(This is a weird Snippet...but an interesting one--- I am old enuf to remember being told to mix the orange powder into the white margarine to make it look like butter! )
Margarine was originally manufactured to fatten turkeys. When it killed the turkeys, the people who had put all the money into the research wanted a payback so they put their heads together to figure out what to do with this product to get their money back. It was a white substance with no food appeal so they added the yellow coloring and sold it to people to use in place of butter. How do you like it?
DO YOU KNOW.. The difference between margarine and butter?
Both have the same amount of calories. Butter is slightly higher in saturated fats at 8 grams; compared to 5 grams for margarine. Eating margarine can increase heart disease in women by 53% over eating the same amount of butter,
according to a recent Harvard Medical Study. Eating butter increases the absorption of many other nutrients in other foods. Butter has many nutritional benefits where margarine has a few and only because they are added!
Butter tastes much better than margarine and it can enhance the flavors of other foods. Butter has been around for centuries where margarine has been around for less than 100 years .
And now, for Margarine.. Very High in Trans fatty acids. Triples risk of coronary heart disease. Increases total cholesterol and LDL (this is the bad cholesterol) and lowers HDL cholesterol, (the good cholesterol)
Increases the risk of cancers up to five times.. Lowers quality of breast milk. Decreases immune response.
Decreases insulin response.
And here's the most disturbing fact.... HERE IS THE PART THAT IS VERY INTERESTING!
Margarine is but ONE MOLECULE away from being PLASTIC... and shares 27 ingredients with PAINT
These facts alone were enough to have me avoiding margarine for life and anything else that is hydrogenated (this means hydrogen is added, changing the molecular structure of the substance).
You can try this yourself: Purchase a tub of margarine and leave it open in your garage or shaded area. Within a couple of days you will notice a couple of things:
* no flies, not even those pesky fruit flies will go near it (that should tell you something)
* it does not rot or smell differently because it has no nutritional value ; nothing will grow on it. Even those
teeny weeny microorganisms will not a find a home to grow. Why? Because it is nearly plastic . Would you melt your Tupperware and spread that on your toast?
Tuesday, December 13, 2011
December 2011 PARADIGM BYTES
PARADIGM BYTES
Newsletter for Paradigm 97
December 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
(I saw this on a list-serve, and wanted to share) It is great being a nurse (at least most days) , isn't it?
Dear Sugar,
In March 2004, my daughter Emily died 4 days after she was born, because of an overworked labor and delivery team and their errors,
plural – one of those “all the holes in the Swiss cheese lined up” stories. During her life she was in a lot of pain. She could not hear, see,
move or swallow her own saliva. After we made the terrible decision to take her off life support she fought for her life for 12 hours. I cannot
honestly say this is a story where she taught me to live better or anything like that. The death of a child is only a tragedy. And yet, there was a
nurse in the NICU who stubbornly, stoically, referred to my husband and I – first-time parents – as mum and dad; who told us we had better
change her diaper, even when she was dying, and critiqued our technique. Who invited us to give her her first and last bath. Who told us we
were good parents. Who made the unthinkable and abnormal into two parents caring for their child.
What she didn’t know is that we had been trying to have a child for 8 years. And the reason it had taken that long is that my uterus was
scarred from childhood abuse. And that I had learned never to expect a helping hand, and then had done therapy to overcome that, and then
had been so terribly let down by our L&D team. I would have lain down and given up, I think, had that nurse not reached out to me with the
exact right words at the exact right time.
Eighteen months later we had my son, now 6. This year we welcomed our second son. Our family still is missing my little girl, but it feels complete. I am incredibly, joyfully, happy. It is amazing the difference it makes sometimes when someone just reaches into the heart of your experience and names it, and sits there with you in it. Jenn
To see this in context of where/why it was written:
http://therumpus.net/2011/11/dear-sugar-the-rumpus-advice-column-90-94-ways-of-saying-thank-you/
The contributor wrote: "This is the best advice column I have ever read".
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Surprising Health Woes of Getting Older Aging is a fact of life, and with it come certain senior health issues. Many people worry about cognitive decline and weaker bones, but there are other, lesser-known concerns, too. That’s why it’s important for everyone to do what they can to encourage healthy aging.
“The rate at which we experience change tends to be quite individual, often based on lifestyle choices, genetics, and environmental factors,” explains Evelyn Fitzwater, DSN, RN, associate director of the Center for Aging With Dignity at the University of Cincinnati College of Nursing. The sequence of change, however, is similar for all of us. Here are some of the more surprising health effects you should expect.
A Change in Taste
One of the many senior health problems not often discussed is a decline in taste buds. We are each born with approximately 9,000 taste buds, but that number starts to decrease between the ages 40 and 50 in women and 50 and 60 in men. The result is that people need greater taste stimulation to experience the four flavors of sweet, salty, sour, and bitter. Salty and sweet tastes tend to be lost first, with bitter and sour following along behind. Experts aren’t exactly sure what causes this, though some think it is related to disease, smoking, and environmental exposures.
Multitasking Challenges
In a world where we expect even our phones to juggle duties — make a call, surf the Web, provide GPS directions! — it might seem inefficient to turn all your focus on one thing. But as you get older, you may find yourself having to do just that. “Multitasking is a complex cognitive task that relies on a number of our brain’s functions, including attention, executive functions, and working memory, among others,” says Jena Kravitz, PsyD, a clinical neuropsychologist at the Good Samaritan Hospital in Los Angeles. “At a basic level, the ability to multitask relies on how quickly and efficiently our brain can switch between tasks while blocking out distraction and maintaining focus.” It’s important to be aware, though, that this difficulty is usually a result of natural healthy aging and is not necessarily indicative of serious cognitive decline.
Drier Skin
Even with healthy aging, skin becomes thinner, less elastic, and more wrinkle-prone. It also may be drier than it used to be. With less oil and fewer sweat glands than in younger years, skin is not as well moisturized and protected, which can cause itching and cracking. You should be able to soothe the dryness with a rich moisturizing cream or ointment. However, sometimes dry skin is a symptom of a thyroid problem or an illness such as diabetes or kidney disease, so check with your doctor if the condition does not improve.
Visual Disturbances
Senior health problems can include a variety of issues with the eyes and eyesight, including cataracts, diabetic retinopathy, glaucoma, and macular degeneration. “According to research, by the time we turn 60, our pupils decrease to about one-third their normal size,” Fitzwater says. “The pupil of the eye also becomes less responsive to changes in light, making it difficult to see in the dark. And the lens of the eye gradually thickens and yellows.” These changes may result in difficulty noticing detail and a reduction in peripheral vision. Seeing your eye doctor regularly is essential to maintaining your vision as you age.
Difficulty Finding Words
Another aspect of senior health is difficulty finding the right word during conversations, a situation some people begin to experience in their forties or fifties. “Our brain retrieves words in a similar manner as it retrieves memories,” Kravitz says. “As we get older, some people’s retrieval mechanisms become slower, and this can manifest in a noticeable change in word-finding.”
Balance Issues
One obstacle to healthy aging can be problems with balance. According to the U.S. Centers for Disease Control and Prevention, more than one in three adults over age 65 falls each year. In many cases, an issue with the inner ear is the culprit, though the brain, heart, or even certain medications could also be the cause. If you’re experiencing this, see your doctor for an evaluation.
Decreased Sense of Smell
As with taste, your sense of smell can decrease after age 60, even if you're aging in a healthy way. While a number of reasons could be behind this, a declining sense of smell linked to aging is called presbyosmia. This type of sensory loss cannot be prevented. However, in some cases, a decreased sense of smell is not a result of aging but a side effect of medications, so check with your doctor to make sure this isn’t the case.
Slower Processing Speeds and Delayed Reflexes
Though the ability to remember should not be significantly different in in someone who is healthy and aging, you may find that you process information more slowly as you get older. Don’t be alarmed, though: It's not necessarily an indication of serious cognitive decline. “Processing speed, or the rate at which we process new information, is susceptible to age-related changes, and most older adults do report a slowing down,” Kravitz says. “This is most often observed in older adults who drive and is almost always the cause of fender-benders or minor accidents with the mailbox while backing out of the driveway.”
http://www.everydayhealth.com/senior-health-pictures/surprising-health-woes-of-getting-older.aspx?xid=aol_eh-senior_1_2011121_&aolcat=HLT&ncid=webmail7#/slide-9
(Ain't Life Grand?)
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Price of heart failure ---Low income raises HF risk The odds of suffering heart failure appear to be higher in seniors with a low income, even among those with a college or higher education, according to research presented last week at the American Heart Association's Scientific Sessions 2011 in Orlando. "As far as the risk of developing heart failure is concerned, lower education may not matter if a person is able to maintain a high income in later years," said Ali Ahmed, MD, MPH, senior researcher and the director of the Geriatric Heart Failure Clinics at the University of Alabama at Birmingham and the Birmingham VA Medical Center.
The researchers said the study is the first to link low income with an increased risk of heart failure in Medicare-eligible community-dwelling older men and women.
The researchers said they were surprised by the influence of income on heart failure risk in a population where nearly everyone has health insurance that provides care for major heart failure risk factors such as hypertension, diabetes and coronary artery disease. Although both poorer and well-off people benefit from the Medicare program, there may be certain differences that expose the poor to suboptimal care for major heart failure risk factors.
http://news.nurse.com/article/20111128/NATIONAL01/311280004
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Survey: U.S. doctors disagree on pregnancy start (Reuters) - Most U.S. doctors believe pregnancy starts when the sperm fertilizes the egg, a survey shows, contradicting the position of a key medical group with a view that could potentially affect U.S. policy and laws regarding contraception and research.
The American College of Obstetrics and Gynecology (ACOG), the leading organization for this field of medicine, defines pregnancy as beginning when the fertilized egg implants in the uterus, roughly a week after fertilization.
"People say that the medical profession has settled on this," said Farr Curlin, senior author of the study, which appeared in the American Journal of Obstetrics and Gynecology, and a professor at the University of Chicago. ...
http://www.reuters.com/article/2011/11/18/us-pregnancy-idUSTRE7AH0FD20111118?feedType=nl&feedName=ushealth1100
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FDA Revokes Approval of Avastin for Breast Cancer Drug isn't safe or effective for women with metastatic disease, agency says
FRIDAY, Nov. 18 (HealthDay News) -- Saying the risks outweigh the benefits in patients with advanced breast cancer, U.S. Food and Drug Administration Commissioner Dr. Margaret Hamburg said on Friday that the agency has rescinded its approval of the cancer drug Avastin for that use.
Avastin (bevacizumab), however, will remain available for treating some types of colon, lung, kidney and brain cancer.
"Today, I am revoking the FDA's approval of the breast cancer indication for Avastin after concluding that the drug has not been shown to be safe and effective for that use," Hamburg said during a late morning press conference. ... http://consumer.healthday.com/Article.asp?AID=659083
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New Stent Type Has Rare But Potentially Serious Problem, FDA Investigates The FDA says it is working with drug-eluting stent makers to better understand what makes the devices shrink or become deformed on rare occasions. A drug-eluting stent is a scaffold placed into narrowed, diseased peripheral or coronary arteries; it releases a medication to block cell proliferation, which helps prevent eventual reclogging of the blood vessel. The DES (drug-eluting stent) is placed during an angioplasty procedure. ... http://www.medicalnewstoday.com/articles/237999.php
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HIV numbers hit new high as AIDS drugs save lives (Reuters) - More people than ever are living with the AIDS virus but this is largely due to better access to drugs that keep HIV patients alive and well for many years, the United Nations AIDS program (UNAIDS) said on Monday.
In its annual report on the pandemic, UNAIDS said the number of people dying of the disease fell to 1.8 million in 2010, down from a peak of 2.2 million in the mid-2000s. ,,, http://www.reuters.com/article/2011/11/21/us-aids-global-unaids-idUSTRE7AK0KX20111121?feedType=nl&feedName=ushealth1100
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HIV/AIDS Update - Tentative approval of lamivudine/nevirapine/zidovudine 150 /200 /300 mg fixed-dose combination On Novermber 18, 2011, the Food and Drug Administration (FDA) granted tentative approval for a triple-drug fixed-dose combination tablet containing lamivudine, nevirapine, and zidovudine, 150 mg/200 mg/300 mg, indicated for use in combination with other antiretrovirals for the treatment of HIV-1 infection. The tablet is manufactured by Hetero Labs Limited of Hyderabad, India.
"Tentative approval" means that FDA has concluded that a drug product has met all required quality, safety and efficacy standards, but is not eligible for marketing in the U.S. because of existing patent protections. Tentative approval does, however, make the product eligible for purchase outside the United States under the President's Emergency Plan for AIDS Relief (PEPFAR) program.
These products were reviewed under expedited review provisions for PEPFAR under the FDA guidance titled Fixed Dose Combinations, Co-Packaged Drug Products, and Single-Entity Versions of Previously approved Antiretrovirals for the Treatment of HIV, to facilitate submission of such applications to FDA.
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FDA approves first drug to treat a rare bone marrow disease The U.S. Food and Drug Administration today approved Jakafi (ruxolitinib), the first drug approved to specifically treat patients with the bone marrow disease myelofibrosis.
Myelofibrosis is a disease in which the bone marrow is replaced by scar tissue resulting in blood cells being made in organs such as the liver and the spleen. This disease is marked by an enlarged spleen, anemia, decreased white blood cells and platelets, and myelofibrosis-related symptoms.
Symptoms include fatigue, abdominal discomfort, pain under the ribs, feeling full (satiety), muscle and bone pain, itching, and night sweats.
Jakafi, a pill taken two times a day, inhibits enzymes called JAK 1 and 2 (Janus Associated Kinase) that are involved in regulating blood and immunological functioning. Myelofibrosis is associated with the deregulation of JAK 1 and 2. ...
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm280102.htm
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Left Atrial Size Is a Potent Predictor of Mortality in Mitral Regurgitation Due to Flail Leaflets Left atrium (LA) enlargement is common in organic mitral regurgitation (MR) and is an emerging prognostic indicator. However, outcome implications of LA enlargement have not been analyzed in the context of routine clinical practice and in a multicenter study. ...
http://circimaging.ahajournals.org/content/4/5/473.full?WT.mc_id=EMxj02x20111125xL1
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Role of Elevated Heart Rate in the Development of Cardiovascular Disease in Hypertension That elevated heart rate (HR) is a risk factor for cardiovascular morbidity and mortality in healthy people as well as in patients with cardiac diseases is supported by numerous epidemiological association studies.1–4 Increased HR has been recognized as a negative prognostic factor independent of many other clinical parameters that can influence the HR, including physical activity scores, left ventricular function, or use of β-blockers. Thus, HR appears to satisfy all epidemiological criteria for being considered as a true risk factor, and its predictive value for cardiovascular disease appeared to be as strong as that of most important cardiovascular risk factors. ... http://hyper.ahajournals.org/content/58/5/745.full?WT.mc_id=EMxj02x20111125xL1
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Residual Cardiovascular Risk Despite Optimal LDL Cholesterol Reduction with Statins: The Evidence, Etiology, and Therapeutic Challenges This review captures the existence, cause, and treatment challenges of residual cardiovascular risk (CVR) after aggressive low-density lipoprotein cholesterol (LDL-C) reduction. Scientific evidence implicates low high-density lipoprotein cholesterol (HDL-C) and high triglycerides (TG) in the CVR observed after LDL-C lowering. However, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial with fenofibrate, the Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events (ILLUMINATE) study with torcetrapib, and the recently terminated Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) study with niacin, do not clearly attribute risk reduction value to HDL-C/TG modulation. The optimum approach to long-term lipid-modifying therapies for CVR reduction remains uncertain. ... http://www.springerlink.com/content/807x653260054775/ ; (PDF available)
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RANDOM FACT: The best estimates available suggest that the total volume of gold ever mined up to the end of 2006 was approximately 158,000 tones, of which around 65% has been mined since 1950.
RANDOM FACT: An oyster takes ten years to produce a pearl that is about the size of a pea.
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14 Little-Known Causes of Osteoporosis Although osteoporosis is often considered an older woman’s problem, many younger adults put themselves at risk for weakened bones and fractures without even realizing it.
“Osteoporosis is silent, so you don’t know you have it until you have a fracture,” explains Erin LeBlanc, MD, MPH, an investigator at the Kaiser Permanente Center for Health Research in Portland, Ore., who has done extensive research on women’s health and osteoporosis. And that means you may also not realize you’re increasing your risk — unless you know what factors contribute to the condition.
While osteoporosis has some well-known risk factors — such as a low-calcium diet, inactivity, and your genes — these other triggers may surprise you. ...
http://www.everydayhealth.com/osteoporosis/little-known-causes-of-osteoporosis.aspx?xid=aol_eh-osteo_1_20111205_&aolcat=HLT&ncid=webmail13
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Steering a course towards advanced nurse practitioner: a critical care perspective
Aim: This article is a report of a study of the experiences of expert critical care nurses in their transition to the role of advanced nurse practitioner within an intensive care unit (ICU) setting.
Background: The advanced nurse practitioner role was developed to support the ICU team and to undertake many of the roles traditionally associated with junior medical staff in this specialized area. The impetus for this study therefore was generated from the need to explore the role development experiences of trainee advanced nurse practitioners to inform future developments and practice.
Methods: This study used grounded theory methodology to conduct and analyse data from 25 participants. The data were collected between March 2010 and August 2010, using interview format. Data collection and analysis was conducted simultaneously using methods associated with grounded theory, theoretical sampling and the constant comparative method. ... http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2011.00448.x/abstract
(To get the full PDF : http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2011.00448.x/full )
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How Nurses Can Increase Their Earning Potential
By Megan M. Krischke, contributor
October 14, 2011 - The tenuous state of the U.S. economy has caused many nurses to take a hard look at their personal financial stability and find ways to maximize their earning power. One solution is personal professional development--acquiring advanced skill sets, meeting qualifications for specialty certifications and earning advanced degrees. Nurses can also use skills they already possess as the foundation for building a business that is an extension of their nursing experience.
Nan Brown, RN, BSN, and Lil Bogdan, RN, BSN, believe nurses are particularly gifted with the skills required to increase their earning power and achieve their dreams. Brown and Bogdan are co-founders of the L’Athene line of natural skin care products, once carried exclusively by Nordstom’s department stores and now also sold in spas and physicians’ offices.
“Nurses are great communicators, they know how to be flexible and wear many hats, they manage time and people, they implement and complete tasks and they are extremely resourceful. We have said many times that the skills we already had as nurses contributed greatly to our financial success,” stated Brown. ... http://www.nursezone.com/Nursing-News-Events/more-features/How-Nurses-Can-Increase-Their-Earning-Potential_38066.aspx
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United States Registered Nurse Workforce Report Card and Shortage Forecast
Abstract
Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - 1 112 112) RN jobs. There will be significant RN workforce shortages throughout the country in 2030; the western region will have the largest shortage ratio of 389 RN jobs per 100 000. Increased efforts to understand shortage dynamics are warranted. ...
http://ajm.sagepub.com/content/early/2011/11/18/1062860611416634.abstract
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Antibiotics overprescribed for children: study (Reuters) - Pediatricians in the United States write more than 10 million unnecessary antibiotic prescriptions every year for conditions such as the flu and asthma, contributing to potentially dangerous drug resistance, a study said.
Researchers looked at a nationally representative sample of almost 65,000 outpatient visits by children under 18 during 2006 to 2008, with findings reported in the journal Pediatrics.
In total, doctors prescribed an antibiotic at one in every five visits, with most dispensed for children with respiratory ailments such as sinus infections and pneumonia.
Some of those infections were caused by bacteria, warranting antibiotics. But almost one-quarter of all antibiotic prescriptions were given to children with respiratory conditions that probably or definitely do not call for antibiotics, such as bronchitis, the flu, asthma and allergies. ...
http://www.reuters.com/article/2011/11/08/us-prescriptions-children-idUSTRE7A747G20111108?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Tomatoes first grew as wild, cherry-size berries in the South American Andes, but the fruit, as we know it today,
was developed in Mexico where it was known as tomatil and traveled to Europe by boat with the returning conquistadors.
Bonus Fact: A tomato is 94% water.
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Heartburn Trigger Foods Heartburn and Foods: Dos and Don'ts Heartburn can be triggered by a number of specific foods.
Learn simple changes you can make in your diet to avoid the burn.
Common causes of heartburn include being overweight, being pregnant, or having GERD (gastroesophageal reflux disease). But what you eat and how even how you eat can also trigger heartburn, or acid reflux. A number of different foods and beverages can cause heartburn by aggravating the tissues that line the esophagus or by affecting the ability of the lower esophageal sphincter to close properly and keep acids in the stomach. ...
http://www.everydayhealth.com/digestive-health-pictures/heartburn-and-foods-dos-and-donts.aspx?xid=aol_eh-digest_4_20111205_&aolcat=AHD&ncid=webmail7#/slide-1
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FDA Hepatitis Update - CLIA waiver expands availability of rapid blood test for antibodies to the hepatitis C Virus (HCV) On November 28, 2011, the Food and Drug Administration granted a Clinical Laboratory Improvement Act (CLIA) waiver for the first rapid blood test for HCV, the OraQuick HCV Rapid Antibody Test, manufactured by OraSure Technologies, Inc. in Bethlehem, PA.
The OraQuick HCV Rapid Antibody Test is used in clinical settings to test individuals at risk for infection with HCV and individuals who have signs or symptoms associated with hepatitis.
The CLIA waiver will broaden access to the test by permitting more widespread distribution and use of the OraQuick HCV Test to nontraditional laboratory sites, including physicians' offices, health department clinics and other freestanding counseling and testing sites. The broader availability and easier access to this test may contribute to a higher rate of detection for this disease.
OraQuick is a test strip that is read visually and does not require an instrument for diagnosis. Its 20-minute response time allows decentralized testing of HCV enabling the patient to be referred immediately for further testing.
The test qualifies for the CLIA waiver based on data submitted to FDA that demonstrated that the test is simple, accurate, and reasonably free of harm. fda@service.govdelivery.com
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Migraines may raise depression risk: study (Reuters Health) -
People who get painful migraine headaches may be at a higher risk for developing clinical depression, suggests a new study from Canada.
The research, published in the journal Headache, also hints that the relationship may go both ways, and people with clinical depression could have a higher risk of developing migraines, but that finding could have been due to chance, the researchers say.
Nonetheless, lead author Geeta Modgill, who was at the University of Calgary while conducting the work, told Reuters Health that migraine and depression sufferers should know the signs of both ailments since each might be at a higher risk for the other condition. ...
http://www.reuters.com/article/2011/11/24/us-health-migraines-idUSTRE7AN1U420111124?feedType=nl&feedName=ushealth1100
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Aspirin not worth risks for healthy women: study (Reuters Health) - Aspirin is a bad bargain for healthy women trying to stave off heart attacks or strokes, although it's commonly used for that purpose, according to Dutch researchers.
In a new report, they say 50 women will need to take the medication for 10 years for just one to be helped -- and that's assuming they are at high risk to begin with.
"There are very few women who actually benefit," said Dr. Jannick Dorresteijn of University Medical Center Utrecht in The Netherlands. "If you don't want to treat 49 patients for nothing to benefit one, you shouldn't treat anyone with aspirin."
The new study adds to a long-standing controversy over aspirin, one of the world's most widely used drugs.
Doctors agree it's worth taking for people who've already had a heart attack or a stroke, but they are less certain when it comes to so-called primary prevention. ...
http://www.reuters.com/article/2011/11/25/us-health-aspirin-idUSTRE7AN1TM20111125?feedType=nl&feedName=ushealth1100
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ERs often skip tests for young kids with fever (Reuters Health) - Babies and toddlers who arrive at the ER with an unexplained fever often receive no kind of diagnostic test to get at the source of the high temperature, a new study finds.
Whether that's a bad or good thing is not clear, according to the researchers.
But in some cases, the study found, ER doctors prescribe antibiotics without testing to confirm whether or not the child has a bacterial infection. And that could potentially lead to antibiotic overuse. ... http://www.reuters.com/article/2011/11/23/us-er-fever-idUSTRE7AM2R320111123?feedType=nl&feedName=ushealth1100
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Safety data favors less-invasive weight-loss surgery (Reuters Health) - Minimally-invasive weight-loss procedures seem to be safer than open bariatric surgery, according to researchers who analyzed past studies comparing the two methods.
The new report suggests that so-called laparoscopic surgery carries an 80 to 90 percent lower risk of infections and hernias, but that just as many people getting both procedures need the operation repeated. The risk of death from either appears to be low, researchers added.
"Within the surgical field it's been almost accepted to a degree that laparoscopic is the way to go," said Jennifer Reoch, a nursing graduate student at McGill University in Montreal, who led the new research. "Our study was to kind of give a little more weight to that decision." ...
http://www.reuters.com/article/2011/11/23/us-weightloss-surgery-idUSTRE7AM2RX20111123?feedType=nl&feedName=ushealth11
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(We know that 4 gr of Tylenol is the most one should take a day....not sure to what this person is referring "staggered overdose)
Dangers Of Staggered Overdose Of Acetaminophen (Tylenol, Paracetamol)
Repeatedly taking marginally too much paracetamol (acetaminophen, Tylenol) over time can cause a dangerous overdose that is hard to detect and can lead to death, because patients usually don't report an overdose when they visit the hospital, rather that they feel unwell. Clinicians need to be able to detect these cases rapidly so that they can provide prompt and effective treatment, as these patients are in greater danger compared with those who have taken a single overdose. ... http://www.medicalnewstoday.com/articles/238220.php
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Thank you, Barbara (BACello):
Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)*
This report updates the previously published summary of recommendations of the Advisory Committee on Immunization
Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC) for vaccinating health-care
personnel (HCP) in the United States. This report summarizes all current ACIP recommendations for vaccination of HCP
and does not contain any new recommendations or policies. The recommendations provided in this report apply, but are
not limited, to HCP in acute-care hospitals; long-term-care facilities (e.g., nursing homes and skilled nursing facilities);
physician's offices; rehabilitation centers; urgent care centers, and outpatient clinics as well as to persons who
provide home health care and emergency medical services. (full text) ...
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm?s_cid=rr6007a1_e&source=govdelivery
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RANDOM FACT: A desire path is one that was stomped out away from the original path or walkway; usually to make a short cut.
These are found a lot on college campuses.
Bonus Fact: A lunule refers to the white-shaded crescent peeking out on the bottom of your finger nail. (did you remember this?)
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Cholesterol drugs safe, even after a decade of use
(Reuters) - Cholesterol-lowering drugs continue to produce benefits without any serious safety problems, such as increased cancer risk, even after more than a decade of use, researchers said Wednesday.
The finding from a large British clinical study following patients for 11 years provides reassurance for people at risk of heart attacks who are typically prescribed such medicines indefinitely.
So-called statin drugs are not without side effects. They can cause nausea, muscle pain, and occasional kidney and liver damage.
But long-term follow-up in the 20,000-patient Heart Protection Study (HPS) found no evidence that statins increased the risk of non-vascular mortality or made patients more likely to develop cancer. ...
http://www.reuters.com/article/2011/11/23/us-cholesterol-idUSTRE7AM00Q20111123?feedType=nl&feedName=ushealth1100
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Coronary Artery Calcium Progression: An Important Clinical Measurement?
A Review of Published Reports
Baseline coronary artery calcification (CAC) accurately identifies coronary atherosclerosis and might improve prediction of future cardiac events. Serial assessment of CAC scores has been proposed for monitoring atherosclerosis progression and for assessing the effectiveness of medical therapies aimed at reducing cardiac risk. However, whether knowledge of progression of CAC scores over time further improves risk prediction is unclear. Several trials relating medical therapies to CAC progression have been performed without any formal guidelines on the definition of CAC progression and how it is best quantified. ... http://content.onlinejacc.org/cgi/content/short/56/20/1613?rss=1
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Aspirin for primary prevention of vascular events in women: individualized prediction of treatment effects (study)
Aims To identify women who benefit from aspirin 100 mg on alternate days for primary prevention of vascular events by using treatment effect prediction based on individual patient characteristics.
Methods and results Randomized controlled trial data from the Women's Health Study were used to predict treatment effects for individual women in terms of absolute risk reduction for major cardiovascular events (i.e. myocardial infarction, stroke, or cardiovascular death). ...
http://eurheartj.oxfordjournals.org/content/early/2011/11/16/eurheartj.ehr423.abstract
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Studies suggest that these three fab fluids may keep hunger at bay, reduce calorie intake, and keep the pounds from creeping on:
Skim milk: In a study, the people who drank about 20 ounces of skim milk at breakfast ate way less at lunch compared with the people who had fruit juice with their morning meals. The researchers think the proteins in skim milk -- whey and casein -- may help make skim milk quite the filler-upper. (Related: Not a milk drinker? Fill up on this popular high-protein breakfast food instead.)
Olive oil: This Mediterranean staple is loaded with a hunger-curbing compound called oleic acid. This monounsaturated fat stimulates the small intestine to make another fatlike substance that sends "full" signals from the stomach to the brain. Other foods high in oleic acid include sunflower seeds, canola oil, safflower oil, almonds, and avocados. (Related: Find out why corn oil may be a bad choice for you.)
Water: Numerous studies suggest that folks who drink ample water feel fuller and eat far fewer calories throughout the day compared with people who don't drink enough agua. Water drinkers are also less likely to indulge in sweetened drinks like soda, calorie-laden coffee drinks, and sugary sports drinks. And in yet another study, drinking 16 ounces of water before each meal helped dieters lose more weight -- and lose it faster -- than dieters who didn't drink water before meals.
http://www.realage.com/health-tips/3-liquids-to-suppress-your-appetite-naturally?eid=1010640918&memberid=4687812
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HUMOR SECTION
While my wife and I were shopping at a mall, a shapely young woman in a short, form-fitting dress strolled by. My eyes involuntarily followed her.
Without looking up from the item she was examining, my wife asked, "Was that worth the trouble you're in?"
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Here is a very simple little test comprised of four questions to determine the level of your intellect. Your replies must be spontaneous and immediate, with no deliberating or wasting time... And no cheating!
1: You are competing in a race and overtake the runner lying in second place. In which position are you now?
Answer: If you answered that you're now coming first then you're completely wrong. You overtook the second runner and took their place, therefore you're coming second. For the next question try not to be so dim.
2: If you overtake the last runner, what position are you now in?
Answer: If you answered second-last, once again you're completely wrong. Think about it. How can you over take the person coming last? If you're behind them then they can't be last. The answer is impossible! It would appear that thinking is not one of your strong points.
Anyway, here's another to try, don't take any notes or use a calculator, and remember your replies must be instantaneous. Take heart!
3: Take 1000. Add 40. Add another 1000. Add 30. 1000 again. Plus 20. Plus 1000. And plus 10. What is the total?
Answer: 5000? Wrong again! The correct answer is 4100. Try again with a good calculator. Today is clearly not your day. Although you should manage to get the last question right...
4: Marie's father has five daughters: 1. Chacha 2. Cheche 3. Chichi 4. Chocho Question: What is the fifth daughter's name? Think quickly... you'll find the answer below.
Answer: Chuchu? WRONG! It's obviously Marie! Read the question again.
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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 information has recently been updated and is now available:
Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus (PDF - 168KB)
Posted: 11/29/2011
This website is the FDA's Enforcement site....all the foodstuffs that have had to be recalled due to contamination.
(Listeria, for one). http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm281022.htm
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/
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
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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CareFusion EnVe Ventilators Recall Class: Class I
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/ListofRecalls/ucm278634.htm
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Draeger Medical Inc., Infinity Acute Care System Monitoring Solution (M540) Catalog number MS25510
All serial numbers are affected by this recall.
This product was manufactured from March 1, 2011 through September 30, 2011 and distributed only to the Rush University Medical Center (Chicago, Illinois) from July 1, 2011 through September 30, 2011.
Use: This product is a networked solution system used to monitor a patient’s vital signs and therapy, control alarms, review Web-based diagnostic images, and access patient records. The number of monitored vital signs can be increased or decreased based on the patient’s needs.
The weight-based drug dosage calculation may indicate incorrect recommended values, including a drug dosage up to ten times the indicated dosage. Additionally, there may be a 5-10 second delay between the electrocardiogram and blood pressure curves (waveforms) at the Infinity Central Station. This product may cause serious adverse health consequences, including death. ...
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm282461.htm
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CooperVision AVAIRA AQUAFORM Sphere Soft Contact Lenses Class 1 Recall The unintended presence of a silicone oil residue on AVAIRA Sphere soft contact lenses. Symptoms may range from hazy, blurry vision, discomfort to eye injuries requiring medical treatment.
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm282733.htm
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NURSING HINTS CORNER
Squeezing for strength Here is a quick way to check the strength of a patient's handgrip Roll up a blood pressure cuff, pump it up slightly and have the patient squeeze it while measuring the millimeters of mercury. Do the same thing with his other hand. The reading for the dominant hand may be higher by 10 to 20 mm HG. This technique can help detect the slightest neurologic change, saving the patient from potential problems. Dorothy M. Kellogg, RN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.120, Springhouse Corporation/www.springnetcom. ;
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ADVERTISEMENTS from the members
(contact me with your ad)
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:
Christina.Roskilly@live.com (Christina) December 7, 2011
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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 or, instead, 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
We can have democracy in this country, or we can have great wealth concentrated
in the hands of a few, but we can't have both.
--Louis Brandeis,
Supreme Court Justice from 1916--1939
Drop me a line..... Frankie RNFrankie@AOL.com
Newsletter for Paradigm 97
December 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
(I saw this on a list-serve, and wanted to share) It is great being a nurse (at least most days) , isn't it?
Dear Sugar,
In March 2004, my daughter Emily died 4 days after she was born, because of an overworked labor and delivery team and their errors,
plural – one of those “all the holes in the Swiss cheese lined up” stories. During her life she was in a lot of pain. She could not hear, see,
move or swallow her own saliva. After we made the terrible decision to take her off life support she fought for her life for 12 hours. I cannot
honestly say this is a story where she taught me to live better or anything like that. The death of a child is only a tragedy. And yet, there was a
nurse in the NICU who stubbornly, stoically, referred to my husband and I – first-time parents – as mum and dad; who told us we had better
change her diaper, even when she was dying, and critiqued our technique. Who invited us to give her her first and last bath. Who told us we
were good parents. Who made the unthinkable and abnormal into two parents caring for their child.
What she didn’t know is that we had been trying to have a child for 8 years. And the reason it had taken that long is that my uterus was
scarred from childhood abuse. And that I had learned never to expect a helping hand, and then had done therapy to overcome that, and then
had been so terribly let down by our L&D team. I would have lain down and given up, I think, had that nurse not reached out to me with the
exact right words at the exact right time.
Eighteen months later we had my son, now 6. This year we welcomed our second son. Our family still is missing my little girl, but it feels complete. I am incredibly, joyfully, happy. It is amazing the difference it makes sometimes when someone just reaches into the heart of your experience and names it, and sits there with you in it. Jenn
To see this in context of where/why it was written:
http://therumpus.net/2011/11/dear-sugar-the-rumpus-advice-column-90-94-ways-of-saying-thank-you/
The contributor wrote: "This is the best advice column I have ever read".
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Surprising Health Woes of Getting Older Aging is a fact of life, and with it come certain senior health issues. Many people worry about cognitive decline and weaker bones, but there are other, lesser-known concerns, too. That’s why it’s important for everyone to do what they can to encourage healthy aging.
“The rate at which we experience change tends to be quite individual, often based on lifestyle choices, genetics, and environmental factors,” explains Evelyn Fitzwater, DSN, RN, associate director of the Center for Aging With Dignity at the University of Cincinnati College of Nursing. The sequence of change, however, is similar for all of us. Here are some of the more surprising health effects you should expect.
A Change in Taste
One of the many senior health problems not often discussed is a decline in taste buds. We are each born with approximately 9,000 taste buds, but that number starts to decrease between the ages 40 and 50 in women and 50 and 60 in men. The result is that people need greater taste stimulation to experience the four flavors of sweet, salty, sour, and bitter. Salty and sweet tastes tend to be lost first, with bitter and sour following along behind. Experts aren’t exactly sure what causes this, though some think it is related to disease, smoking, and environmental exposures.
Multitasking Challenges
In a world where we expect even our phones to juggle duties — make a call, surf the Web, provide GPS directions! — it might seem inefficient to turn all your focus on one thing. But as you get older, you may find yourself having to do just that. “Multitasking is a complex cognitive task that relies on a number of our brain’s functions, including attention, executive functions, and working memory, among others,” says Jena Kravitz, PsyD, a clinical neuropsychologist at the Good Samaritan Hospital in Los Angeles. “At a basic level, the ability to multitask relies on how quickly and efficiently our brain can switch between tasks while blocking out distraction and maintaining focus.” It’s important to be aware, though, that this difficulty is usually a result of natural healthy aging and is not necessarily indicative of serious cognitive decline.
Drier Skin
Even with healthy aging, skin becomes thinner, less elastic, and more wrinkle-prone. It also may be drier than it used to be. With less oil and fewer sweat glands than in younger years, skin is not as well moisturized and protected, which can cause itching and cracking. You should be able to soothe the dryness with a rich moisturizing cream or ointment. However, sometimes dry skin is a symptom of a thyroid problem or an illness such as diabetes or kidney disease, so check with your doctor if the condition does not improve.
Visual Disturbances
Senior health problems can include a variety of issues with the eyes and eyesight, including cataracts, diabetic retinopathy, glaucoma, and macular degeneration. “According to research, by the time we turn 60, our pupils decrease to about one-third their normal size,” Fitzwater says. “The pupil of the eye also becomes less responsive to changes in light, making it difficult to see in the dark. And the lens of the eye gradually thickens and yellows.” These changes may result in difficulty noticing detail and a reduction in peripheral vision. Seeing your eye doctor regularly is essential to maintaining your vision as you age.
Difficulty Finding Words
Another aspect of senior health is difficulty finding the right word during conversations, a situation some people begin to experience in their forties or fifties. “Our brain retrieves words in a similar manner as it retrieves memories,” Kravitz says. “As we get older, some people’s retrieval mechanisms become slower, and this can manifest in a noticeable change in word-finding.”
Balance Issues
One obstacle to healthy aging can be problems with balance. According to the U.S. Centers for Disease Control and Prevention, more than one in three adults over age 65 falls each year. In many cases, an issue with the inner ear is the culprit, though the brain, heart, or even certain medications could also be the cause. If you’re experiencing this, see your doctor for an evaluation.
Decreased Sense of Smell
As with taste, your sense of smell can decrease after age 60, even if you're aging in a healthy way. While a number of reasons could be behind this, a declining sense of smell linked to aging is called presbyosmia. This type of sensory loss cannot be prevented. However, in some cases, a decreased sense of smell is not a result of aging but a side effect of medications, so check with your doctor to make sure this isn’t the case.
Slower Processing Speeds and Delayed Reflexes
Though the ability to remember should not be significantly different in in someone who is healthy and aging, you may find that you process information more slowly as you get older. Don’t be alarmed, though: It's not necessarily an indication of serious cognitive decline. “Processing speed, or the rate at which we process new information, is susceptible to age-related changes, and most older adults do report a slowing down,” Kravitz says. “This is most often observed in older adults who drive and is almost always the cause of fender-benders or minor accidents with the mailbox while backing out of the driveway.”
http://www.everydayhealth.com/senior-health-pictures/surprising-health-woes-of-getting-older.aspx?xid=aol_eh-senior_1_2011121_&aolcat=HLT&ncid=webmail7#/slide-9
(Ain't Life Grand?)
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
Price of heart failure ---Low income raises HF risk The odds of suffering heart failure appear to be higher in seniors with a low income, even among those with a college or higher education, according to research presented last week at the American Heart Association's Scientific Sessions 2011 in Orlando. "As far as the risk of developing heart failure is concerned, lower education may not matter if a person is able to maintain a high income in later years," said Ali Ahmed, MD, MPH, senior researcher and the director of the Geriatric Heart Failure Clinics at the University of Alabama at Birmingham and the Birmingham VA Medical Center.
The researchers said the study is the first to link low income with an increased risk of heart failure in Medicare-eligible community-dwelling older men and women.
The researchers said they were surprised by the influence of income on heart failure risk in a population where nearly everyone has health insurance that provides care for major heart failure risk factors such as hypertension, diabetes and coronary artery disease. Although both poorer and well-off people benefit from the Medicare program, there may be certain differences that expose the poor to suboptimal care for major heart failure risk factors.
http://news.nurse.com/article/20111128/NATIONAL01/311280004
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Survey: U.S. doctors disagree on pregnancy start (Reuters) - Most U.S. doctors believe pregnancy starts when the sperm fertilizes the egg, a survey shows, contradicting the position of a key medical group with a view that could potentially affect U.S. policy and laws regarding contraception and research.
The American College of Obstetrics and Gynecology (ACOG), the leading organization for this field of medicine, defines pregnancy as beginning when the fertilized egg implants in the uterus, roughly a week after fertilization.
"People say that the medical profession has settled on this," said Farr Curlin, senior author of the study, which appeared in the American Journal of Obstetrics and Gynecology, and a professor at the University of Chicago. ...
http://www.reuters.com/article/2011/11/18/us-pregnancy-idUSTRE7AH0FD20111118?feedType=nl&feedName=ushealth1100
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FDA Revokes Approval of Avastin for Breast Cancer Drug isn't safe or effective for women with metastatic disease, agency says
FRIDAY, Nov. 18 (HealthDay News) -- Saying the risks outweigh the benefits in patients with advanced breast cancer, U.S. Food and Drug Administration Commissioner Dr. Margaret Hamburg said on Friday that the agency has rescinded its approval of the cancer drug Avastin for that use.
Avastin (bevacizumab), however, will remain available for treating some types of colon, lung, kidney and brain cancer.
"Today, I am revoking the FDA's approval of the breast cancer indication for Avastin after concluding that the drug has not been shown to be safe and effective for that use," Hamburg said during a late morning press conference. ... http://consumer.healthday.com/Article.asp?AID=659083
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New Stent Type Has Rare But Potentially Serious Problem, FDA Investigates The FDA says it is working with drug-eluting stent makers to better understand what makes the devices shrink or become deformed on rare occasions. A drug-eluting stent is a scaffold placed into narrowed, diseased peripheral or coronary arteries; it releases a medication to block cell proliferation, which helps prevent eventual reclogging of the blood vessel. The DES (drug-eluting stent) is placed during an angioplasty procedure. ... http://www.medicalnewstoday.com/articles/237999.php
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HIV numbers hit new high as AIDS drugs save lives (Reuters) - More people than ever are living with the AIDS virus but this is largely due to better access to drugs that keep HIV patients alive and well for many years, the United Nations AIDS program (UNAIDS) said on Monday.
In its annual report on the pandemic, UNAIDS said the number of people dying of the disease fell to 1.8 million in 2010, down from a peak of 2.2 million in the mid-2000s. ,,, http://www.reuters.com/article/2011/11/21/us-aids-global-unaids-idUSTRE7AK0KX20111121?feedType=nl&feedName=ushealth1100
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HIV/AIDS Update - Tentative approval of lamivudine/nevirapine/zidovudine 150 /200 /300 mg fixed-dose combination On Novermber 18, 2011, the Food and Drug Administration (FDA) granted tentative approval for a triple-drug fixed-dose combination tablet containing lamivudine, nevirapine, and zidovudine, 150 mg/200 mg/300 mg, indicated for use in combination with other antiretrovirals for the treatment of HIV-1 infection. The tablet is manufactured by Hetero Labs Limited of Hyderabad, India.
"Tentative approval" means that FDA has concluded that a drug product has met all required quality, safety and efficacy standards, but is not eligible for marketing in the U.S. because of existing patent protections. Tentative approval does, however, make the product eligible for purchase outside the United States under the President's Emergency Plan for AIDS Relief (PEPFAR) program.
These products were reviewed under expedited review provisions for PEPFAR under the FDA guidance titled Fixed Dose Combinations, Co-Packaged Drug Products, and Single-Entity Versions of Previously approved Antiretrovirals for the Treatment of HIV, to facilitate submission of such applications to FDA.
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FDA approves first drug to treat a rare bone marrow disease The U.S. Food and Drug Administration today approved Jakafi (ruxolitinib), the first drug approved to specifically treat patients with the bone marrow disease myelofibrosis.
Myelofibrosis is a disease in which the bone marrow is replaced by scar tissue resulting in blood cells being made in organs such as the liver and the spleen. This disease is marked by an enlarged spleen, anemia, decreased white blood cells and platelets, and myelofibrosis-related symptoms.
Symptoms include fatigue, abdominal discomfort, pain under the ribs, feeling full (satiety), muscle and bone pain, itching, and night sweats.
Jakafi, a pill taken two times a day, inhibits enzymes called JAK 1 and 2 (Janus Associated Kinase) that are involved in regulating blood and immunological functioning. Myelofibrosis is associated with the deregulation of JAK 1 and 2. ...
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm280102.htm
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Left Atrial Size Is a Potent Predictor of Mortality in Mitral Regurgitation Due to Flail Leaflets Left atrium (LA) enlargement is common in organic mitral regurgitation (MR) and is an emerging prognostic indicator. However, outcome implications of LA enlargement have not been analyzed in the context of routine clinical practice and in a multicenter study. ...
http://circimaging.ahajournals.org/content/4/5/473.full?WT.mc_id=EMxj02x20111125xL1
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Role of Elevated Heart Rate in the Development of Cardiovascular Disease in Hypertension That elevated heart rate (HR) is a risk factor for cardiovascular morbidity and mortality in healthy people as well as in patients with cardiac diseases is supported by numerous epidemiological association studies.1–4 Increased HR has been recognized as a negative prognostic factor independent of many other clinical parameters that can influence the HR, including physical activity scores, left ventricular function, or use of β-blockers. Thus, HR appears to satisfy all epidemiological criteria for being considered as a true risk factor, and its predictive value for cardiovascular disease appeared to be as strong as that of most important cardiovascular risk factors. ... http://hyper.ahajournals.org/content/58/5/745.full?WT.mc_id=EMxj02x20111125xL1
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Residual Cardiovascular Risk Despite Optimal LDL Cholesterol Reduction with Statins: The Evidence, Etiology, and Therapeutic Challenges This review captures the existence, cause, and treatment challenges of residual cardiovascular risk (CVR) after aggressive low-density lipoprotein cholesterol (LDL-C) reduction. Scientific evidence implicates low high-density lipoprotein cholesterol (HDL-C) and high triglycerides (TG) in the CVR observed after LDL-C lowering. However, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial with fenofibrate, the Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events (ILLUMINATE) study with torcetrapib, and the recently terminated Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) study with niacin, do not clearly attribute risk reduction value to HDL-C/TG modulation. The optimum approach to long-term lipid-modifying therapies for CVR reduction remains uncertain. ... http://www.springerlink.com/content/807x653260054775/ ; (PDF available)
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RANDOM FACT: The best estimates available suggest that the total volume of gold ever mined up to the end of 2006 was approximately 158,000 tones, of which around 65% has been mined since 1950.
RANDOM FACT: An oyster takes ten years to produce a pearl that is about the size of a pea.
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14 Little-Known Causes of Osteoporosis Although osteoporosis is often considered an older woman’s problem, many younger adults put themselves at risk for weakened bones and fractures without even realizing it.
“Osteoporosis is silent, so you don’t know you have it until you have a fracture,” explains Erin LeBlanc, MD, MPH, an investigator at the Kaiser Permanente Center for Health Research in Portland, Ore., who has done extensive research on women’s health and osteoporosis. And that means you may also not realize you’re increasing your risk — unless you know what factors contribute to the condition.
While osteoporosis has some well-known risk factors — such as a low-calcium diet, inactivity, and your genes — these other triggers may surprise you. ...
http://www.everydayhealth.com/osteoporosis/little-known-causes-of-osteoporosis.aspx?xid=aol_eh-osteo_1_20111205_&aolcat=HLT&ncid=webmail13
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Steering a course towards advanced nurse practitioner: a critical care perspective
Aim: This article is a report of a study of the experiences of expert critical care nurses in their transition to the role of advanced nurse practitioner within an intensive care unit (ICU) setting.
Background: The advanced nurse practitioner role was developed to support the ICU team and to undertake many of the roles traditionally associated with junior medical staff in this specialized area. The impetus for this study therefore was generated from the need to explore the role development experiences of trainee advanced nurse practitioners to inform future developments and practice.
Methods: This study used grounded theory methodology to conduct and analyse data from 25 participants. The data were collected between March 2010 and August 2010, using interview format. Data collection and analysis was conducted simultaneously using methods associated with grounded theory, theoretical sampling and the constant comparative method. ... http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2011.00448.x/abstract
(To get the full PDF : http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2011.00448.x/full )
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How Nurses Can Increase Their Earning Potential
By Megan M. Krischke, contributor
October 14, 2011 - The tenuous state of the U.S. economy has caused many nurses to take a hard look at their personal financial stability and find ways to maximize their earning power. One solution is personal professional development--acquiring advanced skill sets, meeting qualifications for specialty certifications and earning advanced degrees. Nurses can also use skills they already possess as the foundation for building a business that is an extension of their nursing experience.
Nan Brown, RN, BSN, and Lil Bogdan, RN, BSN, believe nurses are particularly gifted with the skills required to increase their earning power and achieve their dreams. Brown and Bogdan are co-founders of the L’Athene line of natural skin care products, once carried exclusively by Nordstom’s department stores and now also sold in spas and physicians’ offices.
“Nurses are great communicators, they know how to be flexible and wear many hats, they manage time and people, they implement and complete tasks and they are extremely resourceful. We have said many times that the skills we already had as nurses contributed greatly to our financial success,” stated Brown. ... http://www.nursezone.com/Nursing-News-Events/more-features/How-Nurses-Can-Increase-Their-Earning-Potential_38066.aspx
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United States Registered Nurse Workforce Report Card and Shortage Forecast
Abstract
Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - 1 112 112) RN jobs. There will be significant RN workforce shortages throughout the country in 2030; the western region will have the largest shortage ratio of 389 RN jobs per 100 000. Increased efforts to understand shortage dynamics are warranted. ...
http://ajm.sagepub.com/content/early/2011/11/18/1062860611416634.abstract
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Antibiotics overprescribed for children: study (Reuters) - Pediatricians in the United States write more than 10 million unnecessary antibiotic prescriptions every year for conditions such as the flu and asthma, contributing to potentially dangerous drug resistance, a study said.
Researchers looked at a nationally representative sample of almost 65,000 outpatient visits by children under 18 during 2006 to 2008, with findings reported in the journal Pediatrics.
In total, doctors prescribed an antibiotic at one in every five visits, with most dispensed for children with respiratory ailments such as sinus infections and pneumonia.
Some of those infections were caused by bacteria, warranting antibiotics. But almost one-quarter of all antibiotic prescriptions were given to children with respiratory conditions that probably or definitely do not call for antibiotics, such as bronchitis, the flu, asthma and allergies. ...
http://www.reuters.com/article/2011/11/08/us-prescriptions-children-idUSTRE7A747G20111108?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Tomatoes first grew as wild, cherry-size berries in the South American Andes, but the fruit, as we know it today,
was developed in Mexico where it was known as tomatil and traveled to Europe by boat with the returning conquistadors.
Bonus Fact: A tomato is 94% water.
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Heartburn Trigger Foods Heartburn and Foods: Dos and Don'ts Heartburn can be triggered by a number of specific foods.
Learn simple changes you can make in your diet to avoid the burn.
Common causes of heartburn include being overweight, being pregnant, or having GERD (gastroesophageal reflux disease). But what you eat and how even how you eat can also trigger heartburn, or acid reflux. A number of different foods and beverages can cause heartburn by aggravating the tissues that line the esophagus or by affecting the ability of the lower esophageal sphincter to close properly and keep acids in the stomach. ...
http://www.everydayhealth.com/digestive-health-pictures/heartburn-and-foods-dos-and-donts.aspx?xid=aol_eh-digest_4_20111205_&aolcat=AHD&ncid=webmail7#/slide-1
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FDA Hepatitis Update - CLIA waiver expands availability of rapid blood test for antibodies to the hepatitis C Virus (HCV) On November 28, 2011, the Food and Drug Administration granted a Clinical Laboratory Improvement Act (CLIA) waiver for the first rapid blood test for HCV, the OraQuick HCV Rapid Antibody Test, manufactured by OraSure Technologies, Inc. in Bethlehem, PA.
The OraQuick HCV Rapid Antibody Test is used in clinical settings to test individuals at risk for infection with HCV and individuals who have signs or symptoms associated with hepatitis.
The CLIA waiver will broaden access to the test by permitting more widespread distribution and use of the OraQuick HCV Test to nontraditional laboratory sites, including physicians' offices, health department clinics and other freestanding counseling and testing sites. The broader availability and easier access to this test may contribute to a higher rate of detection for this disease.
OraQuick is a test strip that is read visually and does not require an instrument for diagnosis. Its 20-minute response time allows decentralized testing of HCV enabling the patient to be referred immediately for further testing.
The test qualifies for the CLIA waiver based on data submitted to FDA that demonstrated that the test is simple, accurate, and reasonably free of harm. fda@service.govdelivery.com
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Migraines may raise depression risk: study (Reuters Health) -
People who get painful migraine headaches may be at a higher risk for developing clinical depression, suggests a new study from Canada.
The research, published in the journal Headache, also hints that the relationship may go both ways, and people with clinical depression could have a higher risk of developing migraines, but that finding could have been due to chance, the researchers say.
Nonetheless, lead author Geeta Modgill, who was at the University of Calgary while conducting the work, told Reuters Health that migraine and depression sufferers should know the signs of both ailments since each might be at a higher risk for the other condition. ...
http://www.reuters.com/article/2011/11/24/us-health-migraines-idUSTRE7AN1U420111124?feedType=nl&feedName=ushealth1100
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Aspirin not worth risks for healthy women: study (Reuters Health) - Aspirin is a bad bargain for healthy women trying to stave off heart attacks or strokes, although it's commonly used for that purpose, according to Dutch researchers.
In a new report, they say 50 women will need to take the medication for 10 years for just one to be helped -- and that's assuming they are at high risk to begin with.
"There are very few women who actually benefit," said Dr. Jannick Dorresteijn of University Medical Center Utrecht in The Netherlands. "If you don't want to treat 49 patients for nothing to benefit one, you shouldn't treat anyone with aspirin."
The new study adds to a long-standing controversy over aspirin, one of the world's most widely used drugs.
Doctors agree it's worth taking for people who've already had a heart attack or a stroke, but they are less certain when it comes to so-called primary prevention. ...
http://www.reuters.com/article/2011/11/25/us-health-aspirin-idUSTRE7AN1TM20111125?feedType=nl&feedName=ushealth1100
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ERs often skip tests for young kids with fever (Reuters Health) - Babies and toddlers who arrive at the ER with an unexplained fever often receive no kind of diagnostic test to get at the source of the high temperature, a new study finds.
Whether that's a bad or good thing is not clear, according to the researchers.
But in some cases, the study found, ER doctors prescribe antibiotics without testing to confirm whether or not the child has a bacterial infection. And that could potentially lead to antibiotic overuse. ... http://www.reuters.com/article/2011/11/23/us-er-fever-idUSTRE7AM2R320111123?feedType=nl&feedName=ushealth1100
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Safety data favors less-invasive weight-loss surgery (Reuters Health) - Minimally-invasive weight-loss procedures seem to be safer than open bariatric surgery, according to researchers who analyzed past studies comparing the two methods.
The new report suggests that so-called laparoscopic surgery carries an 80 to 90 percent lower risk of infections and hernias, but that just as many people getting both procedures need the operation repeated. The risk of death from either appears to be low, researchers added.
"Within the surgical field it's been almost accepted to a degree that laparoscopic is the way to go," said Jennifer Reoch, a nursing graduate student at McGill University in Montreal, who led the new research. "Our study was to kind of give a little more weight to that decision." ...
http://www.reuters.com/article/2011/11/23/us-weightloss-surgery-idUSTRE7AM2RX20111123?feedType=nl&feedName=ushealth11
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(We know that 4 gr of Tylenol is the most one should take a day....not sure to what this person is referring "staggered overdose)
Dangers Of Staggered Overdose Of Acetaminophen (Tylenol, Paracetamol)
Repeatedly taking marginally too much paracetamol (acetaminophen, Tylenol) over time can cause a dangerous overdose that is hard to detect and can lead to death, because patients usually don't report an overdose when they visit the hospital, rather that they feel unwell. Clinicians need to be able to detect these cases rapidly so that they can provide prompt and effective treatment, as these patients are in greater danger compared with those who have taken a single overdose. ... http://www.medicalnewstoday.com/articles/238220.php
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Thank you, Barbara (BACello):
Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)*
This report updates the previously published summary of recommendations of the Advisory Committee on Immunization
Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC) for vaccinating health-care
personnel (HCP) in the United States. This report summarizes all current ACIP recommendations for vaccination of HCP
and does not contain any new recommendations or policies. The recommendations provided in this report apply, but are
not limited, to HCP in acute-care hospitals; long-term-care facilities (e.g., nursing homes and skilled nursing facilities);
physician's offices; rehabilitation centers; urgent care centers, and outpatient clinics as well as to persons who
provide home health care and emergency medical services. (full text) ...
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm?s_cid=rr6007a1_e&source=govdelivery
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RANDOM FACT: A desire path is one that was stomped out away from the original path or walkway; usually to make a short cut.
These are found a lot on college campuses.
Bonus Fact: A lunule refers to the white-shaded crescent peeking out on the bottom of your finger nail. (did you remember this?)
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Cholesterol drugs safe, even after a decade of use
(Reuters) - Cholesterol-lowering drugs continue to produce benefits without any serious safety problems, such as increased cancer risk, even after more than a decade of use, researchers said Wednesday.
The finding from a large British clinical study following patients for 11 years provides reassurance for people at risk of heart attacks who are typically prescribed such medicines indefinitely.
So-called statin drugs are not without side effects. They can cause nausea, muscle pain, and occasional kidney and liver damage.
But long-term follow-up in the 20,000-patient Heart Protection Study (HPS) found no evidence that statins increased the risk of non-vascular mortality or made patients more likely to develop cancer. ...
http://www.reuters.com/article/2011/11/23/us-cholesterol-idUSTRE7AM00Q20111123?feedType=nl&feedName=ushealth1100
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Coronary Artery Calcium Progression: An Important Clinical Measurement?
A Review of Published Reports
Baseline coronary artery calcification (CAC) accurately identifies coronary atherosclerosis and might improve prediction of future cardiac events. Serial assessment of CAC scores has been proposed for monitoring atherosclerosis progression and for assessing the effectiveness of medical therapies aimed at reducing cardiac risk. However, whether knowledge of progression of CAC scores over time further improves risk prediction is unclear. Several trials relating medical therapies to CAC progression have been performed without any formal guidelines on the definition of CAC progression and how it is best quantified. ... http://content.onlinejacc.org/cgi/content/short/56/20/1613?rss=1
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Aspirin for primary prevention of vascular events in women: individualized prediction of treatment effects (study)
Aims To identify women who benefit from aspirin 100 mg on alternate days for primary prevention of vascular events by using treatment effect prediction based on individual patient characteristics.
Methods and results Randomized controlled trial data from the Women's Health Study were used to predict treatment effects for individual women in terms of absolute risk reduction for major cardiovascular events (i.e. myocardial infarction, stroke, or cardiovascular death). ...
http://eurheartj.oxfordjournals.org/content/early/2011/11/16/eurheartj.ehr423.abstract
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Studies suggest that these three fab fluids may keep hunger at bay, reduce calorie intake, and keep the pounds from creeping on:
Skim milk: In a study, the people who drank about 20 ounces of skim milk at breakfast ate way less at lunch compared with the people who had fruit juice with their morning meals. The researchers think the proteins in skim milk -- whey and casein -- may help make skim milk quite the filler-upper. (Related: Not a milk drinker? Fill up on this popular high-protein breakfast food instead.)
Olive oil: This Mediterranean staple is loaded with a hunger-curbing compound called oleic acid. This monounsaturated fat stimulates the small intestine to make another fatlike substance that sends "full" signals from the stomach to the brain. Other foods high in oleic acid include sunflower seeds, canola oil, safflower oil, almonds, and avocados. (Related: Find out why corn oil may be a bad choice for you.)
Water: Numerous studies suggest that folks who drink ample water feel fuller and eat far fewer calories throughout the day compared with people who don't drink enough agua. Water drinkers are also less likely to indulge in sweetened drinks like soda, calorie-laden coffee drinks, and sugary sports drinks. And in yet another study, drinking 16 ounces of water before each meal helped dieters lose more weight -- and lose it faster -- than dieters who didn't drink water before meals.
http://www.realage.com/health-tips/3-liquids-to-suppress-your-appetite-naturally?eid=1010640918&memberid=4687812
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HUMOR SECTION
While my wife and I were shopping at a mall, a shapely young woman in a short, form-fitting dress strolled by. My eyes involuntarily followed her.
Without looking up from the item she was examining, my wife asked, "Was that worth the trouble you're in?"
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Here is a very simple little test comprised of four questions to determine the level of your intellect. Your replies must be spontaneous and immediate, with no deliberating or wasting time... And no cheating!
1: You are competing in a race and overtake the runner lying in second place. In which position are you now?
Answer: If you answered that you're now coming first then you're completely wrong. You overtook the second runner and took their place, therefore you're coming second. For the next question try not to be so dim.
2: If you overtake the last runner, what position are you now in?
Answer: If you answered second-last, once again you're completely wrong. Think about it. How can you over take the person coming last? If you're behind them then they can't be last. The answer is impossible! It would appear that thinking is not one of your strong points.
Anyway, here's another to try, don't take any notes or use a calculator, and remember your replies must be instantaneous. Take heart!
3: Take 1000. Add 40. Add another 1000. Add 30. 1000 again. Plus 20. Plus 1000. And plus 10. What is the total?
Answer: 5000? Wrong again! The correct answer is 4100. Try again with a good calculator. Today is clearly not your day. Although you should manage to get the last question right...
4: Marie's father has five daughters: 1. Chacha 2. Cheche 3. Chichi 4. Chocho Question: What is the fifth daughter's name? Think quickly... you'll find the answer below.
Answer: Chuchu? WRONG! It's obviously Marie! Read the question again.
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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 information has recently been updated and is now available:
Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus (PDF - 168KB)
Posted: 11/29/2011
This website is the FDA's Enforcement site....all the foodstuffs that have had to be recalled due to contamination.
(Listeria, for one). http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm281022.htm
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/
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
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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CareFusion EnVe Ventilators Recall Class: Class I
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/ListofRecalls/ucm278634.htm
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Draeger Medical Inc., Infinity Acute Care System Monitoring Solution (M540) Catalog number MS25510
All serial numbers are affected by this recall.
This product was manufactured from March 1, 2011 through September 30, 2011 and distributed only to the Rush University Medical Center (Chicago, Illinois) from July 1, 2011 through September 30, 2011.
Use: This product is a networked solution system used to monitor a patient’s vital signs and therapy, control alarms, review Web-based diagnostic images, and access patient records. The number of monitored vital signs can be increased or decreased based on the patient’s needs.
The weight-based drug dosage calculation may indicate incorrect recommended values, including a drug dosage up to ten times the indicated dosage. Additionally, there may be a 5-10 second delay between the electrocardiogram and blood pressure curves (waveforms) at the Infinity Central Station. This product may cause serious adverse health consequences, including death. ...
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm282461.htm
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CooperVision AVAIRA AQUAFORM Sphere Soft Contact Lenses Class 1 Recall The unintended presence of a silicone oil residue on AVAIRA Sphere soft contact lenses. Symptoms may range from hazy, blurry vision, discomfort to eye injuries requiring medical treatment.
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm282733.htm
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NURSING HINTS CORNER
Squeezing for strength Here is a quick way to check the strength of a patient's handgrip Roll up a blood pressure cuff, pump it up slightly and have the patient squeeze it while measuring the millimeters of mercury. Do the same thing with his other hand. The reading for the dominant hand may be higher by 10 to 20 mm HG. This technique can help detect the slightest neurologic change, saving the patient from potential problems. Dorothy M. Kellogg, RN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.120, Springhouse Corporation/www.springnetcom. ;
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ADVERTISEMENTS from the members
(contact me with your ad)
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:
Christina.Roskilly@live.com (Christina) December 7, 2011
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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 or, instead, 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
We can have democracy in this country, or we can have great wealth concentrated
in the hands of a few, but we can't have both.
--Louis Brandeis,
Supreme Court Justice from 1916--1939
Drop me a line..... Frankie RNFrankie@AOL.com
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