Thursday, July 16, 2015

July PARADIGM BYTES Newsletter

PARADIGM BYTES

Newsletter for Paradigm 97
July 16, 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
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.

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

SNIPPET
  Willful Blindness

  Kennedy, Maureen Shawn MA, RN, FAAN

Asked whether they see themselves as patient advocates, most nurses would probably say they do. I remember working with nurses who guarded their charges like mother (or father) bears, making sure patients and families were treated appropriately by everyone involved in their care.

But I also recall times when patient advocacy took a backseat to politics or convenience, when it was easier not to challenge the status quo, even if that meant ignoring unsafe practices. There's a term for this: willful blindness. It refers to conscious avoidance, a choice not to know about, or act on, something that one should or could know. Last May, Margaret Heffernan, author of Willful Blindness: Why We Ignore the Obvious at Our Peril (Walker and Company, 2011), spoke at the American Association of Critical-Care Nurses’ annual meeting in San Diego. She gave many examples, including the shady business practices that led to the collapse of Enron, the Catholic Church's cover-up of child sexual abuse crimes perpetrated by members of its clergy, and the U.S. government's cover-up of human rights violations against Iraqi prisoners at Abu Ghraib. In each case the evidence of wrongdoing was apparent, yet many people chose not to see it, and did nothing  .... 

 http://journals.lww.com/ajnonline/Fulltext/2015/07000/Willful_Blindness.1.aspx

American Journal of Nursing: July 2015 - Volume 115 - Issue 7 - p 7  

doi: 10.1097/01.NAJ.0000467252.24642.92 Editorial

 

http://journals.lww.com/ajnonline/Fulltext/2015/07000/Willful_Blindness.1.aspx
 
 ~~**~~**~~**~~**~~**~~
INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
 
 
 Drastic acceleration of HIV fight needed to stop AIDS resurgence  

The global HIV epidemic could see a resurgence in just five years without a drastic acceleration in efforts to prevent and treat the AIDS virus, the United Nations and disease experts said on Thursday.
While good progress has been made in improving access to life-saving AIDS drugs, an analysis by UNAIDS and an expert panel commissioned by The Lancet medical journal found the rate of new HIV infections is not falling fast enough.
"We must face hard truths -- if the current rate of new HIV infections continues, merely sustaining the major efforts we already have in place will not be enough to stop deaths from AIDS increasing within five years in many countries," said Peter Piot, director of the London School of Hygiene & Tropical Medicine and a lead author of the report.
He said this, plus high demographic growth in some affected countries, is increasing the number of people infected with the incurable virus who will need lifelong treatment.  ...
http://www.reuters.com/article/2015/06/24/us-health-aids-hiv-idUSKBN0P42RY20150624?feedType=nl&feedName=healthNews
 
**************************
Another Genetic Error Linked to Childhood

Leukemia Researchers find gene variant associated with acute lymphoblastic leukemia


THURSDAY, July 9, 2015 (HealthDay News) -- Scientists say they've identified a gene mutation associated with childhood acute lymphoblastic leukemia.
ALL, as acute lymphoblastic leukemia is called, is the most common type of cancer in children.
"This is now the second such syndrome of leukemia susceptibility we have described recently, suggesting that there is a significant proportion of childhood leukemia that is inherited," said study corresponding author Dr. Kenneth Offit, chief of the clinical genetics service at Memorial Sloan Kettering Cancer Center in New York City.
The mutation is in the gene ETV6, which plays a role in cancers of lymphocytes -- immune cells that circulate in the blood. This gene mutation was found in several children with leukemia who are members of the same family, the research team said.
The mutation causes significant changes in the function of the gene, according to the study recently published in the journal PLoS Genetics.  ...
http://www.nlm.nih.gov/medlineplus/news/fullstory_153506.html
 
******************
   :Washington state reports first U.S. measles death in 12 years

A previously undetected measles infection was found by an autopsy to be the underlying cause of a Washington state woman's death this spring, marking the first known U.S. fatality from the disease in 12 years, public health officials said on Thursday.  The woman from Clallam County, in northwestern Washington, was most likely exposed to measles at a medical facility during a recent outbreak in the area, the state Health Department said in a statement on its website.  She was there at the same time as another person who turned out to have been contagious with the virus. But the woman never developed some of the common symptoms of measles, such as a rash, so her infection was not discovered until after her death, the agency said.   Her precise immunization status was unknown, and though she had measles anti-bodies, the woman also had several other health conditions and was on medications that suppressed her immune system, Health Department spokesman Donn Moyer said. ...

http://www.reuters.com/article/2015/07/02/us-usa-measles-idUSKCN0PC2L920150702?feedType=nl&feedName=healthNews

*********************
 Pluto was discovered in 1930 by astronomer Clyde Tombaugh--who worked in the Lowell Observatory in Flagstaff, Arizona. Tombaugh was only 24 when he discovered it.

For 76 years, Pluto was considered a planet. However, when astronomers discovered that it was just one of many large objects within the Kuiper belt, Pluto was renamed a 'dwarf planet' in 2006.


  RANDOM FACT: 

Pluto takes the longest time of the eight planets (248 Earth years) to orbit around the sun. Because it's the closest to the sun, Mercury has the fastest orbit, at 88 Earth days. Earth takes 365 days to orbit the sun.

It takes Pluto 6 days, 9 hours, and 17 minutes to spin once, making it the planet with the second-slowest rotation in the solar system. Venus has the slowest rotation, taking 243 days to spin just once. Jupiter is the fastest-spinning planet, rotating on average once in just less than 10 hours.
***

Bonus Fact:

Pluto spins in the opposite direction as Earth, which means the sun rises in the west and sets in the east. Only Venus, Uranus, and Pluto have a retrograde rotation.

Because Pluto's moon Charon is almost the size of the planet itself, astronomers sometimes refer to the two as a double planet

Since Pluto and Charon orbit each other, Charon appears to stand still in Pluto's sky. Additionally, the same sides of Pluto and Charon always face each other.  
 
****************  
Sent in by a member re: milking the cord article.  She writes: 
Good job....I'll just add my 2 bits:
 
And 'milking the cord' which was in fashion for a bit will increase jaundice in the baby!
Linda B. Jenkins, RN


 Study: Delay Umbilical Cord Clamping to Boost Kids' Development

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
***************************
Umbilical cord ‘milking’ improves blood flow in preterm infants

For preemies delivered by C-section, technique increases blood pressure, finds NIH-funded study

A technique to increase the flow of blood from the umbilical cord into the infant’s circulatory system improves blood pressure and red blood cell levels in preterm infants delivered by cesarean section, according to a study funded by the National Institutes of Health.
The study, published online in Pediatrics, was conducted by researchers at the Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns in San Diego, and Loma Linda University, Loma Linda, California. It was supported by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
The technique, known as cord milking, consists of encircling the cord with thumb and forefingers, gently squeezing, and slowly pushing the blood through the cord to the infant’s abdomen. For infants delivered by cesarean, cord milking appears to offer benefits over the standard practice of waiting 45 to 60 seconds before clamping and then cutting the umbilical cord. These benefits, which include greater blood flow to and from the heart, higher red blood cell level, and higher blood pressure, were seen only in the infants delivered by cesarean. Among a smaller number of vaginal births, the researchers found no difference in blood volume between infants undergoing cord milking and those undergoing delayed cord clamping.  ...  
http://www.nih.gov/news/health/jun2015/nichd-29.htm

******************
 Quiz: Fun Facts About Your Hands  (10 questions)

Which grows faster, your fingernails or your toenails?

  •  
  •  
  •  
Which Hand does most of the work when you are typing?

  •  
  •  
  •  

For the rest of the 10 questions, go to:

http://www.webmd.com/women/rm-quiz-handfacts?ecd=wnl_wmh_070715&ctr=wnl-wmh-070715_nsl-ld-stry&mb=nSAyD2ApSXwBuGGvz8QhGShonS%2fH3cwym2k%40XDZknbs%3d 

*******************

2%:
Percent of psychiatrists in the U.S. who are African American.
15%:
Rate of somatization among African Americans, compared to 9% among Caucasian Americans
1:
Older Asian American women have the highest suicide rate of all women over age 65 in the U.S.
 
 
*********************
 Nurse Fatigue and Shift Length: A Pilot Study
Nurse fatigue in the United States is recognized as a source of adverse patient events as well as negative impacts on nurse safety. The Occupational Safety and Health Administration (2013) cautions people against working more than 8-hour shifts as longer shifts may result in reduced alertness. Shift length was a focus of the Joint Commission (2011) recommendations to mitigate fatigue in health care workers.
In the United States, nurses who provide direct patient care routinely work 12-hour shifts. In a study of about 23,000 nurses, Stimpfel, Sloane, and Aiken (2012) reported 65% worked 12-hour shifts or longer. Nationwide there are 1,617,200 nurses working in hospitals (American Nurses Association, 2011). If 65% worked 12-hour shifts, then there could be well over one million nurses scheduled and working shifts with long hours. ...  (part one of seven)
http://www.medscape.com/viewarticle/843884

*************************
 Study: California’s nurse-to-patient ratio law reduces RN injuries     A study that sought to understand if the California nurse-to-patient ratio law improves nurse safety showed promising results, according to the article, “California’s Nurse-to-Patient Ratio Law and Occupational Injury,” published May 2015 in the International Archives of Occupational and Environmental Health.

California is the only state to govern a minimum nurse-to-patient ratio law for various units. In general, the ratio is one nurse to five patients. The law has been in place since 2004.

Researchers asked: “Could the law improve safety for the nurses themselves?” To find the answer, they looked at data from the U.S. Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses. The SOII collects data from 150,000 to more than 200,000 private firms, depending on year... 

http://news.nurse.com/article/20150522/NATIONAL06/150522002#.VX86PPlViko

************************
Quiz Time
Which statement about insulin use during EN therapy is correct?
a.  Giving 24-hour basal insulin may increase hypoglycemia risk if EN therapy is interrupted unexpectedly.
b.  Premixed 70/30 insulin given once daily may be safer than long-acting insulin in patients receiving continuous tube feedings.
c.  The recommended starting total daily dose of insulin can be calculated at 0.5 to 0.8 units/kg.
d. Long-acting insulin is safer than premixed insulin for patients receiving continuous tube feedings.



*******************************
 For first time, gene therapy shows promise in cystic fibrosis 

Scientists conducting a major trial of a therapy that replaces the faulty gene responsible for cystic fibrosis say the treatment has showed significant benefit for the first time in patients' lung function.
The technique, developed with the technology commercialization firm Imperial Innovations, replaces the defective gene behind the inherited lung disease by using inhaled molecules of DNA to deliver a normal working copy of the gene to lung cells.
"Patients who received the gene therapy showed a significant, if modest, benefit in tests of lung function compared with the placebo group," said Eric Alton, a professor at Imperial College London who led the trial.  ...
http://www.reuters.com/article/2015/07/02/us-health-cysticfibrosis-gene-idUSKCN0PC2RE20150702?feedType=nl&feedName=healthNews
  

********************
  Slideshow: A Visual Guide to Sleep Disorders
What Are Sleep Disorders?   These conditions affect how much and how well you sleep. Causes range from poor habits that keep you awake to medical problems that disrupt your sleep cycle. If you don't feel rested in the mornings, see your doctor. Not getting enough shuteye is a serious problem that can threaten your health and safety.  ...
http://www.webmd.com/sleep-disorders/ss/slideshow-sleep-disorders-overview?ecd=wnl_wmh_070115&ctr=wnl-wmh-070115_nsl-ld-stry&mb=nSAyD2ApSXwBuGGvz8QhGShonS%2fH3cwym2k%40XDZknbs%3d

*******************
Nursing Hint:
 Neglecting to do your own full assessment on arrival, every shift, or when the patient changes floors because you “trust” the other nurse. There are times where we as nurses may not do as good a job assessing as we no doubt should. While nothing excuses doing a job halfway, things come up. A nurse might have to stop an assessment for a code, or leave to help a patient to the bathroom with the intent to come back and that patient falls. Sometimes, we as nurses just assume that since the same patient has been with us for three weeks, nothing has changed and we could save time by doing a “glance over” assessment. Some nurses, I hate to say, just don’t care enough to do their job as they should. Always do a full assessment, and on admission, don’t forget to look at the butt! 
 
*************************
 Baking Soda can be used for many jobs around the house, scrubbing sinks, bath tub, stove, refrigerator and laundry. It leaves everything smelling nice and cleans just as good as any cleanser without scratching enamel. 

Hint 1:

Remove animal hair from furniture or clothes by rubbing the area with a sheet of Bounce. It will magnetically attract all the loose hairs.

*************

Hint 2: 

A small amount of lemon juice pour onto minor wounds can help stop bleeding and disinfect the injury (it will sting a bit). Lemon juice applied to itches, poison ivy rashes and wasp stings is said to relieve discomfort.

Another Hint:   I learned this while volunteering at a local hospital.  The cleaning woman was using a tennis ball attached to a long pole.  She was scrubbing heel marks on the tile; the marks disappeared rapidly.  She said that her boss had engineered the apparatus... awesome.
 
 **************************
Now don't shoot the messenger (meaning me about the life insurance article)  :
TODAY'S THRIFTY TIP: 

You only need life insurance if someone, such as a child or a spouse, is financially dependent upon you. That means most singles, seniors and kids don't need a policy. 

Other policies you can probably do without include credit-card insurance (better to use the premium to pay down your debt in the first place), rental-car insurance (most auto policies and credit cards carry some coverage) and mortgage life insurance (a regular term-life insurance policy is more comprehensive).  
  
*******************
RANDOM TIDBITS

The first day of autumn is known as the autumnal equinox. On this day, the number of hours of daylight and darkness are equal. This is because the sun is aligned with the center of the Earth between the north and south of the planet.

In Greek mythology, autumn was the time when Persephone, the daughter of Demeter, was abducted by Hades, the god-king of the underworld. During this time, Demeter, the goddess of the harvest, was distraught and the ground grew sparse and cold. When Persephone returned in the springtime, plants and life bloomed anew because of Demeter's happiness.

Yellow, orange and variations thereof always reside in the pigmentation of tree leaves, but they are overpowered by the abundance of green from the chlorophyll in the leaves. Come autumn, when the sun weakens and days grow shorter, the amount of chlorophyll in leaves diminishes, allowing the other pigments in the leaves to show through.

Fall is a peak migration time for many species of birds. During autumn, birds will fly to other areas seeking more hospitable climates. The Arctic tern journeys about 11,000 miles each way for its annual migration. That is like going all the way across the United States about three and a half times.

Autumn also signals another colorful spectacle apart from the tree leaves. The aurora borealis, also known as the Northern Lights, tends to be visible this time of year. This is because geomagnetic storms are about twice as likely to occur during the fall thanks to cool evening weather. 

Evergreen trees will not lose their leaves like deciduous trees. Their leaves, also called needles, are covered with a thick wax. This wax protects the inner components of the needles, preventing them from freezing.

********************
New data fuel hopes for broad use of Novartis psoriasis drug 

Novartis is increasingly confident about the potential of its new injectable drug Cosentyx, as fresh clinical data confirms its long-term benefits in treating psoriatic arthritis.
Cosentyx was approved by the U.S. Food and Drug Administration in January for treating the painful skin condition plaque psoriasis, but the company also has high hopes for the product in related conditions.
Trial results published in the medical journal The Lancet on Monday showed the drug acting rapidly on psoriatic arthritis and, significantly, that its efficacy was sustained over one year. The treatment is given once a month.  ...
 http://www.reuters.com/article/2015/06/28/us-novartis-cosentyx-idUSKCN0P815L20150628?feedType=nl&feedName=healthNews

****************************** 
  

10 Instant Ways to Calm Yourself Down


1. Hand Massage

I learned this one in both the MBSR program and in Brukner’s book. What’s great about it is that you can do it while attending a lecture, listening to your kids fight, or sitting at your desk working. No one will notice. Simply use the thumb of one hand and press around the palm of the other hand. It’s very soothing.

2. Palm Push

By pushing your palms together and holding for five to ten seconds, you give your body “proprioceptive input,” according to Brukner, which “lets your body know where it is in space.” I like this one because it reminds me of tree position in yoga, which is the last of the standing series postures in Bikram yoga. By then, I am quite happy to hold the tree position. The palm push is like a mini, portable tree position I can pull out any time to calm down.

3. Closing Your Eyes

Aron says that 80 percent of sensory stimulation comes in through the eyes, so shutting them every now and then gives your brain a much-needed break. She also says that she has found that highly sensitive persons do better if they can stay in bed with their eyes closed for nine hours. They don’t have to be sleeping. Just lying in bed with our eyes closed allows for some chill time that we need before being bombarded with stimulation.  ...
http://www.everydayhealth.com/columns/therese-borchard-sanity-break/10-quick-ways-to-calm-down/?xid=aol_eh-news_11_20150622_&aolcat=HLT
 
**********************
 
  AMA and CMS Providing Assistance For ICD-10 Transition

On October 1, 2015, clinicians must use the ICD-10 code set. As expected, many doctors are concerned about the time and resources needed to make that transition. To ease the transition, the Centers for Medicare & Medicaid Services (CMS), with the assistance of the American Medical Association (AMA) has announced 4 changes to the transition period to  help clinicians – especially those in practices with limited resources.

The 4 changes are:

  1. Claim denials. For the first year ICD-10 is in place, Medicare claims will not be denied solely based on the specificity of the diagnosis codes as long as they are from the appropriate family of ICD-10 codes.
     
  2. Quality-reporting penalties. Similar to claim denials, CMS will not subject physicians to penalties for the Physician Quality Reporting System, the value-based payment modifier or meaningful use based on the specificity of diagnosis codes as long as they use a code from the correct ICD-10 family of codes.
     
  3. Payment disruptions. If Medicare contractors are unable to process claims as a result of problems with ICD-10, CMS will authorize advance payments to physicians.
     
  4. Navigating transition problems. CMS has said it will establish a communication center to monitor issues and resolve them as quickly as possible. This will include an “ICD-10 ombudsman” devoted to triaging physician issues.
In a news release, Steven Stack, MD, president of the AMA wrote “These provisions are a culmination of vigorous efforts to convince the agency of the need for a transition period to avoid financial disruptions during this time of tremendous change. These provisions are a testament to the power of organized medicine and what we can achieve when we band together for the good of our patients and our profession.”
 
Medicare claims processing systems will not have the capability to accept ICD-9 codes for the dates of services after September 30, 2015. s

CMS plans to name a CMS ICS-10 Ombudsman to triage and answer queries obtain the submission of claims. For more information, visit   http://www.roadto10.org/

Source

AMA Viewpoint. CMS to make ICD-10 transition less disruptive for physicians [news release].  Chicago, Il: American Medical Association; July 6, 2015.http://www.ama-assn.org/ama/ama-wire/post/cms-icd-10-transition-less-disruptive-physicians
 
 
**************************
 
 Is Fresh fish always healthier than frozen fish?
 
True or False

Unless you know for sure it's high-quality fresh fish, go with frozen. A lot of fish is flash frozen on the boat right after it's caught. After thawing, it should still be quite good.

On the other hand, "fresh" fish that was never frozen may have spent a few days sitting in a smelly ship's hold by the time you buy it. And some "fresh" fish may have been frozen and then thawed out behind the supermarket counter.

__________________________

 The health risks from eating fish often outweigh the benefits.

True or False

Many foods, from fruits and vegetables to dairy products and meat, can be tainted with chemicals and other unsavory things. Fish, too, can have mercury and PCBs. But experts say the benefits are much more likely to outweigh the risks.

____________

People who eat fish regularly have a lower risk of:  
Stroke or 
heart disease or 
depression or 
all the above.
  •                                      
(Answer:  All the above)
The benefits of regularly eating healthy fish keep piling up. It lowers blood pressure, cuts the risk of irregular heartbeats, and drops the risk of fatal heart disease by 36%.
It also seems to lower the risk of stroke and some cancers, improve your mood, and help with other conditions, such as rheumatoid arthritis.
____________________
                                        
 Most of the health benefit of eating fish comes from:     

Omega- 3 fatty acids or
Omega- 6 fatty acids  or
Omega- 9 fatty acids    


(Answer: Omega- 3 fatty acids)                                   

 Omega-3 fatty acids help our cells work. Because our bodies don't make enough of them, we have to get them in food. Fish that are high in omega-3 fatty acids include salmon, herring, mackerel, and sardines.   


_______________________

Oysters raise libido.  True   or  False?


(answer: Oysters as an aphrodisiac? It turns out to be a legend, or at least researchers have never found a connection.

In theory, people who have very low levels of certain nutrients, like selenium, could feel friskier after eating more oysters. But that condition is rare. 

_______________________

  How many servings of fish per week does the American Heart Association recommend?  1? or 2? or 3? or 4?


(  correct answer: 2)     The American Heart Association recommends at least two servings of fish per week, especially fatty fish high in omega-3 fatty acids. What's a serving? About 3.5 ounces -- a little bigger than the palm of a woman's hand.
_______________________
"Sushi grade" raw fish is certified to be free of bacteria and parasites.    True?  or  False?
(answer: False)  
Bad news, sushi fans. No matter how good the restaurant, eating raw seafood poses a higher risk of food-borne illness than cooked seafood.
Although "sushi-grade" sounds good, it's a marketing term. It has no legal meaning. Fish for sushi is often flash frozen, which should kill parasites. But the only sure way to avoid parasites and bacteria is to cook your fish.
____________________
Which of the following usually has the lowest percentage of calories from fat?   Chicken? or scallops? or pork?
(answer: Shellfish)
-- like crab, lobster, shrimp, scallops, and clams -- is quite low in fat. Compared to beef and chicken, shellfish tends to have higher levels of healthy fats and lower levels of unhealthy fats. Shellfish is a great source of protein, too.
So break out your lobster crackers and put on your bib. Just go easy on the drawn butter.

_______________________

Eating fish can help your memory as you age.   True or False

(answer: true)
  •  
  • Fish really might be brain food. Studies have found that eating baked or broiled fish once a week -- over the long term -- seems to help people keep their short-term memory sharp.
Eating fish also appears to lower your risk of Alzheimer's disease and mental decline.

____________________


 Wild fish always have more omega-3 fatty acids than farm-raised fish.  True  or False?


(answer: true)

It depends on the fish. Some fish, such as salmon, mackerel, herring, and trout, can be high in healthy omega-3s whether they're farmed or wild.  

But a lot of farmed fish, especially tilapia, are fed a corn-based diet. As a result, they tend to have much lower levels of omega-3s.

__________________________

Fish is supposed to smell "fishy."  True or False?

(answer: false)

Fresh seafood should have a mild smell or none at all. If it smells sour or fishy, it's past its prime. If it stinks up your kitchen every time you open the refrigerator door, throw it out.

Good fish should never be mushy either. It should be moist and springy when you touch it. 
_____________________

It's better to get omega-3 fatty acids from fish than from fish oil supplements.    True or False?

Stick with fish, not capsules. Most of the encouraging studies have looked at people eating fish, not taking a supplement. Extracted omega-3 fatty acids may not have the full benefits of what's naturally in fish.

Some recent studies of people at higher risk of heart disease did not find that omega-3 supplements helped. People with heart disease should talk to their doctor to see if omega-3 supplements might be a good idea.
______________

 Cooking fish properly will kill worms and other parasites.   True or False?


(answer:  true)
Fish can carry some nasty parasites. One of the most revolting is the tapeworm. It can live in the human gut for years, growing up to a couple of yards long, causing severe pain, weight loss, and anemia. 
Want the good news? Cooking your fish so the internal temperature reaches 140 degrees Fahrenheit will kill any parasites.
________________________

Pregnant women should not eat fish.     True or False?

(answer: false)

Pregnant women should eat fish -- up to 12 ounces of seafood per week. Fish has nutrients that are important for a baby's brain development. Studies show that pregnant women who eat fish regularly have children that go on to score higher on intelligence tests.

However, pregnant women should avoid fish high in mercury, like shark, swordfish, tilefish, and king mackerel. Instead, choose varieties that are lower in mercury, like shrimp, canned light tuna, salmon, and catfish. Women who are pregnant or breastfeeding can eat white tuna (albacore), but only 6 ounces a week, because it's higher in mercury than light tuna.

___________________________

 Seafood is the most common cause of food allergies.   True or False?


(answer: true)

Allergies to shellfish, like shrimp and lobster, are more likely to send people to the ER than any other food allergy. But people can also be allergic to finned fish, like haddock and trout. 

Seafood allergies may develop suddenly in adulthood. Unfortunately, they don't tend to fade and can often be very serious. If you get a seafood allergy, you're probably stuck with it. 

_____________________
 
 Even fried fish is good for you.    True or False?

(answer:  false)
Fish is healthiest when it's baked or broiled. Unfortunately, fish's health benefits may disappear once it's deep-fried. Eating a lot of fried foods -- especially when cooked in saturated or trans fats -- is closely linked to heart disease and stroke. In one study of older women, a single serving of fried fish a week was associated with a 48% higher risk of heart failure.  
Skip the fried fish. Choose baked or broiled instead.
___________________________

   Fear of fish is called:

aquaphobia   or ichthyophobia  or landlubberism

 You know that eating fish is good for you, but what if you just hate it? Keep trying. Remember that seafood has all sorts of textures and flavors. Try a bland fish like tilapia or cod. Or try something with a firm, meaty texture, like swordfish or scallops.  
In time, you're bound to find seafood you like -- and your health will be better for it.
**(answer: ichthyophobia
*********************

 Reviewed by Kathleen M. Zelman, RD, LD, MPH on May 04, 2014

This tool does not provide medical advice. See additional information


 http://www.webmd.com/food-recipes/rm-quiz-fish-fact-fiction?ecd=wnl_wmh_062115&ctr=wnl-wmh-062115_nsl-ld-stry&mb=nSAyD2ApSXwBuGGvz8QhGShonS%2fH3cwym2k%40XDZknbs%3d

 
 
*******************
Storing herbs

The length of time your herbs keep fresh depends on how you store them. Fresh herbs such as basil, cilantro or chives are best stored in the fridge in plastic. Cover the herbs with a plastic bag and secure with a rubber band at the roots or stems. Take the herbs out as you need them.

__________________________________

Store onions and potatoes separately

You should never store onions and potatoes together. The
potatoes will spoil faster this way. It's best to store the 
onions in a cool, dry place and the potatoes on a separate 
shelf, at a far distance from the onions.

__________________________________________
Make berries last longer with vinegar 
 
 
 Before you store your berries in the fridge soak them in 
vinegar to extend their freshness by two weeks. Add one 
part vinegar to 10 parts water and dip each berry in this 
solution for a few seconds. Rinse afterwards and then put 
them in the fridge.
 ******************************* 
   

 
  RANDOM FACT:
The US Mint began putting notches on the edges of coins containing gold and silver to discourage holders from shaving off small quantities of the precious metals. Dimes, quarters and half dollars are notched because they used to contain silver. Pennies and nickels aren't notched because the metals they contain are not valuable enough to shave.
***

Bonus Fact:

In France, where tennis first became popular, a big, round zero on scoreboard looked like an egg and was called 'l'oeuf,' which is French for 'egg.' When tennis was introduced in the U.S., Americans pronounced it 'love.


 

                                                        ~~**~~**~~**~~**~~**~~
HUMOR SECTION

  I couldn't find my luggage at the airport baggage area. So I went to the lost luggage office and told the woman there that my bags never showed up.

She smiled and told me not to worry as they were trained professionals and I was in good hands. "Now," she asked me, "has your plane arrived yet?"

*******
Recently, I called to make reservations on a small charter plane that departs from Teterboro airport in New Jersey.

I knew that I would be flying in a very small plane, so I was not surprised when the clerk said, "The plane is very full with baggage and passengers." Then she asked, "How much do you weigh, sir?"

Not thinking clearly I answered, "With or without clothes?"

"Well," said the clerk, "how do you intend to travel?"

                                                  *************

A doctor said to his patient: "You have a slight heart condition, but I wouldn't worry about it."

"Really, Doc?" the patient replied. "Well, if you had a slight heart condition I wouldn't worry about it either
."

                                                 ****************
 

"I wanna hang a map of the world in my house. Then I'm gonna put pins into all the locations that I've traveled to. But first, I'm gonna have to travel to the top two corners of the map so it won't fall down." --                                Mitch Hedberg 

 
~**~**~~**~~**~~**~~**~~
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 
Pay Only $34.99 for a full year of CONTACT HOURS 
www.nurse.com for CNE offerings.
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.

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

Decubqueen's websitewww.accuruler.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


Metric conversion calculators and tables for metric conversions

*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
 
FDA is alerting pet owners, veterinarians, health care providers and pharmacists that pets are at risk of illness and death when exposed to topical pain medications containing the nonsteroidal anti-inflammatory drug (NSAID) flurbiprofen. People using these medications should use care when applying them in a household with pets, as even very small amounts could be dangerous to these animals.
The FDA received reports of cats in two households that became ill or died after their owners used topical medications containing flurbiprofen on themselves to treat muscle, joint, or other pain. The pet owners had applied the cream or lotion to their own neck or feet, and not directly to the pet, and it is not known exactly how the cats became exposed to the medication. The products contained the NSAID flurbiprofen and the muscle relaxer cyclobenzaprine, as well as other varying active ingredients, including baclofen, gabapentin, lidocaine, or prilocaine.
 
                                                                      ~~**~~**~~**~~**~~**~~
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.
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
No new members this month

~~**~~**~~**~~**~~**~~
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 addressSo, be certain to let me know when you change your address. RNFrankie@AOL.com
~~**~~**~~**~~**~~**~~
EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)

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

~~**~~**~~**~~**~~**~~
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.
~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY

We are not cisterns made for hoarding, we are channels made for sharing. 
Billy Graham  



Hope to hear from you..... Frankie