Sunday, November 13, 2011

fundraising for men's Health issues....please donate

(This arrived too late for the Newsletter, and must be for November, so now is a supplement to the November issue)
http://www.blogger.com/img/blank.gif Please donate...


Bob Hess writes: Frankie – Is there any way you could support me in this charitable event? I was the top fundraiser with Gannett Healthcare Group last year, and I’m in the lead again this year. It’s fun for an excellent cause.

Thanks for anything. This is the email I’ve been sending out with the link to my donation page. The donations need to be made TO ME. Maybe you could do an email blast for me or something?

Bob


It's my birthday month, so it must be Movember. I’m making my annual charity fundraising appeal to colleagues.

When I was a doctoral student, I heard a lot about women's health, all well and good, and the money needed to fund research. When I asked about men's health, someone said, "No one cares." I know this was said jokingly, but I wondered.

For the second year in a row, much to the dismay of my wife, who doesn’t like hair on my face, I've decided to donate my face to raising awareness about cancers that affect men. Last year my friends, family, and colleagues donated thousands of dollars, and I was the top fundraiser in my company.

My commitment is the growth of a moustache for the entire month of Movember, which I know will generate conversation, controversy, and laughter. I grow a terrible moustache. If you visit my site , you can see what the contemplative me looked like when I had a moustache for about 30 years. When I finally shaved it off, my wife told me she never liked it. My father-in-law (with his large moustache), said, "Now, I don't trust you." So my wife won't be pleased about this, but my father-in-law will.

Anyway, I'm doing this because:

- 1 in 2 men will be diagnosed with cancer in his lifetime

- 1 in 6 men will be diagnosed with prostate cancer during his lifetime.

- As a man who has been blindsided by his own prostate, this is a cause that I feel passionately about and I'm asking you to support my efforts by making a donation to support the great work of the Prostate Cancer Foundation and LIVESTRONG.

To help, Click this link http://us.movember.com/mospace/769148/ and donate online using your credit card or PayPal account. Please be sure to Donate to Me. Donations can also be mailed in; instructions can be found at http://us.movember.com/mospace/donations.

The money raised will help make a tangible difference to the lives of others, through the world's most promising prostate cancer research and LIVESTRONG's programs that support young adults and their families battling and surviving cancer. For more details on how the funds raised from previous campaigns have been used and the impact Movember is having please visit

http://us.movemberfoundation.com/research-and-programs/.

Thank you. You can follow my month-long journey on Twitter at http://twitter.com/Drroberthess.

Bob

Robert Hess, RN, PhD, FAAN
Executive Vice President, Global Programming
Office: 856-424-2046
Mobile: 610-805-8635

Friday, November 11, 2011

Paradigm Bytes November 12, 2011

PARADIGM BYTES
Newsletter for Paradigm 97
November 12, 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
FDA NEWS RELEASE

For Immediate Release: Nov. 8, 2011 Media Inquiries: Morgan Liscinsky, 301-796-0397, morgan.liscinsky@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA

FDA launches website on safe disposal of used needles and other “sharps”
Improperly disposed sharps pose public health risks

The U.S. Food and Drug Administration today launched a new website for patients and caregivers on the safe disposal of needles and other so-called “sharps” that are used at home, at work and while traveling.

The website will help people understand the public health risks created by improperly disposing of used sharps and how users should safely dispose of them.

Sharps is a term for medical devices with sharp points or edges that can puncture or cut the skin. Such medical devices include hypodermic needles and syringes used to administer medication; lancets or fingerstick devices to collect blood for testing; needle and tubing systems for infusing intravenous and subcutaneous medicines; and connection needles used for home hemodialysis.

After being used, many sharps end up in home and public trash cans or flushed down toilets. This kind of improper disposal puts people, such as sanitation workers, sewage treatment workers, janitors, housekeepers, family members and children at risk for needle stick injuries or infection with viruses such as Hepatitis B and C and Human Immunodeficiency Virus (HIV).

“Safe disposal of used needles and other sharps is a public health priority,” said Jeffrey Shuren, M.D., director of the FDA’s Center for Devices and Radiological Health. “This website provides information about how to keep used sharps from ending up in places where they could harm people.”

With more diseases and conditions such as diabetes, cancer, allergies, arthritis and HIV being managed outside of hospitals and doctors’ offices, the number of sharps used in homes and work offices is increasing. In addition, pets are being treated in homes and livestock are being treated on farms, which are also contributing to the increased number of sharps outside of veterinary hospitals.

The U.S. Environmental Protection Agency estimates that more than 3 billion needles and other sharps are used in homes in the United States each year.

Sharps disposal guidelines and programs vary by jurisdiction. For example, in 2008, California passed legislation banning throwing needles in household trash. Florida, New Jersey and New York have established community drop off programs at hospitals and other health care facilities. People using sharps at home or work or while traveling should check with their local trash removal services or health department to find out about disposal methods available in their area.

For the safe disposal of needles and other sharps used outside of the health care setting, the FDA recommends the following:

DO:


Immediately place used sharps in an FDA-cleared sharps disposal container to reduce the risk of needle-sticks, cuts or punctures from loose sharps. (A list of products and companies with FDA-cleared sharps disposal containers is available on the FDA website. Although the products on the list have received FDA clearance, all products may not be currently available on the market.)
If an FDA-cleared container is not available, some associations and community guidelines recommend using a heavy-duty plastic household container as an alternative. The container should be leak-resistant, remain upright during use and have a tight fitting, puncture-resistant lid, such as a plastic laundry detergent container.
Keep sharps and sharps disposal containers out of reach of children and pets.
Call your local trash or public health department in your phone book to find out about sharps disposal programs in your area.
Follow your community guidelines for getting rid of your sharps disposal container.


DO NOT:


Throw loose sharps into the trash.
Flush sharps down the toilet.
Put sharps in a recycling bin; they are not recyclable.
Try to remove, bend, break or recap sharps used by another person.
Attempt to remove a needle without a needle clipper device.


For more information:


Needles and Other Sharps (Safe Disposal Outside of Health Care Settings)
Improperly Discarded ‘Sharps’ Can Be Dangerous – Consumer Update
Sharps Flickr Slideshow


~~**~~**~~**~~**~~**~~
FROM THE MEMBERS

This was sent in by BAcello (Barbara)...Thank you ! She writes: "

BAcello (Barbara) submitted the following ... She writes: Several months ago, a friend told me about the most incredible reference site I have ever seen. I have been using it since then to
ensure it is legitimate, not virus-laden, and most importantly, free. I am convinced that it is or I would not be sharing it. It has never come
up in my search engine results. I think it is part of the The National University Library System (NULS), but it is open & accessible.
This site has 70,000+ full text books. You can do a search without signing up for anything, but you have to jump through
some hoops to access the downloads. IMO it is well worth it:

1. Register for http://library.nu

2. Open a gmail account if you don't have one.
3. Register for ifile.it
4. If you have an ad blocker, turn it off or the links may not show up.
5. If your firewall blocks the site, put it on the firewall"approved list." (I have Trend Micro on one computer & it does try to block it.
The other computer uses Bit Defender & it does not block it.)

6. When you try to download a file, ignore the HUGE 'download' links at the top of the page. They download trash you don't want/need.
Scroll down about half to 3/4 of the way down & use the tiny ifile.it link in the center of the page.

7. Fiddle with your search terms. For example, I was looking for exam prep materials for nursing home administrator interns.
Using 'nursing home administrator' and 'nursing home' did not bring up much. However, I found hundreds of related LTC books listed
under 'nursing.' 'Long term care' will also bring up quite a bit.
The people who indexed it obviously don?t understand the health professions, but once you find the right search terms, you?ll find
current,evidence-based information. The other day, my husband was looking for a book that lists for $288 on amazon. We downloaded
it on library.nu for free. For that search we used the book title & it came right up.
You can also search by author name or ISBN.


~~**~~**~~**~~**~~**~~
INTERESTING READING

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

Nurse practitioners were 'Lone Rangers,' founder says (CNN) -- In rural Boulder County, Colorado, Loretta Ford felt as if she were an epidemiologist, a sanitation department and a health inspector -- but in title, she was a nurse. She and colleagues carried everything, including the baby scales, as they set up temporary clinics in churches, schools and wherever else they could.
In the 1940s and '50s, there was no one else taking care of these basic community needs except Ford and her fellow public health nurses. As she gained experience, Ford realized that more nurses should be able to have specialized training so they could make basic decisions on their own about the health status of patients.
Ford, 90, the co-founder of the nurse practitioner movement, is being inducted into the National Women's Hall of Fame on Saturday in Seneca Falls, New York. Thanks in large part to her efforts, there are more than 140,000 nurse practitioners working in the United States today. Many can prescribe and diagnose as doctors can, but their nursing background emphasizes health promotion and patient empowerment. ... http://www.cnn.com/2011/09/30/health/living-well/loretta-ford-nurse-practitioner/
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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.
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(Reuters Health) - They say "You are what you eat." Maybe it should also be, "You are where you live."

A new study has found that the affluence of your neighborhood is linked to your risk of obesity and diabetes. People living in a high-poverty area were more likely to be obese and more likely to have diabetes than those in a low-poverty census tract.
The researchers characterize the association as "modest but potentially important."
"The effects we see in the study are comparable to what you see from targeted lifestyle interventions or with providing people with medications to prevent the onset of diabetes," chief author Jens Ludwig of the University of Chicago told Reuters Health in a telephone interview. ... http://www.reuters.com/article/2011/10/19/us-diabetes-idUSTRE79I7NG20111019?feedType=nl&feedName=ushealth1100
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Obesity is not just a U.S. issue although Americans are still the fattest, a Gallup poll indicates.
The Gallup-Healthways Well-Being Index, which tracks obesity in America, Britain and Germany monthly, found Americans are in far worse shape than are Britons and Germans. Twenty-five percent of Americans are obese, compared with 20 percent of Britons and slightly more than 10 percent of Germans, the index indicated. ...

http://www.upi.com/Health_News/2011/11/01/World-getting-more-obese-US-No-1/UPI-47441320165417/?spt=hs&or=hn

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Weighing Weight-Loss Programs THURSDAY, Nov. 3 (HealthDay News) -- A new British study finds that commercial weight-loss programs are more effective and less costly than primary care-based programs led by specially trained staff.
University of Birmingham researchers compared weight loss among obese and overweight women and men enrolled in commercial weight-loss programs that lasted 12 weeks (Weight Watchers, Slimming World, Rosemary Conley) or in primary care-based programs (group-based dietetics, general practice one-to-one counseling, pharmacy one-to-one counseling).
The study also included a control group of patients who were given 12 vouchers for free use of a local fitness center.
There were 740 people at the start of the study, and follow-up data were available for 658 of them at the end of the 12-week program and for 522 of them one year later. ... http://consumer.healthday.com/Article.asp?AID=658601 ; (I joined Weight Watchers and have lost 12 pounds so far. I consider them the best).
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Freezing of Gait in Parkinson Disease Is Associated With Impaired Conflict Resolution
Freezing of gait (FOG) in Parkinson disease (PD) may involve executive dysfunction. This study examined whether executive functioning and attention are more affected in patients with FOG compared with those without and determined whether these processes are influenced by anti-Parkinson medication.... http://nnr.sagepub.com/content/25/8/765.abstract?rss=1
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RANDOM FACT:
1) There is no physical way to determine the difference between an Africanized honey bee and the less harmful European bee - even a specialist must examine several bees together to differentiate.

RANDOM FACT:
2) The Sydney funnel-web spider is Australia's most dangerous arachnid, with a bite capable of causing death in as little as fifteen minutes.

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Are you eating these 7 superfoods? Though fall is in many ways the unofficial season of gluttony (we're looking at you, Halloween and Thanksgiving), it's also a great time of year for healthy eats. The ground is flush with nutrient-rich root veggies and the trees are full of the crisp, quintessentially-autumn fruit that's number three on our list, they're practically doubling over.
Maybe best of all, with the sticky summer months behind us, there's something that just feels right about cooking again -- throwing on a cozy sweater and whipping up a meal with some of the healthy ingredients autumn has to offer. ... http://www.huffingtonpost.com/2011/10/17/7-fall-superfoods_n_1007886.html?ncid=webmail11

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Preemies Breathe Easier With Less Invasive Therapy

A minimally invasive way of helping premature babies breathe better reduced the need for mechanical ventilation, researchers said.
In a randomized clinical trial, delivering surfactant though a thin catheter in the first days after birth reduced the absolute risk of needing ventilation by about 18 percentage points, according to Egbert Herting, PhD, of the University of Lübeck in Lübeck, Germany, and colleagues.

Over their whole hospital stay, the absolute risk reduction was 40 percentage points in favor of the catheter-delivered surfactant, Herting said online in The Lancet. Surfactants markedly improve outcomes for pre-term babies with respiratory distress syndrome and are usually delivered via the endotracheal tube during mechanical ventilation, the authors noted. ...
http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/28827?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com

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Long-Term Mammography Needed for Breast Cancer Survivors Regular surveillance mammography after breast cancer boosts survival and should be continued for at least a decade, a systematic review suggested.

Second cancers in the same or opposite breast occurred at a fairly constant rate over the first 10 years instead of being largely in the first two or three years as often thought, Clare Robertson, MSc, of the University of Aberdeen, Scotland, and colleagues found.

Mammographic follow-up to detect these tumors was associated with reduced all-cause mortality and breast cancer-specific mortality in the studies reviewed.
Because the analysis also presented favorable data regarding cost-effectiveness, the group argued online in Health Technology Assessment for routine surveillance mammography out to at least 10 years. (I have always held to the belief that one does not use the Bp cuff on the mastectomy side for 10 years--- anyone disagree?) ...

http://www.medpagetoday.com/OBGYN/BreastCancer/28834?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com
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FDA clears first single use face mask for children
The U.S. Food and Drug Administration has cleared the Kimberly-Clark Pediatric/Child Face Mask, designed to be worn in hospitals and health care facilities to help reduce the spread of airborne respiratory tract bacteria, viruses, and other pathogens.
The mask is designed to fit children ages 5 years to 12 years. Children do not breathe as forcefully as adults, particularly children with respiratory infections, so the face mask is less resistant to airflow than an adult mask.
“Children are not small adults,” said Susan Cummins, M.D., chief pediatric medical officer at FDA’s Center for Devices and Radiological Health. “This pediatric face mask helps fill an unmet need for medical devices that are specifically designed for children’s unique anatomy and growing bodies.”...
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm273491.htm
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Fibroid Surgery May Up Birth Rates After Recurrent Miscarriage
Removing fibroids that distort the uterine cavity may improve live birth rates among women with recurrent miscarriage, researchers found.
Myomectomy was associated with a significant drop in mid-trimester loss rate (21.7% versus 0%, P<0.01), Sotirios Saravelos, MD, of the University of Sheffield in the U.K., and colleagues reported online in Human Reproduction.
"We would recommend offering hysteroscopic surgery to all women with a history of one or more mid-trimester pregnancy losses," Saravelos and colleagues wrote.
But women with fibroids not distorting the uterine cavity can achieve high live birth rates without intervention, they noted.
Uterine fibroids have been linked with spontaneous miscarriage, but no studies have assessed their role in recurrent miscarriage. ...
http://www.medpagetoday.com/OBGYN/Fibroids/28835?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com ;
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Virus to blame for rise throat cancer (Reuters Health) - Cancer of the back of the mouth and throat is on the rise, primarily because of more cases stemming from a viral infection called human papillomavirus (HPV), researchers report in a new study.
The number of people who were diagnosed with HPV-related oral cancer in 2004 was triple the number diagnosed in 1988, due largely, researchers suspect, to changes in sexual behavior that have helped spread the virus. ... http://www.reuters.com/article/2011/10/03/us-throat-cancer-idUSTRE79266I20111003
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Vasopressin Injection USP, Multiple Dose Vials: Recall - Sub-Potency : American Regent, Inc. is conducting a nationwide voluntary recall of multiple lots of Vasopressin Injection, USP to the Retail/Hospital level. This product recall was initiated by American Regent, Inc. because some vials may not maintain potency throughout their shelf-life. Potential adverse events after administration of solutions that are below potency limits may include reduced effectiveness. See the company Press Release for a listing of affected lot numbers. The products were distributed to wholesalers and distributors nationwide.
BACKGROUND: Vasopressin Injection, USP is indicated for prevention and treatment of postoperative abdominal distention, in abdominal roentgenography to dispel interfering gas shadows, and in diabetes insipidus.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm266648.htm
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Strides gets USFDA approval for anti-bacterial injection NEW DELHI: Drug firm Strides Arcolab today said it has received the US health regulator's approval to market injectable Clindamycin USP, used in the treatment of bacterial infections, in the American market.
The product will be available in three single-dose vial sizes and in pharmacy bulk packaging, Strides Arcolab said in a statement.
"The product is expected to be launched in early 2012," it said, adding that the company received approval for its Clindamycin USP from the US Food and Drug Administration (USFDA).
http://articles.economictimes.indiatimes.com/2011-10-03/news/30238517_1_strides-arcolab-usfda-approval-injectable-products

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RANDOM FACTS: In 2008, Houston ranked fourth for highest increase in the local technological innovation over the preceding 15 years, according to Forbes magazine.

Bonus Fact: American Lung Association rated the Houston's metropolitan area's ozone level as the 6th worst in the United States in 2006. (As you probably know, I am from Texas (El Paso), but lived in Houston area many years. I believe it is mostly due to Texas City's oil refineries).
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Safest Hospitals Have Higher Nursing Standards Facilities that win the "Magnet Hospital" designation for meeting high nursing standards were more likely to adopt safe patient care practices than their noncertified counterparts, researchers found.

In 2004 and 2006, Magnet hospitals had significantly higher composite safe practice scores than non-Magnet facilities, Jayani Jayawardhana, PhD, of the University of Georgia in Athens, Ga., and colleagues reported online in the Journal of Nursing Administration.

Magnet hospitals -- there are currently 383 of them across the U.S. -- are known for a quality work environment and high retention rates of nurses. The program, run by the American Nurses Credentialing Center, focuses on characteristics such as nursing autonomy, use of evidence-based care, job satisfaction, and other parameters. ...

http://www.medpagetoday.com/HospitalBasedMedicine/Nursing/28830?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com

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RANDOM FACT: The human lungs contain over 300,000 million capillaries which, if they were laid end to end, would stretch 2400km (1500 miles).

BONUS FACT: Human bone is as strong as granite in supporting weight. A block of bone the size of a matchbox can support 9 tonnes � that is four times as much as concrete can support.
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Use of folic acid and vitamin supplementation among adults with depression and anxiety: a cross-sectional, population-based survey Evidence suggests that folate deficiency may be causatively linked to depressive symptoms. However, little is known on the status of use of folic acid and vitamin supplements among people with mental disorders. This study examined the prevalence and the likelihood of use of folic acid or vitamin supplements among adults with depression and anxiety in comparison to those without these conditions. (Research)
Methods
Using data from 46, 119 participants (aged ≥ 18 years) in the 2006 Behavioral Risk Factor Surveillance System survey, we estimated the adjusted prevalence and odds ratios with 95% confidence intervals for taking folic acid and vitamin supplements among those with ever diagnosed depression (n = 8, 019), ever diagnosed anxiety (n = 5, 546) or elevated depressive symptoms (n = 3, 978, defined as having a depression severity score of ≥ 10 on the Patient Health Questionnaire-8 diagnostic algorithm). ... http://www.nutritionj.com/content/10/1/102
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Brain Takes Multiple Hits from Low B12 Levels Low levels of vitamin B12 may contribute to cognitive problems for older adults in more than one way, according to a cross-sectional study.

Markers of B12 insufficiency all predicted lower global cognitive scores over nearly five years of follow-up, Christine C. Tangney, PhD, of Rush University Medical Center in Chicago, and colleagues found.

The mediating factors appeared to be white matter lesions and cerebral infarcts in association with the nonspecific marker homocysteine and brain atrophy for the vitamin B12-specific marker methylmalonic acid (MMA). ...

http://www.medpagetoday.com/Neurology/GeneralNeurology/28740?utm_content=&utm_medium=email&utm_campaign=join-the-conversation-B12&utm_source=WC&userid=379846&email=rnfrankie@aol.com&eun=g379846d0r

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HINT: Did you know balloons make great ice packs for small injuries?

Fill a balloon or two to make a quick ice pack. Fill a balloon halfway with water - make sure you leave enough room for it to expand -
and tie a knot. Place it in the freezer to have ready whenever you need an ice pack!
*************

A problem of grand proportions It's tempting to read a silver lining into the otherwise dreary news that food prices are skyrocketing and appear on pace to post their largest annual increase since 1980.

Record high oil prices sent bicycle sales up 24 percent and gas-guzzling SUV sales down 35 percent in 2008, according to the U.S. Department of Transportation. High electric bills have prompted more than one of us to don a sweater rather than crank the heat. And increased cigarette taxes are credited with reducing teen smoking, according to at least one anti-tobacco group.

Sometimes, in other words, we need our wallets to be our willpower. So will rising food costs be the answer to our nation's notorious portion control issues? ... http://www.chicagotribune.com/health/sc-health-1102-portions-20111102,0,5894702.story ;

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Obesity more likely with Night Owls (HealthDay News) -- Going to bed early and waking up early may help teens stay thinner and more physically active than their night-owl peers, and this was the case even when both groups got the same amount of sleep, researchers say.
"The children who went to bed late and woke up late, and the children who went to bed early and woke up early got virtually the same amount of sleep in total," study co-author Carol Maher, a postdoctoral fellow with the University of South Australia, said in a news release from the American Academy of Sleep Medicine. http://www.consumer.healthday.com/Article.asp?AID=657315
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Saw palmetto doesn't ease prostate symptoms: study (Reuters) - Saw palmetto, a plant extract sold as a natural boost to urinary health, doesn't improve the symptoms of enlarged prostate in middle-aged men, a U.S. study said.
Even at high dosages, men taking saw palmetto daily didn't report any more improvement in symptoms, such as needing to urinate frequently or urgently, than those taking a drug-free placebo pill, according to findings published in the Journal of the American Medical Association.
"Even pushing up to the highest dose ... we couldn't see a benefit greater than placebo," said Michael Barry at Massachusetts General Hospital in Boston, who led the study. ...

http://www.reuters.com/article/2011/10/03/us-prostate-idUSTRE7920BV20111003?feedType=nl&feedName=ushealth1100
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MRI Safe for Most Patients With Cardiac Devices
Fewer than 1% of patients with implanted cardiac devices encountered device-related problems during MRI, suggesting the imaging technique can be used safely in selected patients with implanted devices, investigators reported.
In three of 438 patients (0.3%), MRI triggered back-up programming mode in implanted devices. Right ventricular sensing and atrial and ventricular lead impedance values declined immediately after MRI. Long-term follow-up revealed decreased right ventricular sensing and lead impedance, increased right ventricular capture, and reduced battery voltage. None of the changes required revision or replacement of an implanted device, as reported in the October issue of Annals of Internal Medicine. ...
http://www.medpagetoday.com/Cardiology/Arrhythmias/28859?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com
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RANDOM FACT: A five-year-old English girl nearly died in 2009 after she had swallowed so much of her own hair that it became a rope-like structure that wrapped around her intestines - a condition known as Rapunzel Syndrome [The Rapunzel syndrome is an extremely rare intestinal condition in humans resulting from eating hair (trichophagia)].

Bonus Fact:
Being unmarried can shorten a man's life by 10 years.
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9 Simple Ways to Lower Cholesterol If you’re one of the 100 million Americans with unhealthy cholesterol levels, heart-healthy lifestyle changes are one of the most important ways to lower your cholesterol levels and prevent them from progressing. Ivan V. Pacold, MD, a cardiology professor at Loyola University’s Stritch School of Medicine in Chicago, says that “even if these changes don’t show up directly in your cholesterol numbers, they can be lowering your risk for heart disease.” So if you haven’t made the change to a heart-healthy lifestyle, here are nine ways to get started. ...

http://www.everydayhealth.com/high-cholesterol-pictures/simple-ways-to-lower-cholesterol.aspx?xid=aol_eh-cardio_1_20111107_&aolcat=ESR&ncid=webmail16#/slide-1 ;
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52 Little Changes for Big Weight Loss Results Ever wonder why McDonald’s color scheme is yellow and red? “We are naturally drawn to red, yellow and orange in our dining area or restaurants because psychologically it stimulates us to want to eat -- and eat a lot. Studies show if you put your food on blue plates it can cause you to eat less,” says Tamal Dodge, a certified yoga instructor in Santa Monica, Calif. and star of the “Element: Hatha & Flow Yoga for Beginners” DVD.

http://www.ivillage.com/52-little-changes-big-weight-loss-results/4-b-394731?nlcid=wh|11-08-2011|#394749

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RANDOM FACT: In 2005, a 57 year-old woman gave birth to her own granddaughter, a baby conceived with an egg donated by
her 27 year-old daughter.

RANDOM FACT: In 2006, a 41 year-old British woman married what she called "the love of my life": a male dolphin named Cindy. hmmm
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Feel like you are hungry all the time? 7 Tips For Controlling Your Appetite
If you just can't seem to stop those hunger pains throughout the day, it may have something to do with the amount of sleep you're getting.
When it comes to the math behind weight loss, it’s all about “calories in, calories out.” However, it’s not always that black and white. If you suffer from constant food cravings, it may not always be an issue of hunger. Thankfully, there are some steps you can take to remedy the situation. If you're certain that you are eating as you should for your metabolic type and you still feel hungry all the time, use these tips to help curb your appetite. ...
http://www.everydayhealth.com/jillianmichaels/seven-ways-to-control-appetite.aspx?xid=aol_eh-fit_1_20111107_&aolcat=HLT&; ncid=webmail7#/slide-1

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Thank you Miriam (mrwrn@AOL.com) for this great article.Unfortunately the following is only a partial listing, but I will have more in the December newsletter......if you want the entire listing, write me !

Apples
Protects your heart, Prevents constipation
Blocks diarrhea, Improves lung capacity
Cushions joints

Apricots
Combats cancer,Controls blood pressure,
Saves your eyesight, Shields against Alzheimer's,
Slows aging process

Artichokes

Aids digestion, Lowers cholesterol
Protects your heart,Stabilizes blood sugar
Guards against liver disease

Avocados
Battles diabetes,Lowers cholesterol,
Helps stops strokes,Controls blood pressure
Smooths skin

Bananas
Protects your heart, Quiets a cough
Strengthens bones,Controls blood pressure
Blocks diarrhea

Beans

Prevents constipation,Helps hemorrhoids
Lowers cholesterol, Combats cancer
Stabilizes blood sugar

Beets
Controls blood pressure, Combats cancer
Strengthens bones, Protects your heart
Aids weight loss

Blueberries
Combats cancer, Protects your heart
Stabilizes blood sugar,Boosts memory
Prevents constipation

Broccoli
Strengthens bones, Saves eyesight
Combats cancer, Protects your heart
Controls blood pressure
*****************************

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HUMOR SECTION
A cardiologist died and was given an elaborate funeral. A huge heart covered in flowers stood behind the casket during the service.
Following the eulogy, the heart opened, and the casket was rolled inside. The the heart then closed, sealing the doctor in the beautiful heart forever. At that point, one of the mourners burst into laughter. When all eyes stared at him, he said, "I'm sorry, I was just thinking of my own funeral....I'm a gynecologist". The proctologist fainted!


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

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.

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com 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.

This is an excellent nursing site, check it out: http://nursingpub.com/

Back issues of the ISMP newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.

Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance
info@sharedgovernance.org www.sharedgovernance.org

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

(the following is presented for the final time...take note, please.) :
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


This is a sampling of the offers on : 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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Recall of Blood Component Infusion Set (Product Code: 4C2223)

Blood Component Infusion Set 80 Micron Blood Component Filter Female Luer
Manufacturer: Fenwal, Inc. Lake Zurich, Illinois
Fenwal identified a labeling issue with the 4C2223 Blood Component Infusion Set in which the package label incorrectly states 80 Micron filter when the actual filter size is a standard blood filter of 170-260 micron in size. Fenwal is recommending that customers immediately discontinue the use of this product and return the product to Fenwal. http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/Recalls/ucm278069.htm

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FDA Hepatitis Update - Pegasys (peginterferon alfa-2a) new disposable autoinjector On September 29, 2011, the Food and Drug Administration approved a135 mcg/0.5ml and 180 mcg/0.5 ml disposable autoinjector (DAI) to administer Pegasys (peginterferon alfa-2a), an antiviral indicated for treatment of Chronic Hepatitis C (CHC) by subcutaneous injection.

Pegasys continues to be available in a vial or prefilled syringe, and now also in a 135 mcg/0.5ml and 180 mcg/0.5 ml PEGASYS disposable autoinjector. The package insert and the Medication Guide have been updated to provide new information and instructions for use related to the disposable autoinjector.

Because the autoinjectors are designed to deliver the full content, autoinjectors should only be used for patients who need the full dose (180 or 135 mcg). If the required dose is not available in an autoinjector, prefilled syringes, or vials should be used to administer the required dose. The autoinjector is for subcutaneous administration only. http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/103964s5204lbl.pdf
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Vasopressin Injection USP, Multiple Dose Vials: Recall - Sub-Potency: American Regent, Inc. is conducting a nationwide voluntary recall of multiple lots of Vasopressin Injection, USP to the Retail/Hospital level. This product recall was initiated by American Regent, Inc. because some vials may not maintain potency throughout their shelf-life. Potential adverse events after administration of solutions that are below potency limits may include reduced effectiveness. See the company Press Release for a listing of affected lot numbers. The products were distributed to wholesalers and distributors nationwide.
BACKGROUND: Vasopressin Injection, USP is indicated for prevention and treatment of postoperative abdominal distention, in abdominal roentgenography to dispel interfering gas shadows, and in diabetes insipidus.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm266648.htm
*****************************
Recall of CareFusion EnVe Ventilator, model 19250-001. The affected products were manufactured between December 2010 and May 2011.
Use: The CareFusion EnVe Ventilator is a portable ventilator used to provide breathing assistance to pediatric and adult patients in hospital and medical transport settings.
Recalling Firm: CareFusion 203, Inc. 17400 Medina Road, Suite 100 Minneapolis, Minnesota 55447-1341
Reason for Recall: CareFusion has identified potential defects associated with the EnVe Ventilator model 19250-001 that can interrupt ventilation to the patient. The issues include: a potential delay in resuming ventilation after reconnection; a potential automatic reset; and a potential for disconnection during transport. Failure to adequately ventilate may lead to hypoxia or hypercarbia, which may result in serious neurological injury or death.
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecallsdefault.htm
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NURSING HINTS CORNER

Secured with Strips Instead of using tape to hold a NG tube in place, I use tincture of benzoin and Steri-Strips. I apply a small amount of benzoin across the bridge of the patient's nose. When it is dry, I wrap the Steri-Strip around the tube and place it over the patient's nose.
The strips not only adhere to the tube securely, but also look better than tape, so the patients appreciate them, too. Fran Ellis, RN

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.150, 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

WELCOME TO:


engleharts@bellsouth.net (Kay) October 6, 2011

sandsfamily4@att.net (Becky) October 6, 2011

pumpkinann26@yahoo.com, (Audrey) October 12, 2011

Jb_cooke@yahoo.com (June) October 24, 2011

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NOTICE:

I attempt to send the notices to your email addresses on file and if the notices 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, 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)


~~**~~**~~**~~**~~**~~
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

Learn to get in touch with silence within yourself,
and know that everything in this life has purpose.
There are no mistakes, no coincidences,
all events are blessings given to us to learn from.

--Elizabeth Kubler-Ross



Hope to hear from you !..... Frankie

RNFrankie@AOL.com

From Rocante@AOL.com

When you are the patient, or your loved one is in the hospital, you see everything the nursing staff does through the prism of experience.
While most nurses provide excellent care, sometimes you may notice mistakes being made. So, as a quick skills refresher, this month's column is about some recent experiences I've had or that have been shared with me.

DISCHARGE PLANNING BEGINS UPON ADMISSION

Somewhat of an oxymoron, but a nurse should always remember that discharge planning begins when a patient is admitted. Some hospitals
have easy-to-follow discharge planning forms, while other hospitals seem to put everything short of the kitchen sink on one piece of paper. Regardless which process your hospital uses, don't forget to focus on this as you do your daily note-taking tasks.
Discharge planning isn't just rote work. When you prepare your patient to go home, you just don't hand over forms and rattle off instructions like
you're throwing a bunch of spaghetti at the wall hoping it sticks. Patients going through the discharge process need to show that they
understand the instructions. Be sure you have the patient repeat back the information you've just covered. This ensures that they comprehend
what you've told them, and if they make an error you can correct it before they're sent home. Going through the discharge procedures.
Clear communication about meds during a hospital stay and upon discharge is crucial, going through the discharge procedure thoroughly helps minimize the possibility that your patient will be readmitted.
You may find that some of the discharge forms need an update. For example, I recently came into the possession of a discharge form that
instructed the patient to be sure to use latex gloves when changing their dressing. This is a hospital that's converted to the use of non-latex to help
minimize sensitivity issues for both the health care team and patients alike. So when I read this discharge form I knew it hadn't been updated in a very long time.
WHEN A PATIENT BRINGS MEDICATION FROM HOME

As hospitals have moved more towards the "client-based" concept of care, nurses have seen a shift in how patients expect their room to be
"done-up" during their hospital stay. This means bringing more personal items from home. A nurse may now see patients who pack not only a
favorite book, but their iPad, iPod, pictures of the family, their favorite pajamas, pillows and various other "good luck" paraphernalia.
But what about the patient who brings their medication from home? Most hospitals have policies and procedures that address personal items,
including medication. These policies may differ from hospital to hospital, but not from nurse to nurse. Meaning that all the nurses in one facility should be following the same rules. It is generally the nurse's responsibility to have knowledge of, report and record when a patient brings in medication from home.

Some hospitals require that all medication be dispensed from the inhouse pharmacy and will ask the patient's family to take any personal
medication home. The patient may think that this is one way a hospital can "jack-up" the bill. However, there's a sound reason for such a policy, namely knowing the provenance of the personal medication. There is no way to be sure that the medication in the bottle is indeed the correct medication and that it hasn't been tampered with. This policy also reduces the chance of medication being given that is contraindicated.
Imagine, what might happen if a patient who is on blood thinners to minimize throwing a clot after joint replacement surgery decides to
pop an aspirin or two that they brought from home to take care of that pesky post-operative headache.
Some hospitals do allow for patients to take their personal medication, generally requiring a written order. The nurse would then collect
and deliver the medication to the inhouse pharmacy for inventory and verification. In some hospitals the medication is then dispensed from the pharmacy, while in others it's locked up in the floor's Pyxis (or other similar) medstation and dispensed as prescribed. I understand that there are
even some hospitals that allow for medications to be literally kept at the patient's bedside.
Whichever system is used, there should be a clearly-written policy that outlines the process and nurses in turn should follow that policy precisely.

DE FACTO VS. WRITTEN POLICIES

Picking and choosing which policy or procedure to follow is what often gets nurses, physicians and hospitals into trouble. The set of documents that describe an organization's policies for operation and the procedures necessary to fulfill those policies are developed in response to external forces. Federal, state, county or city law mandate regulations, as do state medical and nursing boards, along with oversight bodies, such as the Center for Medicaid Services (CMS), the Joint Commission (JCAHO).

De facto is a Latin expression that means "by fact." It refers to what happens in actuality rather than what is officially established by law.
Policies and procedures are subject to human foibles and failings.

For example, let's say the hospital allows patients to take their own meds if there's a written order stipulating such, but over time physicians and nurses have become lax about logging in, inventorying, and securing the medication in either the pharmacy or the medstation. The medication is now simply left at the patient's bedside contrary to written hospital policies and procedures. This method has now become the norm, a de facto practice. The result is that each member of the healthcare team is now open to a negative outcome, not only is the hospital in a precarious position, but so are the nurses who have been following the de facto policy. This could result in a nurse being terminated for violating the written policy and procedure. Managers might uphold a good written policy or procedure, but fail to take the added steps of reminding, informing or educating their team about the enforcement of said written policy or procedure. When a de facto policy has become standard practice, management must properly notify the health care team that from "this point forward" XYZ policy will be enforced.
One example of a state law governing nursing policy is California's nurse/patient ratio law or Title 22.
"interpreting the personal medication policy. Thus one nurse may still adhere by the written policy, while another nurse allows the medication at
the bedside but insists on administering it herself, while another nurse might even allow the patient or a family member to give the medication.
("lost" that sentence...sorry)
Policies and procedures are subject to human foibles and failings. The most common is the lack of enforcement All this makes for a tangle of regulations and laws that can make a person's head spin. These voluminous documents are not there to make life miserable, but to help shield us from our own "never" events. Which is why, when in doubt, a nurse should always refer to the hospital's policies and procedures (P&P). Today they can usually be found in electronic format, making access and searching easier.

IT'S EASY IN THE HURLEY BURLY pace of a nurse's workday to take shortcuts that help make work easier and more efficient. But when you suspect that these shortcuts are becoming wrong turns, you must consult your chain of command. Your hospital's policies and procedures are there for a good, as well as legal, reason. Review them and familiarize yourself with the ones that apply to your position as this safeguards both your patient's well-being and your license to practice.

Genevieve M. Clavreul RN, Ph.D.