PARADIGM BYTES
Newsletter for Paradigm 97
June 8, 2015
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
Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPET
A program to stop catheter-associated urinary tract infections (CAUTIs) at one neurosurgical intensive care unit (ICU) has been a resounding success. By mid-May, the unit hadn't seen an infection in nearly 8 months.
Before the program was implemented, there was typically at least one infection a month in the ICU at the North Shore University Hospital in Manhasset, New York. This was the highest rate in the entire North Shore–LIJ Health System, reported Sherley John, RN, one of the leaders of the anti-CAUTI team.
The neuro-ICU population, 45% of which is stroke patients, is particularly challenging, said Merin Thomas, RN, another anti-CAUTI team leader.
"They have neurogenic bladder, they tend to retain urine, and they are on hypertonic solutions," she told Medscape Medical News. "From 2011 onward, we could tell that CAUTI, of all the quality data, was screaming out that it needed help."
The team described their anti-CAUTI program at the American Association of Critical-Care Nurses (AACN) 2015 National Teaching Institute and Critical Care Exposition in San Diego. ...
http://www.medscape.com/viewarticle/845516
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INTERESTING READING
Please remember that the REUTERS articles are usually good for only 30 days
Study: Delay Umbilical Cord Clamping to Boost Kids' Development
http://newslink.reuters.com/5519ed543b35d0751d8b9c612nl0h.9f1/VWcmbMPoYKKSvBHKA4ab9
http://newslink.reuters.com/5519ed543b35d0751d8b9c612nl0h.9f1/VWcmbMPoYKKSvBHIA08d1
Delayed clamping of the umbilical cord at birth was associated with slightly better fine-motor and social skills in young children, according to the results of a small randomized, controlled trial in Sweden.
Children with delayed cord clamping (CC) exhibited improved adjusted mean differences in the Ages and Stages Questionnaire (ASQ) in both fine-motor (adjusted mean difference: 2.1, CI 0.2-4.0) and personal-social domains (AMD 2.8, 95% CI 0.8-4.7) compared with children in the early CC group, reported Ola Andersson, MD, PhD, department of children and women's health at Uppsala University, and colleagues. ... http://link.broadcaster3.medpagetoday.com/54a1cc733d9c8659048bce2a2ndaa.vd6/VWWmOMPosMi-iJFqA1f91
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| FBI probing what J&J knew about uterine surgery device: WSJ |
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(Reuters) - The Federal Bureau of Investigation is probing a surgical tool found to spread uterine cancer and what Johnson & Johnson knew about its risks before withdrawing its version of the device last year, the Wall Street Journal reported. ... |
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Mediterranean diet tied to lower endometrial cancer risk
Women who regularly ate seven to nine of the components of the Mediterranean diet had a 57% reduced risk of endometrial cancer, compared with 46% in women who ate six of the components and 34% in those who consumed five, according to a study in the British Journal of Cancer. Researchers found no significant reduced cancer risk among women who ate less than five components of the diet. Medical News Today (5/27) http://r.smartbrief.com/resp/gKtVDrrXoMncvnuYfDlkdwfCkrfQ?format=standard
Women who regularly ate seven to nine of the components of the Mediterranean diet had a 57% reduced risk of endometrial cancer, compared with 46% in women who ate six of the components and 34% in those who consumed five, according to a study in the British Journal of Cancer. Researchers found no significant reduced cancer risk among women who ate less than five components of the diet. Medical News Today (5/27) http://r.smartbrief.com/resp/gKtVDrrXoMncvnuYfDlkdwfCkrfQ?format=standard
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A study in the journal BMJ found that novel oral contraceptives, such as those that include the synthetic hormones drospirenone or cyproterone, were associated with a risk of venous thromboembolism that is up to 1.8 times greater than the risk associated with older contraceptive pills. The findings were based on an analysis of data involving more than 50,000 women in the U.K. Los Angeles Times (tiered subscription model) (5/27), Time.com (5/26)
http://r.smartbrief.com/resp/gKtVDrrXoMncvnwEfDlkdwfCWvbI?format=standard
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Thank you Kurt Ullman for this article:
BOSTON — Nursing is recognized as one of the nation's most demanding professions, complete with long work shifts, ongoing regulatory changes and the need for a constant focus while making critical decisions regarding the health of patients. Given such a challenging work environment, personal matters are often sacrificed or take a back seat. Finances are a perfect example: according to Fidelity Investments® Money FIT Nurses Study, more than half of nurses surveyed (56 percent) say they lack confidence in making financial decisions—and four in 10 (41 percent) attribute this to the fact they don’t have enough time to focus on them.
While an overwhelming majority of nurses–92 percent–say they want to learn more about financial planning, this struggle for time continues to be a challenge that has implications on retirement readiness. With this in mind, Fidelity Investments, the leading provider of workplace retirement plans for not-for-profit health care institutions1, is launching an awareness campaign during National Nurses Week (May 6-12) to encourage nurses to take the time to focus on their own financial wellness. ...
https://www.fidelity.com/about-fidelity/individual-investing/more-than-half-of-nurses-lack-confidence-in-making-financial-decisions
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NIH researchers reveal link between powerful gene regulatory elements and autoimmune diseases
Investigators with the National Institutes of Health have discovered the genomic switches of a blood cell key to regulating the human immune system. The findings, published in Nature today, open the door to new research and development in drugs and personalized medicine to help those with autoimmune disorders such as inflammatory bowel disease or rheumatoid arthritis. Autoimmune diseases occur when the immune system mistakenly attacks its own cells, causing inflammation. Different tissues are affected in different diseases, for example, the joints become swollen and inflamed in rheumatoid arthritis, and the brain and spinal cord are damaged in multiple sclerosis. The causes of these diseases are not well understood, but scientists believe that they have a genetic component because they often run in families.
“We now know more about the genetics of autoimmune diseases,” said NIAMS Director Stephen I. Katz, M.D., Ph.D. “Knowledge of the genetic risk factors helps us assess a person’s susceptibility to disease. With further research on the associated biological mechanisms, it could eventually enable physicians to tailor treatments to each individual.”
Identifying autoimmune disease susceptibility genes can be a challenge because in most cases a complex mix of genetic and environmental factors is involved. Genetic studies have shown that people with autoimmune diseases possess unique genetic variants, but most of the alterations are found in regions of the DNA that do not carry genes. Scientists have suspected that the variants are in DNA elements called enhancers, which act like switches to control gene activities. ...
The senior author of the paper, John J. O’Shea, M.D., is the scientific director at NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases. The lead author, Golnaz Vahedi, Ph.D., is a postdoctoral fellow in Dr. O’Shea’s lab in the Molecular Immunology and Inflammation Branch. The study was performed in collaboration with investigators led by NIH Director, Francis S. Collins, M.D., Ph.D., in the Medical Genomics and Metabolic Genetics Branch at the National Human Genome Research Institute.
http://www.nih.gov/news/health/feb2015/niams-17.htm
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Experts develop noninvasive procedure to remove bone tumors in children
Children with osteoid osteoma, a benign leg tumor, could have their tumors destroyed through the use of a magnetic resonance imaging-guided high-intensity focused ultrasound machine. The procedure is under clinical study at the Children's National Health System led by Dr. Karun Sharma, an interventional radiologist. WTOP-FM (Washington, D.C.) (5/27
Children with osteoid osteoma, a benign leg tumor, could have their tumors destroyed through the use of a magnetic resonance imaging-guided high-intensity focused ultrasound machine. The procedure is under clinical study at the Children's National Health System led by Dr. Karun Sharma, an interventional radiologist. WTOP-FM (Washington, D.C.) (5/27
http://r.smartbrief.com/resp/gKtVDrrXoMncvnxcfDlkdwfCbYQw?format=standard
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Tips in Inserting IV Device to Elderly
For some, inserting an IV cannula is a difficult challenge itself, what more when it comes to inserting an Intravenous device to an elderly patient? Yes, the veins may seem very visible, but they are also very fragile. This is because older adults experience significant changes in their skin in terms of texture, depth and integrity, making them more prone to tears and bruising. Also, the veins have increased peripheral resistance which may render them unsuitable for cannulation. ...
http://nursingcrib.com/demo-checklist/tips-in-inserting-iv-device-to-elderly/
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Activate MedPage Today's CME feature and receive free CME credit on Medical stories like this one.
(go to website for activation)
Disease Damage Rises Steadily in Lupus Contributing factors included steroid use, disease activity, and hypertension.
Irreversible organ damage accrues steadily over time among patients with systemic lupus erythematosus (SLE), with important risk factors being the use of specific medications, disease activity, hypertension, and pre-existing damage, a large international study found.
Among patients enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort, the likelihood of developing organ damage when none was present at baseline was increased for those using corticosteroids but lower among those on antimalarial drugs, according to Ian N. Bruce, MD, of the University of Manchester in England, and colleagues. ... Primary Source Annals of the Rheumatic Diseases
http://www.medpagetoday.com/Rheumatology/Lupus/50638?xid=nl_mpt_DHE_2015-03-25eun=g379846d0r&userid=379846&email=rnfrankie@aol.com&mu_id=5373084
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Weird Nursing Rules You’ve Never Heard Of (I know the sentence ended with a preposition)
There are hospitals in the United States are implementing “English only” rules in certain parts of their facility. This is often due to complaints from people not being able to understand some nurses who speak other languages among themselves. Though this may be considered as a matter concerning etiquette, this can be attributed to patient safety also. In trauma situations, it is vital that all staff be able to communicate and understand each other in a common language, which is English. ...
Sources:
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RANDOM FACTS:
There have been a few states that never managed to make the cut and become incorporated into the United States we know today. Some of these state names were quite inventive and the dedicated residents who petitioned for them were very frustrated when the states never manifested.
Absaroka
It was named after the Absaroka Range of the Rocky Mountains, which claimed parts of South Dakota, Montana, and Wyoming. Residents of this area attempted to secede in 1939.
Deseret
Although you might assume as much, it was not named for the desert. It was actually named after a Mormon word meaning honeybee. Parts of modern day Nevada, Utah, Southern California, most of Arizona, and a portion of New Mexico were claimed by Mormon settlers escaping religious persecution in New York.
Franklin
This region was comprised of eight counties that originally belonged to North Carolina but are now eastern Tennessee. In fact, Franklin almost became the 14th State, only needing two more votes to reach the 2/3 majority vote needed for statehood. The larger state of Tennessee was formed instead.
Kanawha
This region later became the largest portion of the state of West Virginia, and included some of the far northwestern counties of Virginia. It came about during the crazy tensions of the Civil War. They voted to secede when Virginia joined the Confederate States of America.
Lincoln
Another name used in multiple requests for a state. The original request was in Texas and would have consumed almost half of the state. The second came about in the early 1900s and included the Idaho Panhandle. Believe it or not, the idea was proposed again in 2005.
Long Island
The region grew weary of the 'Boss' political system in New York and wanted to seek its freedom in 1869. This idea was revisited in the 1990s, but New York is unwilling to give up this diverse and economically sound portion of the state.
Sequoyah
The name Sequoyah was requested by Native Americans and encompassed the majority of Oklahoma. This included a tract of land where the U.S. Government had relocated them.
Superior
The Upper Peninsula, part of the state of Michigan, is only connected to the rest of the state by the Mackinac Bridge. It lies between Lake Superior, and Lake Michigan, hence the name. This one raises its head on a regular basis, especially when debating Michigan tax laws. Interestingly, the land area was originally part of the Wisconsin territory, but awarded to Michigan when the city of Toledo was absorbed by Ohio.
Texlahoma
Early in the 20th century, rural areas had terrible roads and cars were popular, making for dangerous driving. Since the politicians in the capitals were not listening to their complaints, forty-six counties in Texas and twenty-three in Oklahoma planned to secede and combine into a new state.
Transylvania
The region included parts of Northern Tennessee and Southwestern Kentucky. It was originally purchased by the Transylvania Company from the Cherokee Indians, hence the unusual name.
Westsylvania
This was the second name for the failed Vandalia colony attempting to become the 14th state, in 1776. Pennsylvania, West Virginia and eastern Kentucky made up this area. Pennsylvania, having the most land to lose, made a law stating talk of secession to be an act of treason punishable by death. That dream quickly and quietly went away.
Absaroka
It was named after the Absaroka Range of the Rocky Mountains, which claimed parts of South Dakota, Montana, and Wyoming. Residents of this area attempted to secede in 1939.
Deseret
Although you might assume as much, it was not named for the desert. It was actually named after a Mormon word meaning honeybee. Parts of modern day Nevada, Utah, Southern California, most of Arizona, and a portion of New Mexico were claimed by Mormon settlers escaping religious persecution in New York.
Franklin
This region was comprised of eight counties that originally belonged to North Carolina but are now eastern Tennessee. In fact, Franklin almost became the 14th State, only needing two more votes to reach the 2/3 majority vote needed for statehood. The larger state of Tennessee was formed instead.
Kanawha
This region later became the largest portion of the state of West Virginia, and included some of the far northwestern counties of Virginia. It came about during the crazy tensions of the Civil War. They voted to secede when Virginia joined the Confederate States of America.
Lincoln
Another name used in multiple requests for a state. The original request was in Texas and would have consumed almost half of the state. The second came about in the early 1900s and included the Idaho Panhandle. Believe it or not, the idea was proposed again in 2005.
Long Island
The region grew weary of the 'Boss' political system in New York and wanted to seek its freedom in 1869. This idea was revisited in the 1990s, but New York is unwilling to give up this diverse and economically sound portion of the state.
Sequoyah
The name Sequoyah was requested by Native Americans and encompassed the majority of Oklahoma. This included a tract of land where the U.S. Government had relocated them.
Superior
The Upper Peninsula, part of the state of Michigan, is only connected to the rest of the state by the Mackinac Bridge. It lies between Lake Superior, and Lake Michigan, hence the name. This one raises its head on a regular basis, especially when debating Michigan tax laws. Interestingly, the land area was originally part of the Wisconsin territory, but awarded to Michigan when the city of Toledo was absorbed by Ohio.
Texlahoma
Early in the 20th century, rural areas had terrible roads and cars were popular, making for dangerous driving. Since the politicians in the capitals were not listening to their complaints, forty-six counties in Texas and twenty-three in Oklahoma planned to secede and combine into a new state.
Transylvania
The region included parts of Northern Tennessee and Southwestern Kentucky. It was originally purchased by the Transylvania Company from the Cherokee Indians, hence the unusual name.
Westsylvania
This was the second name for the failed Vandalia colony attempting to become the 14th state, in 1776. Pennsylvania, West Virginia and eastern Kentucky made up this area. Pennsylvania, having the most land to lose, made a law stating talk of secession to be an act of treason punishable by death. That dream quickly and quietly went away.
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Great Historical Note: (can't get rid of that background color)
| When Eddington recorded the bending of light around the Sun, Albert Einstein’s hypothesis became established theory for most of the scientific community. There was proof that Einstein’s description of the Universe was better than Newton’s. Einstein’s discovery was featured in headlines around world during the fall and winter of 1919. It’s one of our more remarkable Albert Einstein facts that his initial insights in 1905 would make him world famous 14 years later! Einstein had been refining and improving his hypotheses during this time, however, it was his miracle year of 1905 that laid the groundwork for his future work and much of modern physics. In 1921, Einstein received the Nobel Prize for his work on the photoelectric effect. Despite the evidence, his theory of relativity was so advanced that the Nobel did not award him the prize for what may have been a more revolutionary insight. Einstein toured the world and was given a hero’s welcome wherever he went. For the first time in modern history, someone had become famous by being incredibly smart! Einstein visited the United States, Japan, Singapore and Palestine, recording his observations of the different cultures he encountered in letters to friends and family. |
Cancer cells may wake up after years of remission, study finds
A study in the journal Leukemia found that cancer cells can become dormant to resist chemotherapy and reactivate after some years. Researchers compared a patient's blood and bone marrow samples taken at diagnosis with leukemia and at relapse 20 years later. Cancer cells from both samples included a fusion of the genes BCR and ABL1 as well as additional changes in the cells from the relapse samples. BBC (5/28)
http://r.smartbrief.com/resp/gKyeDrrXoMnczOzgfDlkdwfCOFRy?format=standard
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Researchers found that babies born at 33 to 34 weeks had a higher risk of being hospitalized for bronchiolitis due to respiratory syncytial virus compared with those born at 35 weeks or more. The findings in the Italian Journal of Pediatrics revealed that higher rates of hospitalization were associated with male gender, prenatal exposure to maternal smoking, lack of breast-feeding, prenatal treatment with corticosteroids, singleton delivery, respiratory diseases in the neonatal period and surfactant therapy. Lung Disease News (5/27)
http://r.smartbrief.com/resp/gKyeDrrXoMnczOzsfDlkdwfCPqcR?format=standard
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Research suggests white matter damage in the brain may be an early indicator of early-onset Alzheimer's disease or focal AD syndromes that are localized and affect vision and language. Co-author Dr. Federica Agosta of the San Raffaele Scientific Institute in Italy said white matter damage may come before gray matter damage in Alzheimer's disease, and disease may progress by spreading through white matter. The study used diffusion tensor imaging, and Agosta said the approach may help ensure patients in the early stages of disease are not misdiagnosed.HealthDay News (5/27)
http://r.smartbrief.com/resp/gKyeDrrXoMnczOzEfDlkdwfCRuKS?format=standard
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Family history may not impact breast cancer survival odds
These results should reassure younger women diagnosed with breast cancer, study co-author Dr. Ramsey Cutress, a researcher at the University of Southampton in the U.K., said by email.
“They should not be concerned that their family history alone will affect the chance of a successful outcome,” Cutress said.
Worldwide, breast cancer is the most common malignancy in women. About one in nine women will eventually develop it, according to the U.S. National Institutes of Health. The risk increases with age, from one in 227 at age 30 to one in 26 by age 70.
A woman is more likely to develop breast cancer if her mother, sister or daughter has been diagnosed with the disease, particularly if the diagnosis was before age 50. ...
http://www.reuters.com/article/2015/05/26/us-cancer-breast-family-outcomes-idUSKBN0OB2OS20150526?feedType=nl&feedName=healthNews
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Research ties PTSD to risk of sleep apnea among veterans
A study published in the Journal of Clinical Sleep Medicine suggests veterans with post-traumatic stress disorder may have higher likelihood of sleep apnea, and as PTSD symptom severity rose, so did sleep apnea risk. Researchers found that out of 195 veterans who visited an outpatient PTSD clinic for evaluation, 69% faced high likelihood of developing obstructive sleep apnea, possibly due to chronic stress or combat-linked sleep disturbance. A researcher said the study supports routine sleep apnea screening in veterans with PTSD. HealthDay News (5/29) ...
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Preventing high-alert medication errors in hospital patients
Publication Date: May 2015 Vol. 10 No. 5 Author: Pamela Anderson, MSN, RN, APRN-BC, CCRN, and Terri Townsend, MA, RN, CCRN-CMC, CVRN-BC ( REGISTER & TAKE TEST Hours : 1.1)
Mistakes involving medications are among the most common healthcare errors. Medication errors lengthen hospital stays, increase inpatient expenses, and lead to more than 7,000 deaths annually in the United States. Each error costs an estimated $2,000 to $8,750. An error can happen in the home or a healthcare facility; this article focuses on errors in hospitals.
While any medication potentially can cause harm, a select group of drugs—high-alert medications (HAMs)—carries a higher risk of patient injury. According to The Joint Commission (TJC), HAMs frequently are associated with harm, the harm they cause is serious, and when they’re misused, the risk of serious injury or death is high. Even when given correctly, these drugs carry a significant risk of causing harm. The Institute for Safe Medication Practices (ISMP) describes HAMs as drugs “that bear a heightened risk of causing significant patient harm when…used in error.” ...
http://www.americannursetoday.com/preventing-high-alert-medication-errors/
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| Could You Have a Thyroid Problem? |
An over- or underactive thyroid can cause all sorts of health problems, from weight changes to fatigue to hair loss. Know the symptoms.
View Slideshow › |
|
http://www.webmd.com/women/ss/slideshow-thyroid-symptoms-and-solutions?ecd=wnl_spr_053015&ctr=wnl-spr-053015_nsl-ld-stry&mb=nSAyD2ApSXwBuGGvz8QhGShonS%2fH3cwym2k%40XDZknbs%3d
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| TODAY'S THRIFTY TIP: Reset your due dates (you probably already know this, but just in case you don't) Do some of your bills arrive before you get your pay check, forcing you to pay late fees? Are you tired of trying to remember when to pay your bills because they are all due at different times? Or wish your bills didn't arrive all at once, draining your checking account? There is an easy fix to all these problems; call and ask for a different due date. Most companies are happy to change the date to one that works better for you. |
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How our Math instruction changes over the years:
Last week I purchased a burger for $1.58. I handed the cashier $2.00 and started digging for some change. I pulled out 8 cents and gave it to her. She stood there with $2 and 8 cents. She looked bewildered, holding the nickel and 3 pennies, while looking at the screen on her register.
I sensed her discomfort and tried to tell her to just give me two quarters, but she hailed the manager for help. While he tried to explain the transaction to her, she burst into tears.
The incident got me thinking about how our kids were learning math in school.... (or not).
Teaching Math In 1950: A logger sells a truckload of lumber for $100. His cost of production is 4/5ths of the price. What is his profit?
Teaching Math In 1960: A logger sells a truckload of lumber for $100. His cost of production is 4/5ths of the price, or $80. What is his profit?
Teaching Math In 1970: A logger exchanges a set "L" of lumber for a set of "M" of money. The cardinality of set "M" is 100. Each element is worth one dollar. Make 100 dots representing the elements of the set "M." The set "C," the cost of production, contains 20 fewer points than set "M." Represent the set "C" as a subset of set "M." Answer this question: What is the cardinality of the set "P" of profits?
Teaching Math In 1980: A logger sells a truckload of lumber for $100. His cost of production is $80 and his profit is $20. Your assignment: Underline the number 20.
Teaching Math In 1990: By cutting down beautiful forest trees, the logger makes $20. What do you think of this way of making a living? Topic for class participation after answering the question: How did the forest birds and squirrels feel as the logger cut down the trees. (There are no wrong answers)
Teaching Math In The 2000s: A logger sells a truckload of lumber for $100. His cost of production is $120. How does Goldman Sachs determine that his profit margin is $60?
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Sleep is a universal characteristic of complex living organisms and has been observed in insects, mollusks, fish, amphibians, birds, and mammals. In fact, sleep is so important that humans can survive longer without food than they can without sleep.
RANDOM FACT:
During sleep, the brain "consolidates" memories and skills, meaning that the brain strengthens, reorganizes, and restructures memories during sleep.
Bonus Fact:
REM atonia, or sleep paralysis, occurs in the typical sleeper every night to prevent people from acting out their dreams. Only a few muscles have the ability to move during REM sleep, such as the eye muscles, the auditory muscles, and the diaphragm for respiration.
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Cholesterol Drugs May Boost Outcomes After Bypass
People taking a statin had lower risk of dying in weeks after the heart surgery, researchers say
TUESDAY, June 2, 2015 (HealthDay News) -- A new study suggests that the widely used anti-cholesterol drugs known as statins may have another benefit: Cutting the odds for death in the weeks and months after heart bypass surgery.
Use of a statin -- especially the drug Zocor -- was linked to a 65 percent to 74 percent lower risk of death following coronary artery bypass graft surgery. Bypass is performed for patients suffering from severely clogged or narrowed arteries, and is designed to re-route blood flow around such blockages.
The study was led by Robert Sanders, an assistant professor of anesthesiology at the University of Wisconsin, Madison. His team of U.S. and U.K. researchers noted that the vast majority of heart surgery patients included in the analysis -- roughly 85 percent -- were already routinely taking a statin before their heart surgery.
"The unknown is why the other 15 percent were not on statins," Sanders said. Some may have had an intolerance to the medications or adverse effects, while others might simply not have been offered the cholesterol drug by their physicians, he noted.
The new study was based on data involving more than 16,000 British heart surgery patients. All were at least 40 years old at the time they underwent coronary bypass graft surgery, and the researchers tracked outcomes at one month and six months after bypass. ...
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Quiz Time:
Which statement about assessing respiratory rate and opioid-induced respiratory depression (OIRD) is correct?
a. It is easy to obtain an accurate respiratory rate manually.
b. Absence of bradypnea rules out respiratory depression.
c. Level of consciousness is more likely than respiratory rate to uncover warning signs of OIRD.
d. Respiratory rate is more likely than level of consciousness to uncover warning signs of OIRD.
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The ABCs of Vitamins * there are 18 questions... I have only 6 here. (The explanation and answers are on the website.)
1. Taking Vitamin C can ward off a cold? ............True False
2. What vitamins or minerals may help reduce the risk of age-related vision loss? Zeaxanthin or zinc or Vitamin C and E or All the above?
3. The word vitamin comes from? Vitaly Minkov, the Russian researcher who first discovered vitamins or "vital" and "amines" or vituamine - the first vitamin to be discovered?
4. Taking vitamin B12 gives you more energy: ..........True False
5. Which vitamins and minerals help maintain strong bones? Calcium and Vitamin D or Vitamin K or magnesium and potassium or all the above?
6. What's the difference between Vitamins and minerals? Our bodies make vitamins but not minerals or Vitamins come from plants and minerals from the earth or vitamins supply energy and minerals are used to make new cells.
http://www.webmd.com/diet/rm-quiz-vitamins-benefits?ecd=wnl_men_052915&ctr=wnl-men-052915_nsl-ld-stry&mb=nSAyD2ApSXwBuGGvz8QhGShonS%2fH3cwym2k%40XDZknbs%3d
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Lewy Body Dementia:
Lewy body dementia, the second most common type of progressive dementia after Alzheimer's disease, causes a progressive decline in mental abilities.
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As of 2010, the longest suspension bridge in the world is the Akashi Kaikyo Bridge in Kobe, Japan. Opened in 1998, it spans an amazing 6,529 feet.
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Used for water distribution, the Delaware Aqueduct in New York is the longest tunnel in the world (as of 2010). Drilled through solid rock, it reaches a staggering 85 miles in length.
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The Hoover Dam, built along the Colorado River between 1931 and 1936 reaches 726 feet in height.
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The London Eye in England is the largest Ferris wheel in Europe, standing at a height of 442 feet.
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The tallest wind turbine in the world has rotor tips that reach over 656 feet above the ground.
It may also cause visual hallucinations, which generally take the form of objects, people or animals that aren't there. This can lead to unusual behavior such as having conversations with deceased loved ones.
Another indicator of Lewy body dementia may be significant fluctuations in alertness and attention, which may include daytime drowsiness or periods of staring into space. And, like Parkinson's disease, Lewy body dementia can result in rigid muscles, slowed movement and tremors. ... http://www.mayoclinic.org/diseases-conditions/lewy-body-dementia/basics/definition/con-20025038
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TRIVIA:
The building of the Panama Canal, which links the Atlantic and Pacific Oceans, was one of the most difficult engineering projects ever. It is estimated that over 25,000 workers lost their lives during the long and dangerous project, with most dying from disease and landslides.***
As of 2010, the longest suspension bridge in the world is the Akashi Kaikyo Bridge in Kobe, Japan. Opened in 1998, it spans an amazing 6,529 feet.
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Used for water distribution, the Delaware Aqueduct in New York is the longest tunnel in the world (as of 2010). Drilled through solid rock, it reaches a staggering 85 miles in length.
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The Hoover Dam, built along the Colorado River between 1931 and 1936 reaches 726 feet in height.
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The London Eye in England is the largest Ferris wheel in Europe, standing at a height of 442 feet.
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The tallest wind turbine in the world has rotor tips that reach over 656 feet above the ground.
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(Guess who has been sitting forever getting the newsletter ready !!)
Excessive sitting associated with early death and metabolic and heart risks
If sedentary office workers could get off their posteriors for at least 2 hours a day, it could reduce their risk for heart disease, diabetes, and all-cause mortality, according to a panel of public health experts convened by the U.K. Department of Health.
Ideally, office workers should stand or move about for at least 4 hours during their workday, but the initial 2-hour goal is a step in the right direction, the committee said in a consensus statement published in theBritish Journal of Sports Medicine.
Even more ideally, individuals should be exercising moderately for 150 minutes per week, but so few people are meeting this goal that the panel, headed byJohn Buckley, PhD, MSc, of the University of Chester, instead offered the more modest goal of simply getting people up out of their seats for a few hours.
"The evidence is clearly emerging that a first 'behavioral' step could be to simply get people standing and moving more frequently as part of their working day," the panel wrote. "Moreover, in the workplace, this may potentially be more socially achievable than targeted exercise."
http://www.medpagetoday.com/PrimaryCare/ExerciseFitness/51967?xid=nl_mpt_DHE_2015-06-06&eun=g379846d0r
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Heron's nausea drug meets goal in late-stage trial, shares soar
Heron Therapeutics Inc said its experimental drug for treating chemotherapy-induced nausea and vomiting (CINV) met its main goal in a late-stage trial.
The company, whose shares were up 41 percent in extended trading, said it expects to resubmit a marketing application for the drug to the U.S. FDA in mid-2015.
The company had filed for marketing application for Sustol twice but the FDA had sought additional data.
The drug, Sustol, in combination with two other drugs, was compared with a standard-of-care three-drug regimen. ...
http://www.reuters.com/article/2015/05/28/us-heron-trial-idUSKBN0OD2UF20150528?feedType=nl&feedName=healthNews
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Transition to gene-based cancer treatment may not be simple
The medical view of cancer is in transition, as cancer doctors increasingly focus on the defective genes that are driving the disease rather than the organ in which it takes root.
Oncologists hope that by understanding the genetic underpinnings of cancer rather than focusing on whether it originated in the breast or the liver, they will be able to give patients better, more personalized and more effective treatments.
But leading cancer experts say that as doctors have tested that theory more closely, they are seeing both successes and failures, suggesting that the ideal route to treating cancer may be far more complicated than hoped.
At the moment, there is not enough understanding of the mutations that drive cancer growth, said Dr. Richard Pazdur, chief of oncology at the U.S. Food and Drug Administration
"What people want and the scientific reality are two different situations," Pazdur said in an interview at the American Society of Clinical Oncology (ASCO) meeting in Chicago.
He said there are currently "only a handful of therapies" that target specific cancer-causing genes. Some oncologists have begun using those drugs to treat cancers in people with the corresponding genetic mutations, even when the drugs haven’t been approved for the type of cancer a patient has. ...
http://www.reuters.com/article/2015/06/02/us-cancer-asco-genes-insight-idUSKBN0OI0BU20150602?feedType=nl&feedName=healthNews
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WORD ORIGINS
jack -- In cards, the jack refers to the characer ranking between the ten and the queen. It derives from athe common name Jak, which in turn is short for John, in the sense of Jack's meaning a regular fellow--an ordinary Joe, in other words. The jack was usualy called the knave in upperclass circles, for which reason Pip's friends are amused in Charles Dickens' Great Expectations, "He calles the knaves, Jacks, this boy!"
think outside of the box -- A popular puzzle of the early 1980s required the player to draw a complex shape, beginning inside a text box, in four strokes without lifting pencil from paper. The shape could be drawn only if the player went ouside it for one long stroke; the rules did not prevent this, but most players assumed that they had to remain within the box and so failed to solve the puzzle. Thus "think outside the box," which dates to about 1984.
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Ice Creams, etc.
- Frozen yogurt is yogurt that is frozen using a technique similar to soft serve. While lower in calories and fat than ice cream, not all frozen yogurt is made with live
and active cultures the way that standard yogurt is. To make sure that a frozen yogurt contains "yogurt" and a significant amount of live and active cultures, look for the National Yogurt Association (NYA) Live & Active Cultures seal. Without that seal, frozen yogurt does not contain any probiotics. - Gelato. This Italian ice cream doesn't have as much air as traditional ice cream, so it has a much denser texture.
- Ice cream. As if you needed an explanation, this frozen treat is made from milk or cream, sugar and flavorings. The FDA requires that ice creams with solid additions (nuts, chocolate, fruit, etc.) contain at least 8 percent milk fat, while plain ice creams are required to have at least 10 percent milk fat. "French" ice cream is usually made with a cooked egg custard base.
- Ice milk is made with lower-fat milk than ice cream, making it less creamy. However, it does contain fewer calories than ice cream.
- Italian ice (also called Granita) is a mix of juice (or other liquid like coffee), water and sugar, usually in a 4:1 ratio of liquid to sugar. The ices are stirred frequently during freezing to give it a flaky texture. These are almost always fat-free, contain minimal additives and are the lowest in calories of all frozen desserts.
- Sherbet has a fruit juice base but often contains some milk, egg whites or gelatin to thicken and richen it. It's a creamy version of sorbet (see below).
- Slow-churned (double churned) ice cream is made through low-temperature extrusion, to make light ice cream taste richer, creamier, and more like the full-fat variety. Look for the terms "cold churned," "slow churned" or "double churned" on the label, which refers to the extrusion’s churning process. Extrusion distributes the milk fat evenly throughout the product for added richness and texture without adding extra calories. By law, "light" ice cream must contain at least 50% less fat or 33% fewer calories than regular full-fat varieties.
- Soft-serve is a soft "ice cream" that contains double the amount of air as standard ice cream, which stretches the ingredients and creates a lighter texture. It's lower in fat and calories, but it often contains fillers and additives.
- Sorbet, softer in consistency than a sherbet, is usually fruit and sugar that has been frozen. Its texture more "solid" and less flaky than Italian ice.
- Nutrition Facts
A little research (and label reading) is in order if you want to keep ice cream as a regular part of your diet. Here's what you need to know. - While ice cream does contain bone-building calcium, you're better off getting calcium from other food sources since ice cream contains about half the calcium as an equal serving of milk, which is lower in fat and calories. Don't fool yourself into thinking you're eating healthy by getting calcium from Haagen-Dazs or Ben and Jerry’s—both of which can pack more fat per serving than a fast food hamburger!
- Some ice creams, especially "light" varieties are sweetened with artificial sweeteners instead. Using artificial sweetener in place of some or all of the traditional sugar can reduce calories, but these sweeteners aren't for everyone and may cause stomach upset when eaten in high quantities.
- In general, regular (full-fat) ice cream contains about 140 calories and 6 grams of fat per 1/2 cup serving. Besides the fat content, premium brands pack more ice cream into each serving because they contain less air—they are denser and harder to scoop than regular brands—meaning more calories, fat and sugar per serving. Low fat or "light" ice creams weigh in at about half the fat of premium brands but they still contain their fair share of calories thanks to the extra sugar added to make them more palatable.
- Toppings such as chocolate chips, candies and sprinkles send the calorie count even higher, and don't offer any nutritional benefits. Choose vitamin-packed fruit purée (not fruit "syrup"), fresh fruit, or nuts, which contain healthy fat, protein and fiber. While chocolate does have some health benefits, most choices like chips and syrup are usually full of fillers with very little actual chocolate. If you want extra chocolate, use a vegetable peeler to shave dark chocolate over the top of your serving.
- If animal-based products aren’t part of your diet or you can't stomach dairy, you can choose from a wide variety of non-dairy frozen desserts such as soy, coconut or rice "cream." These desserts cut the saturated fat because they don’t contain milk or cream, but can derive around 50% of their calories from fat (usually by adding oil to the product for smoothness or “mouth feel”).
- Indulge in a Better Ice Cream
So what should you look for when you want to indulge in a creamy dessert but not go overboard? SparkPeople dietitian, Becky Hand, recommends checking the nutrition label and choosing a frozen dessert that meets these guidelines per 1/2 cup serving: - 120 calories or less
- 4g of total fat or less
- 3g of saturated fat or less (sorbet, sherbet and low-fat ice cream usually fit the bill)
- 10mg of cholesterol or less
- 15g of sugar or less (this is equal to about 3 teaspoons of actual table sugar)
If you want total control over what goes into your ice cream, consider buying your own ice cream maker. Experiment with the recipes that come in the package, adding your own fresh fruit to create a treat that tastes good and is good for you at the same time.
The following frozen desserts make good choices; they most closely meet the guidelines above, but several other brands and varieties might also fit the bill, even if not listed here.
| Frozen Dessert (and Serving Size) | Calories | Fat |
| Whole Fruit No Sugar Added Sorbet (1/2 cup) | 60 | 0 |
| Healthy Choice Fudge Bars (1 bar) | 80 | 1 |
| Breyers Double Churned 98% Fat Free ice cream (1/2 cup) | 90 | 2 |
| Dreyer’s or Edy’s Fat Free frozen yogurt (1/2 cup) | 90 | 0 |
| Blue Bunny Fat Free frozen yogurt (1/2 cup) | 100 | 0 |
| Turkey Hill Fat Free frozen yogurt (1/2 cup) | 100 | 0 |
| Skinny Cow Low-Fat Fudge Bars (1 bar) | 100 | 1 |
| Breyers Double Churned Light ice cream (1/2 cup) | 100 | 4 |
| Dreyer's or Edy's Slow Churned Light ice cream(1/2 cup) | 110 | 4 |
| So Delicious Dairy Free Neapolitan frozen dessert (1/2 cup) | 120 | 3.5 |
| Haagen-Daz Sorbets (1/2 cup) | 120-130 | 0 |
| Good Humor Sherbet (1/2 cup) | 130 | 1 |
| Skinny Cow Ice Cream Sandwiches (1 sandwich) | 140 | 1.5-2.5 |
| Rice Dream non-dairy frozen dessert (1/2 cup) | 150 | 6 |
| Tofutti Premium non-dairy frozen dessert (1/2 cup) | 170 | 9 |
Ice cream is by no means a health food or a vital component of a healthy diet. But it is a simple pleasure most people wouldn't want to give up. Remember these tips next time you plan to indulge to keep yourself in check.
This article has been reviewed and approved by Licensed and Registered Dietitian, Becky Hand.
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Gadsby, a 50,000 word novel by Ernest Wright, contains no words with the letter e.
Earliest use of the flashback in Western literature: Homer's Odyssey.
Charles Dickens's original phrase for Scrooge was "Bah! Christmas!" not "Bah! Humbug!"
The first names of Dr. Jekyll and Mr. Hyde are Henry and Edward.
Marco Polo dictated the book about his travels while he was a prisoner of war in Genoa. When it was published, everyone thought it was fiction.
There were two streetcars in Tennessee Williams's A Streetcar Named Desire
******************6 important elements you've never heard of
***
Bonus Fact:
Gallium (Ga)
Few elements are weirder than gallium: A relatively soft, glittering metal, it's widely used today in semiconductors and other electronics, as well as in the pharmaceutical industry. But in years past, gallium (atomic number 31) was a key part of a favorite parlor trick for magicians because it melts when it's just slightly warmer than room temperature. Thus, spoons that are made of gallium look normal, but when dipped into a cup of hot tea will instantly dissolve.
Tellurium (Te)
Tellurium, a silvery-white metal first discovered in Transylvania, is often used in solar panels, computer memory chips and rewritable optical discs. Its name comes from the Latin word for earth (tellus).
Dysprosium (Dy)
Dysprosium (atomic number 66), is named after the ancient Greek dysprositos, meaning "hard to get," appropriately enough. The soft, metallic substance is in big demand for electric motors, especially those in electric vehicles and wind turbines, which has earned dysprosium a place on the U.S. Department of Energy's list of critical materials for the green economy.
RANDOM FACTS:
Europium (Eu)
Euro paper banknotes contain tiny amounts of this hard, silvery metal as an anti-counterfeiting measure. It is also used to produce a strong, rich red color in television and computer screens.
Scandium (Sc)
In the 1970s, metallurgists found that aluminum-scandium alloys are strong and lightweight, making it useful in aerospace components. It wasn't long before sporting-equipment manufacturers started using the alloys in everything from baseball bats to lacrosse sticks.
Beryllium (Be)
Beryllium is recognized as a carcinogen by the International Agency for Research on Cancer. In another form, however, beryllium is highly desirable, even priceless. When combined with trace amounts of chromium, beryllium takes on a beautiful green hue as the gemstone commonly known as the emerald.
Euro paper banknotes contain tiny amounts of this hard, silvery metal as an anti-counterfeiting measure. It is also used to produce a strong, rich red color in television and computer screens.
Scandium (Sc)
In the 1970s, metallurgists found that aluminum-scandium alloys are strong and lightweight, making it useful in aerospace components. It wasn't long before sporting-equipment manufacturers started using the alloys in everything from baseball bats to lacrosse sticks.
Beryllium (Be)
Beryllium is recognized as a carcinogen by the International Agency for Research on Cancer. In another form, however, beryllium is highly desirable, even priceless. When combined with trace amounts of chromium, beryllium takes on a beautiful green hue as the gemstone commonly known as the emerald.
Bonus Fact:
Gallium (Ga)
Few elements are weirder than gallium: A relatively soft, glittering metal, it's widely used today in semiconductors and other electronics, as well as in the pharmaceutical industry. But in years past, gallium (atomic number 31) was a key part of a favorite parlor trick for magicians because it melts when it's just slightly warmer than room temperature. Thus, spoons that are made of gallium look normal, but when dipped into a cup of hot tea will instantly dissolve.
Tellurium (Te)
Tellurium, a silvery-white metal first discovered in Transylvania, is often used in solar panels, computer memory chips and rewritable optical discs. Its name comes from the Latin word for earth (tellus).
Dysprosium (Dy)
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HUMOR SECTION
An elderly woman died last month. Having never married, she requested no male pallbearers.
In her handwritten instructions for her memorial service, she wrote, "They wouldn't take me out while I was alive, I don't want them to take me out when I'm dead."
In her handwritten instructions for her memorial service, she wrote, "They wouldn't take me out while I was alive, I don't want them to take me out when I'm dead."
******************
Joe sets up his friend Michael to go on a blind date with a friend of a friend of his. But Mike is a little worried about going out with someone he's never seen before. "What do I do if she's ugly?" says Mike, "I'll be stuck with her all night."
"Don't worry," Joe says, "just go up to her door and meet her first. If you like what you see, then everything goes as planned. If you don't just shout 'Aaaaaauuuggghhh!' and fake an asthma attack. That'll give you an excuse to cancel the date right then and there."
So that night, Mike knocks at the girl's door and when she comes out he is awe-struck at how beautiful and sexy she is. He's about to speak when the girl suddenly shouts:
.."Aaaaaauuuggghhh!"
"Don't worry," Joe says, "just go up to her door and meet her first. If you like what you see, then everything goes as planned. If you don't just shout 'Aaaaaauuuggghhh!' and fake an asthma attack. That'll give you an excuse to cancel the date right then and there."
So that night, Mike knocks at the girl's door and when she comes out he is awe-struck at how beautiful and sexy she is. He's about to speak when the girl suddenly shouts:
.."Aaaaaauuuggghhh!"
~**~**~~**~~**~~**~~**~~
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
Go to www.sharedgovernance.org for access to a 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 Dr Robert Hess. info@sharedgovernance.orgwww.sharedgovernance.org
Go to www.sharedgovernance.org for access to a 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 Dr Robert Hess. info@sharedgovernance.orgwww.sharedgovernance.org
Pay Only $34.99 for a full year of CONTACT HOURS
www.nurse.com for CNE offerings.
www.nurse.com for CNE offerings.
Free CEs http://www.myfreece.com/welcome.asp
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.
A very good website For the new nurses....and those who just want to double check: http://nursingcrib.com/
This is an excellent nursing site, check it out:http://nursingpub.com/
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
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*
MEDICAL RECALLS
*
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Vascu-Guard Peripheral Vascular Patch by Baxter: Recall - Difficulty Distinguishing the Smooth from Rough Surface
The following product codes are affected by this recall:
1504026 VASCU-GUARD TS 1x6cm
1504028 VASCU-GUARD TS 0.8x8cm
1504030 VASCU-GUARD TS 1x10cm
1504032 VASCU-GUARD TS 2x9cm
1504026 VASCU-GUARD TS 1x6cm
1504028 VASCU-GUARD TS 0.8x8cm
1504030 VASCU-GUARD TS 1x10cm
1504032 VASCU-GUARD TS 2x9cm
UPDATED 06/05/2015. Class I recall notice posted.
[Posted 06/03/2015]
AUDIENCE: Cardiology, Nursing, Risk Manager
ISSUE: Baxter International Inc. announced today it is voluntarily recalling four product codes of its Vascu-Guard Peripheral Vascular Patch. Baxter received customer complaints of difficulty in distinguishing the smooth from rough surface of the Vascu-Guard patch as described in the labeled instructions for use. This is due to a deviation in the surface texture of the vascular patch in a new packaging configuration. Incorrect orientation of the patch with the rough side toward the bloodstream may increase the risk of vessel thrombosis and/or embolism.
BACKGROUND: The Vascu-Guard Peripheral Vascular Patch is intended for use in peripheral vascular reconstruction including carotid, renal, iliac, femoral, profunda, and tibial blood vessels and arteriovenous access revisions.
RECOMMENDATION: Customers have been directed to locate and remove all affected product from their facilities. Recalled products should be returned to Baxter for credit by contacting Baxter Healthcare Center for Service at 1-888-229-0001. Customers can still order this product presented in a plastic jar filled with sterile water and 1% Propylene Oxide; it is unaffected by this recall.
Consumers with questions regarding this recall can call Baxter at 1-800-422-9837. Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to using these products.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
- Complete and submit the report Online: www.fda.gov/MedWatch/report
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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........AccuRuler Accurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
bjwalters@co.camden.ga.us (Barbara)
deseng78@cloud.com (De)
Xdidax5@gmail.com (Diana)
jenniferwiegert@hotmail.com (Jennifer)
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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. So, be certain to let me know when you change your address. 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
(I don't especially agree with the politics, but definitely agree with this statement )
--Ron Paul
Hope to hear from you..... Frankie
