler used to improve breathing in people with lung diseases including chronic bronchitis and emphysema may increase their risk of dying by 52 percent, U.S. and British researchers said on Tuesday.
The increased risk occurred in patients who used the Spiriva Respimat inhaler, a newer device sold by privately held Boehringer Ingelheim (BI) and Pfizer. It delivers a soluble form of Spiriva, known generically as tiotropium. ... http://www.reuters.com/article/2011/06/15/us-inhaler-deaths-idUSTRE75D6YC20110615?feedType=nl&feedName=ushealth1100
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This was sent in by BAcello (Barbara) Thank You.

Can In-Hospital Falls Really Be Prevented?

Study shows that current prevention strategies may not be very effective
ROSEMONT, Ill., July 6, 2011 /PRNewswire-USNewswire/ -- While falls are a common cause of injury, particularly in older, hospitalized patients, some may not be as preventable as once thought. According to a new literature review published in theJournal of the American Academy of Orthopaedic Surgeons (JAAOS), many of the risks that frequently cause falls are not adequately addressed with the fall prevention initiatives used in healthcare facilities.
Falls are the leading cause of fatal and nonfatal injuries to older people in the United States. Each year, more than 11 million people older than 65 years of age fall-one in three senior citizens.

In hospitals, approximately 3 to 20 percent of inpatients fall at least once during their stay. These falls are considered "preventable" by the Centers for Medicare & Medicaid, and therefore healthcare facilities are held accountable for the costs of treating any resulting injuries. However, in this literature review, the authors found that hospitals may not be able to prevent most falls, as many risk factors are not under the caregivers' direct control. ... http://www.fiercehealthcare.com/press-releases/can-hospital-falls-really-be-prevented
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RANDOM FACT: In a 2004 poll, 12 percent of respondents confessed to having sex in the workplace, while another 10 percent said they have fantasized about it.
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The National Quality Forum in June proposed an updated version of its list of serious reportable events, such as medication errors that kill or gravely injure patients. Hospitals in 24 states and the District of Columbia are required to report on some version of the National Quality Forum's list, and items from the list have been selected for nonpayment by private health plans, Medicare and many state Medicaid programs.
Four new items -- part of the first update to the list since 2006 -- are:

Death or serious injury of a neonate associated with labor or delivery in a low-risk pregnancy.
Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen (e.g., for a biopsy).
Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology or radiology test results.
Death or serious injury of a patient or staff associated with the introduction of a metallic object into the magnetic resonance imaging area.

The list now contains 29 serious reportable events.
"Our objective is to identify important events that need to have some light shined on them so action is taken, because they're resulting in patients being seriously harmed or dying," said Janet M. Corrigan, PhD, president and CEO of the National Quality Forum, a standards-setting organization that counts the American Medical Association as one of hundreds of members. "The intent in encouraging public reporting is to promote actions that result in safer systems so it doesn't happen again." http://www.ama-assn.org/amednews/2011/06/27/prsa0627.htm
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Most tumors not within cell phone radiation range Reuters Health) - Brain tumors among cell phone users are not clustered within range of most of the radiation emitted from the devices, a new report finds - suggesting that mobile phones do not cause cancer.
Moreover, people who had used mobile phones for the longest amount of time, and spent the most time on the phones, were no more likely to experience tumors located within 5 centimeters of the phone, where "90 percent of the radiation" is emitted, study author Dr. Suvi Larjavaara from the University of Tampere in Finland told Reuters Health.
These findings appeared as the World Health Organization announced that, upon review of available scientific evidence, cell phones should be classified as "possibly carcinogenic." ...
http://www.reuters.com/article/2011/06/15/us-cellphone-tumors-idUSTRE75E59Y20110615?feedType=nl&feedName=ushealth1100
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Myth #1: Bulk coffee
at the grocery store is the best product to buy.
Oxygen and bright light are the worst flavor busters for roasted beans. Unless the store is conscientious about selling fresh coffee, the storage tubes can get coated with coffee oils, which turn rancid, so be wary of bulk coffee from supermarket display bins. Your best bet to get the absolute freshest beans is to buy from a local roaster (or roast your own). At the grocery store, opt for coffee beans packaged by quality-conscious roasters and sold in sturdy, vacuum-sealed bags.

Myth #2: The best place to store your coffee is in the freezer or refrigerator.

Roasted beans are porous and readily take up moisture and food odors, so the refrigerator is one of the worst places to store coffee. Flavor experts strongly advise against ever freezing coffee, especially dark roasts. Optimally, buy a 5- to 7-day supply of fresh beans at a time and keep at room temperature in an airtight container.

Myth #3: Pre-ground beans taste just as good as if you ground your own coffee.

Coffee starts losing quality almost immediately upon grinding. The best-tasting brews are made from beans ground just before brewing.

Myth #4: Distilled water is the best water for brewing coffee.

Softened or distilled water makes terrible coffee—the minerals in good water are essential. Also bad? Tap water with chlorine or off flavors. Serious coffee lovers use bottled spring water or activated-charcoal/carbon filters on their taps.

Myth #5: The type of coffee filter you use doesn’t matter.

Bargain-priced paper coffee filters yield inferior coffee, according to the experts. Look for “oxygen-bleached” or “dioxin-free” paper filters. Alternatively, you may wish to invest in a long-lived gold-plated filter.

Myth #6: Boiling water is the perfect temperature for brewing coffee.

Beware the heat. Water that is too hot will extract compounds in the coffee that are bitter rather than pleasant. The proper brewing temperature is 200°F, or about 45 seconds off a full boil. (Most good coffeemakers regulate this automatically.)

Myth #7: A French press is a better way to brew coffee than drip coffee makers.

Not if you’re concerned about your health. Boiled or unfiltered coffee (such as that made with a French press, or Turkish-style coffee) contains higher levels of cafestol, a compound that can increase blood levels of LDL ("bad") cholesterol. Choose filtered methods instead, such as a drip coffee maker.

http://www.huffingtonpost.com/eatingwell/7-coffee-myths_b_911913.html
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RANDOM FACT: If just 25 percent of U.S. families used 10 fewer plastic bags a month, we would save over 2.5 billion bags a year.

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Experts find rogue stem cells in liver cancer
(Reuters)
- Liver cancers are embedded with a type of super cancer stem cells that make them resistant to chemotherapy, spread to other body parts and stage a comeback even after they are surgically removed, researchers in Hong Kong reported on Thursday.
The discovery, published this week in the journal Cell Stem Cell, is important because it means experts can target these stem cells in their fight against liver cancer, a major blight in China and southeast Asia.
These cancer stem cells have a unique surface protein called CD24 and patients with high counts of CD24 tend to have poorer chances of survival, said lead researcher Irene Ng, pathology professor and director of the State Key Laboratory for Liver Research at the University of Hong Kong.
"CD24 is like a button, a switch on some cancer stem cells. Once they are switched on, they activate a protein in the cell called STAT3," Ng told a news conference. ... http://www.reuters.com/article/2011/07/07/us-cancer-liver-stemcells-idUSTRE7661XV20110707?feedType=nl&feedName=ushealth1100
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Incidence of stroke symptoms among adults with chronic kidney disease: results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study
Nephrology Dialysis Transplantation, 05/09/2011

Muntner P et al. – Reduced Estimated glomerular filtration rate (eGFR) and higher albuminuria levels are associated with an increased risk for incident stroke symptoms.
Background. Reduced glomerular filtration rate and albuminuria are associated with an increased risk for stroke. Their association with stroke symptoms is not known.
Methods. The incidence of stroke symptoms was determined in 20 386 participants ≥45 years of age in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who were free of a history of stroke, transient ischemic attack and stroke symptoms at baseline. Six stroke symptoms were assessed via telephone interviews at baseline and every 6 months. Participants were followed over a median of 2.1 years (maximum follow-up of 6 years). Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI equation and the albumin-to-creatinine ratio from spot urine samples. ...
http://www.mdlinx.com/nursing/news-article.cfm/3590413/0/kidney/next/5?source=scroller
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RANDOM FACT:
About 1 percent of U.S. landfill space is full of disposable diapers, which take 500 years to decompose.

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Urinary incontinence in a community sample of older adults: prevalence and impact on quality of life
Abstract:
Purpose.  To measure the prevalence of urinary incontinence (UI) in a community-dwelling sample and the impact of self-reported UI on well-being and activity in older men and women.Method.   Participants were older adults aged ≥≥65 years. Measures included the frequency of urgency incontinence, depression, positive and negative affect and social activity, independence in activities of daily living (IADL) and self-rated health. The data were collected by face to face interview (1994) and computer assisted telephone interviews (1996).Results.   Of the 796 participants, 28%% experienced urgency incontinence and 21%% reported stress incontinence occasionally or often, with higher rates among women. The threshold for the impact on depression, negative affect and IADL was with occasional occurrence of urinary urgency incontinence. For positive affect and self-rated health, the threshold was experiencing urinary urgency incontinence often. The presence of urinary stress incontinence was associated with depression, IADL dependence, self-rated health and positive affect. Overall, women with incontinence had higher negative affect scores, but men with stress incontinence had higher scores than those without.Conclusions.   The impact of incontinence highlights the need for more effective management of the condition. The threshold for the effects of urinary urgency incontinence on mental health and functionality is lower than for the effects on general health. There is a need to consider how older people judge the impact of UI in the design of targeted health promotion programmes. ...
(If you are interested in the complete article...the cost is $27.00)

http://www.ingentaconnect.com/content/apl/tids/2011/00000033/F0020015/art00012
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Is your car on the thieves "Most Wanted List"? For the first time since 2002, six of the top ten most-stolen cars were domestic brands. Ford took three spots, Dodge took two and Chevy took one.

But the most stolen car remained a foreign brand. Car thieves continue to prefer, oddly enough, the 1994 Honda Accord. That mid-sized sedan is followed by the 1995 Honda Civic and the 1991 Toyota Camry. Honda and Toyota models have held the top three spots since 2000.

Honda Accord also topped the LoJack stolen vehicles survey, which was out in April.

The National Insurance Crime Bureau released the annual statistics based off crime data compiled by the FBI. Other stolen-car reports are based off insurance records, but the NICB says its list is more accurate. Most people with older cars don't bother to insure their vehicles for theft, so insurance data is skewed, the organization said. ... http://autos.aol.com/article/2011-most-stolen-cars/?ncid=webmail5
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Earthworms: The Australian Gippsland Earthworm grows to 12 feet long and can weigh 1-1/2 pounds.

There are approximately 2,700 different kinds of earthworms. In one acre of land, there can be more than a million earthworms.

Worms tunnel deeply in the soil and bring subsoil closer to the surface mixing it with the topsoil. Slime, a secretion of earthworms, contains nitrogen. Nitrogen is an important nutrient for plants. The sticky slime helps to hold clusters of soil particles together in formations called aggregates.

Worms are hermaphrodites. Each worm has both male and female organs. Worms mate by joining their clitella (swollen area near the head of a mature worm) and ex-changing sperm. Then each worm forms an egg capsule in its clitellum.

Even though worms don't have eyes, they can sense light, especially at their anterior (front end). They move away from light and will become paralyzed if exposed to light for too long (approximately one hour).
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#34 A blanket solution... By insulating your electric water heater and its outgoing pipes, you can lower the temperature setting and save up to $200 a year. Pipe sleeves start at $2.00/ 12 feet, while heater blankets run about $20.00. Check with a plumber for safety.

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HUMOR SECTION
ROUGH LANDING

A pilot landed a plane with a rather bumpy landing. As part of his job he was required to stand by the terminal door and say goodbye to the passengers as they exited the airplane. He was afraid that someone might say something about his rather less than perfect landing, but everyone left without saying a word except for one passenger, an elderly lady. She slowly approached the pilot after most passengers had exited the plane, and asked, "Did we land? Or were we shot down?"

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


Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursecom / for CNE offerings

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

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

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

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WEBSITES/ LINKS

Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.

Link for medication disposal....after patient/person dies:

http://nursingworld.org/HomepageCategory/NursingInsider/DEA-Sponsoring-National-Take-Back-Initiative.aspx
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Ripoff Reports: http://www.ripoffreport.com

This is a consumer reporting Web site and publication, by consumers, for consumers, to file and document complaints about companies or individuals. Unlike the Better Business Bureau, Ripoff Report does not hide reports of "satisfied" complaints. All complaints remain public and unedited in order to create a working history n the company or individual in question.
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This site is directed to parents with toddlers.......looks like a lot of good info for patient/parent teaching... When sickness strikes or
accidents happen, how can you tell if it's a true emergency or something you can handle at home? Here are some common kid injuries and illnesses that require an Rx of TLC — versus the ones that need quick treatment from the ER pros. ... http://www.whattoexpect.com/toddler/health-and-safety/when-to-go-to-the-er.aspx?xid=aol_wte-preg_3-_20110801&aolcat=HLT
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This is an excellent nursing site, check it out: http://nursingpub.com/
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Back issues of the ISMP newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.
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Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org

This was sent in by Bob Hess........

Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member
Please follow me on Twitter as DrRobertHess.

When asked to elaborate on shared governance, he wrote: "I don’t know where to start, but for an overview, read my white paper… http://nursingworld.org/mods/mod680/govvers.htm" " *********************

Decubqueen's website: www.accu-ruler.com

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


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

The Nursing Site http://thenursingsite.com .

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

http://www.snopes.com

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

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

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

(This is the last presentation of the following site)
12 lead EKG Interpretation Part #1
http://nursingpub.com/12-lead-ekg-explained-part-1
12 Lead EKG Interpretation Part #2 http://nursingpub.com/12-lead-ekg-interpretation-part-2
12 Lead EKG Interpretation Part #3
http://nursingpub.com/12-lead-ekg-interpretation-part-3

Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm

Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/


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MEDICAL RECALLS
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Zocor (simvastatin): Label Change - New Restrictions, Contraindications, and Dose Limitations
Simvastatin sold under the brand-name Zocor, as a single-ingredient generic product, and sold in combination with ezetimibe as Vytorin and in combination with niacin as Simcor
ISSUE: FDA notified healthcare professionals that it is recommending limiting the use of the highest approved dose of the cholesterol-lowering medication simvastatin (80 mg) because of increased risk of muscle damage. Patients taking simvastatin 80 mg daily have an increased risk of myopathy compared to patients taking lower doses of this drug or other drugs in the same class. This risk appears to be higher during the first year of treatment, is often the result of interactions with certain medicines, and is frequently associated with a genetic predisposition toward simvastatin-related myopathy. The most serious form of myopathy, called rhabdomyolysis, can damage the kidneys and lead to kidney failure which can be fatal. FDA is requiring changes to the simvastatin label to add new contraindications (should not be used with certain medications) and dose limitations for using simvastatin with certain medicines.
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Boston Scientific Innova Self-Expanding Stent System: Recall - Failure to Deploy
Boston Scientific sent an urgent medical device recall letter to OUS customers on May 13, 2011. The recall notice explained the issue, identified the affected products, required distributors to cease further distribution and use of the product, and requested the return of unused product to Boston Scientific. Complaints of no deployment and partial deployment have been received. This type of failure may result in vessel wall injury, increased procedure time and/or emergency surgery to remove the partially deployed stent. This recall does not affect stents that have already been implanted as the issue occurs during delivery of the stent. See the Recall Notice for a complete list of affected lot numbers.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm259764.htm

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Airway Humidifier Recalled WASHINGTON -- The FDA has issued a Class I recall on a humidification device used during mechanical ventilation because possible occlusion may stem the flow of oxygen to the patient.
The recall affects 132 lots of the GE Healthcare Vital Signs Hygroscopic Condenser Humidifier Passive Humidification Device (HCH) for Vital Signs Anesthesia Breathing Circuits.
The HCH is sold as part of the Vital Signs anesthesia breathing circuit to maintain moisture in the airway while the patient is on mechanical ventilation.
A full list of affected product codes and lot numbers is available in the company's release on the FDA website. Class I recalls affect products that have a reasonable probability of causing serious injury or death with use.

http://www.medpagetoday.com/PublicHealthPolicy/FDAGeneral/27927?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846

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NURSING HINTS CORNER

A Viewpoint on Catheterization


One of the biggest problems in catheterizing a woman patient without assistance is getting a good view of her perineal area. So try placing a bedpan or fracture pan upside down with a pad over it. Then position the patient's buttocks on the pan. You'll be able to see the area more clearly, and catheter insertion will be easier. Cathie Holtzinger, RN

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.140, Springhouse Corporation/www.springnetcom. ;

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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.

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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com

No new members this edition

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NOTICE:
I attempt to send newsletters to your 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 ? So please send me your new name/address, okay?
RNFrankie@AOL.com

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


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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)

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DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.

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THOUGHT FOR THE DAY
Now this is a Nurse !

Do not assume that she who seeks to comfort you now, lives untroubled among the simple
and quiet words that sometimes do you good. Her life may also have much sadness and difficulty,
that remains far beyond yours. Were it otherwise, she would never have been able to find these words.
--Rainer Maria Rilke

This is my birthday month--(late) August .... Frankie

RNFrankie@AOL.com