PARADIGM97

Margaret Sanger

2012-01-14T16:50:00.000-08:00

Margaret Higgens was born in Corning, New York, on 14th September 1883. She was the sixth of eleven children. Her mother also had seven more babies that died in childhood, before dying of cervical cancer. Educated at Claverack College, she became a trained nurse and married William Sanger, an architect, in 1902. After moving to Saranac for health reasons she gave birth to three children. Over the next 12 years she devoted herself to being a housewife and mother.
In her autobiography she wrote: "My own motherhood was joyous, loving, happy. I wanted to share these joys with other women. Since the birth of my first child I had realized the importance of spacing babies, but only a few months before had I fully grasped the significant fact that a powerful law denied and prevented mothers from obtaining knowledge to properly space their families."
When her three children were old enough to go to school she returned to work as a public health nurse in the slums of New York. Sanger joined the Socialist Party and became friends with other radicals such as John Reed, Upton Sinclair, Mabel Dodge, Robert Minor, Agnes Smedley, Kate Richards O'Hare, Eugene Debs, Elizabeth Flynn, Norman Thomas and Emma Goldman.
In July 1912 she was summoned to a Grand Street tenement. "My patient was a small, slight Russian Jewess, about twenty-eight years old, of the special cast of feature to which suffering lends a madonna-like expression. The cramped three-room apartment was in a sorry state of turmoil. Jake Sachs, a truck driver scarcely older than his wife, had come home to find the three children crying and her unconscious from the effects of a self-induced abortion." When Sadie Sachs died Margaret Sanger made a pledge to devote her life to making reliable contraceptive information available to women. She began her campaign by writing a column for the New York Call entitled "What Every Girl Should Know."
Upset by the poverty she experienced as a nurse in New York she founded a radical feminist magazine, The Woman Rebel. As Sanger later observed in her autobiography: "During these years in New York more and more my calls began to come from the Lower East Side, as though I were being magnetically drawn there by some force outside my control. I hated the wretchedness and hopelessness of the poor, and never experienced that satisfaction in working among them that so many noble women have found. My concern for my patients was now quite different from my earlier hospital attitude. I could see that much was wrong with them that did not appear in the physiological or medical diagnosis. A woman in childbirth was not merely a woman in childbirth. My expanded outlook included a view other background, her potentialities as a human being, the kind of children she was bearing, and what was going to happen to them."

After the death of a patient during childbirth Sanger decided to devote her life to making reliable contraceptive information available to women. She published the Birth Control Review and persuaded Lou Rogers and Cornelia Barns to be co-art editors of the journal.
The main theme of her articles was that "no woman can call herself free who doesn't own and control her own body."
After advice about birth-control appeared in her newspaper in1915, she was charged with publishing an "obscene and lewd article".

The Masses gave its full support to Sanger's campaign. Floyd Dell was assistant editor at the journal: "The Masses published articles in defense of of Margaret Sanger, and the magazine was immediately flooded with thousands of letters from women, asking for information about the methods of birth control, and giving the best as well as the most heart-breaking reasons for needing such information. These letters, as associate editor, I answered, saying that we were forbidden by law to give the information; then, as a private individual, I carefully turned over all these letters to other private individuals, who mailed this information to the women; and in this law-breaking I cheerfully and conscientiously participated. I believed then, as I do now, that it is a moral duty to violate evil laws."
Margaret Sanger fled to Britain and it was while she was in London she met Marie Stopes. She later recalled: "She then explained to me that, owing to her previous unfortunate marriage she had no experience in matters of contraception nor any occasion to inform herself of their use. Could I tell her exactly what methods were used? I replied that it would give me the greatest pleasure to bring to her home such devices as I had in my possession. Accordingly, we met again the following week for dinner in her home, and inspected and discussed the French pessary which she stated she then saw for the first time. I gave her my own pamphlets, all of which contained contraceptive information."
After hearing Sanger's story Marie Stopes decided to start a birth-control campaign in Britain. She knew it would be dangerous as several people in Britain, including Richard Carlile, Charles Bradlaugh and Annie Besant, had been sent to prison for advocating birth-control.
In December 1914 Sanger sent a letter to Havelock Ellis. As Phyllis Grosskurth, the author of Havelock Ellis (1980), has pointed out: "He invited her to tea the following week and was startled to find her so pretty and so comparatively young. At first she was overwhelmed by his patriarchal beauty and his refusal to make small talk. She was also surprised - as many others were on first meeting him - by his thin, high voice, so unexpected in a man of his size."
Sanger fell in love with Ellis. She wrote in An Autobiography (1938): "I was at peace, and content as I had never been before... I was not excited as I went back through the heavy fog to my own dull little room. My emotion was too deep for that. I felt as though I had been exalted into a hitherto undreamed-of world."
Soon afterwards Sanger tried to turn it into a sexual relationship. Havelock Ellis wrote to her explaining "What I felt, and feel, is that by just being your natural spontaneous self you are giving me so much more than I can hope to give you. You see, I am an extremely odd, reserved, slow undemonstrative person, whom it takes years and years to know. I have two or three very dear friends who date from 20 or 25 years back (and they like me better now than they did at first) and none of recent date."
Sanger returned to New York City and on 16th October, 1916, with the help of Kitty Marion, she opened a family planning and birth control clinic in the Brownsville neighborhood of Brooklyn. It was raided nine days later by the police and Sanger served 30 days in prison. In 1917 she published What Every Mother Should Know.
In 1921 Sanger founded the American Birth-Control League. Later that year her friend Marie Stopes also opened the first of her birth-control clinics in Holloway on 17th March 1921. Guy Aldred and Rose Witcop, joined the campaign and when they published a pamphlet written by Margaret Sanger, they were found guilty of selling an obscene publication. The case drew much press coverage and the couple were supported financially by John Maynard Keynes, Dora Black and Bertrand Russell. Later that year this group was joined by Katharine Glasier, Susan Lawrence, Margaret Bonfield, Dorothy Jewson and H. G. Wells to establish the Workers' Birth Control Group.

Margaret Sanger continued her campaign and in 1927, Sanger helped organize the first World Population Conference in Geneva. The following year she resigned as the president of the American Birth-Control League and devoted her energies to the Birth Control Clinical Research Bureau. She also published two books on the subject: Motherhood in Bondage (1928) and My Fight for Birth Control (1931).
In 1932 Margaret Sanger became president of the Birth Control International Information Center. The dissemination of birth control information by doctors was finally legalized in the United States in 1937. Her memoirs, The Autobiography of Margaret Sanger was published in 1938.
Margaret Sanger died in Tucson, Arizona, on 6th September 1966. http://www.spartacus.schoolnet.co.uk/Jsanger.htm

January Paradigm 97 Newsletter:

2012-01-14T16:26:00.000-08:00

PARADIGM BYTES
Newsletter for Paradigm 97
January 12, 2012

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

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

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SNIPPETS

Contact: Lauren Wilson, Communications Director
2468 Rayburn House Office Building Washington DC 20515
Phone: (202) 225-8885 Fax: (202) 226-1477 www.house.gov/ebjohnson

CONGRESSWOMAN EDDIE BERNICE JOHNSON INTRODUCES THE NATIONAL NURSE ACT OF 2011, HR 3679

Washington, DC – (Friday, December 16) – Yesterday, Congresswoman Eddie Bernice Johnson (D-TX) introduced the National Nurse Act of 2011, HR 3679. The bill, co-led by Congressman Peter King (R-NY), has garnered eighteen original co-sponsors. It would designate the Chief Nurse Officer of the U.S. Public Health Service as the “National Nurse for Public Health.”
The National Nurse would function alongside the Surgeon General and focus on health promotion, improving health literacy, and decreasing health disparities.

“The National Nurse Act of 2011 is an important piece of legislation that would establish a focal point for promoting health and disease prevention. There are currently 3.4 million nurses, making the demographic the largest sector of healthcare workers in the United States.

“As the first registered nurse in Congress, I believe that having a National Nurse focused on prevention activities will help reduce illnesses and decrease the costs for care and services,” said Congresswoman Johnson.

The National Nurse Act of 2011 is currently endorsed by dozens of prominent nursing organizations and key stakeholders.

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U.S. Representative Eddie Bernice Johnson is the highest-ranking Texan on the House Committee on Transportation & Infrastructure and a senior member of the Science Committee. She represents the 30th Congressional District of Texas, which, includes Downtown Dallas, Fair Park, Oak Lawn, Turtle Creek, Old East Dallas, Pleasant Grove, & South Oak Cliff; all of Balch Springs, DeSoto, Hutchins, Lancaster & Wilmer and parts of Cedar Hill, Duncanville, Ferris, Glenn Heights and Ovilla.

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INTERESTING READING

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

522 Million People Could Have Diabetes By 2030, Experts Say Many Cases Still Preventable
GENEVA - The International Diabetes Federation predicts that at least one in 10 adults could have diabetes by 2030, according to its latest statistics.
In a report issued on Monday, the advocacy group estimated that 552 million people could have diabetes in two decades' time based on factors like aging and demographic changes. Currently, the group says that about one adult in 13 has diabetes.
The figure includes both types of diabetes as well as cases that are undiagnosed. The group expects the number of cases to jump by 90 per cent even in Africa, where infectious diseases have previously been the top killer. Without including the impact of increasing obesity, the International Diabetes Federation said its figures were conservative. ... http://www.huffingtonpost.ca/2011/11/14/522-million-people-could-_n_1091753.html?ncid=webmail1#s446200&title=Diabetes

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Quiz Time
An important advance in treating combat-related pain during patient military evacuation flights is:
a. use of morphine
b. use of nonsteroidal anti-inflammatory drugs
c. use of Reiki
d. use of regional anesthesia
(Answer at end of Newsletter)
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ED nurses continue to be victims of workplace violence, according to new report
The latest data from the “Emergency Department Violence Surveillance Study,” an ongoing survey study from the Emergency Nurses Association (ENA), show rates of physical violence and verbal abuse against nurses did not decrease from May 2009 to January 2011. In the 12 months from January 2010 to January 2011, more than half (53.4%) of nurses reported experiencing verbal abuse and more than one in ten (12.9%) reported experiencing physical violence over a seven-day period compared with 54% reporting verbal abuse and 11% reporting only physical violence in the first year of the study. The study also found that reporting policies (especially zero-tolerance policies) were associated with a lower odds of physical violence and verbal abuse. Read the ENA press release. and the report.
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HHS Unveils MLR Rule Dec 02, 2011

The Department of Health and Human Services today released its final medical loss ratio rule. The rule will ensure that health insurance companies spend at least 80 percent of consumers' health insurance premiums on medical care rather than on income, overhead and marketing expenses.
The Hill: "Insurance plans will soon have to give consumers more information about how their premium dollars are spent,
even if the spending meets new federal requirements. The disclosure requirements were included in final regulations on
the healthcare reform law's medical loss ratio (MLR) provision. The Health and Human Services Department finalized
its MLR rules Friday" (Baker, 12/2). There are some links to the interim rule & other info with the article.........
http://www.kaiserhealthnews.org/Daily-Reports/2011/December/02/mlr-rule.aspx

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Frequent red meat eaters at higher risk of stroke (Reuters Health) - A high-protein diet might benefit health in some ways, but depending on what kind of protein a person consumes, it could raise their stroke risk too, suggests a large new study that finds eating lots of red meat ups the likelihood of having a stroke while poultry lowers it.
"The main message from this paper is that the type of protein or the protein package is really important for the risk of stroke. We have to consider protein in the context of the foods," said Dr. Frank Hu, a professor at the Harvard School of Public Health and one of the authors of the study. ...
http://www.reuters.com/article/2012/01/11/us-redmeat-stroke-idUSTRE80A20O20120111?feedType=nl&feedName=ushealth1100
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By MedPage Today Staff
Published: December 30, 2011
Injections That Are 'Soft as Silk' Silk Needle Threaded With Medicines

Instead of the "pinch" of a hypodermic needle to administer drugs, tiny biodegradable needles made of silk protein could be used to deliver precise doses painlessly, researchers suggested.
An engineering group described in Advanced Functional Materials how the microneedles could be made at room temperature and pressure with a water-based process, which wouldn't destroy sensitive biologic medications.
Even large-molecule drugs could be mixed with the silk protein solution, and adjusting the conditions under which they dried determined short or extended release of the medication.
Because the tip of the needles penetrate the skin without reaching nerves, they would be painless to use, the researchers noted.
"This is a very flexible technology that can be scaled up or down, shipped and stored without refrigeration and administered as easily as a patch or bandage," one of the researchers said in a press release. "We believe the potential is enormous."
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Spools and Tails May Be Keys to Schizophrenia Tx
Postmortem studies of brain tissue from patients with schizophrenia have revealed alterations of gene expression relating to low levels of histone acetylation – a finding that could open up new ways of treating the disease itself and not just the devastating symptoms.
Histones are intracellular proteins that serve as structural spools for DNA to wind around, forming chromatin, with "tails" that regularly undergo chemical modifications such as acetylation and methylation.
These epigenetic changes can determine which genes are activated and which are repressed, explained Elizabeth Thomas, PhD, of the Scripps Research Institute in La Jolla, Calif.
In a series of PCR assay experiments, the researchers found alterations in histone acetylation in the promoter region of several genes that have been linked to schizophrenia. They then studied the effects of a histone deacetylase inhibitor on mouse brain tissue, and found a reversal of the abnormal gene expression.
If the use of a histone deacetylase inhibitor such as valproic acid is found to have similar effects in the human brain, the effects could be normalization of histone acetylation patterns and gene expression, the researchers wrote in Translational Psychiatry.

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RANDOM FACTS: Fortune cookies actually originated in Japanese culture. You would find more Japanese-owned restaurants that served the still very popular American adaptation of Asian cuisine before WWII. When large populations of the Japanese-American citizens were put into internment camps, the fates of their restaurants were turned over to Chinese-Americans, and so we associate the famous cookie with the Chinese.

Bonus Fact: Actual Chinese cuisine is much different than what Americans know as Chinese food. However, the success of American-Asian food has necessitated vocational schools in China to teach potential immigrants the art of the cuisine. For example, Egg Foo Young is unheard of in traditional Chinese cuisine.
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Study Examines Changes in Resting Heart Rate Over Time Although resting heart rate (RHR) has been long known to be associated with cardiovascular risk, change in RHR over time has not been well studied. A new paper from Norway published in JAMA demonstrates that an increase in RHR over 10 years helps predict the risk of all-cause and ischemic heart disease (IHD) death.
Javaid Nauman and colleagues analyzed data from 46,410 Norwegian adults without known cardiovascular disease who had their RHR measured at baseline and at 10 years. ...
http://www.forbes.com/sites/larryhusten/2011/12/21/study-examines-changes-in-resting-heart-rate-over-time/
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RANDOM FACT: Levi Strauss arrived in California during the Gold Rush trying to sell canvas tents to miners. However, he soon
learned that what the prospectors needed most was pants, and so he turned his tent business into a pants business;
eventually using imported denim in place of canvas.
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Bonus Fact: In 2005, an original pair of Levi's--aged more than 115 years--were sold to a collector for $60,000.
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A Taste of Nursing Research: An Interactive Program Introducing Evidence-Based Practice and Research to Clinical Nurses Abstract
Developing and implementing a program to introduce clinical nurses to research and evidence-based practice (EBP) should spark interest and participation. In this article, the authors describe and evaluate a staff development initiative not only to introduce the principles of EBP and research but also to give nurses the opportunity to participate in the research process and development of EBP questions.
http://journals.lww.com/jnsdonline/Abstract/2011/11000/A_Taste_of_Nursing_Research__An_Interactive.18.aspx

Brown, Christine R. BSN, RN, CCRN; Johnson, Ann S. BSN, RNC, NNP-BC; Appling, Susan E. MS, CRNP
Journal for Nurses in Staff Development - JNSD:
November/December 2011 - Volume 27 - Issue 6 - p E1–E5
doi: 10.1097/NND.0b013e3182371190
Articles: Online Only
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High lead exposure linked to hearing loss in youth
(Reuters Health) - Teens exposed to higher-than-normal levels of lead are more likely to have trouble hearing, suggests a new study that links the hearing problems to lead levels well below those considered "safe" by current standards.
But other heavy metals weren't clearly tied to hearing problems, researchers said. And with lead, the report found only a small proportion of adolescents had blood concentrations that might be linked to hearing loss.
"It looks like the levels in the blood of most kids are very low and people are avoiding (heavy metals)," said study author Dr. Josef Shargorodsky, from the Massachusetts Eye and Ear Infirmary and Brigham and Women's Hospital in Boston. ...

http://www.reuters.com/article/2011/12/22/us-high-lead-hearing-loss-idUSTRE7BL1T720111222?feedType=nl&feedName=ushealth1100
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Breast implants need lifetime of care: experts (Reuters) - The Internet and women's magazines are filled with enticing adverts for breast implant surgery, but experts and regulators have varying views on how long they last and possible risks.
The implants now at the centre of a worldwide health scare came from the now-defunct French company Poly Implant Prothese (PIP) and appear to have an abnormally high rupture rate. That risk, though typically low, is present in all implants. ... http://www.reuters.com/article/2011/12/27/us-breast-implants-idUSTRE7BQ0EC20111227?feedType=nl&feedName=ushealth1100
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Siemens recalls clinical pregnancy tests (Reuters) - Siemens has recalled 15 batches of clinical pregnancy tests because some of them incorrectly showed a positive result, a spokesman for the company said on Friday.
He said the recall affects several hundred hospitals around the world, which were told as early as mid-December to destroy pregnancy tests from the batches. Until the cause of the malfunction has been found, Siemens will not be supplying any such tests, he said.

http://www.reuters.com/article/2011/12/30/us-siemens-recall-idUSTRE7BT0CN20111230?feedType=nl&feedName=ushealth1100
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Analysis: Court tests liability of healthcare executives (Reuters) - After decades in relative obscurity, a legal doctrine that holds corporate officers liable for company wrongdoing is finding its way back into some high-profile healthcare prosecutions.
The "responsible corporate officer" doctrine allows for prison terms of up to one year for misdemeanor violations of the Federal Food, Drug and Cosmetic Act, but typically defendants have received only probation.
Recently, however, the government has sought to reinvigorate the doctrine, and some executives are facing stiffer penalties than they had ever imagined.
On Tuesday, the Department of Health and Human Services will seek to convince a federal appeals court to uphold a 12-year exclusion from government business for three former executives of Purdue Pharma. The executives had pleaded guilty in 2007 to a misdemeanor for misbranding the painkiller OxyContin. ...

http://www.reuters.com/article/2011/12/06/us-health-legal-idUSTRE7B50NA20111206?feedType=nl&feedName=ushealth1100
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Medtronic settles U.S. probe over doctor kickbacks
(Reuters) - Medtronic Inc has agreed to pay $23.5 million to settle allegations that it paid kickbacks to doctors to encourage them to use its pacemakers and defibrillators, the U.S. Justice Department said on Monday.
The company was accused of seeking physicians to participate in studies and registries and paying doctors fees of between $1,000 to $2,000 per patient for information and data collected as long as they used Medtronic's devices, according to the Justice Department.
Medtronic caused false claims to be submitted to the federal healthcare programs Medicare and Medicaid, the Justice Department said. The settlement resolves two whistleblower lawsuits against the company. ...

http://www.reuters.com/article/2011/12/13/us-medtronic-kickbacks-idUSTRE7BC2GV20111213?feedType=nl&feedName=ushealth1100
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The New York Times: Report Finds Most Errors At Hospitals Go Unreported
Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report (Pear, 1/6).
http://tinyurl.com/6makzby The 42 page study can be downloaded from: http://oig.hhs.gov/oei/reports/oei-06-09-00091.pdf (I don't think this is an accurate report....what do you think?)
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USA Today: Workplaces Ban Not Only Smoking, But Smokers Themselves
As bans on smoking sweep the USA, an increasing number of employers — primarily hospitals — are also imposing bans on smokers. They won't hire applicants whose urine tests positive for nicotine use, whether cigarettes, smokeless tobacco or even patches (Koch, 1/5).
http://tinyurl.com/729eovy
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Emergency Hospitalizations for Adverse Drug Events in Older Americans. A study in the New England Journal of Medicine found that 67% of emergency hospitalizations related to adverse drug events were caused by four medications or mediation classes alone or in combination: warfarin,insulins, oral antiplatelets, and oral hypoglycemic agency. Adverse drug events are important preventable causes of hospitalization in older adults, however nationally representative data on adverse drug events is scarce ...

http://www.nejm.org/doi/full/10.1056/NEJMsa1103053
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RANDOM FACT: Rather than wring every dime he could out of the popular "Matrix" movie series, Keanu Reeves signed away his back-end deal for the two sequels to the films' special-effects and costume-design teams -- an act of benevolence that cost him many millions.

Bonus Fact: Named after his uncle, Henry Keanu Reeves, the actor's first name roughly translates to "cool mountain breeze" in Hawaiian.

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HUMOR SECTION

The shopkeeper was dismayed when a brand new business much like his own opened up next door and erected a huge sign which read BEST DEALS.

He was horrified when another competitor opened up on his right, and announced its arrival with an even larger sign, reading LOWEST PRICES.

The shopkeeper was panicked, until he got an idea. He put the biggest sign of all over his own shop- it read...... MAIN ENTRANCE

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

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

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

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

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

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

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

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

This information has recently been updated and is now available.
Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus (PDF - 168KB)

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

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

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm

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

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MEDICAL RECALLS
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CareFusion AVEA Ventilator: Recall - Failure May Lead to Lack of Ventilation
FDA notified healthcare professionals of a class I recall of CareFusion AVEA Ventilators. The AVEA ventilator can develop a failure where the ventilator activates a false extended high peak alarm, opens the safety valve and stops ventilating. Without health care professional intervention, patients may suffer life-threatening injury or death.
The AVEA ventilator is intended for continuous breathing support for the care of neonatal through adult patients who require mechanical ventilation. These ventilators are used in hospitals and other health care institutions. The recalled ventilators were manufactured between March 1, 2009 and June 30, 2011. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm285063.htm
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Selective Serotonin Reuptake Inhibitor (SSRI) Antidepressants: Drug Safety Communication - Use During Pregnancy and Potential Risk of Persistent Pulmonary Hypertension of the Newborn Including Celexa (citalopram); Lexapro (escitalopram); Prozac, Sarafem, Symbyax (fluoxetine); Luvox, Luvox CR (fluvoxamine); Paxil, Paxil CR, Pexeva (paroxetine); Zoloft (sertraline); Viibryd (vilazodone)

FDA notified healthcare professionals and the public on the use of selective serotonin reuptake inhibitor (SSRI) antidepressants by women during pregnancy and the potential risk of a rare heart and lung condition known as Persistent Pulmonary Hypertension of the Newborn (PPHN). The initial Public Health Advisory in July 2006 on this potential risk was based on a single published study. Since then, there have been conflicting findings from new studies evaluating this potential risk, making it unclear whether use of SSRIs during pregnancy can cause PPHN.
FDA has reviewed the additional new study results and has concluded that, given the conflicting results from different studies, it is premature to reach any conclusion about a possible link between SSRI use in pregnancy and PPHN. FDA will update the SSRI drug labels to reflect the new data and the conflicting results.
BACKGROUND: SSRIs are marketed under various brand and generic drug names, and are used to treat depression and other psychiatric disorders. There are no adequate and well-controlled studies of SSRIs in pregnant women.
PPHN occurs when a newborn baby does not adapt to breathing outside the womb. Newborns with PPHN may require intensive care support including a mechanical ventilator to increase their oxygen level. If severe, PPHN can result in multiple organ damage, including brain damage, and even death.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm283696.htm

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NURSING HINTS CORNER

X marks the spot. Locating pedal and posttibial pulses can be time-consuming. After I find them, I use a felt-tip pen to mark and X over a palpable pulse and a D over a pulse that is detectable by a Doppler ultrasound stethoscope only. This not only helps the nurse on the next shift, but it also allows us to determine quickly if the pulse has worsened or improved. Christine Ozoro, RN, BSN.

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.119, Springhouse Corporation/www.springnetcom.

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

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

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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number. So please send me your new name/address, okay? RNFrankie@AOL.com

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

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

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

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THOUGHT FOR THE DAY

The bitterest tears shed over graves are for words left
unsaid and deeds left undone.

Harriet Beecher Stowe, Author

Drop me a line.... Frankie
RNFrankie@AOL.com

Answer to Quiz Time:

Correct answer: d. Regional anesthesia is now used to manage combat-related pain during air transport to the next level of care and for postoperative pain. Regional analgesia is a preventive strategy that yields improved analgesia, outcomes, and patient satisfaction.

Additional SNIPPET

2011-12-13T15:07:00.000-08:00

(This is a weird Snippet...but an interesting one--- I am old enuf to remember being told to mix the orange powder into the white margarine to make it look like butter! )

Margarine was originally manufactured to fatten turkeys. When it killed the turkeys, the people who had put all the money into the research wanted a payback so they put their heads together to figure out what to do with this product to get their money back. It was a white substance with no food appeal so they added the yellow coloring and sold it to people to use in place of butter. How do you like it?

DO YOU KNOW.. The difference between margarine and butter?

Both have the same amount of calories. Butter is slightly higher in saturated fats at 8 grams; compared to 5 grams for margarine. Eating margarine can increase heart disease in women by 53% over eating the same amount of butter,
according to a recent Harvard Medical Study. Eating butter increases the absorption of many other nutrients in other foods. Butter has many nutritional benefits where margarine has a few and only because they are added!

Butter tastes much better than margarine and it can enhance the flavors of other foods. Butter has been around for centuries where margarine has been around for less than 100 years .

And now, for Margarine.. Very High in Trans fatty acids. Triples risk of coronary heart disease. Increases total cholesterol and LDL (this is the bad cholesterol) and lowers HDL cholesterol, (the good cholesterol)
Increases the risk of cancers up to five times.. Lowers quality of breast milk. Decreases immune response.
Decreases insulin response.
And here's the most disturbing fact.... HERE IS THE PART THAT IS VERY INTERESTING!
Margarine is but ONE MOLECULE away from being PLASTIC... and shares 27 ingredients with PAINT

These facts alone were enough to have me avoiding margarine for life and anything else that is hydrogenated (this means hydrogen is added, changing the molecular structure of the substance).
You can try this yourself: Purchase a tub of margarine and leave it open in your garage or shaded area. Within a couple of days you will notice a couple of things:
* no flies, not even those pesky fruit flies will go near it (that should tell you something)
* it does not rot or smell differently because it has no nutritional value ; nothing will grow on it. Even those
teeny weeny microorganisms will not a find a home to grow. Why? Because it is nearly plastic . Would you melt your Tupperware and spread that on your toast?

December 2011 PARADIGM BYTES

2011-12-13T14:33:00.000-08:00

PARADIGM BYTES
Newsletter for Paradigm 97
December 12, 2011

PARADIGM DEFINED:

1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

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

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SNIPPETS

(I saw this on a list-serve, and wanted to share) It is great being a nurse (at least most days) , isn't it?

Dear Sugar,

In March 2004, my daughter Emily died 4 days after she was born, because of an overworked labor and delivery team and their errors,
plural – one of those “all the holes in the Swiss cheese lined up” stories. During her life she was in a lot of pain. She could not hear, see,
move or swallow her own saliva. After we made the terrible decision to take her off life support she fought for her life for 12 hours. I cannot
honestly say this is a story where she taught me to live better or anything like that. The death of a child is only a tragedy. And yet, there was a
nurse in the NICU who stubbornly, stoically, referred to my husband and I – first-time parents – as mum and dad; who told us we had better
change her diaper, even when she was dying, and critiqued our technique. Who invited us to give her her first and last bath. Who told us we
were good parents. Who made the unthinkable and abnormal into two parents caring for their child.

What she didn’t know is that we had been trying to have a child for 8 years. And the reason it had taken that long is that my uterus was
scarred from childhood abuse. And that I had learned never to expect a helping hand, and then had done therapy to overcome that, and then
had been so terribly let down by our L&D team. I would have lain down and given up, I think, had that nurse not reached out to me with the
exact right words at the exact right time.

Eighteen months later we had my son, now 6. This year we welcomed our second son. Our family still is missing my little girl, but it feels complete. I am incredibly, joyfully, happy. It is amazing the difference it makes sometimes when someone just reaches into the heart of your experience and names it, and sits there with you in it. Jenn

To see this in context of where/why it was written:
http://therumpus.net/2011/11/dear-sugar-the-rumpus-advice-column-90-94-ways-of-saying-thank-you/

The contributor wrote: "This is the best advice column I have ever read".

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Surprising Health Woes of Getting Older Aging is a fact of life, and with it come certain senior health issues. Many people worry about cognitive decline and weaker bones, but there are other, lesser-known concerns, too. That’s why it’s important for everyone to do what they can to encourage healthy aging.
“The rate at which we experience change tends to be quite individual, often based on lifestyle choices, genetics, and environmental factors,” explains Evelyn Fitzwater, DSN, RN, associate director of the Center for Aging With Dignity at the University of Cincinnati College of Nursing. The sequence of change, however, is similar for all of us. Here are some of the more surprising health effects you should expect.
A Change in Taste
One of the many senior health problems not often discussed is a decline in taste buds. We are each born with approximately 9,000 taste buds, but that number starts to decrease between the ages 40 and 50 in women and 50 and 60 in men. The result is that people need greater taste stimulation to experience the four flavors of sweet, salty, sour, and bitter. Salty and sweet tastes tend to be lost first, with bitter and sour following along behind. Experts aren’t exactly sure what causes this, though some think it is related to disease, smoking, and environmental exposures.
Multitasking Challenges
In a world where we expect even our phones to juggle duties — make a call, surf the Web, provide GPS directions! — it might seem inefficient to turn all your focus on one thing. But as you get older, you may find yourself having to do just that. “Multitasking is a complex cognitive task that relies on a number of our brain’s functions, including attention, executive functions, and working memory, among others,” says Jena Kravitz, PsyD, a clinical neuropsychologist at the Good Samaritan Hospital in Los Angeles. “At a basic level, the ability to multitask relies on how quickly and efficiently our brain can switch between tasks while blocking out distraction and maintaining focus.” It’s important to be aware, though, that this difficulty is usually a result of natural healthy aging and is not necessarily indicative of serious cognitive decline.
Drier Skin
Even with healthy aging, skin becomes thinner, less elastic, and more wrinkle-prone. It also may be drier than it used to be. With less oil and fewer sweat glands than in younger years, skin is not as well moisturized and protected, which can cause itching and cracking. You should be able to soothe the dryness with a rich moisturizing cream or ointment. However, sometimes dry skin is a symptom of a thyroid problem or an illness such as diabetes or kidney disease, so check with your doctor if the condition does not improve.
Visual Disturbances
Senior health problems can include a variety of issues with the eyes and eyesight, including cataracts, diabetic retinopathy, glaucoma, and macular degeneration. “According to research, by the time we turn 60, our pupils decrease to about one-third their normal size,” Fitzwater says. “The pupil of the eye also becomes less responsive to changes in light, making it difficult to see in the dark. And the lens of the eye gradually thickens and yellows.” These changes may result in difficulty noticing detail and a reduction in peripheral vision. Seeing your eye doctor regularly is essential to maintaining your vision as you age.
Difficulty Finding Words
Another aspect of senior health is difficulty finding the right word during conversations, a situation some people begin to experience in their forties or fifties. “Our brain retrieves words in a similar manner as it retrieves memories,” Kravitz says. “As we get older, some people’s retrieval mechanisms become slower, and this can manifest in a noticeable change in word-finding.”
Balance Issues
One obstacle to healthy aging can be problems with balance. According to the U.S. Centers for Disease Control and Prevention, more than one in three adults over age 65 falls each year. In many cases, an issue with the inner ear is the culprit, though the brain, heart, or even certain medications could also be the cause. If you’re experiencing this, see your doctor for an evaluation.
Decreased Sense of Smell
As with taste, your sense of smell can decrease after age 60, even if you're aging in a healthy way. While a number of reasons could be behind this, a declining sense of smell linked to aging is called presbyosmia. This type of sensory loss cannot be prevented. However, in some cases, a decreased sense of smell is not a result of aging but a side effect of medications, so check with your doctor to make sure this isn’t the case.
Slower Processing Speeds and Delayed Reflexes
Though the ability to remember should not be significantly different in in someone who is healthy and aging, you may find that you process information more slowly as you get older. Don’t be alarmed, though: It's not necessarily an indication of serious cognitive decline. “Processing speed, or the rate at which we process new information, is susceptible to age-related changes, and most older adults do report a slowing down,” Kravitz says. “This is most often observed in older adults who drive and is almost always the cause of fender-benders or minor accidents with the mailbox while backing out of the driveway.”
http://www.everydayhealth.com/senior-health-pictures/surprising-health-woes-of-getting-older.aspx?xid=aol_eh-senior_1_2011121_&aolcat=HLT&ncid=webmail7#/slide-9

(Ain't Life Grand?)

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INTERESTING READING

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

Price of heart failure ---Low income raises HF risk The odds of suffering heart failure appear to be higher in seniors with a low income, even among those with a college or higher education, according to research presented last week at the American Heart Association's Scientific Sessions 2011 in Orlando. "As far as the risk of developing heart failure is concerned, lower education may not matter if a person is able to maintain a high income in later years," said Ali Ahmed, MD, MPH, senior researcher and the director of the Geriatric Heart Failure Clinics at the University of Alabama at Birmingham and the Birmingham VA Medical Center.

The researchers said the study is the first to link low income with an increased risk of heart failure in Medicare-eligible community-dwelling older men and women.

The researchers said they were surprised by the influence of income on heart failure risk in a population where nearly everyone has health insurance that provides care for major heart failure risk factors such as hypertension, diabetes and coronary artery disease. Although both poorer and well-off people benefit from the Medicare program, there may be certain differences that expose the poor to suboptimal care for major heart failure risk factors.
http://news.nurse.com/article/20111128/NATIONAL01/311280004
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Survey: U.S. doctors disagree on pregnancy start (Reuters) - Most U.S. doctors believe pregnancy starts when the sperm fertilizes the egg, a survey shows, contradicting the position of a key medical group with a view that could potentially affect U.S. policy and laws regarding contraception and research.
The American College of Obstetrics and Gynecology (ACOG), the leading organization for this field of medicine, defines pregnancy as beginning when the fertilized egg implants in the uterus, roughly a week after fertilization.
"People say that the medical profession has settled on this," said Farr Curlin, senior author of the study, which appeared in the American Journal of Obstetrics and Gynecology, and a professor at the University of Chicago. ...
http://www.reuters.com/article/2011/11/18/us-pregnancy-idUSTRE7AH0FD20111118?feedType=nl&feedName=ushealth1100
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FDA Revokes Approval of Avastin for Breast Cancer Drug isn't safe or effective for women with metastatic disease, agency says
FRIDAY, Nov. 18 (HealthDay News) -- Saying the risks outweigh the benefits in patients with advanced breast cancer, U.S. Food and Drug Administration Commissioner Dr. Margaret Hamburg said on Friday that the agency has rescinded its approval of the cancer drug Avastin for that use.
Avastin (bevacizumab), however, will remain available for treating some types of colon, lung, kidney and brain cancer.
"Today, I am revoking the FDA's approval of the breast cancer indication for Avastin after concluding that the drug has not been shown to be safe and effective for that use," Hamburg said during a late morning press conference. ... http://consumer.healthday.com/Article.asp?AID=659083
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New Stent Type Has Rare But Potentially Serious Problem, FDA Investigates The FDA says it is working with drug-eluting stent makers to better understand what makes the devices shrink or become deformed on rare occasions. A drug-eluting stent is a scaffold placed into narrowed, diseased peripheral or coronary arteries; it releases a medication to block cell proliferation, which helps prevent eventual reclogging of the blood vessel. The DES (drug-eluting stent) is placed during an angioplasty procedure. ... http://www.medicalnewstoday.com/articles/237999.php

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HIV numbers hit new high as AIDS drugs save lives (Reuters) - More people than ever are living with the AIDS virus but this is largely due to better access to drugs that keep HIV patients alive and well for many years, the United Nations AIDS program (UNAIDS) said on Monday.
In its annual report on the pandemic, UNAIDS said the number of people dying of the disease fell to 1.8 million in 2010, down from a peak of 2.2 million in the mid-2000s. ,,, http://www.reuters.com/article/2011/11/21/us-aids-global-unaids-idUSTRE7AK0KX20111121?feedType=nl&feedName=ushealth1100
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HIV/AIDS Update - Tentative approval of lamivudine/nevirapine/zidovudine 150 /200 /300 mg fixed-dose combination On Novermber 18, 2011, the Food and Drug Administration (FDA) granted tentative approval for a triple-drug fixed-dose combination tablet containing lamivudine, nevirapine, and zidovudine, 150 mg/200 mg/300 mg, indicated for use in combination with other antiretrovirals for the treatment of HIV-1 infection. The tablet is manufactured by Hetero Labs Limited of Hyderabad, India.

"Tentative approval" means that FDA has concluded that a drug product has met all required quality, safety and efficacy standards, but is not eligible for marketing in the U.S. because of existing patent protections. Tentative approval does, however, make the product eligible for purchase outside the United States under the President's Emergency Plan for AIDS Relief (PEPFAR) program.

These products were reviewed under expedited review provisions for PEPFAR under the FDA guidance titled Fixed Dose Combinations, Co-Packaged Drug Products, and Single-Entity Versions of Previously approved Antiretrovirals for the Treatment of HIV, to facilitate submission of such applications to FDA.
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FDA approves first drug to treat a rare bone marrow disease The U.S. Food and Drug Administration today approved Jakafi (ruxolitinib), the first drug approved to specifically treat patients with the bone marrow disease myelofibrosis.
Myelofibrosis is a disease in which the bone marrow is replaced by scar tissue resulting in blood cells being made in organs such as the liver and the spleen. This disease is marked by an enlarged spleen, anemia, decreased white blood cells and platelets, and myelofibrosis-related symptoms.
Symptoms include fatigue, abdominal discomfort, pain under the ribs, feeling full (satiety), muscle and bone pain, itching, and night sweats.
Jakafi, a pill taken two times a day, inhibits enzymes called JAK 1 and 2 (Janus Associated Kinase) that are involved in regulating blood and immunological functioning. Myelofibrosis is associated with the deregulation of JAK 1 and 2. ...
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm280102.htm
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Left Atrial Size Is a Potent Predictor of Mortality in Mitral Regurgitation Due to Flail Leaflets Left atrium (LA) enlargement is common in organic mitral regurgitation (MR) and is an emerging prognostic indicator. However, outcome implications of LA enlargement have not been analyzed in the context of routine clinical practice and in a multicenter study. ...
http://circimaging.ahajournals.org/content/4/5/473.full?WT.mc_id=EMxj02x20111125xL1

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Role of Elevated Heart Rate in the Development of Cardiovascular Disease in Hypertension That elevated heart rate (HR) is a risk factor for cardiovascular morbidity and mortality in healthy people as well as in patients with cardiac diseases is supported by numerous epidemiological association studies.1–4 Increased HR has been recognized as a negative prognostic factor independent of many other clinical parameters that can influence the HR, including physical activity scores, left ventricular function, or use of β-blockers. Thus, HR appears to satisfy all epidemiological criteria for being considered as a true risk factor, and its predictive value for cardiovascular disease appeared to be as strong as that of most important cardiovascular risk factors. ... http://hyper.ahajournals.org/content/58/5/745.full?WT.mc_id=EMxj02x20111125xL1
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Residual Cardiovascular Risk Despite Optimal LDL Cholesterol Reduction with Statins: The Evidence, Etiology, and Therapeutic Challenges This review captures the existence, cause, and treatment challenges of residual cardiovascular risk (CVR) after aggressive low-density lipoprotein cholesterol (LDL-C) reduction. Scientific evidence implicates low high-density lipoprotein cholesterol (HDL-C) and high triglycerides (TG) in the CVR observed after LDL-C lowering. However, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial with fenofibrate, the Investigation of Lipid Level Management to Understand its Impact in Atherosclerotic Events (ILLUMINATE) study with torcetrapib, and the recently terminated Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes (AIM-HIGH) study with niacin, do not clearly attribute risk reduction value to HDL-C/TG modulation. The optimum approach to long-term lipid-modifying therapies for CVR reduction remains uncertain. ... http://www.springerlink.com/content/807x653260054775/ ; (PDF available)
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RANDOM FACT: The best estimates available suggest that the total volume of gold ever mined up to the end of 2006 was approximately 158,000 tones, of which around 65% has been mined since 1950.
RANDOM FACT: An oyster takes ten years to produce a pearl that is about the size of a pea.

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14 Little-Known Causes of Osteoporosis Although osteoporosis is often considered an older woman’s problem, many younger adults put themselves at risk for weakened bones and fractures without even realizing it.
“Osteoporosis is silent, so you don’t know you have it until you have a fracture,” explains Erin LeBlanc, MD, MPH, an investigator at the Kaiser Permanente Center for Health Research in Portland, Ore., who has done extensive research on women’s health and osteoporosis. And that means you may also not realize you’re increasing your risk — unless you know what factors contribute to the condition.
While osteoporosis has some well-known risk factors — such as a low-calcium diet, inactivity, and your genes — these other triggers may surprise you. ...
http://www.everydayhealth.com/osteoporosis/little-known-causes-of-osteoporosis.aspx?xid=aol_eh-osteo_1_20111205_&aolcat=HLT&ncid=webmail13
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Steering a course towards advanced nurse practitioner: a critical care perspective

Aim: This article is a report of a study of the experiences of expert critical care nurses in their transition to the role of advanced nurse practitioner within an intensive care unit (ICU) setting.

Background: The advanced nurse practitioner role was developed to support the ICU team and to undertake many of the roles traditionally associated with junior medical staff in this specialized area. The impetus for this study therefore was generated from the need to explore the role development experiences of trainee advanced nurse practitioners to inform future developments and practice.

Methods: This study used grounded theory methodology to conduct and analyse data from 25 participants. The data were collected between March 2010 and August 2010, using interview format. Data collection and analysis was conducted simultaneously using methods associated with grounded theory, theoretical sampling and the constant comparative method. ... http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2011.00448.x/abstract
(To get the full PDF : http://onlinelibrary.wiley.com/doi/10.1111/j.1478-5153.2011.00448.x/full )

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How Nurses Can Increase Their Earning Potential
By Megan M. Krischke, contributor
October 14, 2011 - The tenuous state of the U.S. economy has caused many nurses to take a hard look at their personal financial stability and find ways to maximize their earning power. One solution is personal professional development--acquiring advanced skill sets, meeting qualifications for specialty certifications and earning advanced degrees. Nurses can also use skills they already possess as the foundation for building a business that is an extension of their nursing experience.
Nan Brown, RN, BSN, and Lil Bogdan, RN, BSN, believe nurses are particularly gifted with the skills required to increase their earning power and achieve their dreams. Brown and Bogdan are co-founders of the L’Athene line of natural skin care products, once carried exclusively by Nordstom’s department stores and now also sold in spas and physicians’ offices.

“Nurses are great communicators, they know how to be flexible and wear many hats, they manage time and people, they implement and complete tasks and they are extremely resourceful. We have said many times that the skills we already had as nurses contributed greatly to our financial success,” stated Brown. ... http://www.nursezone.com/Nursing-News-Events/more-features/How-Nurses-Can-Increase-Their-Earning-Potential_38066.aspx
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United States Registered Nurse Workforce Report Card and Shortage Forecast
Abstract
Registered nurses (RNs) play a critical role in health care delivery. With an aging US population, health care demand is growing at an unprecedented pace. Using projected changes in population size and age, the authors developed demand and supply models to forecast the RN job shortage in each of the 50 states. Letter grades were assigned based on projected RN job shortage ratios. The number of states receiving a grade of “D” or “F” for their RN shortage ratio will increase from 5 in 2009 to 30 by 2030, for a total national deficit of 918 232 (725 619 - 1 112 112) RN jobs. There will be significant RN workforce shortages throughout the country in 2030; the western region will have the largest shortage ratio of 389 RN jobs per 100 000. Increased efforts to understand shortage dynamics are warranted. ...
http://ajm.sagepub.com/content/early/2011/11/18/1062860611416634.abstract
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Antibiotics overprescribed for children: study (Reuters) - Pediatricians in the United States write more than 10 million unnecessary antibiotic prescriptions every year for conditions such as the flu and asthma, contributing to potentially dangerous drug resistance, a study said.
Researchers looked at a nationally representative sample of almost 65,000 outpatient visits by children under 18 during 2006 to 2008, with findings reported in the journal Pediatrics.
In total, doctors prescribed an antibiotic at one in every five visits, with most dispensed for children with respiratory ailments such as sinus infections and pneumonia.
Some of those infections were caused by bacteria, warranting antibiotics. But almost one-quarter of all antibiotic prescriptions were given to children with respiratory conditions that probably or definitely do not call for antibiotics, such as bronchitis, the flu, asthma and allergies. ...

http://www.reuters.com/article/2011/11/08/us-prescriptions-children-idUSTRE7A747G20111108?feedType=nl&feedName=ushealth1100
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RANDOM FACT: Tomatoes first grew as wild, cherry-size berries in the South American Andes, but the fruit, as we know it today,
was developed in Mexico where it was known as tomatil and traveled to Europe by boat with the returning conquistadors.

Bonus Fact: A tomato is 94% water.
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Heartburn Trigger Foods Heartburn and Foods: Dos and Don'ts Heartburn can be triggered by a number of specific foods.
Learn simple changes you can make in your diet to avoid the burn.
Common causes of heartburn include being overweight, being pregnant, or having GERD (gastroesophageal reflux disease). But what you eat and how even how you eat can also trigger heartburn, or acid reflux. A number of different foods and beverages can cause heartburn by aggravating the tissues that line the esophagus or by affecting the ability of the lower esophageal sphincter to close properly and keep acids in the stomach. ...
http://www.everydayhealth.com/digestive-health-pictures/heartburn-and-foods-dos-and-donts.aspx?xid=aol_eh-digest_4_20111205_&aolcat=AHD&ncid=webmail7#/slide-1
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FDA Hepatitis Update - CLIA waiver expands availability of rapid blood test for antibodies to the hepatitis C Virus (HCV) On November 28, 2011, the Food and Drug Administration granted a Clinical Laboratory Improvement Act (CLIA) waiver for the first rapid blood test for HCV, the OraQuick HCV Rapid Antibody Test, manufactured by OraSure Technologies, Inc. in Bethlehem, PA.
The OraQuick HCV Rapid Antibody Test is used in clinical settings to test individuals at risk for infection with HCV and individuals who have signs or symptoms associated with hepatitis.
The CLIA waiver will broaden access to the test by permitting more widespread distribution and use of the OraQuick HCV Test to nontraditional laboratory sites, including physicians' offices, health department clinics and other freestanding counseling and testing sites. The broader availability and easier access to this test may contribute to a higher rate of detection for this disease.
OraQuick is a test strip that is read visually and does not require an instrument for diagnosis. Its 20-minute response time allows decentralized testing of HCV enabling the patient to be referred immediately for further testing.
The test qualifies for the CLIA waiver based on data submitted to FDA that demonstrated that the test is simple, accurate, and reasonably free of harm. fda@service.govdelivery.com
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Migraines may raise depression risk: study (Reuters Health) -
People who get painful migraine headaches may be at a higher risk for developing clinical depression, suggests a new study from Canada.
The research, published in the journal Headache, also hints that the relationship may go both ways, and people with clinical depression could have a higher risk of developing migraines, but that finding could have been due to chance, the researchers say.
Nonetheless, lead author Geeta Modgill, who was at the University of Calgary while conducting the work, told Reuters Health that migraine and depression sufferers should know the signs of both ailments since each might be at a higher risk for the other condition. ...

http://www.reuters.com/article/2011/11/24/us-health-migraines-idUSTRE7AN1U420111124?feedType=nl&feedName=ushealth1100
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Aspirin not worth risks for healthy women: study (Reuters Health) - Aspirin is a bad bargain for healthy women trying to stave off heart attacks or strokes, although it's commonly used for that purpose, according to Dutch researchers.
In a new report, they say 50 women will need to take the medication for 10 years for just one to be helped -- and that's assuming they are at high risk to begin with.
"There are very few women who actually benefit," said Dr. Jannick Dorresteijn of University Medical Center Utrecht in The Netherlands. "If you don't want to treat 49 patients for nothing to benefit one, you shouldn't treat anyone with aspirin."
The new study adds to a long-standing controversy over aspirin, one of the world's most widely used drugs.
Doctors agree it's worth taking for people who've already had a heart attack or a stroke, but they are less certain when it comes to so-called primary prevention. ...
http://www.reuters.com/article/2011/11/25/us-health-aspirin-idUSTRE7AN1TM20111125?feedType=nl&feedName=ushealth1100

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ERs often skip tests for young kids with fever (Reuters Health) - Babies and toddlers who arrive at the ER with an unexplained fever often receive no kind of diagnostic test to get at the source of the high temperature, a new study finds.
Whether that's a bad or good thing is not clear, according to the researchers.
But in some cases, the study found, ER doctors prescribe antibiotics without testing to confirm whether or not the child has a bacterial infection. And that could potentially lead to antibiotic overuse. ... http://www.reuters.com/article/2011/11/23/us-er-fever-idUSTRE7AM2R320111123?feedType=nl&feedName=ushealth1100
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Safety data favors less-invasive weight-loss surgery (Reuters Health) - Minimally-invasive weight-loss procedures seem to be safer than open bariatric surgery, according to researchers who analyzed past studies comparing the two methods.
The new report suggests that so-called laparoscopic surgery carries an 80 to 90 percent lower risk of infections and hernias, but that just as many people getting both procedures need the operation repeated. The risk of death from either appears to be low, researchers added.
"Within the surgical field it's been almost accepted to a degree that laparoscopic is the way to go," said Jennifer Reoch, a nursing graduate student at McGill University in Montreal, who led the new research. "Our study was to kind of give a little more weight to that decision." ...
http://www.reuters.com/article/2011/11/23/us-weightloss-surgery-idUSTRE7AM2RX20111123?feedType=nl&feedName=ushealth11
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(We know that 4 gr of Tylenol is the most one should take a day....not sure to what this person is referring "staggered overdose)

Dangers Of Staggered Overdose Of Acetaminophen (Tylenol, Paracetamol)
Repeatedly taking marginally too much paracetamol (acetaminophen, Tylenol) over time can cause a dangerous overdose that is hard to detect and can lead to death, because patients usually don't report an overdose when they visit the hospital, rather that they feel unwell. Clinicians need to be able to detect these cases rapidly so that they can provide prompt and effective treatment, as these patients are in greater danger compared with those who have taken a single overdose. ... http://www.medicalnewstoday.com/articles/238220.php
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Thank you, Barbara (BACello):

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP)*
This report updates the previously published summary of recommendations of the Advisory Committee on Immunization
Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC) for vaccinating health-care
personnel (HCP) in the United States. This report summarizes all current ACIP recommendations for vaccination of HCP
and does not contain any new recommendations or policies. The recommendations provided in this report apply, but are
not limited, to HCP in acute-care hospitals; long-term-care facilities (e.g., nursing homes and skilled nursing facilities);
physician's offices; rehabilitation centers; urgent care centers, and outpatient clinics as well as to persons who
provide home health care and emergency medical services. (full text) ...
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6007a1.htm?s_cid=rr6007a1_e&source=govdelivery

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RANDOM FACT: A desire path is one that was stomped out away from the original path or walkway; usually to make a short cut.
These are found a lot on college campuses.

Bonus Fact: A lunule refers to the white-shaded crescent peeking out on the bottom of your finger nail. (did you remember this?)

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Cholesterol drugs safe, even after a decade of use
(Reuters) - Cholesterol-lowering drugs continue to produce benefits without any serious safety problems, such as increased cancer risk, even after more than a decade of use, researchers said Wednesday.
The finding from a large British clinical study following patients for 11 years provides reassurance for people at risk of heart attacks who are typically prescribed such medicines indefinitely.
So-called statin drugs are not without side effects. They can cause nausea, muscle pain, and occasional kidney and liver damage.
But long-term follow-up in the 20,000-patient Heart Protection Study (HPS) found no evidence that statins increased the risk of non-vascular mortality or made patients more likely to develop cancer. ...

http://www.reuters.com/article/2011/11/23/us-cholesterol-idUSTRE7AM00Q20111123?feedType=nl&feedName=ushealth1100
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Coronary Artery Calcium Progression: An Important Clinical Measurement?
A Review of Published Reports
Baseline coronary artery calcification (CAC) accurately identifies coronary atherosclerosis and might improve prediction of future cardiac events. Serial assessment of CAC scores has been proposed for monitoring atherosclerosis progression and for assessing the effectiveness of medical therapies aimed at reducing cardiac risk. However, whether knowledge of progression of CAC scores over time further improves risk prediction is unclear. Several trials relating medical therapies to CAC progression have been performed without any formal guidelines on the definition of CAC progression and how it is best quantified. ... http://content.onlinejacc.org/cgi/content/short/56/20/1613?rss=1
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Aspirin for primary prevention of vascular events in women: individualized prediction of treatment effects (study)
Aims To identify women who benefit from aspirin 100 mg on alternate days for primary prevention of vascular events by using treatment effect prediction based on individual patient characteristics.
Methods and results Randomized controlled trial data from the Women's Health Study were used to predict treatment effects for individual women in terms of absolute risk reduction for major cardiovascular events (i.e. myocardial infarction, stroke, or cardiovascular death). ...

http://eurheartj.oxfordjournals.org/content/early/2011/11/16/eurheartj.ehr423.abstract
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Studies suggest that these three fab fluids may keep hunger at bay, reduce calorie intake, and keep the pounds from creeping on:
Skim milk: In a study, the people who drank about 20 ounces of skim milk at breakfast ate way less at lunch compared with the people who had fruit juice with their morning meals. The researchers think the proteins in skim milk -- whey and casein -- may help make skim milk quite the filler-upper. (Related: Not a milk drinker? Fill up on this popular high-protein breakfast food instead.)
Olive oil: This Mediterranean staple is loaded with a hunger-curbing compound called oleic acid. This monounsaturated fat stimulates the small intestine to make another fatlike substance that sends "full" signals from the stomach to the brain. Other foods high in oleic acid include sunflower seeds, canola oil, safflower oil, almonds, and avocados. (Related: Find out why corn oil may be a bad choice for you.)
Water: Numerous studies suggest that folks who drink ample water feel fuller and eat far fewer calories throughout the day compared with people who don't drink enough agua. Water drinkers are also less likely to indulge in sweetened drinks like soda, calorie-laden coffee drinks, and sugary sports drinks. And in yet another study, drinking 16 ounces of water before each meal helped dieters lose more weight -- and lose it faster -- than dieters who didn't drink water before meals.

http://www.realage.com/health-tips/3-liquids-to-suppress-your-appetite-naturally?eid=1010640918&memberid=4687812
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HUMOR SECTION

While my wife and I were shopping at a mall, a shapely young woman in a short, form-fitting dress strolled by. My eyes involuntarily followed her.

Without looking up from the item she was examining, my wife asked, "Was that worth the trouble you're in?"
****
Here is a very simple little test comprised of four questions to determine the level of your intellect. Your replies must be spontaneous and immediate, with no deliberating or wasting time... And no cheating!

1: You are competing in a race and overtake the runner lying in second place. In which position are you now?

Answer: If you answered that you're now coming first then you're completely wrong. You overtook the second runner and took their place, therefore you're coming second. For the next question try not to be so dim.

2: If you overtake the last runner, what position are you now in?

Answer: If you answered second-last, once again you're completely wrong. Think about it. How can you over take the person coming last? If you're behind them then they can't be last. The answer is impossible! It would appear that thinking is not one of your strong points.

Anyway, here's another to try, don't take any notes or use a calculator, and remember your replies must be instantaneous. Take heart!

3: Take 1000. Add 40. Add another 1000. Add 30. 1000 again. Plus 20. Plus 1000. And plus 10. What is the total?

Answer: 5000? Wrong again! The correct answer is 4100. Try again with a good calculator. Today is clearly not your day. Although you should manage to get the last question right...

4: Marie's father has five daughters: 1. Chacha 2. Cheche 3. Chichi 4. Chocho Question: What is the fifth daughter's name? Think quickly... you'll find the answer below.

Answer: Chuchu? WRONG! It's obviously Marie! Read the question again.
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

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

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

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

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

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

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WEBSITES/ LINKS

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

This information has recently been updated and is now available:
Draft Guidance for Industry: Use of Nucleic Acid Tests on Pooled and Individual Samples from Donors of Whole Blood and Blood Components, including Source Plasma, to Reduce the Risk of Transmission of Hepatitis B Virus (PDF - 168KB)
Posted: 11/29/2011

This website is the FDA's Enforcement site....all the foodstuffs that have had to be recalled due to contamination.
(Listeria, for one). http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm281022.htm

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

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

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

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MEDICAL RECALLS
*
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CareFusion EnVe Ventilators Recall Class: Class I

CareFusion has identified potential defects associated with the EnVe Ventilator model 19250-001 that can interrupt ventilation to the patient.
The issues include: a potential delay in resuming ventilation after reconnection; a potential automatic reset; and a potential for disconnection during transport. Failure to adequately ventilate may lead to hypoxia or hypercarbia, which may result in serious neurological injury or death. ... http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm278634.htm
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Draeger Medical Inc., Infinity Acute Care System Monitoring Solution (M540) Catalog number MS25510
All serial numbers are affected by this recall.
This product was manufactured from March 1, 2011 through September 30, 2011 and distributed only to the Rush University Medical Center (Chicago, Illinois) from July 1, 2011 through September 30, 2011.
Use: This product is a networked solution system used to monitor a patient’s vital signs and therapy, control alarms, review Web-based diagnostic images, and access patient records. The number of monitored vital signs can be increased or decreased based on the patient’s needs.
The weight-based drug dosage calculation may indicate incorrect recommended values, including a drug dosage up to ten times the indicated dosage. Additionally, there may be a 5-10 second delay between the electrocardiogram and blood pressure curves (waveforms) at the Infinity Central Station. This product may cause serious adverse health consequences, including death. ...
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm282461.htm
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CooperVision AVAIRA AQUAFORM Sphere Soft Contact Lenses Class 1 Recall The unintended presence of a silicone oil residue on AVAIRA Sphere soft contact lenses. Symptoms may range from hazy, blurry vision, discomfort to eye injuries requiring medical treatment.
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm282733.htm
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NURSING HINTS CORNER

Squeezing for strength Here is a quick way to check the strength of a patient's handgrip Roll up a blood pressure cuff, pump it up slightly and have the patient squeeze it while measuring the millimeters of mercury. Do the same thing with his other hand. The reading for the dominant hand may be higher by 10 to 20 mm HG. This technique can help detect the slightest neurologic change, saving the patient from potential problems. Dorothy M. Kellogg, RN

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.120, Springhouse Corporation/www.springnetcom. ;

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ADVERTISEMENTS from the members
(contact me with your ad)

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

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

WELCOME TO:

Christina.Roskilly@live.com (Christina) December 7, 2011

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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address. You could always send me your Home number or, instead, send me your new name/address, okay? RNFrankie@AOL.com

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

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

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

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THOUGHT FOR THE DAY

We can have democracy in this country, or we can have great wealth concentrated
in the hands of a few, but we can't have both.

--Louis Brandeis,
Supreme Court Justice from 1916--1939

Drop me a line..... Frankie RNFrankie@AOL.com

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

2011-11-13T06:38:00.000-08:00

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

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

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

Bob

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

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

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

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

Anyway, I'm doing this because:

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

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

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

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

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

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

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

Bob

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

Paradigm Bytes November 12, 2011

2011-11-11T11:49:00.000-08:00

PARADIGM BYTES
Newsletter for Paradigm 97
November 12, 2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

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

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SNIPPETS
FDA NEWS RELEASE

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

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

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

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

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

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

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

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

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

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

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

DO:

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

DO NOT:

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

For more information:

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

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FROM THE MEMBERS

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

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

1. Register for http://library.nu

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

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

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

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INTERESTING READING

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

Nurse practitioners were 'Lone Rangers,' founder says (CNN) -- In rural Boulder County, Colorado, Loretta Ford felt as if she were an epidemiologist, a sanitation department and a health inspector -- but in title, she was a nurse. She and colleagues carried everything, including the baby scales, as they set up temporary clinics in churches, schools and wherever else they could.
In the 1940s and '50s, there was no one else taking care of these basic community needs except Ford and her fellow public health nurses. As she gained experience, Ford realized that more nurses should be able to have specialized training so they could make basic decisions on their own about the health status of patients.
Ford, 90, the co-founder of the nurse practitioner movement, is being inducted into the National Women's Hall of Fame on Saturday in Seneca Falls, New York. Thanks in large part to her efforts, there are more than 140,000 nurse practitioners working in the United States today. Many can prescribe and diagnose as doctors can, but their nursing background emphasizes health promotion and patient empowerment. ... http://www.cnn.com/2011/09/30/health/living-well/loretta-ford-nurse-practitioner/
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Myth #1: Bulk coffee at the grocery store is the best product to buy.

Oxygen and bright light are the worst flavor busters for roasted beans. Unless the store is conscientious about selling fresh coffee, the storage tubes can get coated with coffee oils, which turn rancid, so be wary of bulk coffee from supermarket display bins. Your best bet to get the absolute freshest beans is to buy from a local roaster (or roast your own). At the grocery store, opt for coffee beans packaged by quality-conscious roasters and sold in sturdy, vacuum-sealed bags.

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

Roasted beans are porous and readily take up moisture and food odors, so the refrigerator is one of the worst places to store coffee. Flavor experts strongly advise against ever freezing coffee, especially dark roasts. Optimally, buy a 5- to 7-day supply of fresh beans at a time and keep at room temperature in an airtight container.
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(Reuters Health) - They say "You are what you eat." Maybe it should also be, "You are where you live."

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

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

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

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

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

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Preemies Breathe Easier With Less Invasive Therapy

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Fill a balloon or two to make a quick ice pack. Fill a balloon halfway with water - make sure you leave enough room for it to expand -
and tie a knot. Place it in the freezer to have ready whenever you need an ice pack!
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A problem of grand proportions It's tempting to read a silver lining into the otherwise dreary news that food prices are skyrocketing and appear on pace to post their largest annual increase since 1980.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

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

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

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

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

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

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

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

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

(the following is presented for the final time...take note, please.) :
12 lead EKG Interpretation Part #1
http://nursingpub.com/12-lead-ekg-explained-part-1
12 Lead EKG Interpretation Part #2
http://nursingpub.com/12-lead-ekg-interpretation-part-2
12 Lead EKG Interpretation Part #3
http://nursingpub.com/12-lead-ekg-interpretation-part-3

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm

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

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*
MEDICAL RECALLS
*
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Recall of Blood Component Infusion Set (Product Code: 4C2223)

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

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

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

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

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

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.150, Springhouse Corporation/www.springnetcom. ;

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

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

WELCOME TO:

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

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

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

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

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NOTICE:

I attempt to send the notices to your email addresses on file and if the notices are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....lol So please send me your new name/address, okay? RNFrankie@AOL.com

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

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

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

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THOUGHT FOR THE DAY

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

--Elizabeth Kubler-Ross

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

RNFrankie@AOL.com

From Rocante@AOL.com

2011-11-11T11:37:00.000-08:00

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

DISCHARGE PLANNING BEGINS UPON ADMISSION

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

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

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

DE FACTO VS. WRITTEN POLICIES

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

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

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

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

Genevieve M. Clavreul RN, Ph.D.

PARADIGM BYTES October 12, 2011

2011-10-12T06:12:00.000-07:00

PARADIGM BYTES
Newsletter for Paradigm 97
October 12, 2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype. 2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

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

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SNIPPETS

This is from Sandy Summers..........Thank you
10 common body language traps for women in the workplace

A female executive was having problems dealing with her male colleagues. "They like me, but they never take me seriously," she complained. "It's as if they think I'm flirting with them. Which I definitely am not!"

After watching her interact with various men on the senior management team, I saw the problem. She was trying to discuss work-related issues while using a "social gaze."

Here's what I mean . . .

If you create an imaginary triangle on someone’s face, with their eyes as the base and mid-forehead as the apex, you will have mapped out the "look of business." When you keep your gaze in that area, you nonverbally signal a no-nonsense, business-like approach. But when you invert the triangle and move your focus to the area between the eyes and mouth, you turn your gaze into one more appropriate for social encounters. And a social gaze can be misinterpreted as flirtatious—even in a corporate setting.

It’s a small thing, really. But as this woman found out, one small nonverbal signal can change the dynamics of an entire business interaction.

There are two sets of nonverbal signals that are especially important to all professionals. When first introduced to a leader, followers immediately and unconsciously assess him or her for warmth (empathy, likeability, caring) and authority (power, credibility, status). “Warm” leaders connect with staff in a way that makes them want to do a really good job because of that personal connection, affection and respect. But employees also look for leaders who project stability and authority, who make them feel secure, and whom they believe can follow through and achieve results.

Obviously the most appealing leaders are seen to have both qualities, and the least effective leaders are those regarded as uncaring and insecure. Perhaps not so obviously, many of the nonverbal signals for warmth and authority are divided along gender lines. Although I know several leaders of both sexes who do not fit the stereotypes, I’ve also observed that gender differences in body language most often do align with these two groupings. Women are the champions in the warmth and empathy arena, but lose out with power and authority cues—mostly because they fall prey to ten common body language traps. Read Traps 1-10 here, they wouldn't all fit in one posting: http://tinyurl.com/3tm55rv

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FROM THE MEMBERS

HeadsUp on Critical ThinkingTMcomes occasionally to your inbox whenever there are new issues or resources related to critical thinking and clinical reasoning.

This HeadsUp deals with the question, What's the difference between Critical Thinking (CT) and Clinical Reasoning (CR)? I'm getting lots of questions like this and I must say that I'm not surprised, given some of the statements I've read. For example, in a recent PowerPoint presentation, a Harvard Professor stated that "While CT is analytical, CR is based on pattern recognition."

Statements like the above make NO sense. What evidence supports this? With all the complexity we have today, we need expert analytical CR, which INCLUDES pattern recognition! To me, statements like this from leaders confuse nurses and show little knowledge of the CT and CR literature.

If you want clarity about the relationship between CT and CR, I'm happy to tell you that my new online CE article, Improving Critical Thinking and Clinical Reasoning addresses both CT and CR and is now available, FREE, at http://ce.nurse.com/ce168-60/improving-your-ability-to-think-critically/ (taking the test costs $10, unless you have a subscription or if your organization belongs to Gannett's CE Direct--see https://lms.nurse.com/).

The fifth edition of Critical Thinking, Clinical Reasoning, and Clinical Judgment: A Practical Approach, 5th Edition ---due out in December from Elsevier ---clarifies this issue in depth. For now, I hope this article helps you make sense of the relationship between CT and CR.

Duke, researchers sued over cancer clinical trials

DURHAM – Two cancer patients and the estates of six others have sued Duke University and the Duke University Health System, accusing them of negligence and other wrongs stemming from disgraced researcher Anil Potti’s work.

Filed Thursday in state court, the suit, in addition to going after Duke, targets two spinoff companies, Potti and four other researchers or administrators.

In 90 pages, the patients and their lawyer, Thomas Henson Jr., accuse Duke and the health system of ignoring numerous warning signs that Potti’s research wasn’t valid and later trying to cover up its deficiencies. ... gronberg@heraldsun.com; 419-6648

http://www.heraldsun.com/view/full_story/15465032/article-Duke--researchers-sued-over-cancer-clinical-trials?instance=homethirdleft
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American Regent Pulls Another Drug
American Regent has recalled a number of lots of its injectable vasopressin because it may lose potency during the product's shelf life.
The recall affects a total of 17 lots of Vasopressin Injection, USP -- five lots of 20 units/mL (200 units/10 mL), 10 mL multiple dose vials; 11 lots of 20 units/mL, 1 mL multiple dose vials; and one lot of 10 units/0.5 mL multiple dose vials.
The drug is indicated for use in abdominal roentgenography to dispel interfering gas shadows, to treat diabetes insipidus, and for treatment or prevention of postoperative abdominal distention. ...
http://www.medpagetoday.com/PublicHealthPolicy/FDAGeneral/27919
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FDA Warns LASIK Providers: Stop Making False Claims; Agency giving practitioners 90 days to curtail inflated promises, missing safety info in ads
THURSDAY, Sept. 29 (HealthDay News) -- The U.S. Food and Drug Administration is once again cracking down on eye care professionals who make false safety claims and promises about the popular LASIK eye surgery.
The agency's Letter to Eye Care Professionals, issued this week, follows an earlier warning from May of 2009. In its latest salvo against deceptive, potentially harmful advertising, the FDA is now giving eye doctors 90 days to get in line and update any advertising or promotional materials that make false claims. After this time, the agency will take regulatory action, said FDA spokeswoman Erica Jefferson. ... http://consumer.healthday.com/Article.asp?AID=657349

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INTERESTING READING

Please remember that the REUTERS articles usually good for only 30 days
(I found this to be fascinating)... an amazing procedure:

Doctors gave a 5 year old boy devil-like horns When George Ashman was born in 2006 with a large unsightly red scar on his forehead, his mother feared he'd become a target for bullies.
"When he was born, immediately my mind raced forward 10 years. George would be the picked-on kid with no friends, no girlfriend," mom Karen Ashman of Somerset, United Kingdom, told the Daily Mail.
The haemangioma birthmark was made up of bright, soft lumps of abnormal blood vessels, making it tricky to remove.
After the family sought help from the Great Ormond Street Hospital in London, doctors implanted devil-like horns to stretch out the skin on his forehead so the blemish could then be removed, The Daily Mirror reports.
IB Times explains that "small inflatable sacks were inserted under his hairline at either side of his forehead," which filled up with natural bodily fluid. Over four months, the pair of horns stretched the skin, allowing for his birthmark to be removed. ...
http://www.huffingtonpost.com/2011/09/24/george-ashman-devil-horns_n_979381.html?1316907894&ncid=webmail2
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Harvard's "Healthy Eating Plate" adds to diet guidelines
A few months back, the USDA announced it had scrapped the famous food pyramid and replaced it with a plate as a way of conceptualizing the government’s advice on diet.
As will happen with this kind of thing, myplate.gov won praise but also some criticism.
To address some perceived flaws, experts from the Harvard School of Public Health and Harvard Health Publications have unveiled their own iteration of the new icon, which they’re calling the Healthy Eating Plate. ...
http://blogs.wsj.com/health/2011/09/14/from-harvard-a-different-take-on-a-healthy-plate/

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Hospital Uniforms Teeming with Germs, Study Finds
More than 60% of physicians' coats and nurses' uniforms sampled in a major Israeli hospital tested positive for disease-causing bacteria, including methicillin-resistant Staphylococcus aureus, researchers said.

For 63% of the 60 physicians and 75 nurses at Hebrew University's Shaare Zedek Medical Center in Jerusalem in the study, at least one spot sampled on their outer clothing carried pathogenic bacteria, according to Yonit Wiener-Well, MD, and colleagues there.

These bacteria were isolated from half of the total of 235 samples taken from participants' coats, uniforms, and scrub suits, the researchers reported in the September issue of the American Journal of Infection Control.
Most of the participants indicated that they changed their uniforms daily and that their clothing's hygiene was fair or better.
Wiener-Well and colleagues cautioned that the frequency of bacterial transmission from healthcare workers' clothing to patients is unknown. ... http://www.medpagetoday.com/HospitalBasedMedicine/InfectionControl/28359?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846
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Few Breast Cancer Patients Can Skip Adding Chemo Older patients with small, hormone-sensitive early breast cancer had normal life expectancy without adjuvant systemic therapy, data from a large cohort study showed.
Overall, omission of systemic therapy was associated with a 32% greater mortality risk in women with node-negative, receptor-positive breast cancer followed for 15 years.
The one exception was patients 60 or older with low-grade tumors ≤10 mm. That small subgroup, not specifically quantified by investigators, had a mortality risk similar to women without breast cancer, as reported online in the Journal of the National Cancer Institute.
"Patients with mortality rates exceeding the background mortality may potentially benefit from systemic adjuvant treatment," Peer Christiansen, MD, DMSc, of Aarhus University Hospital in Denmark, and coauthors wrote in conclusion. ...

http://www.medpagetoday.com/HematologyOncology/BreastCancer/28356?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846
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Orange Juice File this one under "things we always sort of knew, but wish we didn't." All that "100% orange juice, not from concentrate" stuff you've been drinking? Technically, it's "not from concentrate," but it's not really 100% orange juice either, a report at Civil Eats details.
The process is rather depressing. Gizmodo explains part of the process:

Once the juice is squeezed and stored in gigantic vats, they start removing oxygen. Why? Because removing oxygen from the juice allows the liquid to keep for up to a year without spoiling. But! Removing that oxygen also removes the natural flavors of oranges. Yeah, it's all backwards. So in order to have OJ actually taste like oranges, drink companies hire flavor and fragrance companies, the same ones that make perfumes for Dior, to create these "flavor packs" to make juice taste like, well, juice again.

Any taste difference in say Minute Maid versus Tropicana is therefore due to the specific flavor pack the company uses. Since these flavor packs are made from orange byproducts, they don't have to be considered an ingredient, and therefore are not required to appear on food labels. This is despite the fact they are chemically altered.
Perhaps its time to take the juicer out of that dusty corner in the garage.
http://www.huffingtonpost.com/2011/07/29/100-percent-orange-juice-artificial_n_913395.html
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Is it Rheumatoid arthritis?
Over one million Americans have rheumatoid arthritis (RA), an autoimmune condition that leads to inflammation, stiffness, pain, and swelling of joints, especially in the hands and feet. If left untreated, RA can cause joint damage or even disability, which is why experts say early diagnosis and treatment of this condition are essential for the best outcome. But because the symptoms of RA can mimic those of other inflammatory joint conditions, how do doctors make an accurate RA diagnosis?
Experts can often determine whether you have rheumatoid arthritis or a different type of joint problem by identifying the pattern of joints that are affected. One aspect of this pattern is symmetry. That means that if you drew a line down the center of your body, in some conditions your joint pain would be symmetric, or affect both sides equally in the same place. For example, if your left elbow hurt, your right elbow would hurt, too. If the joint involvement is asymmetric, however, your left elbow would hurt, but your right elbow would not.... http://www.everydayhealth.com/arthritis/rheumatoid-arthritis/understanding/index.aspx?xid=aol_eh-arthritis_36-_20110808&aolcat=AJA&ncid=webmail5
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(I don't know about you, but I hadn't given even two minutes of thought over possibility of contamination of privacy curtains. This looks like an excellent research for nursing).

Hospital privacy curtains laden with germs
To avoid spreading those bugs, health care providers should make sure to wash their hands after routine contact with the curtains and before interacting with patients, Dr. Michael Ohl, from the University of Iowa, Iowa City, said at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy.
"There is growing recognition that the hospital environment plays an important role in the transmission of infections in the health care setting and it's clear that these (privacy curtains) are potentially important sites of contamination because they are frequently touched by patients and providers," Dr. Ohl told Reuters Health.
Health care providers often touch these curtains after they have washed their hands and then proceed to touch the patient. Further, these curtains often hang for a long time and are difficult to disinfect. ...

http://www.reuters.com/article/2011/09/22/us-hospital-curtains-idUSTRE78L64G20110922?feedType=nl&feedName=ushealth1100
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Bath Salts: Treatment Uses for Nurses

When Jane Evans, RN, heard a patient was running down the highway to escape the "electricity" pursuing him, she knew this wasn't an isolated incident but part of a frightening new trend. This spring, Schuylkill Medical Center in Pottsville, Pa., started seeing two or three patients like this per day — people who exhibited psychotic, even violent behavior, yet tested negative on drug screens.

Once calm, these patients admitted to abusing the same product: bath salts. Not a relaxing spa accessory, "bath salt" is a synthetic cathinone called methylenedioxypyrovalerone, packaged under a benign name but specifically made to be abused. Upon ingesting the powdery white substance, users experience euphoria as well as hallucinations, delusions and paranoia.

Bath salt use has exploded nationwide: calls to poison control centers regarding bath salts surged from 303 last year to 4,137 as of July 2011, according to the American Association of Poison Control Centers. Bath salts are sold legally in some states, and manufacturers skirt the law by labeling packets "not for human consumption," according to Wendy Stephan, health education coordinator, Florida Poison Information Center, Miami. The drug also is cheap. Head shops and websites sell it for $25-$40 under names such as White Rush and Meow Meow.

Given the increase of abuse, nurses across the country who haven't yet treated patients who have ingested bath salts are likely to do so in the near future. ... http://news.nurse.com/article/20110919/NATIONAL01/109190044

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The U.S. government advocates eating more fruits and vegetables but does not subsidize their growers anywhere near the level used to support meat and other crop producers who grow food for animals that become meat. Land that qualifies for direct commodity-crop subsidies does not need to be planted, and putting in fruits and vegetables can disqualify it, even as estimates show that if Americans follow the new dietary guidelines, the country will need another 13 million acres of fruit and vegetable crops to meet demand. ... The Washington Post http://www.washingtonpost.com/national/health-science/us-touts-fruit-and-vegetables-while-subsidizing-animals-that-become-meat/2011/08/22/gIQATFG5IL_story.html

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It's been dubbed the "21st century equivalent of the Black Death." In the U.K., it's the most common reason employees take long-term sick leave. It costs American companies $300 billion a year. In Japan, it's a fatal epidemic.

It's stress.
Stress has beaten out stroke, heart attack, cancer and back problems as the main reason British workers take four or more weeks away from the job, according to a new report by the Chartered Institute of Personnel and Development. The Japan Ministry of Labor began publishing official statistics on "Karoshi" (death from overwork) in 1987, but the first case was documented in 1969, when a worker dropped dead of a stroke. He was 29.
The symptoms of stress are similar to those of someone in withdrawal from an addictive drug: finding it difficult to focus; losing your sense of humor; irritability; and shortened temper. Stress can also lead to under- and overeating, as well as smoking and drinking to excess. And in its most extreme forms it can result in stomach and bowel problems, heart disease and stroke. ...
http://jobs.aol.com/articles/2011/10/06/top-cause-of-workplace-sickness-dubbed-black-death-of-21st-cent/?ncid=webmail2
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Scientists find gene that controls chronic pain
Reuters) - British scientists have identified a gene responsible for regulating chronic pain, called HCN2, and say their discovery should help drug researchers in their search for more effective, targeted pain-killing medicines.
Scientists from Cambridge University said that if drugs could be designed to block the protein produced by the gene, they could treat a type of pain known as neuropathic pain, which is linked to nerve damage and often very difficult to control with currently available drugs. ...

http://www.reuters.com/article/2011/09/08/us-pain-gene-idUSTRE7875PN20110908?feedType=nl&feedName=ushealth1100
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So before you leave the house, read our list of what NOT to keep in your wallet, so you can pare down to just the essentials—and protect your finances and identity. 1,000 wallets and purses are stolen every two minutes in America. (44% of LearnVest readers have had their wallets lost or stolen once, while 8% have had theirs stolen twice or more). While it’s smart to be concerned with online security (check out our article on creating the perfect password here), 76% of identity thefts result from the theft of something physical, like a wallet. Additionally, it costs an average of $8,000 to recover from identity theft. ... http://www.learnvest.com/money-tuneup/credit-and-loans/what-not-to-keep-in-your-wallet/?utm_source=email&utm_medium=lvdaily&utm_campaign=click-here#top-block
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HINT: Remove the fish first... Don't throw out the water from the fish tank--pour it on your garden. It's a great fertilizer and green to boot !
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(Reuters) - A listeria outbreak linked to cantaloupes from Colorado has infected 72 people in the United States and killed 13, U.S. health officials said.
The foodborne outbreak is the deadliest in the United States in more than a decade, exceeding the 2008-2009 salmonella outbreak from tainted peanuts that killed nine and infected more than 700 people in the United States, according to the U.S. Centers for Disease Control and Prevention.
So far, 18 states have reported infections from one of the four strains of listeria involved in the outbreak, the CDC said.
Of the 13 deaths, four were in New Mexico, two were in Colorado, two were in Texas, and there was one each in Kansas, Maryland, Missouri, Nebraska and Oklahoma.
All of the illnesses started on or after July 31.
The CDC has traced the source of the outbreak to cantaloupes grown at Jensen Farms in Granada, Colorado. ... (apparently, this outbreak is expected to get worse)

http://www.reuters.com/article/2011/09/28/us-usa-listeria-deaths-idUSTRE78R03L20110928?feedType=nl&feedName=ushealth1100
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Linezolid versus Glycopeptide Antibiotics for the Treatment of Suspected Methicillin-Resistant Staphylococcus Aureus Nosocomial Pneumonia: A Meta-Analysis of Randomized Controlled Trials
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of nosocomial pneumonia. Societal guidelines suggest linezolid may be the preferred treatment of MRSA nosocomial pneumonia. We investigated the efficacy of linezolid compared with glycopeptide antibiotics (vancomycin or teicoplanin) for nosocomial pneumonia. ...

http://chestjournal.chestpubs.org/content/early/2010/09/21/chest.10-1556.short?rss=1
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Apixaban Prevents Strokes, Boosts Survival in Afib Patients

PARIS -- Compared with warfarin treatment, atrial fibrillation patients treated with the investigational factor Xa inhibitor apixaban had fewer strokes or embolic events, fewer major bleeding events, and were less likely to die during an average of almost two years of treatment, researchers said. Those results emerged from the 18,201-patient ARISTOTLE study, which was published online today by the New England Journal of Medicine.

"The primary outcome of stroke or systemic embolism occurred in 212 patients in the apixaban group (1.2% per year) as compared with 265 patients in the warfarin group (1.60% per year)," Christopher B. Granger, MD, of the Duke Clinical Research Institute at Duke University Medical Center in Durham, N.C., and colleagues wrote.

Explain that apixaban, an oral factor Xa inhibitor, was compared to dose adjusted warfarin in subjects with atrial fibrillation.

Note that in the primary outcome of hemorrhagic or ischemic stroke or systemic embolization, apixaban was superior to warfarin.

Note that apixaban had a lower rate of major bleeding and a lower rate of death from any cause than warfarin.

Additionally, the hazard ratio in the apixaban group was 0.79 (95% CI 0.66 to 0.95; P<0.001 for noninferiority and P=0.01 for superiority.
The benefit was largely driven by the difference in hemorrhagic stroke -- 0.24% per year for apixaban (40 strokes) versus 0.47% (78 strokes) for warfarin (HR 0.51, 95% CI 0.35-0.75, P<0.001). The rate of ischemic stroke was similar in both arms of the trial, 0.9% per year with apixaban and 1.05% per year with warfarin (P=0.42). ... http://www.medpagetoday.com/clinical-context/Strokes/28230
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America's 10 Poorest States: 24/7 Wall St.
The U.S. Census Bureau released two pieces of widely followed data Tuesday — one on poverty and the other on median income for 2010. The most interesting findings in this release were the state-by-state figures, especially when compared to national averages. A closer look at the statistics shows that a relatively small number of states suffer such widespread levels of low income and poverty that they skew the national numbers downward.
The national poverty rate last year was 15.1%. That is up from 11.3% in 2000 and is the highest it has been since 1993. Over 46 million people lived below the poverty line in 2010. The cut-off for that line is households of four people who made under $22,314. The other troubling news was that median income per household nationwide was an inflation-adjusted $49,445. This is about the same as in 1989 and down 2.3% from 2009. Economists fear that Americans are not consumers. It is easy to tell why when their real income has been frozen in place for more than two decades. ...
http://www.huffingtonpost.com/2011/09/15/americas-poorest-states-_n_964058.html?ncid=webmail1
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Inappropriate use of blood cell booster widespread
Costly drugs that boost red blood cells are being routinely misused in cancer patients, raising concerns about side effects and wasted resources, researchers say.
A quarter of the time, they found patients got the so-called erythropoiesis-stimulating agents (ESAs) for no more than a week, which is too short to do much good.
"These are very expensive drugs and there are a fair number of side effects," said Dr. Jason Wright of Columbia University Medical Center in New York, whose findings were published in the Journal of Clinical Oncology. ... http://www.reuters.com/article/2011/08/05/us-inappropriate-use-blood-cell-booster-idUSTRE7746VH20110805?feedType=nl&feedName=ushealth1100
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ESGO: Ultrasound Allows Early Ovarian Cancer Diagnosis
MILAN -- Ovarian cancer screening with transvaginal ultrasound has shifted the balance of detection to early-stage disease and improved survival, according to a study reported here.
Early-stage tumors have accounted for about 70% of cancers diagnosed through the Kentucky-based program. Patients with screen-detected ovarian cancer had an estimated five-year survival of 88%, as compared with 40% to 50% for unscreened patients in two different cancer registries.
Diagnostic accuracy has improved with the integration of an imaging-based morphology index for assessing tumor growth potential, Edward J. Pavlik, MD, reported at the European Society of Gynecological Oncology meeting. ...
http://www.medpagetoday.com/MeetingCoverage/ESGO/28522?utm_source=WC&utm_medium=email&utm_campaign=Meeting_Roundup_ESGO
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Tick-borne parasite infecting blood supply: CDC
CHICAGO (Reuters) - A tick-borne infection known as Babesiosis, which can cause severe disease and even death, is becoming a growing threat to the U.S. blood supply, government researchers said on Monday.
There are currently no diagnostic tests approved by the U.S. Food and Drug Administration that can detect the infection before people donate blood.
A 31-year study by the Centers for Disease Control and Prevention now suggests the parasitic infection may be increasing.
Babesia infections are marked by anemia, fever, chills and fatigue, but they can also cause organ failure and death. ...

http://news.yahoo.com/tick-borne-parasite-infecting-blood-supply-cdc-220254618.html
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More B Vitamins May Cut Risk of Elderly Depression
Higher intakes of two B vitamins -- but not folate -- may help ward off depression among older people, particularly if they take supplements, according to a large population study.
The prospective study, which followed more than 3,000 people ages 65 and older, found that higher intakes of vitamins B-12 and B-6 were both associated with a slightly reduced risk of depression (P=0.01 and P=0.05, respectively) for up to 12 years of follow-up, reported Kimberly A. Skarupski, MD, of Rush University in Chicago, and colleagues.
"In the assessment and treatment of depressive symptoms in older adults, clinicians and other healthcare professionals should be mindful of the patient's nutritional status in general, and whether there are vitamin insufficiencies in these nutrients before treatment," they wrote in the August issue of the American Journal of Clinical Nutrition. ... http://www.medpagetoday.com/PrimaryCare/DietNutrition/21376
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#96 Call overseas for free... Freephone2phone.com gives you 10 minutes of free talk to landlines in 55 countries and cellphones in some. You listen to short ads, then connect.
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Brain Takes Multiple Hits from Low B12 Levels Low levels of vitamin B12 may contribute to cognitive problems for older adults in more than one way, according to a cross-sectional study.

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

The mediating factors appeared to be white matter lesions and cerebral infarcts in association with the nonspecific marker homocysteine and brain atrophy for the vitamin B12-specific marker methylmalonic acid (MMA). "Vitamin B12 status may affect the brain through multiple mechanisms," the group wrote in the Sept. 27 issue of Neurology.
The Institute of Medicine already recommends B12 supplements for seniors, co-author Martha Clare Morris, ScD, director of nutrition at Rush University Medical Center, noted in an interview with MedPage Today.
"Insufficient vitamin B12 is very common in older people," she explained. "The older we get we have a decreased ability to absorb vitamin B12 from our diet. ... Medications can also impair absorption."
http://www.medpagetoday.com/Neurology/GeneralNeurology/28740?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com
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Eyelid Lipid Plaques Predict CV Disease The presence of the lipid-containing yellow plaques known as xanthelasmata on the eyelids is an independent predictor of cardiovascular disease, a large prospective study found.

During a mean follow-up of 22 years, adults participating in a long-term Danish heart study who had xanthelasmata at baseline had an adjusted hazard ratio for myocardial infarction of 1.48 (95% CI 1.23 to 1.79), according to Anne Tybjærg-Hansen, MD, of Rigshospitalet in Copenhagen, and colleagues.

Participants with these plaques also were at increased risk of ischemic heart disease (HR 1.39, 95% CI 1.20 to 1.60) and death (HR 1.14, 95% CI 1.04 to 1.26), the researchers reported online in BMJ. ... http://www.medpagetoday.com/Cardiology/Atherosclerosis/28541?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&eun=g379846d0r&userid=379846&email=rnfrankie@aol.com
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Study: Agency staff at higher risk of ED errors Agency staff members working in an ED are twice as likely as permanent employees to be involved in medication errors that harm patients, according to new Johns Hopkins research.

The researchers cautioned that while blaming the agency staff members themselves for the errors might be the simplest explanation, the problem is probably more diffuse and complex.

"A place that uses a lot of temporary staff may have more quality of care issues in general," said lead researcher Julius Cuong Pham, MD, PhD, an assistant professor for anesthesiology and critical care medicine and emergency medicine at the Johns Hopkins University School of Medicine. "It may not be the temporary staff that causes those errors, but a function of the whole system." ... http://news.nurse.com/apps/pbcs.dll/article?AID=2011109190002
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CPSC Urges Consumers to Check Their Homes for Numerous Simplicity Nursery Product Recalls.
Since 2007, the U.S. Consumer Product Safety Commission (CPSC) has recalled more than 11 million cribs whose detaching drop-side rails were associated with at least 32 infant suffocation and strangulation deaths since 2000. Additional deaths have occurred due to faulty or defective hardware. These new standards aim to prevent these tragedies and keep children safe in their cribs.Babies spend much of their time sleeping; therefore, the nursery should be the safest room in the house. ...
To check to see if the crib has been recalled: http://www.cpsc.gov/cgi-bin/cribs.aspx
http://www.cpsc.gov/info/cribs/index.html
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ELEPHANT RANDOM FACTS:

Elephants can drink 60 gallons of water per day and can feed for up to 16 hours a day.
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Elephants sleep mostly standing. They usually only sleep four to five hours per night.
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Female elephants have a gestation period of 22 months. They give birth to a single infant referred to as a calf.
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Elephants use their large ears like fans to cool themselves down. The ears of an adult African elephant range from 5 to 6 feet long and
4 feet wide. Elephants have excellent hearing and can hear sounds that humans cannot.
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Elephants have been known to recognize other elephants or even humans that they haven't seen in years. They are highly intelligent animals.
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Elephants live in matriarchal families called a herd. The leader of the herd is the oldest female. Young males remain with the herd until
approximately 15 years before going out on their own.
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Green-glowing cats are new tool in AIDS research (What next???)

(Reuters) - U.S. scientists have developed a strain of green-glowing cats with cells that resist infection from a virus that causes feline AIDS,
a finding that may help prevent the disease in cats and advance AIDS research in people.

The study, published on Sunday in the journal Nature Methods, involved inserting monkey genes that block the virus into feline oocytes,
before they are fertilized.

The scientists also inserted jellyfish genes that make the modified cells glow an eerie green color -- making the altered genes easy to spot. ...

http://www.reuters.com/article/2011/09/11/us-cats-aids-idUSTRE78A2LY20110911?feedType=nl&feedName=ushealth1100 **********************
Get dental work for a fraction of the cost from dentist-supervised students at a dental school. Find a school at ada.org by clicking on “Dental Schools.” For low-cost, federally funded care, go to the National Institute of Dental and Craniofacial Research website. ***********************

Hint 1: Zest is the best! Zest is simply grated peel, and is the epitome of lemon essence--it can be used fresh, dried, or frozen. If you don't have an official zester, you can use the smallest size of a box grater. (If you know you will be using lemons for zest, it is easier to grate the zest from the lemon before juicing them.) To dry zest, spread it on a towel and leave out until dried, then store in a jar. To freeze, use a freezer-safe container. Use zest in salads, marinades, baked goods, grain dishes, etc.

Hint 2: A small amount of lemon juice dripped onto minor wounds can help stop bleeding and disinfect the injury (it will sting a bit). (not too sure about this one... ) Lemon juice applied to itches, poison ivy rashes and wasp stings is said to relieve discomfort.

#81 Penny-wise superfoods... What foods give you the most vitamins and minerals for the least money? In descending order, the best
vegetables are cabbage, collard greens, mustard greens, turnip greens, and carrots. Top fruits are watermelon, plums, oranges, apples, and
strawberries.
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For those who use First Cold Pressed Extra Virgin Olive Oil :
http://www.kitchendaily.com/2011/09/23/the-best-extra-virgin-olive-oil/#photo-1?ncid=webmai

(Sorry about this large blank spot---blame AOL)

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

My husband grew increasingly displeased as our teenage daughter and her boyfriend studied in her room late one evening. Finally losing patience shortly after midnight, he knocked sharply on her door. Her boyfriend immediately opened it and asked if something was wrong.

"I have to ask you to move your car," my husband told him.

"Oh, sure. Is it in someone's way?"

"No," he replied, "it's parked in the wrong driveway."

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

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

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

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

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

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

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

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

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

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

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

12 lead EKG Interpretation Part #1
http://nursingpub.com/12-lead-ekg-explained-part-1
12 Lead EKG Interpretation Part #2 http://nursingpub.com/12-lead-ekg-interpretation-part-2
12 Lead EKG Interpretation Part #3
http://nursingpub.com/12-lead-ekg-interpretation-part-3

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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MEDICAL RECALLS
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FDA MedWatch - Medtronic Model 8637 SynchroMed II Implantable Infusion Pump: Class I Recall - Potential for Reduced Battery Performance
Medtronic and FDA notified healthcare professionals of a Class I recall of the SynchroMed II Infusion system. Medtronic’s analysis of the problem indicates it is related to the formation of a film within the pump battery. This problem can lead to the sudden loss of therapy and the return of underlying symptoms and/or therapy withdrawal symptoms.
The recall includes the SynchroMed II Implantable Infusion Pump models 8637-20 and 8637-40, distributed between May 2004 and July 8, 2011. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm271510.htm

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NURSING HINTS CORNER
Dry Labels for specimens When you are collecting a 24-hour urine specimen, place the collection "jar" in a basin that already had a plastic bag filled with ice. That way, the label on the jar will stay dry and the specimen will remain cool. Loosely knot the end of the bag so you can refill it as the ice melts.
Loretta A. Debus

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.147, Springhouse Corporation/www.springnetcom. ;

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ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com/.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com

WELCOME TO:

engleharts@bellsouth.net (Kay) October 5, 2011

sandsfamily4@att.net (Becky) October 6, 2011
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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number....(?) So please send me your new name/address, okay? RNFrankie@AOL.com

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

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

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

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THOUGHT FOR THE DAY

A Good description of a nurse

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

--Rainer Maria Rilke

Would really like to hear from you..... Frankie

RNFrankie@AOL.com

PARADIGM BYTES September 10, 2011

2011-09-09T14:17:00.000-07:00

PARADIGM BYTES
Newsletter for Paradigm 97
September 10, 2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

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

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SNIPPET

Why are those nurses hogging so much of the hospital budget? ! Thank you, Sandy for all you do ! (Please support her site)
March 25, 2011 -- Recent press reports have highlighted the continuing debate over adequate nurse staffing in U.S. hospitals. A fairly good March 16 piece in the St. Paul Pioneer Press was among those reporting that a new study published in the New England Journal of Medicine had found that nurse understaffing at the Mayo Clinic significantly increased the risk of patient mortality, and that high patient turnover had an even great effect. Christopher Snowbeck's report also provided helpful context, noting that nurse staffing levels have been critical factors in recent labor disputes between hospitals and nursing unions. And today, the Boston Globe ran business columnist Steven Syre's piece about the "conundrum" hospitals face in trying to balance costs with the growing awareness that having fewer nurses threatens patients. It seems that nursing payrolls are the biggest single "expense" hospitals have. This piece also provides a pretty balanced look at recent labor disputes in which nurse staffing has been a key issue. But the writer seems puzzled about why nursing salaries are such a part of hospital budgets. No one says: "Yes, nursing salaries are a big factor because hospitals exist to provide professional nursing care, not to house physicians or machines. And nurses are not just 'expenses'; they create most of the value that hospitals provide." That basic reality might have been helpful for readers to know. In any case, we thank those responsible for these two pieces. more... Christopher Snowbeck's report also provided helpful context, noting that nurse staffing levels have been critical factors in recent labor disputes between hospitals and nursing unions. And today, the Boston Globe ran business columnist Steven Syre's piece about the "conundrum" hospitals face in trying to balance costs with the growing awareness that having fewer nurses threatens patients. It seems that nursing payrolls are the biggest single "expense" hospitals have. This piece also provides a pretty balanced look at recent labor disputes in which nurse staffing has been a key issue. But the writer seems puzzled about why nursing salaries are such a part of hospital budgets. No one says: "Yes, nursing salaries are a big factor because hospitals exist to provide professional nursing care, not to house physicians or machines. And nurses are not just 'expenses'; they create most of the value that hospitals provide." That basic reality might have been helpful for readers to know. In any case, we thank those responsible for these two pieces. ( for more about nurse's salaries...and the need for nurses check out the website). ...
http://www.truthaboutnursing.org/news/2011/mar/25_hogging.html ; ( We all need to have this information...no telling when the opportunity will arise for put forth the argument for good nursing care and what that really means).
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FROM THE MEMBERS

(Received this note from COMBATVET, and wanted to wish him the best in this new endeavor!!!! He wrote:)

"Frankie:

I completed my BSN from the University of Colorado at Colorado Springs and accepted a job teaching there starting this fall.

Robert Weiner" (COMBATVET@AOL.com)

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Just released, Bob Hess's 17-year retrospective on the IPNG, Slicing and Dicing Shared Governance: In and Around the Numbers, in the July/September issue of Nursing Administrative Quarterly.

Hospitals seeking Magnet status must demonstrate empowering structures and processes that involve nurses in governance and decision-making about their practice. Shared governance—an organizational innovation that legitimizes health care professionals' decision-making control over their practice, while extending their influence to administrative areas previously controlled by managers—can achieve this. However, evidence connecting shared governance with clinical, professional, and organizational outcomes has been sparse. Research using the Index of Professional Nursing Governance is changing that. Innovative uses of the Index of Professional Nursing Governance is strengthening new shared governance programs, rejuvenating old ones, and finally connecting innovative models to favorable outcomes. ...
http://journals.lww.com/naqjournal/Abstract/2011/07000/Slicing_and_Dicing_Shared_Governance__In_and.8.aspx

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MEDICAL NEWS
BIG NEWS !!! FDA Approves the Accreditation Bodies to Accredit the Siemens Mammomat Inspiration Pure Full-Field Digital Mammography (FFDM) Unit (8/23/11)

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World Bank Calls famine in the Horn of Africa Man Made... The famine in the Horn of Africa is man made - the result of artificially high prices for food and civil conflict, the World Bank's lead economist for Kenya Wolfgang Fengler told Reuters Tuesday.
"This crisis is man made," Fengler said in a telephone interview. "Droughts have occurred over and again, but you need bad policy making for that to lead to a famine."
Some 12.4 million people in the Horn of Africa - including Somalia, Kenya, Ethiopia and Djibouti - are affected by the worst drought in decades, according to the United Nations. Tens of thousands of people have already died. Fengler said the price of maize, or corn, was significantly higher in east Africa than in the rest of the world due to controls on local food markets. ...
http://www.reuters.com/article/2011/08/16/us-africa-famine-manmade-idUSTRE77F6QN20110816?feedType=nl&feedName=ushealth1100

NON-MEDICAL........just wanted to share !
U.S. Set To File Suits Against Big Banks Over Mortgages
WASHINGTON - The agency that oversees mortgage markets is preparing to file suit against more than a dozen big banks, accusing them of misrepresenting the quality of mortgages they packaged and sold during the housing bubble, The New York Times reported on Thursday.
The Federal Housing Finance Agency, which oversees mortgage giants Fannie Mae and Freddie Mac, is expected to file suit against Bank of America, JPMorgan Chase, Goldman Sachs and Deutsche Bank, among other banks, the Times reported, citing three unidentified individuals briefed on the matter.
The suits stem from subpoenas the finance agency issued to banks last year. They could be filed as early as Friday, the Times said, but if not filed Friday it said the suits would come on Tuesday.
The government will argue the banks, which pooled the mortgages and sold them as securities to investors, failed to perform due diligence required under securities law and missed evidence that borrowers' incomes were falsified or inflated, the Times reported.... http://www.huffingtonpost.com/2011/09/01/us-suits-big-banks-mortgages_n_946010.html?ncid=webmail1 ~~**~~**~~**~~**~~**~~
INTERESTING READING

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

Stem cell team aims for spare heart parts in five years (Reuters) Stem cell researchers in Hong Kong and the United States are trying to grow spare parts for the human heart that may be ready for tests on people within five years, they said on Thursday.
Scientists have already made basic heart muscle from stem cells, but the Hong Kong-led team wants to refine it so it can replace any part damaged in heart attacks, and to recreate the natural pacemaker, where the heartbeat originates. ...
http://www.reuters.com/article/2011/08/18/us-heart-stemcells-idUSTRE77H0ZM20110818?feedType=nl&feedName=ushealth1100
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Mosquito resistance to bednets fuels malaria worries (Reuters) - Mosquitoes can quickly develop resistance to insecticide-treated nets, a study from Senegal shows, raising fears that a leading method of preventing the disease may be less effective than previously thought.
Researchers who studied malaria infections in a village in the West African country found that growing resistance to a common type of insecticide by Anopheles gambiae mosquitoes -- the species responsible for transmitting malaria to humans in Africa -- is causing the disease to rebound. ...
http://www.reuters.com/article/2011/08/18/us-malaria-nets-resistance-idUSTRE77H3L120110818?feedType=nl&feedName=ushealth1100
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Experts find way to make mosquitoes dengue-free (Reuters) Injecting a bacteria into mosquitoes can block them from transmitting the dengue virus and help control the spread of a disease that kills 20,000 annually in more than 100 countries, scientists said.
In two papers published in the journal Nature on Thursday, researchers in Australia showed how female mosquitoes infected with the Wolbachia bacteria passed the bug easily to their offspring, making them all dengue-free. They said such infected mosquitoes should be released into the wild, so that the spread of dengue to people may be reduced.
"The main feature we saw was their ability to reduce dengue transmission," said Professor Scott O'Neill, lead author and science faculty dean at Monash University. "It almost completely abolished dengue virus in the body of the mosquito." ...

http://www.reuters.com/article/2011/08/25/us-dengue-australia-idUSTRE77O00O20110825?feedType=nl&feedName=ushealth1100
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Scientists find weakness in deadly Ebola virus (Reuters)
Laboratory mice bred to produce low levels of this protein -- known Niemann-Pick C1 -- survived exposure to both Ebola, which causes a hemorrhagic fever, and its cousin, Marburg virus.
"This research identifies a critical cellular protein that the Ebola virus needs to cause infection and disease," said Sean Whelan of Harvard Medical School, who worked on one of two studies published on Wednesday in the journal Nature. A protein that helps transport cholesterol inside cells may be a key to developing drugs to treat Ebola, a rare but lethal virus for which there are no known treatments, U.S. researchers said.
"The discovery also improves chances that drugs can be developed that directly combat Ebola infections," Whelan said in a statement. Ebola is one of the most deadly infections known, killing 90 percent of people infected by it. ...

http://www.reuters.com/article/2011/08/24/us-science-ebola-idUSTRE77N5X520110824?feedType=nl&feedName=ushealth1100
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RANDOM FACT #1: Originally named "Baby Gays," Leo Gerstenzang invented the cotton swab in the 1920's.
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RANDOM FACT #2: Nearly 3 out of 4 Americans stick cotton swabs in their ears despite the package's instructions against it.
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Addiction is a brain disorder...
WASHINGTON (AP) — Addiction isn't just about willpower. It's a chronic brain disease, says a new definition aimed at helping families and their doctors better understand the challenges of treating it.
"Addiction is about a lot more than people behaving badly," says Dr. Michael M. Miller of the American Society for Addiction Medicine.
That's true whether it involves drugs and alcohol or gambling and compulsive eating, the doctors group said Monday. And like other chronic conditions such as heart disease or diabetes, treating addiction and preventing relapse is a long-term endeavor, the specialists concluded.
Addiction generally is described by its behavioral symptoms — the highs, the cravings, and the things people will do to achieve one and avoid the other. The new definition doesn't disagree with the standard guide for diagnosis based on those symptoms. http://www.aarp.org/health/conditions-treatments/news-08-2011/us-med-healthbeat-addiction.html?cmp=NLC-RSS-DAILY-BULLETIN
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29 New Genes Linked to MS........Report is part of a 12-month Clinical Context series

The genetic puzzle underlying multiple sclerosis is proving to be increasingly complex, with genome-wide analyses now having identified 29 new gene variants associated with the disease, an international team of researchers reported.
Many of the newly implicated genes play important roles in the immune system, particularly in T-cell activation and differentiation, according to Stephen Sawcer, PhD, of the University of Cambridge in England, and colleagues.
"The over representation of genes that influence T-cell maturation provides independent and compelling evidence that the critical disease mechanisms primarily involve immune dysregulation," the researchers wrote in the August 11 issue of Nature.
These findings emerged from genome-wide association studies of DNA samples fom 9,772 patients in 15 countries and 17,376 controls. ...
New Genes Linked to MS CME

http://www.medpagetoday.com/clinical-context/MultipleSclerosis/28011?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846
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PCI for blocked arteries of Lasting Benefit in Diabetes Long-term outcomes for patients with diabetes were significantly improved following successful percutaneous coronary intervention (PCI) for chronic total occlusions, researchers found.
Through a median of three years of follow-up, the mortality rate following a successful procedure was significantly lower than an unsuccessful one (10.4% versus 13%, P<0.05), according to Roxana Mehran, MD, of the Cardiovascular Research Foundation in New York City, and colleagues.
There was also a substantial reduction in the need for CABG during follow-up after a successful PCI (2.4% versus 15.7%, P<0.01), the researchers reported online in the American Journal of Cardiology. ...

http://www.medpagetoday.com/Cardiology/PCI/28018?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846
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15 minutes of exercise a day can extend life by three years
(Reuters) - Doing just 15 minutes of moderate exercise a day may add three years to your life, a large study in Taiwan has found.
Most people struggle to stick to the standard guideline of 30 minutes a day of exercise, five days a week, and experts hope that by identifying a lower dose, more people will be motivated to get off the couch.
Lead researcher Chi Pang Wen of Taiwan's National Health Research Institutes said dedicating 15 minutes a day to a moderate form of exercise, like brisk walking, would benefit anyone. ... http://www.reuters.com/article/2011/08/16/us-exercise-taiwan-idUSTRE77E69L20110816?feedType=nl&feedName=ushealth1100
100 Ways to get slim... Don't have time or money for the gym? No sweat. Check out these 100 ways to get slim without the gym and watch your inches shrink while your wallet grows fat. Win-win! http://www.ivillage.com/100-ways-get-slim-without-gym/4-b-365413?nlcid=wh|08-16-2011|

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HHS Awards $71.3 Million to Strengthen Nursing Workforce 08/02/11
Nursing workforce development programs, reauthorized by the Affordable Care Act and administered by Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA), are the primary source of federal funding for nursing education and workforce development. These programs bolster nursing education at all levels, from entry-level preparation through the development of advanced practice nurses. They also prepare faculty to teach the nation’s future nursing workforce.
http://nursingworld.org/HomepageCategory/NursingInsider/HHS-Strengthen-Nursing-Workforce.aspx ;
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Dismantling Nursing's Catch-22 The potential positives of med-error reporting often are overshadowed by the repercussions to nurses
Victoria L. Rich, RN, PhD, FAAN, chief nurse executive at the University of Pennsylvania Medical Center and an associate professor at the school of nursing there, recalls working at a hospital in the 1980s where a nurse who made three medication errors in one year automatically was fired. In such a fearful environment, few nurses wanted to report errors, Rich said, referring to those days as "the dark ages."

In the past 15 years, as a preponderance of evidence shows the harm to patients from medical errors and the need to shed light on how and why such errors occur, more hospitals are trying to shift from punishing individuals for honest mistakes to using error reports as evidence to change systems, making it harder for clinicians to make errors and easier to catch mistakes before they cause harm. But the process of creating trust and a true culture of safety is not easy, said Ronda Hughes, RN, PhD, MHS, FAAN, associate professor at Marquette University College of Nursing in Milwaukee, Wis. It requires long-term hospital wide commitment, strong leadership and a lot of time.

"It's something you have to do for years on end," said Hughes, who was a senior health scientist administrator for the Agency for Healthcare Research and Quality and works as a consultant for the Labor Management Institute in Minnesota. "It's not something you can do for weeks or even a year." ... http://news.nurse.com/article/20110808/NATIONAL01/108080059
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Interdisciplinary Pilot Study Suggests Nurses Can Help Chronically Ill Patients Properly Manage Medication after Being Discharged from Hospital Medicare will soon release new rules requiring hospitals to focus more attention on patients after they are discharged. Readmissions have cost Medicare $26 billion a decade and the program plans to cut payments to hospitals that have high readmission rates. Nonadherence to medication regimens may be one factor in high readmission rates. After leaving the hospital, patients are not always likely or able to adhere to the medication regimens they were prescribed, sometimes with disastrous results. Without supervision from a health care provider, some patients either never take the prescribed medication, or take the wrong dosage. One study found that more than seven in ten (72 percent) of adverse events after a patient left the hospital were related to medication. ...
http://inqri.blogspot.com/2011/08/interdisciplinary-pilot-study-suggests.html
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Details Crucial When Reporting Adverse Events Due to Medical Devices
Rapid identification of adverse events associated with medical devices is essential to prevent injury or death. Unfortunately, many adverse events reported to the Food and Drug Administration (FDA) do not include vital information such as the patient’s age, which may delay identification of problems in the pediatric population and result in under-reporting of serious adverse events in children. The American Academy of Pediatrics (AAP) Newsmagazine http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/medsun/news/newsletter.cfm?news=64#8
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Health Care Comes Home reviews the state of current knowledge and practice about many aspects of health care in residential settings and explores the short- and long-term effects of emerging trends and technologies. By evaluating existing systems, the book demands and the capabilities of users. Health Care Comes Home recommends critical steps to improve health care in the home. The book’s recommendations cover the regulation of health care technologies, proper training and preparation for people who provide in-home care, and how existing housing can be modified and new accessible housing can be better designed for residential health care. The book also identifies knowledge gaps in the field and how these can be addressed through research and development initiatives. The National Academies Press. Health Care Comes Home: The Human Factors. 2011.
http://www.nap.edu/catalog.php?record_id=13149
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/medsun/news/newsletter.cfm?news=64#7

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RANDOM FACT: An estimated 1,000,000 dogs in the U.S. have been named as the primary beneficiaries in their owner's will.
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(In my opinion, the individual vaccine is probably safe, but question what happens when double or triple vaccines are given in one dose. )

Vaccines largely safe, U.S. expert panel finds (Reuters) - After a close review of more than 1,000 research studies, a federal panel of experts has concluded that vaccines cause very few side effects, and found no evidence that vaccines cause autism or type 1 diabetes.
The report, issued on Thursday by the Institute of Medicine, part of the National Academies of Sciences, is the first comprehensive report on vaccine side effects since 1994.
Fears that vaccines might cause autism or other health problems have led some parents to skip vaccinating their children, despite repeated reassurances from health authorities. The concerns have also forced costly reformulations of many vaccines. ...
http://www.reuters.com/article/2011/08/25/us-vaccines-idUSTRE77O4ZE20110825?feedType=nl&feedName=ushealth1100

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(As nurses, we could have a patient with quadriplegia; Definitely, there is a chance that we could encounter Autonomic Dysreflexia-- which is life threatening for the quad. It behooves us to know what to do in this emergency.)

Headache attributed to autonomic dysreflexia : An under -recognized clinical entity
Objective: The recognition and the management of headache attributed to autonomic dysreflexia after spinal cord injury (SCI) are challenging issues. Given this, I systematically reviewed the literature to establish the features of the headache attributed to autonomic dysreflexia after SCI.
Methods: This review included all articles that addressed any feature of headache attributed to autonomic dysreflexia after SCI. The literature search addressed publications from 1950 until April 2010. The literature search was conducted using MEDLINE, CINAHL, EMBASE, and PsycINFO® databases. The literature search was limited to only articles written in English.
Results: Of the 273 publications captured in all 4 databases, 45 articles fulfilled our inclusion and exclusion criteria. Typically, the headache attributed to autonomic dysreflexia is a sudden-onset, severe headache accompanied by several signs and symptoms including increased blood pressure, altered heart rate, and diaphoresis cranial to the level of SCI, which is triggered by different noxious and nonnoxious stimuli. However, clinicians need to be aware of other headache features and the variety of potential triggers associated with the headache attributed to autonomic dysreflexia.
Conclusions: The greater awareness of this clinical entity among clinicians, in particular neurologists, is crucial for early recognition and proper management of episodes of autonomic dysreflexia to prevent its complications. Neurology® 2011;77:792–798

http://www.neurology.org/content/77/8/792.abstract
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Mob RANDOM FACTS: Benjamin "Bugsy" Seigel built the Flamingo hotel and casino in 1945, with a mob loan; however due to mismanagement it soon went over budget. Unable to get their money back, the top gangsters including Luciano and Lansky agreed to have him killed. On June 20, 1947, "Bugsy" Seigel was killed in his Los Angeles house.

Bonus Fact: Donnie Brasco, in reality Joe Pistone, spent five years undercover for the FBI between 1976 and 1981. His evidence resulted in more than 100 convictions and the near collapse of the Bonanno family in New York.
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Obesity to worsen, weigh heavily on healthcare costs (Reuters) - Obesity is most widespread in Britain and the United States among the world's leading economies and if present trends continue, about half of both men and women in the United States will be obese by 2030, health experts warned on Friday.
Obesity is fast replacing tobacco as the single most important preventable cause of chronic non-communicable diseases, and will add an extra 7.8 million cases of diabetes, 6.8 million cases of heart disease and stroke, and 539,000 cases of cancer in the United States by 2030.
Some 32 percent of men and 35 percent of women are now obese in the United States, according to a research team led by Claire Wang at the Mailman School of Public Health in Columbia University in New York. They published their findings in a special series of four papers on obesity in The Lancet.
In Britain, obesity rates will balloon to between 41-48 percent for men and 35-43 percent for women by 2030 from what is now 26 percent for both sexes, they warned. ... http://www.reuters.com/article/2011/08/26/us-obesity-health-idUSTRE77P17020110826?feedType=nl&feedName=ushealth1100
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RANDOM FACT: A cat's heart beats twice as fast as a human heart, at 110 to 140 beats per minute.
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Four Signs of Elder abuse:

Physical and sexual abuse
Suspicious bruises or other injuries. Rope burns or other signs of restraints. Sudden change in behavior. Caregiver's refusal to allow visitors.
Emotional or psychological abuse
(Insults, threats, social isolation) Elder is extremely upset, withdrawn, unresponsive; other unusual behavior.
Neglect
Dehydration, malnutrition, untreated bed sores, weight loss. Unattended health problems or lack of necessary aids, such as eyeglasses or dentures. Unsanitary living conditions (lice, soiled bedding). Inadequate clothing; no heat or running water.
Financial exploitation
Unexplained bank withdrawals, unauthorized use of a credit or ATM card, stolen or "misplaced" cards or checkbook. Checks written as a "loan" or "gift." Abrupt changes in a will or other documents. Unexplained transfer of assets to a family member or someone outside the family. Disappearance of valuables. Ill-advised investments. Sudden appearance of a previously uninvolved relative claiming a right to an elder's affairs or possessions.
http://www.aarp.org/politics-society/advocacy/info-2007/protecting_the_vulnerable_sb.html
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#15 Prepay... Adding a bit to your monthly payment can dramatically shorten the life of your mortgage and ultimately save you thousands of dollars in interest. Every extra dollar is applied to the loan's principal. Adding $10 per payment can prune 14 months from a 30-year, 5 percent mortgage for $100,000, and save you $4,500 in interest.
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FDA Okays Late-Stage Melanoma Drug
WASHINGTON -- The FDA has approved vemurafenib (Zelboraf) for the treatment of metastatic and unresectable melanoma along with a companion genetic mutation test. Vemurafenib is specifically indicated for patients whose tumors express a BRAF V600E mutation, the FDA said in a statement. The companion diagnostic tool, known as the cobas 4800 BRAF V600 Mutation Test, can help determine if the melanoma cells contain the indicated mutation.
Vemurafenib is a BRAF inhibitor that blocks the function of the V600E-mutated BRAF protein. The drug has not been studied in patients who test negative for the BRAF V600E mutation, the FDA stated.
Vemurafenib is the second drug approved for late-stage melanoma this year; ipilimumab (Yervoy) was approved by the FDA in March. ...
http://www.medpagetoday.com/PublicHealthPolicy/FDAGeneral/28083?utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news
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Blacks at Higher Risk for Resistant Breast Disease
TUESDAY, Aug. 16 (HealthDay News) -- Black women are more likely to have two or more children and are less likely to breast-feed, putting them at greater risk of developing a difficult-to-treat type of breast cancer, according to a new study.
The study, published in the current issue of Cancer Epidemiology, Biomarkers & Prevention, found the risk for hormone receptor-negative breast cancer was 50 percent greater among women who gave birth to at least two children. The researchers noted, however, that breast-feeding reduced that risk. ... http://consumer.healthday.com/Article.asp?AID=655782
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HPV Vaccination Rates Lagging for Teens
Coverage rates for all three recommended adolescent vaccines have risen, although vaccination against human papillomavirus (HPV) is lagging, the CDC reported.
A national survey showed that overall coverage with the meningococcal conjugate vaccine (MenACWY) and the tetanus, diphtheria, acellular pertussis (Tdap) vaccine each rose by about 10 percentage points in 2010 compared with 2009, the agency reported in the Aug. 26 issue of Morbidity and Mortality Weekly Report.
In contrast, the CDC reported, coverage with at least one dose of the HPV vaccine rose by slightly more than four percentage points, while coverage with the complete three-dose regimen increased by just over five percentage points.
The findings parallel what has been happening since 2006, the agency said: coverage rates for all three vaccines have been rising, but the average annual rate increase for MenACWY and Tdap has been significantly higher than for HPV. ...
http://www.medpagetoday.com/Pediatrics/Vaccines/28197?utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news
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Genome Region Tied to Risk of Second Cancers after RadiationTherapy A new study may provide an important clue about the long-term risk of second primary cancers in children with Hodgkin lymphoma who receive radiation therapy as part of their treatment. In the study, researchers identified two genetic variants, called single nucleotide polymorphisms (SNPs), in a region of chromosome 6 that were strongly associated with an increased risk of a second cancer in this group of cancer survivors.
Published July 24 in Nature Medicine, the study is among the first genome-wide association studies focused on second cancer risk, and one of the few such studies to date that limited the study population to a group that received a specific therapeutic intervention.
Approximately 90 percent of children and adolescents diagnosed with Hodgkin lymphoma are cured. But that cure can come at a price: Nearly 20 percent of survivors will develop a second cancer, which is the second leading cause of death in this population. ...
http://www.cancer.gov/ncicancerbulletin/080911/page2

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RANDOM FACT: Tomatoes first grew as wild, cherry-size berries in the South American Andes, but the fruit, as we know it today,
was developed in Mexico where it was known as tomatil and traveled to Europe by boat with the returning conquistadors.
Bonus Fact: A tomato is 94% water.
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Are skin disorders related to work strain in hospital workers? A cross-sectional study. To evauluate whether occupational stress factors (high demands, low control, low social support, strain, and iso-strain) are associated with skin disorders in hospital workers and whether psychological problems, such as anxiety and depression, act as potential mechanisms through which occupations stress factors are associated with skin disorders. ...

http://www.biomedcentral.com/1471-2458/11/600
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Cervical Screening Guidelines Ignored Many physicians recommend the HPV and Papanicolaou co-tests for cervical cancer screening on an annual basis, despite guidelines that call for re-screening every three years, researchers said.
National survey data show that about 51% of providers ordered the co-test, but in clinical vignettes, only about 14% recommended re-screening in three years for women with normal results, Katherine Roland, MPH, of the Centers for Disease Control and Prevention in Atlanta, and colleagues reported online in the American Journal of Obstetrics & Gynecology.
"Annual cervical cancer screening continues to be a common recommendation, regardless of whether a screening history has been established or an HPV test has been ordered," the researchers wrote. ...

http://www.medpagetoday.com/OBGYN/GeneralOBGYN/28098?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846
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#17 Compare costs BillShrink.com analyzes your everyday costs for services like cell-phones and cable TV and financial accounts. FindABetterBank.com compares checking account plans at banks and credit unions. BrightScope.com compares 401 (k) plans and financial advisers.
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Nearly one in 10 children in the United States is being diagnosed with attention deficit hyperactivity disorder, according to a new government study. That’s an increase of more than 2 percent in ADHD diagnoses compared to a decade ago, researchers from the Centers for Disease Control and Prevention reported today.
The new findings don’t necessarily mean that more kids are developing ADHD, said the study’s lead author Dr. Lara Akinbami, a medical officer at the CDC’s National Center for Health Statistics. “This change is reflected in numerous national data sets,” Akinbami explained. “It’s robust and real. But we can’t say whether it’s a true increase in prevalence or just better detection.” ...

http://www.msnbc.msn.com/id/44190936/ns/health-childrens_health/
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A review of educational strategies to improve nurses roles in recognizing and responding to deteriorating patients
International Nursing Review, 07/19/2011
Liaw SY et al. – The review has highlighted important aspects of patient safety in clinical deterioration that could be further addressed by educational strategies targeting the role of ward nurses. These strategies include: utilizing clinical decision–making models to develop nurses' decision making skills; developing a standardized tool for systematic nursing assessment and management of clinical deterioration; incorporating training in clinical deterioration as a core competence of pre–registered nursing education; providing vital signs training to nursing assistants; and conducting more rigorous studies to evaluate the effectiveness of the educational programmes. ... (You will need to register in order to view entire article, unfortunately. Registration is simple)
http://www.mdlinx.com/nursing/newsl-article.cfm/3670043/ZZ5603146585149290157159/?news_id=399&newsdt=081911&subspec_id=44
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The Newest Way to Detect Cancer They're man's best friend, but dogs, it turns out, may also be a doctor's newest secret weapon for detecting cancer.German researchers report in the European Respiratory Journal that dogs can be trained to detect lung cancer by sniffing human breath. The scientists worked with an admittedly small number of canines — just four, including two German shepherds, a Lab and an Australian shepherd — but the dogs had good success. They were able to suss out cancer in 71 out of 100 breath samples from lung cancer patients, and were able to correctly identify 93% of cancer-free samples, giving them an impressively low rate of false positives.
That's better than the imaging tests that most physicians currently use to detect lung cancer. WebMD reports that in a recent study, longtime smokers who went in for annual CT scans of their lungs cut their risk of dying from lung cancer by only 20%. ...
http://healthland.time.com/2011/08/18/a-new-way-to-detect-lung-cancer-dogs-can-sniff-it-out/#ixzz1Vh6cRqaB

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Check for leaks in the toilet tank: The Environmental Protection Association estimates American homes waste an average of 10,000 gallons of water each year. (Wow! That's a lot of water.) Much of this waste is due to "minor" water leaks. While some toilet leaks are easy to find (think water puddle on the floor), others like a leaky tank can be difficult to spot. To identify these hidden leaks, drop food coloring into your tank. If after 30 minutes, the food coloring is in the bowl, then you have a leak around your toilet flapper. If that's the case, you need to either find a plumber or get a new toilet.
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Study Links Brain Stents to More Deaths and Strokes Aggressive medical therapy was more than twice as effective in lowering the risk of recurrent stroke or death than was stenting of narrowed intracranial arteries, a randomized trial found.

In the SAMMPRIS trial, 14.7% of patients randomized to percutaneous transluminal angioplasty and stenting (PTAS) developed fatal or nonfatal strokes at 30 days compared with 5.8% of patients in the aggressive medical management group (P=0.002), reported Marc I. Chimowitz, MB, ChB, from the Medical University of South Carolina, and colleagues in the study, which was published online by the New England Journal of Medicine. ...
( CE involved, also) . http://www.medpagetoday.com/Cardiology/Strokes/28385
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( Have I missed something? When did corporations have the right to "free speech as warranted by the constitution"?)
Cigarette makers sue FDA over new labeling rules

NEW YORK (Reuters) - Four big cigarette makers sued the Food and Drug Administration, seeking to void as unconstitutional new graphic labels and advertising that warn consumers about the risks of smoking and induce them to quit.

The lawsuit by Reynolds American Inc's R.J. Reynolds unit, Lorillard Inc, Liggett Group LLC and Commonwealth Brands Inc, owned by Britain's Imperial Tobacco Group Plc, said the warnings required no later than September 22, 2012 would force cigarette makers to "engage in anti-smoking advocacy" on the government's behalf.
They said this violates their free speech rights under the First Amendment, according to a complaint filed Tuesday with the U.S. District Court in Washington, D.C. ...
http://www.reuters.com/article/2011/08/17/us-cigarettes-advertising-lawsuit-idUSTRE77G05V20110817?feedType=nl&feedName=ushealth1100
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FDA approves Roche skin cancer drug Zelboraf U.S. drug regulators on Wednesday approved a targeted skin cancer drug from Roche Holding along with its diagnostic test, an advance in personalized health care.
The Food and Drug Administration was two months ahead of schedule in approving the drug, under the brand name Zelboraf, along with a companion diagnostic that identifies which patients have a specific genetic mutation that means they will benefit from the treatment.
Zelboraf offers a treatment for patients who had few options in the past. In March, the FDA approved the first treatment to help patients with advanced melanoma live longer. The drug Yervoy, or ipilimumab, is sold by Bristol-Myers Squibb. ...
http://www.reuters.com/article/2011/08/17/us-roche-zelboraf-idUSTRE77G2SE20110817?feedType=nl&feedName=ushealth1100
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J&J, Lilly drugs found among best for manic episodes (Reuters) - Antipsychotics are far more effective than mood stabilizers in tackling acute manic episodes, researchers found, and Eli Lilly's Zyprexa, Johnson & Johnson's Risperdal and generic haloperidol outperform the rest.
In a study published in the Lancet medical journal on Wednesday, researchers from Britain and Italy ranked antipsychotic drugs according to their effectiveness and said that since current treatment guidelines don't differentiate between the drugs, their findings could offer useful guidance for doctors. ...
http://www.reuters.com/article/2011/08/16/us-mania-antipsychotics-idUSTRE77F72S20110816?feedType=nl&feedName=ushealth1100
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Scouring food labels on processed foods like pasta sauce, cereal, and ice cream has become de rigueur during food shopping, but fresh, unpackaged produce doesn’t come with such visibility into calories, fat, fiber, protein, and key vitamins and nutrients.
Of course, nutrition experts would be happy if Americans ate more of pretty much any fruit or vegetable (only about 32 percent of adults consume recommended levels of fruit and 25 percent recommended levels of veggies, according to government data), but you may be surprised to actually see the nutrition profiles of your favorite produce. Which high-fat fruit can take good care of your ticker? What popular salad topper is shockingly high in sodium?
Avocado
It’s true: Avocados are high in fat, but it’s a super-healthy type! Their monounsaturated fat can help lower cholesterol and keep your heart healthy. Avocados also contain lutein, an antioxidant that strengthens eyesight, and vitamin E, which may lower risk of Alzheimer’s disease. Just be sure to watch your portion size or you could overdo it on fat and calories (a whole medium avocado packs 320 calories and 28 grams of fat!).
Celery
Celery, which is 95 percent water, may not be as nutrient-rich as other produce, but it does contain some healthy compounds, including vitamin A and C, and phthalides, which help lower blood pressure and stress hormones levels. Although celery is also widely touted as a “negative calorie food” — meaning that eating and digesting it burns more calories than the amount in the stalk — experts say the amount of the calorie burn is too small to have a meaningful impact on weight loss.

Blueberry
Blueberries are the second-most popular berry in the United States (behind strawberries), and contain more antioxidants than almost any other fruit or vegetable, according to the USDA. Anthocyanins, the antioxidants that give this fruit its beautifully rich blue hue, may boost brainpower, fight off disease, and slow down the aging process.
Carrot
Mom was right: The high amounts of vitamin A and beta carotene in carrots (and other orange veggies like sweet potatoes and pumpkin) do help keep the eye doctor away, but that’s far from the only way they boost your health. Adequate intake has also been linked to a lower risk of lung and other cancers, a strong immune system, and even maintaining brain health with age.
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Reclast Gets FDA Kidney Failure Warning
The osteoporosis drug zoledronic acid (Reclast) should not be used in patients with significant renal impairment, and physicians should screen patients for kidney dysfunction before starting them on the drug, the FDA said.
The agency ordered the new label warning for the drug after receiving 20 reports of acute kidney failure resulting in death or requiring dialysis.
The new warning indicates that patients with creatinine clearance of less than 35 mL/min or evidence of acute renal impairment should not be given zoledronic acid for osteoporosis.
It also identifies risk factors that physicians should take into consideration when prescribing the product. These include advanced age, concurrent treatment with other nephrotoxic drugs, and dehydration secondary to fever, sepsis, gastrointestinal losses, or diuretic therapy. ...
http://www.medpagetoday.com/ProductAlert/Prescriptions/28320?utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news
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Anti-Seizure Drug May Boost Glioblastoma Survival
Patients undergoing chemotherapy and radiotherapy for malignant glioblastoma appeared to have better overall survival if they also received the anti-seizure medication valproic acid, a retrospective analysis found.
The adjusted hazard ratio for overall survival benefit with temozolomide (Temodar) plus radiation therapy was 0.39 (95% CI 0.24 to 0.63) in patients taking valproic acid, according to Michael Weller, MD, of University Hospital Zurich in Switzerland, and colleagues.
In comparison, similarly treated patients who received an enzyme-inducing anti-epileptic drug, such as carbamazepine, had an adjusted HR for overall survival of 0.69 (95% CI 0.53 to 0.90).
Those receiving valproic acid also fared better than patients not on any anti-epileptic agent, who had an HR of 0.67 (95% CI 0.49 to 0.93), the investigators reported in the Sept. 20 issue of Neurology. ... http://www.medpagetoday.com/Neurology/BrainCancer/28304

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RANDOM FACTS: The Caspian Tiger was the third largest tiger species. The last of this tiger was seen in 1970, after which it has been
declared amongst the extinct animal species. This tiger was found on the lands of Iran, Iraq, Afghanistan, Turkey, Mongolia, Kazakhstan, Caucasus, Tajikistan, Turkmenistan and Uzbekistan.

Bonus Fact: Aurochs was a large-sized cattle-species. It is recorded to have gone into extinction in 1627. It is said that this cattle evolved from India, migrating to the Middle-East, reaching Europe.
(Wonder just how much "we" helped them to become extinct-- bet we had a large part in that play).
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A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase, "or the risk thereof" includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Such events are called "sentinel" because they signal the need for immediate investigation and response. For more information see Sentinel Event Policy and Procedures.
Sentinel Event Alert, Issue 45: Preventing violence in the health care setting
Once considered safe havens, health care institutions today are confronting steadily increasing rates of crime, including violent crimes such as assault, rape and homicide. As criminal activity spills over from the streets onto the campuses and through the doors, providing for the safety and security of all patients, visitors and staff within the walls of a health care institution, as well as on the grounds, requires increasing vigilant attention and action by safety and security personnel as well as all health care staff and providers. ...
http://www.jointcommission.org/sentinel_event_alert_issue_45_preventing_violence_in_the_health_care_setting_/
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RANDOM FACTS: Last year Treasury printed more $100 bills than dollar bills for the first time. There are now more than seven billion pictures of Benjamin Franklin in circulation.

Bonus Fact: Thanks to technological advances, the average dollar bill now circulates for 40 months, up from 18 months two decades ago, according to Federal Reserve estimates.
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Study questions testosterone's link to early death (Reuters) Drooping testosterone levels probably don't cut years off a man's life, although earlier studies had suggested they might, according to a new report.
Instead, decreases in the male sex hormone may simply be a sign of overall health status, which also dips with age, researchers say.
The findings come in the wake of surging interest in testosterone's role in men's sex drive, their mood and thinking, and even early death.
While drug companies refer to "low T" as a treatable medical problem affecting millions of American men, critics say they are trying to make a buck by turning normal aging into a disease. ...
http://www.reuters.com/article/2011/08/19/us-testosterone-study-idUSTRE77H78A20110819?feedType=nl&feedName=ushealth1100
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Method to Detect When Patients Wake During Surgery Fails to Impress Tool looking at exhaled anesthesia superior to brain monitoring, study finds
WEDNESDAY, Aug. 17 (HealthDay News) -- A newer technology intended to alert doctors when patients are regaining consciousness while under anesthesia is no better than conventional monitoring systems in lowering the incidence of "anesthesia awareness," new research shows.
In fact, the newer system -- which measures electrical activity in the brain and is known as bispectral index (BIS) monitoring -- actually picked up on fewer incidents than the standard system, which measures the amount of anesthesia when a patient exhales.
Anesthesia awareness takes place when a patient under general anesthesia can remember what happened during surgery. It occurs in up to 1 percent of high-risk patients, or 20,000 to 40,000 U.S. patients a year.... http://consumer.healthday.com/Article.asp?AID=655991
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Nocturnal Acute Coronary Syndrome Linked to Belly Fat, Disordered Sleep
Nighttime acute coronary syndrome (ACS) occurred significantly more often in patients with visceral fat accumulation and sleep-disordered breathing, investigators reported.
Among 25 patients with nighttime onset of ACS, two-thirds of those with ≥100 cm2 of visceral fat accumulation also had sleep-disordered breathing as compared with a fourth of patients with less visceral fat. ...
http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/28117?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=379846
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#65 Time is money... On average, coupon users save $8.00 per supermarket visit from 13 minutes of clipping--more than $400/year, according to the coupon industry. Those who devote 20 minutes/week to the task shave their annual grocery bill by nearly
$ 1,000.00.

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HUMOR SECTION

A High-School student stared thoughtfully at the second question on his exam, which read, "State the number of tons of coal shipped out of America in any given year."
Suddenly, his brow cleared, and he wrote.............." 1492 None".
***
Two sisters are we, one dark and one fair.
In twin towers dwelling, we're quite the pair.
One from the land and one from the sea.
Tell us truly, who are we?

(don't cheat, now)

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ANSWER: Salt and pepper.

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

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

Pay Only $34.99 for a full year of CONTACT HOURS

www.nurse.com for CNE offerings.

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

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

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

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

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

I receive these notices from FDA regularly. Let me know if you want them included in the newsletter , please. These recalled items are primarily food products: http://www.fda.gov/Safety/Recalls/EnforcementReports/ucm270461.htm

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

Ripoff Reports: http://www.ripoffreport.com This is a consumer reporting Web site and publication, by consumers, for consumers, to file and document complaints about companies or individuals. Unlike the Better Business Bureau, Ripoff Report does not hide reports of "satisfied" complaints. All complaints remain public and unedited in order to create a working history on the company or individual in question.

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm

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

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*
MEDICAL RECALLS
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SATURN Statin Trial a Dead Heat Rosuvastatin (Crestor) failed to beat atorvastatin (Lipitor) for improving atheroma volume in a large head-to-head trial, the drug's manufacturer reported. AstraZeneca issued a terse statement outlining the top-line results of the trial.
"The results for the primary efficacy measure, which was change from baseline in percent atheroma volume in a ≥40 mm segment of the targeted coronary artery as assessed by intravascular ultrasound (IVUS), demonstrated a numerically greater reduction in favor of Crestor versus atorvastatin but did not reach statistical significance," the statement said.
The two-year SATURN study compared 40 mg/day of rosuvastatin to 80 mg/day of atorvastatin in some 1,300 patients.
However, the company said, rosuvastatin treatment did lead to a significantly greater reduction in the trial's secondary efficacy measure, total atheroma volume within the targeted coronary artery.
AstraZeneca's statement did not give numerical results. It said the data and interpretations would be presented at the American Heart Association's scientific meeting in November. http://www.medpagetoday.com/Cardiology/Atherosclerosis/28333
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FDA Reviewer Slams Xarelto for Stroke Prevention in Afib
WASHINGTON -- Rivaroxaban (Xarelto) is not as effective as warfarin for preventing strokes in patients with atrial fibrillation and should not be approved for the new indication, according to an FDA reviewer.
That opinion was set forth in briefing documents prepared for the FDA's Cardiovascular and Renal Drugs Advisory Committee meeting Thursday. The committee will review Johnson & Johnson's application to extend marketing approval for its direct oral factor Xa inhibitor rivaroxaban to include prevention of stroke and systemic embolism in patients with nonvalvular approved atrial fibrillation.
But, in its briefing documents the company argued that the "benefits of treatment with rivaroxaban clearly outweigh the risks when compared with warfarin therapy."
Results from the company-sponsored ROCKET-AF study found that rivaroxaban (Xarelto) was at least as good as warfarin for stroke prevention in atrial fibrillation, with a similar rate of major bleeding and greater ease of use. Johnson & Johnson is seeking approval that indicates their drug works better at preventing strokes than warfarin. ...
http://www.medpagetoday.com/Cardiology/Strokes/28367
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FDA Warns of New Infections With TNF Blockers
The Food and Drug Administration has updated the boxed warning for all tumor necrosis factor-alpha (TNFα) inhibiting drugs to reflect the risk of infection from the bacteria Legionella and Listeria.
There now have been more than 100 cases of infection with these pathogens, according to the agency.
The TNFα inhibitors licensed in the United States are infliximab (Remicade), etanercept (Enbrel), adalimumab (Humira), certolizumab pegol (Cimzia), and golimumab (Simponi).
The drugs are used to treat rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and juvenile idiopathic arthritis.
Serious infections involving viral, bacterial, and mycobacterial pathogens are a recognized risk of treatment with these and other immunosuppressive drugs.
A total of 80 cases of Legionella pneumonia have been reported to the FDA among patients receiving TNFα inhibitors, most often for rheumatoid arthritis. ... http://www.medpagetoday.com/ProductAlert/Prescriptions/28396

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NURSING HINTS CORNER
Tape Prep: Before taping a NG (nasogastric) tube to a patient's face, wipe the area with a Skin-Prep swab pad. This will remove oil from the skin, so the tape will stick better. Let the invisible residue dry for 30 + seconds before applying tape. (this skin prep also works beautifully when applying a Texas catheter--no sting). Cynthia Mace Mills, RN, MSN

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.151, Springhouse Corporation/www.springnetcom. ;

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

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

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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.... So please send me your new name/address, okay? RNFrankie@AOL.com

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

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

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

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THOUGHT FOR THE DAY

What we leave behind is not
what is engraved in stone monuments,
but what is woven into the lives of others.
--Pericles

Hope to see you online..... Frankie
RNFrankie@AOL.com

PARADIGM BYTES August 2011

2011-08-09T18:15:00.000-07:00

PARADIGM BYTES
Newsletter for Paradigm 97
August 10,2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

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

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SNIPPETS

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

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FROM THE MEMBERS

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

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

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

**Starting with this issue, I am inserting excerpts from an article "99 ways to save money". Hope you enjoy them. **
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Diabetes survey finds few follow through on lifestyle changes
A survey of 3,867 people with type 2 diabetes found that 87% knew obesity made their disease worse but only 70% said they had tried to lose weight, and only a third had maintained their goal weight for half a year. Researchers who reported the results at the American Diabetes Association conference found that 63% of people said their physician recommended they increase physical activity, but only 13% said they had been active during the past week. ... http://diabetes.webmd.com/news/20110629/survey-diabetes-patients-dont-change-lifestyle
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Archimedes' nasal-spray version of fentanyl gets FDA Okay The FDA approved Archimedes Pharma's fentanyl nasal spray Lazanda to relieve breakthrough pain in opioid-tolerant cancer patients aged 18 and older. It is indicated for patients aged 18 years and older who are already receiving opioid therapy but who have developed resistance to their regimen.Archimedes expects to launch the product this year through the FDA's Risk Evaluation and Mitigation Strategy program.
Fentanyl nasal spray is already available in 5 European countries, where it is marketed as PecFent (fentanyl pectin nasal spray).

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

DOI: 10.1080/07399332.2010.532577

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

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

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

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

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

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

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

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

Can In-Hospital Falls Really Be Prevented?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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HUMOR SECTION
ROUGH LANDING

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

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

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

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

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

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

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WEBSITES/ LINKS

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

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

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

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

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

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

http://www.snopes.com

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

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

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

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

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

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

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

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

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

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NURSING HINTS CORNER

A Viewpoint on Catheterization

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

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

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

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

No new members this edition

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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number ? So please send me your new name/address, okay?
RNFrankie@AOL.com

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

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

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

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THOUGHT FOR THE DAY
Now this is a Nurse !

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

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

RNFrankie@AOL.com

PARADIGM BYTES July 2011

2011-07-15T08:13:00.000-07:00

PARADIGM BYTES
Newsletter for Paradigm 97
July 12, 2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.

MISSION STATEMENT

We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
+++++++++++++++++++++
The following was written by MarGerlach (Marlene):
It is with great sadness that we must tell you of the death of one of our charter members, Melva Solon (MJSolon @aol.com) on July 8th. Those of you who have been with us since the birth of Paradigm97 in 1997 will no doubt remember her. In reference you may remember because we highlighted the birth of her granddaughter "Baby Angela" in our weekly e-mailed Newsletter at that time. Angela (dubbed, "Little Bit") was born October 20, 1999 at 25 weeks and weighed 1# 10 oz. We published photos and updates for seven months as this little girl struggled and won and is now a healthy 11 year old. Well, her grandma knew struggle also as she watched and helped this little miracle baby grow and become healthy. Melva had her own struggle as she had fought cancer for many years. The best of treatments and all our prayers were eventually not enough and she passed away on July 8th while in hospice care these last few weeks. She was a good friend, and a remarkable and caring person. Her great faith sustained her. Our thoughts and prayers go out to her husband, daughter, granddaughter and siblings and to all who loved her as we did. May she rest in peace.
(I also consider her one of my good online friends...and will really miss her).
Obituary at:
http://www.mywebtimes.com/archives/ottawa/display.php?id=436368

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SNIPPETS
Vitamin D Can Help Elderly Women Survive (must be D3)

Giving vitamin D3 (cholecalciferol) to predominantly elderly women, mainly in institutional care, seems to increase survival. These women are likely to be vitamin D deficient with a significant risk of falls and fractures. This is the key conclusion in a systematic review published in the latest edition of The Cochrane Library.

Up until now there has been no clear view on whether there is a real benefit of taking vitamin D. “A Cochrane meta-analysis published only a couple of years ago found that there was some evidence for benefit, but it could not find an effect on mortality. We were, however, aware that more trials had been published and wanted to assess the effects of vitamin D when you added all the data together,” said Dr Goran Bjelakovic, who works at Department of Internal Medicine - Gastroenterology and Hepatology, at the University of Nis, in Serbia and at The Cochrane Hepato-Biliary Group at The Copenhagen Trial Unit in Copenhagen, Denmark.

The eight-strong international team of researchers identified 50 randomised trials that together had 94,148 participants. They had a mean age of 74 years, and 79% were women. “Our analyses suggest that vitamin D3 reduces mortality by about 6%. This means that you need to give about 200 people vitamin D3 for around two years to save one additional life,” says Bjelakovic.

There were no significant benefits of taking other forms of vitamin D such as vitamin D2, and the active forms of the vitamin, alfacalcidol or calcitriol. However, the researchers point out that they could only find much less data relating to these types of vitamin D and so these conclusions should be taken with caution. “We need to have more randomised trials that look specifically to see whether these forms of vitamin D do or don’t have benefits,” says Bjelakovic. His team did conclude that alfacalcidol and calcitriol significantly increased the risk of hypercalcaemia, and vitamin D3 combined with calcium significantly increased the risk of kidney stones.

There have been reports and comments that taking vitamin D can reduce the risk of getting cancer, but this work showed no evidence that vitamin D reduced cancer-related mortality.

“Previous reviews of preventive trials of vitamin D have not included as much information and have not examined the separate influence of different forms of vitamin D on mortality. By taking data from a larger number of trials we have been able to shed much more light on this important issue,” says Bjelakovic.

Full citation: Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database of Systematic Reviews 2011, Issue 7. Art. No.: CD007470. DOI: 10.1002/14651858.CD007470.pub2.
URL Upon publication: http://doi.wiley.com/ 10.1002/14651858.CD007470.pub2

So What? An Invitation to Nurses To Tell Us How They’re Translating Research into Practice
by jm
By Inge B. Corless, PhD, RN, FAAN, professor at the MGH Institute of Health Professions, Boston, and Brian Goodroad, DNP, RN, AACRN, nurse practitioner and associate professor at Metropolitan State University in Minneapolis–St. Paul, Minnesota

Crossing the Quality Chasm, an Institute of Medicine report from 2001, bemoans the chasm between our current research knowledge and the current state of care. Back in 2003, Don Berwick, now the Administrator of the Centers for Medicare and Medicaid Services, provided the following pithy codification of the problem in a JAMA article called “Disseminating Innovations in Health Care” (subscription required; click here for the abstract): “Failing to use available science is costly and harmful; it leads to overuse of unhelpful care, underuse of effective care, and errors in execution.” Berwick pondered the slow pace of innovation adoption and attributed it to three factors:

the characteristics of the innovation
the characteristics of the potential adopters
contextual factors

Berwick also made this observation about innovations that do get adopted: “Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all.”
Given these obstacles, what can be done to facilitate the integration of research findings into practice? What can be done to change this situation, and what would this entail?
One step is to share our knowledge and our successes in making changes, along with the obstacles to doing so. We invite nurses to identify research that has changed or somehow influenced their practice and to share their experiences with us for potential publication on this blog. We’re not asking for formal academic work here; what’s we’d like is simple, brief (one to five paragraphs) summary description in your own voice. Briefly describe the study and its findings, as you understand them—and then describe how the findings were integrated into practice and any outcomes (whether they were formally measured or anecdotally reported).
These summaries will not be peer-reviewed like AJN‘s print articles, but they will be open to reader comments, which authors can choose to respond to if they wish. We also invite nurse researchers to describe their studies and amplify the implications for practice, discussing what might facilitate integration into practice as well as potential obstacles. (Editor’s note: please send all submissions or inquiries to Inge Corless at this e-mail address: icorless@mghihp.edu. She will review submissions and pass those that seem appropriate along to us here at the blog.)
Nursing is responsible for advancing the state of the science and the integration of science into practice. Our goal in initiating this blog series is to speed the integration of important research findings into practice as well as help those findings already in limited practice to become more widely adopted.
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(PLEASE, read the entire article; keep in mind she is a major advocate for the nursing image in the media)

Lucky Charms
June 2011 -- Recently the drug company Johnson & Johnson (J&J) released a new batch of television advertisements as part of its
Campaign for Nursing's Future, which began in 2002 as an effort to address the nursing shortage. The three new 30-second ads, like those
released in 2005 and 2007, highlight different aspects of nursing practice and do a good job at promoting diversity. Each of the new ads also
conveys something helpful about nursing skill. Unfortunately, each ad focuses mainly on the emotional support nurses give patients, and each
concludes with the vaguely uplifting message "NURSES HEAL." One ad features an authoritative ED nurse reacting quickly to a trauma case,

but even that ad is dominated by the nurse's returning of a lucky charm to the patient. And the other two ads will strike viewers as being mostly

about hand-holding, by a hospice nurse and a pediatric nurse. Thus, despite some positive elements, each ad subtly reinforces the enduring

image of nurses as low-skilled angels. The nursing crisis did not happen because people forgot that nurses hold hands. What decision-makers

need to know is that nurses are autonomous life-saving professionals who need respect and resources, and in this regard the new ads are

actually a step backwards from the 2007 ones. The new ads do at least omit the baby-soft voiceover and sappy music, which undermined

the prior ads' good elements with vapid lyrics about how nurses "dare to care."
The new ads are also more subtle about promoting J&J itself, though that cuts both ways; it distracts viewers less from the good
and bad aspects of the ads. In any case, we thank J&J for its continued efforts to promote nursing, and we urge the company to focus
more closely on telling the public that nurses are health experts who save lives. more.... ( I, for one, find this ad exceedingly irritating
and frustrating....glad that Sandy is at the forefront in fighting this stuff. )
http://www.truthaboutnursing.org/media/commercials/jnj_2011.html

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MEDICAL NEWS

ISMP Webinar: On July 26, ISMP will present Exploring Medication Safety Off the Beaten Path: Unique Medication Safety Challenges in Diagnostic and Procedural Areas. Have medication safety improvements been made in areas such as invasive radiology, GI suites, perioperative areas, or ambulatory clinics? Take a tour of these distinct locations with ISMP consulting staff to learn what unique medication safety risks have been uncovered "off the beaten path." For details, visit: www.ismp.org/educational/webinars.asp.

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INTERESTING READING

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

Buttock site still most popular despite known potential for sciatic nerve injury

Seven out of ten hospital nurses who took part in a Canadian study used the dorsogluteal (DG) buttock site to administer intramuscular injections - despite the potential risks of sciatic nerve injury - with only 14% using the ventrogluteal (VG) hip site recommended by the nursing literature.
The research, published in the May issue of the Journal of Advanced Nursing, found that younger, newer nurses were significantly more likely to follow the latest VG site advice than their older, experienced colleagues. It also discovered that more than one in four nurses using the DG site were unaware of the potential risk of nerve damage.
Just over 40% of the staff nurses surveyed responded to the postal questionnaire. Most of the 264 respondents were aged between 30 and 49 years and had been working in nursing for more than ten years.
"Recent nursing literature suggests that the VG site is preferable because it is located away from major nerves and muscles, can provide better access to muscle tissue and offers faster medication uptake" says lead author Lorna Walsh, a nurse educator at the Centre for Nursing Studies, St John's, Canada.
"It's estimated that more than twelve billion intramuscular injections are administered every year throughout the world and unsafe injection practices have a significant impact on patient ill health and death. Complications can include skin and tissue trauma, muscle fibrosis and contracture, nerve palsies and paralysis, abscesses and gangrene. ... http://www.eurekalert.org/pub_releases/2011-05/w-mnd050911.php
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Benefit of mammograms even greater than thought
CHICAGO (Reuters) - The longest-running breast cancer screening study ever conducted has shown that regular mammograms prevent deaths from breast cancer, and the number of lives saved increases over time, an international research team said on Tuesday.
The study of 130,000 women in two communities in Sweden showed 30 percent fewer women in the screening group died of breast cancer and that this effect persisted year after year. Now, 29 years after the study began, the researchers found that the number of women saved from breast cancer goes up with each year of screening. ...
http://www.reuters.com/article/2011/06/28/us-cancer-breast-mammograms-idUSTRE75R0NM20110628?feedType=nl&feedName=ushealth1100
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TODAY'S THRIFTY TIP: To determine your debt burden, add up all of your monthly consumer debt obligations and minimum required
payments (not counting your mortgage). Include car loans, college loans and credit cards. If the total consumes 15 to 20
percent or more of your paycheck, you need to take measures to reduce your debt, say financial planners.

Also, look for other signs of a high debt burden, such as borrowing to pay for necessities, missing payments or making
late payments, being turned down for credit or neglecting to save for retirement or other financial goals.

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RANDOM FACTS: (1) James Bond wasn't a successful book series in America until JFK included From Russia with Love on a list of
his favorite books in 1961. (2) Casino Royale is the first Bond film not to feature a female dancing silhouette in the opening titles.

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Lawyers weigh in on consistent use of smart pump libraries. As noted in our April 19, 2007 article, “Smart pumps are not smart on their own” (www.ismp.org/Newsletters/acute care/articles/20070419.asp), clinicians should not view the dose-checking feature of smart pumps as an option that can be turned on or off. Nor should the alerts that arise from the system be bypassed without serious consideration. ...
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(The following is a repeat from March issue---but good info) Before dialing, check out DialAHuman.com or GetHuman.com, which list
customer service numbers and give instructions on how to bypass automated prompts to reach a LIVE representative. With another free service, LucyPhone.com, you can avoid being placed on hold. You enter the company's name of phone
number and your number and hit "start". Lucy-phone connects you to the company's line, where you pick an option for getting a live rep. You hang up and get a callback when a person is actually on the line.

I checked out DialAHuman.com ( http://dialahuman.com/ ) ---- looks to be very good. I did not try the Lucy suggestion. I hate the automated recordings......they take forever .

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Birth Defects caused by World's Top- Selling Weedkiller, Scientists Say
WASHINGTON -- The chemical at the heart of the planet’s most widely used herbicide -- Roundup weedkiller, used in farms and gardens across the U.S. -- is coming under more intense scrutiny following the release of a new report calling for a heightened regulatory response around its use.
Critics have argued for decades that glyphosate, the active ingredient in Roundup and other herbicides used around the globe, poses a serious threat to public health. Industry regulators, however, appear to have consistently overlooked their concerns.
A comprehensive review of existing data released this month by Earth Open Source, an organization that uses open-source collaboration to advance sustainable food production, suggests that industry regulators in Europe have known for years that glyphosate, originally introduced by American agricultural biotechnology giant Monsanto in 1976, causes birth defects in the embryos of laboratory animals. ... http://www.huffingtonpost.com/2011/06/24/roundup-scientists-birth-defects_n_883578.html?ncid=webmail2
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Secret number one: Turn down your thermostat a smidge. Sounds odd, right? Yet studies indicate that cozy indoor temps may inhibit calorie-burning because your body will burn extra calories to keep warm. But not if it's feeling toasty. Research suggests that keeping temps below 68 degrees Fahrenheit may help fire up your metabolism. (Here's how to set up your kitchen for weight loss success.)
Secret number two: Go to bed early. A lack of sleep throws appetite hormones into gimme-more mode. Poor sleep also affects blood sugar and insulin levels in a way that can increase the risk of excessive weight gain. Your goal: 7 to 8 hours of nightly shut-eye, day in and day out. (Find out how else sleep loss affects your health.)
Secret number three: Cut down your dinners out to once a month. In the study, eating just one restaurant meal per week upped the risk of obesity by 50 percent. Preparing meals at home allows you to control fat, sugar, and salt content -- and let's you know exactly what you're eating. (Check out our collection of low-fat recipes that taste as good as restaurant meals.) Reference: Contributors to the obesity and hyperglycemia epidemics. A prospective study in a population-based cohort. Bo, S. et al., International Journal of Obesity 2011 Feb 1.
http://www.realage.com/tips/how-to-get-slim-without-exercise?eid=1098938002&memberid=4687812
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(This was sent in by Kurt Ullman......Thank you, Kurt) The medical aspects of radiation incidents (Rev. ed.)
http://orise.orau.gov/files/reacts/medical-aspects-of-radiation- incidents.pdf
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Resident doctors still work too long: report First-year residents may soon get a reprieve from grueling hospital shifts that last more than 24 hours, but that is not enough to prevent an alarming number of medical errors, according to a report released on Friday.
Starting July 1, new rules will require first-year residents to work shifts no longer than 16 straight hours. But that will not spare more experienced residents from working as long as 28 hours at a stretch.
A group of 26 doctors and patient safety experts are calling for limiting all resident physician work to shifts of 12 to 16 hours. Their report was published on Friday in the journal Nature & Science of Sleep journal. ...
http://www.reuters.com/article/2011/06/24/us-doctors-idUSTRE75N0ND20110624?feedType=nl&feedName=ushealth1100
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RANDOM FACT: In the early 1900s, aspirin maker Bayer also commercially developed and sold heroin for medicinal uses.
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CANCER FACTS AND FIGURES:
Provides the estimated numbers of new cancer cases and deaths in 2011 as well as cancer incidence, mortality, and survival statistics and information on cancer symptoms, risk factors, early detection, and treatment. The topic of the special section is cancer disparities and avoidable premature cancer deaths. Also available, the most requested tables and figures.
DOWNLOAD Cancer Facts & Figures 2011 [PDF version, 1,400 KB] http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2011
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How to Outsmart the Obesity Gene: Not a lot of size 6's in your family? Well, then, here's the simple trick to outrunning your
obesity genes: movement.
In a study of people genetically predisposed to obesity, those who were the most active managed to seriously alter their body's predisposition to gain weight. They were far less likely to pack on pounds over time compared with the least active in the study.
Handling Heavy DNA
In the recent study, researchers found 12 genes that increased the risk of obesity. And every obesity gene people had correlated to extra weight gain. Still, although certain genes made them more susceptible to obesity, participants were not slaves to their DNA.... Reference: Physical activity attenuates the genetic predisposition to obesity in 20,000 men and women from EPIC-Norfolk prospective population study. Li, S. et al., PLoS Medicine 2010 Aug 31;7(8). pii: e1000332.
http://www.realage.com/tips/obesity-gene-exercise-to-lose-weight?eid=7236&memberid=4687812
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Rethinking what is edible....
When most people think of healthy foods, they think of choices like colorful kiwi fruit and pineapple, perfectly juicy oranges, and bright, fresh broccoli and squash. Of course, missing from that picture are the parts of those superfoods that you may often discard, such as the skin of the kiwi and the hard core of the pineapple. But before you toss out these food parts, dietitians say, it’s time to reconsider what you’re cutting away. Many of these pared-off parts of fruits and veggies are positively brimming with antioxidants, and eating them can boost your health. ... ( Page 1 of 8 )
http://www.everydayhealth.com/diet-and-nutrition-pictures/rethinking-whats-edible.aspx?xid=aol_eh-nutr_1-_20110613&aolcat=DFT&ncid=webmail5
*************************

One in three multivitamins don't have claimed nutrients A new review of popular multivitamins found that almost a third did not contain the amount of nutrients claimed in their labels. After testing 60 multivitamins, researchers at ConsumerLab.com found many had either too much or too little of specific nutrients.
After testing 38 multivitamins for a new report published online this week, researchers at ConsumerLab.com discovered that eight contained too little of specific nutrients, two contained more nutrient than claimed and three improperly listed ingredients. The good news: some of the best vitamins were also the cheapest. (check out results for children's vitamins) ... http://www.msnbc.msn.com/id/43429680/ns/health-diet_and_nutrition/
**************************

Donors pledge 4.3 Billion for Vaccines for the poor (Reuters) International donors led by Britain and Bill Gates pledged $4.3 billion on Monday to buy vaccines to protect children in poor countries against potential killers such as diarrheal diseases and pneumonia.
The funding should allow more than 250 million of the world's poorest children to be vaccinated by 2015, helping to prevent more than four million premature deaths, the Global Alliance for Vaccines and Immunisation (GAVI) said. ... http://www.reuters.com/article/2011/06/13/us-vaccines-donors-idUSTRE75C1FV20110613?feedType=nl&feedName=ushealth1100

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Breastfeeding linked to lower risk of SIDS Babies who are breastfed- especially those who are fed only breast milk, and not formula as well--are less likely to die of Sudden Infant Death Syndrome (SIDS) suggests a new analysis of past studies. While the findings can't prove that breastfeeding causes the lower risk of SIDS, the authors write in Pediatrics that other explanations seem unlikely. "Breastfeeding is the best method of feeding infants," said Dr. Fern Hauck, the study's lead author from the University of Virginia School of Medicine in Charlottesville. ...
http://www.reuters.com/article/2011/06/14/us-breastfeeding-sids-idUSTRE75C2V220110614?feedType=nl&feedName=ushealth1100
***********************
RANDOM FACT: 84% of a raw apple and 96% of a raw cucumber is water.
*****
RANDOM FACT: The rose family of plants, in addition to flowers, gives us apples, pears, plums, cherries, almonds, peaches and apricots.
*******

Original Research: Tragedy into Policy: A Quantitative Study of Nurses' Attitudes Toward Patient Advocacy Activities.
Black, Lisa M. AJN The American Journal of Nursing, June 2011,111(6):26-35

Although the Centers for Disease Control and Prevention (CDC) reports that an estimated 3.2 million Americans are living with chronic hepatitis C, in southern Nevada fewer than four cases of acute hepatitis C are confirmed annually.1, 2 So when six people who had recently undergone endoscopic procedures were diagnosed with acute hepatitis C within a six-month period (July 2007 to December 2007), alarms were sounded.1 Ultimately, more than 62,000 patients who had undergone endoscopic procedures at either of two southern Nevada endoscopy clinics would be notified that they might have been exposed to bloodborne pathogens, including hepatitis B virus, hepatitis C virus (HCV), and HIV, as a result of unsafe injection practices. ... ( I, for one, would have reported it no matter what the consequences would be. )
http://journals.lww.com/ajnonline/Fulltext/2011/06000/Original_Research__Tragedy_into_Policy__A.23.aspx?WT.mc_id=EMxALLx20100222xxFRIEND
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If the current actions contributing to a multifaceted degradation of the world's oceans aren't curbed, a mass extinction unlike anything human history has ever seen is coming, an expert panel of scientists warns in an alarming new report.
The preliminary report from the International Programme on the State of the Ocean (IPSO) is the result of the first-ever interdisciplinary international workshop examining the combined impact of all of the stressors currently affecting the oceans, including pollution, warming, acidification, overfishing and hypoxia.
“The findings are shocking," Dr. Alex Rogers, IPSO's scientific director, said in a statement released by the group. "This is a very serious situation demanding unequivocal action at every level. We are looking at consequences for humankind that will impact in our lifetime, and worse, our children's and generations beyond that."
The scientific panel concluded that degeneration in the oceans is happening much faster than has been predicted, and that the combination of factors currently distressing the marine environment is contributing to the precise conditions that have been associated with all major extinctions in the Earth's history. ...
http://www.huffingtonpost.com/2011/06/20/ipso-2011-ocean-report-mass-extinction_n_880656.html?icid=maing-grid7|main5|dl2|sec1_lnk2|71953
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Is this an END TO AIDS?
- For his doctors, Timothy Ray Brown was a shot in the dark. An HIV-positive American who was cured by a unique type of bone marrow transplant, the man known as "the Berlin patient" has become an icon of what scientists hope could be the next phase of the AIDS pandemic: its end.
Timothy Ray Brown was living in Berlin when besides being HIV-positive, he had a relapse of leukemia. He was dying. In 2007, his doctor, Gero Huetter, made a radical suggestion: a bone marrow transplant using cells from a donor with a rare genetic mutation, known as CCR5 delta 32. Scientists had known for a few years that people with this gene mutation had proved resistant to HIV.
"We really didn't know when we started this project what would happen," Huetter, an oncologist and haematologist who now works at the University of Heidelberg in southern Germany, told Reuters. The treatment could well have finished Brown off. Instead he remains the only human ever to be cured of AIDS. "He has no replicating virus and he isn't taking any medication. And he will now probably never have any problems with HIV," says Huetter. Brown has since moved to San Francisco. ... http://www.reuters.com/article/2011/06/01/us-aids-idUSTRE75030I20110601?feedType=nl&feedName=ushealth1100
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Alzheimer's diagnostic guidelines updated for first time in decades
NIH-supported revision also proposes staging of disease, potential use of biomarkers

For the first time in 27 years, clinical diagnostic criteria for Alzheimer's disease dementia have been revised, and research guidelines for earlier stages of the disease have been characterized to reflect a deeper understanding of the disorder. The National Institute on Aging/Alzheimer's Association Diagnostic Guidelines for Alzheimer's Disease outline some new approaches for clinicians and provides scientists with more advanced guidelines for moving forward with research on diagnosis and treatments. They mark a major change in how experts think about and study Alzheimer's disease. Development of the new guidelines was led by the National Institutes of Health and the Alzheimer’s Association.
The original criteria were the first to address the disease and described only later stages, when symptoms of dementia are already evident. The updated guidelines announced today cover the full spectrum of the disease as it gradually changes over many years. They describe the earliest preclinical stages of the disease, mild cognitive impairment, and dementia due to Alzheimer's pathology. Importantly, the guidelines now address the use of imaging and biomarkers in blood and spinal fluid that may help determine whether changes in the brain and those in body fluids are due to Alzheimer's disease. Biomarkers are increasingly employed in the research setting to detect onset of the disease and to track progression, but cannot yet be used routinely in clinical diagnosis without further testing and validation. ...
http://www.nih.gov/news/health/apr2011/nia-19.htm
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[Thank you, Barbara (BAcello)] FDA approves rapid MRSA/MSSA test The U.S. Food and Drug Administration has approved a blood culture test
that can determine if Staphylococcus aureus bacteria infections are methicillin resistant (MRSA) or methicillin susceptible (MSSA).
http://haymarket.puresendmail.com/hmiclick/4x0i9x5Rbc4q36Rg7a2RtsqrgoRd3m2R9ygzwf/1/35468?DCMP=EMC-MCK_Daily

(I have not found free full text yet. This link is to an abstract--and you
can purchase the complete article for $12..........BA)

*************
Workplace bullying hurts morale -- and patients
Though most doctors act with respect for other hospital staff, bullying is not unheard of, and it can be passed down to the rest of the
organization, oncology nurse Theresa Brown writes. Being insulted by a fellow provider reinforces a false stereotype of nurses and
creates a negative workplace environment that in turn affects patient care, she writes. The New York Times (tiered subscription model) (5/7) ...
http://www.nytimes.com/2011/05/08/opinion/08Brown.html?_r=1

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

Sleep Strategy Commonly Used by Night Nurses Throws Off Their Circadian Clocks
ScienceDaily (Apr. 14, 2011) — As many as 25 percent of hospital nurses go without sleep for up to 24 hours in order to adjust
to working on the night shift, which is the least effective strategy for adapting their internal, circadian clocks to a night-time schedule.
http://www.sciencedaily.com/releases/2011/04/110414131933.htm
************

CDC updates guidelines on preventing catheter-related infections The CDC has released new guidelines for preventing bloodstream infections
among patients using intravenous catheters. The guidelines, which update the 2002 guidelines, touch on various strategies for prevention
such as more training for health care staff and the use of maximum sterile barrier measures during central venous catheter insertion.
Modern Healthcare (free registration) (4/1)

This Medscape article provides a more thorough overview: http://www.medscape.com/viewarticle/740137
The complete guideline may be downloaded from: http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf

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

ELDER JUSTICE ACT – REPORTING OF CRIMES IN FEDERALLY FUNDED LONG TERM CARE
FACILITIES Benesch Friedlander Coplan & Aronoff LLP
Sections §6701 to §6703 of the Patient Protection and Affordable Care Act of 2010, H.R. 3590 ("PPACA") include requirements
for reporting of crimes in federally funded long term care facilities.

Long term care facilities or nursing homes have heard very little about the reporting obligations because it has not been clear which federal
agency was responsible for implementation and guidance relating to the provisions. In recent private correspondence, the Centers for
Medicare and Medicaid Services ("CMS") has commented that it will take the lead on implementation and will have some guidance
out in the coming months.
The statutory obligations provide that "covered individuals" in long-term care facilities that receive a minimum of $10,000 in federal
funding must report to the Secretary of DHHS and one or more local law enforcement entities - any reasonable suspicion of a crime (as
defined by local law) against any individual who is a resident of, or is receiving care from, the facility.
http://www.lexology.com/r.ashx?i=2733977&l=7F6WNJ4

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Medicare releases report on preventable errors at hospitals
Medicare has released data on eight serious and preventable medical errors that occurred at more than 4,700 U.S. hospitals,based on
billing reports for Medicare patients from 2008 to 2010. Falls were the most common preventable error at hospitals, occurring at a rate of
one for every 2,000 patient stays, followed by severe bedsores or skin ulcers, according to the report. St. Louis Post-Dispatch (4/7)
http://www.stltoday.com/lifestyles/health-med-fit/fitness/article_9a03e00b-8ae7-5bd4-8b9d-b4b7bc85b3d7.html
http://tinyurl.com/3kolpen
*************
Some tools may underestimate hospital adverse events: Researchers looking at data on about 800 inpatients from three hospitals
in 2004 found 393 adverse events. The Institute for Healthcare Improvement's Global Trigger Tool found 354 of the events, while the
tool used by the Agency for Healthcare Research and Quality only detected 35 events and voluntary reporting from the hospitals
only found four events. Researchers cautioned that hospitals "may be seriously misjudging actual performance" in their
voluntary reports. Modern Healthcare (free registration) (4/7)
https://home.modernhealthcare.com/clickshare/authenticateUserSubscription.do?

CSProduct=modernhealthcare&CSAuthReq=1:373432962137841:AID|IDAID=20110407/NEWS/
304079961|ID=:54339D7D08CE4B670E16AA58C49D5B96&AID=20110407/NEWS/304079961&title=
Adverse-event%20figures%20could%20be%20far%20higher%3A%20study&ID=&CSTargetURL=
http%3A%2F%2Fwww.modernhealthcare.com%2Fapps%2Fpbcs.dll%2Flogin%3FAssignSessionID%
3D373432962137841%26AID%3D20110407%2FNEWS%2F304079961

http://tinyurl.com/3swtxy5

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The HHS Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis In response to the IOM report released last year, Assistant Secretary for Health Dr. Howard Koh created a workgroup made up of U.S. Department of Health and Human Services (HHS) experts and charged them with developing a comprehensive strategic plan for viral hepatitis prevention and control. The resulting action plan is entitled, Combating the Silent Epidemic: U.S. Department of Health and Human Services Action Plan for the Prevention, Care and Treatment of Viral Hepatitis, and was released on May 12th.
The Action Plan covers six broad topics: ... http://www.cdc.gov/hepatitis/HHS-ActionPlan.htm
Combating the Silent Epidemic of Viral Hepatitis - 84 page pdf report: http://www.hhs.gov/ash/initiatives/hepatitis/actionplan_viralhepatitis2011.pdf
******************
US approves second new Hepatitis C drug WASHINGTON (AFP) - The US Food and Drug Administration on Monday approved Incivek to treat hepatitis C when taken along with the current two-drug regimen, marking the second such drug approval this month.

"The sustained virologic response for patients treated with Incivek across all studies, and across all patient groups, was between 20 and 45 percent higher than current standard of care," the FDA said. Incivek is a pill that should be taken three times a day with food, and is added to therapy made up of peginterferon alfa and ribavirin. ... http://ca.topmodel.yahoo.com/s/afp/110523/health/health_us_medicine_disease_pharma_company_vertex
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Advancing Oral Health in America Though it is highly preventable, tooth decay is a common chronic disease in the United States and one of the most common diseases worldwide. Individuals and many health care professionals remain unaware of the risk factors and preventive approaches for this and many other oral diseases, and they do not fully appreciate how oral health affects overall health and well-being. In this report, the IOM highlights the vital role that HHS can play in improving oral health and oral health care in the United States if HHS's efforts have clearly articulated goals; are coordinated effectively and adequately funded; and have high-level accountability. Barbara writes: "Please note: Although there is a charge for ordering copies of IOM reports, you can read them online for free. There are also links on the pages that enable you to download all or part of each report. IOM is an excellent source of high quality, well-researched, peer reviewed information.............BA".

(This was sent in by Barbara (BAcello) Thank you...for all you do.)

http://tinyurl.com/3hc7gud

************************ FALL ASSESSMENTS
This is from a list serve to which I belong....Thought it was worth sending on just in case you missed it. The question was "What does one do in assessing a person who fell?" My question is: Why isn't this addressed in detail in school?

I paraphrased the following): Ask if he/she is okay....this is part of the assessment.

"We do a lot of assessments just by saying "how are you?". You want to look for LOC changes, pain level, location and
intensity. In older people you might have to take to hospital any way for xray since they lose their ability to feel
pain at the same intensity young people do. If Fx is suspected then stabilize the location of suspected Fx
location and do as minimal movement as possible especially when you are the only one. Wait for paramedic to arrive.
If you were in the hospital and this happens to one of your pt's then call on your team.

A lot of times you are looking for a possible hip fracture, shortening of the leg and external rotation of the lower extremity.
Usually the foot ankle is rotated out (facing away from the body). Hope this helps, especially in the elderly."
**************

Perrycare@comcast.net (Sarah) writes:

Also think about neck trauma -- Arthritic spines, narrowed spaces where the cord and peripheral nerves pass -- kinda scary, eh?
depending on the mechanism of the fall you might have to think about stabilizing the neck before you do too much moving around.
Granted, this is not the case in most instances, but when I trip over a rug in a small space, like the bathroom, you might want to pay
particular attention to how I landed.
******************

Slow brain bleeds going unnoticed due to the fact that the elders brains can handle more blood not because they have larger ventricles but because it's due to the fact that the brain (gray matter) shrinks with age which leaves more space to handle
the excess blood. (sorry, not sure the author of this one).
*************

"Yes that is one possibility. Many of the elderly are on anticoags due to atrial fib. They fall (one loses muscle mass as they get older so they
become naturally weaker). Atrial fib is the natural way for older hearts too. I recall a cardiologist used to say if you live long enough you will
develop atrial fib. Anywho, so when they fall, they bleed into their brains; their large ventricles are sometimes a life-saver for them b/c they
won't herniate- the brain has more space to accommodate the extra blood without pushing on itself and endangering vital functions. Having
said all of this, when they are on anticoags they bleed into their brains more and faster therefore many die or become disabled which quickly
lead to a whole host of new problems i.e. pressure ulcers, infections, vent dependent....... basically waiting to die.

Also falling and breaking a bone which lead them to become disable or bedridden for months to heal from the fall will open the same host
of risks that I mentioned above as they don't heal as quickly and efficiently as young people do."

Hayat Barron, ICU-RN, CCRN, BSN

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(last, but not least--- will leave you with this Int read)

Probiotics Shorten Diarrhoea Episodes submitted by KurtUllman@Sprintmail.com
Probiotic bacteria given as therapies for diarrhoea reduce the length of time sufferers are affected and lessen the chance of episodes continuing for more than four days. These are the findings of a new systematic review by Cochrane researchers. Every year, diarrhoeal diseases kill nearly two million people in developing countries, mostly young children. The main treatment is rehydration
fluids, but these do not tend to reduce the length of illness, which is crucial in reducing the risk of persistent diarrhoea. Probiotics, so-called “good bacteria”, may help in a variety of different ways including eliminating the bacteria, viruses or parasites responsible,
for example, by competing for the same nutrients. A previous Cochrane review showed benefits with probiotics in diarrhoeal disease, but the
current report reviews data from a far larger evidence base. The researchers reviewed data from 63 trials involving a total of 8,014 patients, over four times the number involved in the previous study. 56 trials focused on infants and young children. Giving probiotics in conjunction with rehydration fluids reduced the duration of diarrhoea by around a day and reduced the risk of diarrhoea lasting four or more days by 59%. No serious adverse effects were reported
in the trials and although vomiting was quite common it also occurred with placebos. “A striking finding of this review is that most trials reported that probiotics reduced diarrhoea,” said lead researcher Stephen Allen of the School of Medicine at Swansea University, UK. “The beneficial effect was consistent and significant across many different types of trials.” “There were no adverse effects, so these therapies can be used safely in addition to rehydration fluids. However, more research needs to be carried out on the specific strains of bacteria that are effective in treating diarrhoea and on preventing the progression from short-term to persistent diarrhoea,” Allen said. A second review, by a separate group of Cochrane researchers, examined the use of probiotics for treating persistent diarrhoea reviewing
data from trials undertaken exclusively in children. The review found that probiotics can reduce the length of an episode of persistent diarrhoea,
however, the authors stress that the review was based on just four trials involving 464 patients and therefore provides only limited evidence of benefit. Full citations: Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for reating acute infectious diarrhoea. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD003048. DOI: 10.1002/14651858.CD003048.pub3 Upon publication, this link will take you to the paper: http://doi.wiley.com/10.1002/14651858.CD003048.pub3. Bernaola Aponte G, Bada Mancilla CA, Carreazo Pariasca NY, Rojas Galarza RA. Probiotics for treating persistent diarrhoea in children. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD007401. DOI: 10.1002/14651858.CD007401.pub2 Upon publication, this link will take you to the paper: http://doi.wiley.com/10.1002/14651858.CD007401.pub2.
~~**~~**~~**~~**~~**~~
HUMOR SECTION

Two women were sitting in the doctor's waiting room comparing notes on their various disorders.

"I want a baby more than anything in the world," said the first, "But I guess it is impossible."

"I used to feel just the same way," said the second. "But then everything changed. That's why I'm here. I'm going to have a baby in three months."

"You must tell me what you did."

"I went to a faith healer."

"But I've tried that. My husband and I went to one for nearly a year and it didn't help a bit."

The other woman smiled and whispered, "Try going alone, next time, dearie."

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

Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /

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

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

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

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

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

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

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

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

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

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

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

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

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

The Nursing Site http://thenursingsite.com .

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

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

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

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

12 lead EKG Interpretation Part #1
http://nursingpub.com/12-lead-ekg-explained-part-1
12 Lead EKG Interpretation Part #2
http://nursingpub.com/12-lead-ekg-interpretation-part-2
12 Lead EKG Interpretation Part #3
http://nursingpub.com/12-lead-ekg-interpretation-part-3

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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*
MEDICAL RECALLS
*
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Defibtech Lifeline and ReviveR Automated External Defibrillators (AEDs): Recall - Software Defect May Cancel Shock

Devices subject to this recall include Model DDU-100 series with software version 2.004 or earlier, sold under the brand names Lifeline and ReviveR. AEDs using software version 2.004 or earlier may cause the device to cancel shock during the charging process. Failure to provide appropriate therapy may result in failure to resuscitate the patient. Defibtech will provide customers with a free software upgrade. Because the conditions that may lead to a canceled shock occur rarely, it is recommended that customers keep their AEDs in service during the software upgrade process. Full instructions and recommendations are being mailed to affected customers. Defibtech is responsible for contacting all end users unless a distributor has agreed to contact their accounts directly regarding this field correction
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm254929.htm
************************
Weck Hem-o-Lok Ligating Clips: Contraindicated for Ligation of Renal Artery During Laparoscopic Living-Donor Nephrectomy The Weck Hem-o-Lok Ligating Clip is a V-shaped clip made from a non-absorbable material that comes in various sizes. It is used to permanently close bleeding vessels or tissue structures.
FDA notified health care providers that Weck Hem-o-Lok Ligating Clips should not be used for the ligation of the renal artery during a laparoscopic living-donor nephrectomy because of serious risks to the donor. The clips may become dislodged, which can lead to uncontrolled bleeding, additional surgery, or death of the donor. In 2006, the manufacturer added this contraindication to the Instructions for Use after receiving 15 reports of 12 injuries and three deaths which occurred between 2001 and 2005. Since the contraindication issued in 2006, there have been three more kidney donor deaths, all associated with the contraindicated use.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm254363.htm
*****************************
List of Medical Device Recalls....
http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/default.htm
****************
Revlimid (lenalidomide): Ongoing Safety Review - increased risk of developing new malignancies ISSUE: FDA is informing the public that we are aware of results from clinical trials conducted inside and outside the United States that found that patients treated with Revlimid (lenalidomide) may be at an increased risk of developing new types of cancer compared to patients who did not take the drug.FDA is currently reviewing all available information on this potential risk and will communicate any new recommendations once it has completed its review. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm250606.htm
***************************
Greenstone LLC announced a recall of medicines with lot number FI0510058-A on the label. Bottles labeled as Citalopram (used to treat depression) may contain Finasteride (used for the treatment of benign prostatic hyperplasia). Women who are, or may become pregnant, should not take or handle Finasteride due to the possible risk of side effects which may cause abnormalities to the external genitalia of a developing male fetus. Citalopram is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or pimozide; it is also contraindicated in patients with a hypersensitivity to Citalopram or any of the inactive ingredients in the tablet. Patients who discontinue Citalopram abruptly by inadvertently taking the mislabeled product may experience discontinuation symptoms and/or worsening of depression.

BACKGROUND: This includes Citalopram 10mg Tablets (100-count bottle) and Finasteride 5mg Tablets (90-count bottle), both distributed in the U.S. market. The recall is due to the possibility that incorrect labels have been placed on the bottles by a third-party manufacturer. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm248595.htm
**************************
APP Pharmaceuticals, Inc. issued a voluntary recall of five lots of Irinotecan Hydrochloride Injection due to the discovery of foreign material and non-sterility in one lot of Irinotecan injection. Non-sterility of a chemotherapeutic product administered via the intravenous route has the potential to result in infections, which could be fatal, especially in patients who are immunocompromised.

BACKGROUND: Irinotecan Hydrochloride Injection is used for recurrent or progressive metastatic colorectal cancer. Three customers reported that they discovered a particulate in the product solution in lot 870DE00301. Investigation of the returned vials confirmed that the particulate was a fungal microbial contaminant. See the Firm Press Release for a listing of recalled lot numbers. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm248598.htm
******************************
Erythropoiesis-Stimulating Agents (ESAs) In Chronic Kidney Disease: Drug Safety Communication - Modified Dosing Recommendations
Epoetin alfa (marketed as Epogen and Procrit) and darbepoetin alfa (marketed as Aranesp)

FDA notified healthcare professionals that new, modified recommendations for more conservative dosing of Erythropoiesis-Stimulating Agents (ESAs) in patients with chronic kidney disease (CKD) have been approved to improve the safe use of these drugs. FDA has made these recommendations because of data showing increased risks of cardiovascular events with ESAs in this patient population. The new dosing recommendations are based on clinical trials showing that using ESAs to target a hemoglobin level of greater than 11 g/dL in patients with CKD provides no additional benefit than lower target levels, and increases the risk of experiencing serious adverse cardiovascular events, such as heart attack or stroke.
ESAs treat certain types of anemia by stimulating the bone marrow to produce red blood cells and by decreasing the need for blood transfusions.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm260641.htm
**********************
Oridion Medical and Philips Healthcare Microstream CO2 Filterline (FilterLine H Set Infant/Neonate, VitaLine H Set Infant/Neonate: Recall - Plastic Strands on the Adapter May Become Dislodged, Inhaled by Patient
Fine plastic strands on the inner surface of the infant/neonatal airway adapter may become dislodged and inhaled by the patient. Inhalation of the plastic strands on the defective devices may cause respiratory compromise, which could result in serious illness or death.
BACKGROUND: The Microstream CO2 Filterline is a medical device used by emergency medical services, hospitals, and other health care providers to measure exhaled carbon dioxide (CO2) during ventilation of newborn and infant patients. See the recall notice for affected models and lots. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm258133.htm

***********************
This is a Class I Notice: Boston Scientific iCross and Atlantis SR Pro 2 Coronary Imaging Catheters: Recall – Catheter Tip Can Break Inside of the Patient
The catheter tip can break inside of the patient and embolize causing tissue and blood vessel injury, heart attack or other serious events requiring additional unplanned surgery.
BACKGROUND: The Boston Scientific iCross and Atlantis A SR Pro2 coronary imaging catheters are intended for ultrasound examination of coronary intravascular pathology only. Intravascular ultrasound imaging is used on patients who are candidates for transluminal coronary interventional procedures. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm259097.htm
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Boston Scientific Innova Self-Expanding Stent System: Recall - Failure to Deploy
Boston Scientific sent an urgent medical device recall letter to OUS customers on May 13, 2011. The recall notice explained the issue, identified the affected products, required distributors to cease further distribution and use of the product, and requested the return of unused product to Boston Scientific. See the Recall Notice for a complete list of affected lot numbers.

Complaints of no deployment and partial deployment have been received. This type of failure may result in vessel wall injury, increased procedure time and/or emergency surgery to remove the partially deployed stent. This recall does not affect stents that have already been implanted as the issue occurs during delivery of the stent http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm259764.htm

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NURSING HINTS CORNER
Body cast dilemma
When my 2-year old son was in a body cast for 2 months, i ket the perineal area of his cast clean and dry with disposable diapers for newborns. I tucked the diaper tightly into the cast;s perineal opening to prevent wetness from soaking into the cast. After two months, the cast had no odor or stains. Sheryl Knoedler, RN, BSN (I think this would be a great patient/parent teaching tool).

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 85, Springhouse Corporation/www.springnetcom. ;

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

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

WELCOME TO:

joy2unu@yahoo.com (Jeanne) June 12, 2011

sabessonette@gmail.com (Sally) June 18, 2011

Tamibihl@yahoo.com (Tami) June 18, 2011

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NOTICE:
I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.... LOL So please send me your new name/address, okay? RNFrankie@AOL.com

New Address: aznitern@Q.com (Roxie) Old Address: aznitern @msn.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

Children are the living messages we send to a time we
will not see.

--Neil Postman

Hope to see you online..... Frankie
RNFrankie@AOL.com

PARADIGM BYTES JUNE 2011

2011-06-12T08:30:00.000-07:00

PARADIGM BYTES
Newsletter for Paradigm 97
June 12, 2011

PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.

Our website...... http://paradigm97.blogspot.com/ ; Please copy, paste, and bookmark it.

MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
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SNIPPETS

If you ever have a patient who is a Quad (SCI), you really need to understand the dangers associated with their condition. I had a patient when I lived in Washington state, who was a new Quad. I arrived one day, his wife and friend were scared to death because he was having a autonomic dysreflexia reaction, and they didn't know what to do. I examined his catheter tubing....and saw that it was crimped. I straightened it out and he immediately became "normal"...his face was no longer reddened and he did not have pain (as such). This was a time to explain all the ramifications of AD and what they needed to know. Since they lived in the mountains, help was a very, very long way away. Patient and caregiver teaching is essential. Please check both links below.ay. The following is more for the family and patient....but educational for anyone.
Autonomic dysreflexia (AD) is a medical problem unique to people with spinal cord injuries (SCI). Although uncommon, it is a serious concern because it can be life threatening and needs immediate attention. If you know what you are looking for, however, it is relatively easy to recognize and treat. But since many health care providers may not be familiar with AD, it is important to understand it yourself and carry a medic alert card.
What is autonomic dysreflexia (AD)?
AD is an abnormal response to a problem in your body—pain, pressure, full bladder or bowel—somewhere below the level of your SCI. Because of the SCI, your body doesn't respond properly to signals that something is wrong. Instead, your body may develop a sudden rise in blood pressure, and this can lead to stroke, seizures or death.
How does AD happen?
AD is usually triggered by something that would cause pain or discomfort in a person without SCI, such as a full bladder, tight clothing or an ingrown toenail. In non-injured individuals, the body reacts to pain by narrowing the blood vessels, and this causes blood pressure to increase. Receptors near your brain and heart receive messages from non-spinal cord pathways (nerves in the sympathetic nervous system) that your blood pressure is getting too high, and your brain responds by sending signals down the spinal cord to slow down the heart beat and relax the blood vessels. As the blood vessels open up and widen, blood pressure goes back down. Meanwhile, pain signals coming through the spinal cord have told the brain there is something wrong, so the individual feels the discomfort and knows to do something about it and remove the source of the pain. ...
http://emedicine.medscape.com/article/322809-overview and http://sci.washington.edu/info/forums/reports/autonomic_dysreflexia.asp
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The following is not really a Snippet......but I think it is very important that all of us become aware of a problem:

Original Research: Tragedy into Policy: A Quantitative Study of Nurses' Attitudes Toward Patient Advocacy Activities.

Black, Lisa M.
AJN The American Journal of Nursing, June 2011,111(6):26-35
Feature Articles

Although the Centers for Disease Control and Prevention (CDC) reports that an estimated 3.2 million Americans are living with chronic hepatitis C, in southern Nevada fewer than four cases of acute hepatitis C are confirmed annually.1, 2 So when six people who had recently undergone endoscopic procedures were diagnosed with acute hepatitis C within a six-month period (July 2007 to December 2007), alarms were sounded.1 Ultimately, more than 62,000 patients who had undergone endoscopic procedures at either of two southern Nevada endoscopy clinics would be notified that they might have been exposed to bloodborne pathogens, including hepatitis B virus, hepatitis C virus (HCV), and HIV, as a result of unsafe injection practices. ... ( I, for one, would have reported it no matter what the consequences would be. )
http://journals.lww.com/ajnonline/Fulltext/2011/06000/Original_Research__Tragedy_into_Policy__A.23.aspx?WT.mc_id=EMxALLx20100222xxFRIEND
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During a discussion on a list serve about stethoscopes, Wendie (whowland1@mac.com) made the following comment:
"This might be a silly addition to the discussion, but I notice this all thetime-- people don't wear the ear plugs properly. They should aim forward towards the point of your nose when they enter your ear canal, because that's the way the ear canal aims; if you wear them so they point straight in to the middle ofyour head or backwards their little openings will be up against soft tissue and you won't hear worth a tinker's dam. I used to spend time every year teaching students that, usually 2nd year by the time I got them, and it was always comical to see their little eyes light up when they realized there was a real reason why they couldn't hear breath sounds or heart sounds, and it wasn't just that they needed to try harder.

This is also one of my small peeves about otherwise good portrayals of nursing on TV-- Nurse Jackie and her colleagues (including that complex beautiful physician she hangs out with) are always hanging their stethoscopes backwards ontheir necks, so when they pull them on, they can't possibly hear through them. You can rotate the vertical axis so it fits you just right. Try". Best, Wendie
Another stethoscope hint: When you are trying to hear the ankle/brachial sounds to assess circulation in the foot, ... tilt the head of the stethoscope up about 45 degrees........works every time.

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FROM THE MEMBERS

This was supposed to have been in a previous Newsletter....I goofed.

ConnieRN2Be1@aol.com writes:

"I graduated from nursing school in May 2005. I have been working in a hospital on a geriatric med-surg floor. it is a specialty unit called an ace (acute care of the elderly) unit. Regular med surg, just specialize with those over the age of 65. I became nationally certified in gerontological nursing and am a geriatric clinical scholar in the hospital". Congratulations, Connie !

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INTERESTING READING

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

The addition of daily azithromycin to standard treatment reduced the frequency of COPD (chronic obstructive pulmonary disease) exacerbations and improved quality of life at 1 year in a large, prospective, randomized, placebo-controlled clinical trial involving more than 1,100 high-risk COPD patients.Use of the macrolide antibiotic was associated with a significantly greater incidence of hearing decrement, although the overall rate was low and Dr. Richard K. Albert reported at an international conference of the American Thoracic Society. ...
http://www.internalmedicinenews.com/newsletter/internal-medicine-news-e-newsletter/singleview40682/daily-azithromycin-cut-acute-copd-exacerbations-in-high-risk-patients/fc603beca5.html
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Study finds need for care after cancer treatment Sixteen percent of 248 patients who survived breast, colorectal, lung or prostate cancer experienced fatigue, 15% had disturbed sleep, 13% suffered cognitive difficulties and 13% reported pain three to five years after their treatment, according to a study presented at the 2011 American Society of Clinical Oncology Annual Meeting in Chicago. "It seems we haven't come a long way in managing pain despite a lot of medical advances. This is eye-opening. It tells us we need to be better in clinical practice about managing our survivors' pain," said researcher Lynne Wagner. Nurse.com
http://news.nurse.com/article/20110603/NATIONAL02/106060028/-1/frontpage
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This is from BAcello . Thanks Barbara...she writes "There is a link for a free pdf download on the right side of the page....

Synopsis of the National Institute for Health and Clinical Annals of Internal Medicine
... that may precipitate delirium, including cognitive impairment or disorientation, ... pain, poor nutrition, sensory impairment, and sleep
disturbance. http://www.annals.org/content/154/11/746.abstract?aimhp "
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Early detection of Ovarian cancer is key, but what are the symptoms and how is it diagnosed?
(Since) your ovaries lie deep within your pelvis, thus making disease detection tricky. Early screening methods for ovarian cancer have so far proved unreliable, and although routine pelvic exams include a check for anything that feels out of the ordinary, early-stage ovarian tumors easily escape detection because they're difficult to feel. In addition, ovarian cancer has a reputation for being "silent," meaning symptoms tend to be either vague or nonexistent until the disease has spread.
As a result, the vast majority of ovarian cancers are diagnosed when the cancer is in an advanced stage, at which point the chances of survival are significantly reduced. In a comparison of survival rates among women with one of the most common types of ovarian cancer, fewer than 20% of women diagnosed at an advanced stage (stage IV) survived more than 5 years after diagnosis. In contrast, 89% of women diagnosed at the earliest stage (stage I) did survive at least 5 years. ...
http://www.realage.com/check-your-health/womens-health/detecting-ovarian-cancer?click=main_sr&cbr=wn1105_mn&eid=1010637809&memberid=4687812
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Urine culture doubtful in determining etiology of diffuse symptoms among elderly individuals: a cross-sectional study of 32 nursing homes The high prevalence of bacteriuria in elderly individuals makes it difficult to know if a new symptom is related to bacteria in the urine. There are different views concerning this relationship and bacteriuria often leads to antibiotic treatments. The aim of this study was to investigate the relationship between bacteria in the urine and new or increased restlessness, fatigue, confusion, aggressiveness, not being herself / himself, dysuria, urgency and fever in individuals at nursing homes for elderly when statistically considering the high prevalence of asymptomatic bacteriuria in this population. ... http://www.biomedcentral.com/1471-2296/12/36
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The Role Telomeres play in our lives....A new study/ discovery Be sure to read this...really very good info.
The tiny "caps" that keep our chromosomes from fusing together are also providing clues that could eventually lead to the achievement of one our nation's most important public health goals: extending good health well into old age.
To help understand the role telomeres play within the human body, it's useful to review some basic biology. All of the tissues within the human body are made up of individual cells. These cells contain chromosomes within their nuclei. Chromosomes are the packages that hold most of our DNA - the genetic instructions that tell the cell what to do.
To help understand the role telomeres play within the human body, it's useful to review some basic biology. All of the tissues within the human body are made up of individual cells. These cells contain chromosomes within their nuclei. Chromosomes are the packages that hold most of our DNA - the genetic instructions that tell the cell what to do.
Telomeres are repeating DNA sequences at the ends of the chromosomes. They do not contain any genetic instructions; they simply repeat a sequence of DNA over and over. When we are young, the telomeres are very long - they may contain as many as 20,000 base pairs of DNA. ...
http://www.agingresearch.org/content/article/detail/878
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THRIFTY TIP: The federal government will reimburse you for 30 percent of the cost, up to $1,500 for highly efficient insulation. Additionally, low-income households can qualify for an average of $6,500 worth of weatherization improvements to their homes through government programs administered by each state!
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THURSDAY, May 26 (HealthDay News) -- For men with advanced hormone-resistant prostate cancer who have also failed chemotherapy, the new drug Zytiga (abiraterone acetate) along with the steroid prednisone appears to boost survival, researchers report.
Based on data from the ongoing clinical trial, Zytiga was approved by the U.S. Food and Drug Administration in April. It works by inhibiting the production of the male hormone testosterone, which promotes the growth of cancer cells. In this regard, the drug mimics hormone therapy. ... http://www.nlm.nih.gov/medlineplus/news/fullstory_112513.html

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FDA approves the first vaccine to prevent meningococcal disease in infants and toddlers The U.S. Food and Drug Administration Release-- April 22, 2011-- approved the use of Menactra in children as young as 9 months for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y and W-135. Meningococcal disease is a life-threatening illness caused by bacteria that infect the bloodstream (sepsis) and the lining that surrounds the brain and spinal cord (meningitis). Neisseria meningitidis is a leading cause of meningitis in young children. Menactra was originally approved in 2005, for use in individuals ages 11 years through 55 years and was approved in October 2007 for children as young as 2 years.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm252392.htm
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RANDOM FACTS: New aluminum cans that are manufactured from used beverage containers use 95% less energy than producing
them from virgin materials.
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Each year, Americans throw out enough plastic film to shrink-wrap the entire state of Texas.
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Thermographic Imaging Systems for Breast Cancer Screening: FDA Safety Communication FDA notified consumers, women who participate in breast cancer screening and healthcare professionals that thermography is not a replacement for screening mammography and should not be used by itself to diagnose breast cancer. Thermographic systems use an infrared camera to produce images (thermograms) that show the patterns of heat and blood flow on or near the surface of the body. The FDA is not aware of any valid scientific data to show that thermographic devices, when used on their own, are an effective screening tool for any medical condition including the early detection of breast cancer or other breast disease. The FDA is concerned that women will believe these misleading claims about thermography and not receive needed mammograms.

Certain facilities, websites, and mobile units are promoting the use of thermography as a stand-alone evaluation tool for screening and diagnosing breast cancer, claiming that is a substitute for or superior to mammography. They also claim that thermography can detect pre-cancerous abnormalities and diagnose breast cancer long before mammography and that compressing the breast during mammography will cause or spread cancer by pushing cancer cells into additional locations in the body.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm257707.htm

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WHO defers fixing date on destroying live smallpox
(Reuters) - A decision on when to destroy the last known stocks of live smallpox was put off for a further three years at the World Health Organization's annual meeting on Tuesday in the latest stage in a debate that has lasted decades.
The issue had deeply divided the annual World Health Assembly in Geneva, with Iran spearheading opposition to a U.S. and Russian-backed plan to postpone setting a date for destruction for five years.
Iran was at the forefront of countries arguing for the stocks held in Russia and the United States to be destroyed now. ... http://www.reuters.com/article/2011/05/24/us-smallpox-who-idUSTRE74N35T20110524?feedType=nl&feedName=ushealth1100
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(Reuters) - Giving a high dose of niacin to people with heart disease who are already taking a cholesterol-lowering statin does nothing more to prevent heart attacks and strokes, U.S. government researchers said on Thursday.
The findings from a large clinical trial challenge the notion that raising high-density lipoprotein, or HDL, the so-called "good" cholesterol, can further reduce heart risks in people who already have their "bad" cholesterol -- low-density lipoprotein, or LDL -- well under control. ...
http://www.reuters.com/article/2011/05/26/us-heart-niacin-idUSTRE74P4SN20110526?feedType=nl&feedName=ushealth1100
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Safety and tolerability of donepezil 23 mg in moderate to severe Alzheimers disease Full Text BMC Neurology, 05/26/2011 Clinical Article Farlow M et al. – The 23 mg/d dose of donepezil was associated with typical cholinergic adverse events(AEs), particularly gastrointestinal–related AEs, similar to that observed in studies with a dose increase from 5 to 10 mg/d. The good safety and predictable tolerability profile for donepezil 23 mg/d supports its favorable risk/benefit ratio in patients with moderate to severe Alzheimers disease(AD)....
http://www.biomedcentral.com/1471-2377/11/57
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People admitted to the hospital on the weekend are 10 percent more likely to die than those who checked in during the week, according to a new analysis of nearly 30 million people.
Even if 10 percent doesn't sound like much of a difference, when applied to the entire U.S. population it equals an additional tens of thousands of people each year, study author Dr. Rocco Ricciardi of Tufts University Medical School told Reuters Health.
"In other words, an extra 20 to 25 thousand people die each year in the United States because of admission on a weekend," he said ... http://health.yahoo.net/news/s/nm/us_more_hospital_deaths_weekends
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Scientists have found that a gene linked to diabetes and cholesterol is a "master switch" that controls other genes found in fat in the body, and say it should help in the search for treatments for obesity-related diseases.

In a study published in the journal Nature Genetics, the British researchers said that since fat plays an important role in peoples' susceptibility to metabolic diseases like obesity, heart disease and diabetes, the regulating gene could be target for drugs to treat such illnesses. ...
http://www.huffingtonpost.com/2011/05/15/scientists-find-genetic-s_n_862237.html?icid=maing-grid7|main5|dl1|sec3_lnk1|63139 ************************** TRIVIA

The CDC estimates that 3.8 million sport and recreation related concussions happen in the United States each year.
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Sixty percent of sport related injuries occur during practice.
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Eat this fish for a heart healthy life Researchers who recently examined an Eskimo community in Alaska were surprised to find that some of the overweight and obese people in the group didn't have the high, unhealthy levels of triglycerides that usually come with being large. And scientists suspect it's because of the fatty fish they were enjoying.
Fish-Fat Connection
Fatty fish, like salmon, is a rich source of docosahexaenoic (DHA) and eicosapentaenoic acid (EPA) -- two omega-3 fatty acids that have a solid rep for promoting heart health. And these two types of fat appeared to have a protective effect in the overweight and obese Yup'ik Eskimos observed in the study. The Yup'ik Eskimos tend to consume about 20 times more omega-3 fatty acids from fish compared to Americans outside of Alaska. ...

http://www.realage.com/tips/follow-this-heart-healthy-eskimo-diet?eid=1098958000&memberid=4687812
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Pituitary tumors are fairly common. About 1 in 10,000 people get them. They grow slowly, do not spread and are usually not cancerous. The most common type of pituitary tumor produces hormones and disrupts the balance of hormones in your body. This can cause endocrine diseases such as Cushing's syndrome and hyperthyroidism. Symptoms of pituitary tumors include:

Headaches
Vision problems
Nausea and vomiting
Any of the problems caused by the production of too many hormones

Pituitary tumors are usually curable. Treatment is often surgery to remove the tumor. Other options include medicines and radiation. http://www.nlm.nih.gov/medlineplus/pituitarytumors.html
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Continuing Education: Drug Therapy gets personal with genetic profiling
Two patients are admitted to different hospitals for treatment of deep vein thrombosis. One receives warfarin, with the dosage based on her age and weight. The other also is prescribed warfarin, but the treating physician determines the dosage with an algorithm that uses data about the patient’s genetic profile and activity of the cytochrome 2C9 enzyme and the VKORC1 enzyme (vitamin K epoxide reductase complex subunit 1); both enzymes metabolize warfarin.
The first patient suffers several bleeding episodes because her coagulation can’t be stabilized; she requires a transfusion and is hospitalized for 10 days. The second patient remains free from bleeding episodes and is discharged 3 days later. ...
http://www.americannursetoday.com/Article.aspx?id=7814&fid=7770
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Trivia all about Wedding Matters: In the U.S., the bride traditionally walks down the aisle last, after the bridesmaids, groomsmen, flower girl, and ring bearer. In England, the bride is the first down the aisle to emphasize her importance. Another key difference in the wedding precession is in America, the groomsmen walk arm-in-arm with the bridesmaids. British bridesmaids, however, follow the bride without escort, while the groomsmen, known in England as ushers, stand in the front.
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Each wedding party in England typically has bridesmaids around the same age as the bride and groom, but also younger bridesmaids, from ages 10-12. In the U.S., the bridesmaids are usually close friends or family of the bride or groom and are around the same age.
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British women traditionally wear hats—big ones—to weddings. At a Christian ceremony in the U.S., the bride is usually the only person with something on her head. Generally the English weddings take place in the afternoon. After the ceremony, the guests attend a wedding breakfast. There are a couple of theories about the origin of the term wedding breakfast. One theory is that the name comes from the tradition of the bride and groom fasting before the wedding, therefore, the reception would be when
they would break their fast. Another is that the wedding breakfast is the first meal of the couple's married life, just as breakfast is the first meal of the day.
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Pre-wedding bashes are called bachelor and bachelorette parties in the U.S., while in the U.K. they are referred to as stag night or stag weekend for the men and hen night for the women. Britain has more legal restrictions about weddings than America. For example, in England and Wales, couples cannot legally get married outdoors unless the location has been approved by local authority.
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In the U.S., wedding cakes—both the main cake and, in some cases, a groom's cake—are a major part of the reception. In Britain, the dessert is traditionally a fruit cake. The top-tier of the fruit cake is saved for the christening of the couples' first child. The top-tier in the U.S. is saved for the couple's first anniversary.
(Facts courtesy of infoplease.com)
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(Unfortunately, I can not have the entire article presented now. Hopefully, the link will work for you. LET ME KNOW, Please)

Preventing accidental IV infusion of breast milk in neonates
Several years ago, we received a letter from the mother of a hospitalized infant named Zoey who
accidentally received breast milk intravenously (IV) instead of through a nasogastric (NG) feeding tube.
The primary underlying cause of this ... newsletter@ismp.org ISMP Nurse Advise-ERR June 2011 Vol. 9, Issue 6
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RANDOM FACT: A dairy cow produces about 100,000 glasses of milk in it's lifetime.
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Patch cover applied without the medicated patch underneath
CATAPRES-TTS (transdermal therapeutic system) is
a square, tan, reservoirtype adhesive patch that contains cloNIDine, which is used to treat hypertension. These patches,
manufactured by Boehringer Ingelheim, come with an optional white, round, adhesive cover that can be placed over the
drug patch to prevent it from coming loose. Each patch—the tan patch containing cloNIDine and the white cover patch
—come in separate pouches. So, each “dose” typically has two pouches: one pouch with the tan medication patch and ne pouch with the optional cover. ... newsletter@ismp.org ISMP Nurse Advise-ERR June 2011 Vol. 9, Issue 6
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Electronic Cigarettes are no panacea Slender, battery-powered electronic cigarettes look lik the real thing. Some even hava a fake ember that lights up with each puff, but they are smoke-free and don't contain tar, instead, the user inhales vapors emitted by a cartridge of nicotine fluid. Sold online and in shopping malls, "e-cigarettes" come in tempting flavors such as cappuccino, cherry, chocolate, and apple-flavors with special appeal to teens and children.

Although e-cigarettes are touted as being healthier than regular cigarettes, the FDA has serious concerns. In the agency's initial tests, it detected diethylene glycol, a toxic chemical found in antifreeze, along with nitrosamines and other cancer-causing compounds. Substandard manufacturing practices are another concern. In the brands tested, the amount of nicotine in each inhalation varied considerably, and some e-cigarettes labeled "nicotine free" contained low levels of the addictive chemical. The trendy devices are often marketed as a smoking-cessation aid, but public-health experts worry that they might lead to increased nicotine addiction among children.
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RANDOM FACT: In the summer, the amount of water pouring over Niagara Falls each second could fill 13,00 bathtubs.

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HUMOR SECTION

In one of my classes, they were discussing the qualifications to be president of the United States. It was pretty simple - the candidate must be a natural born citizen of at least 35 years of age. However, one girl in the class immediately started in on how unfair was the requirement to be a natural born citizen.

In short, her opinion was that this requirement prevented many capable individuals from becoming president. The class was just taking it in and letting her rant, but everyone's jaw hit the floor when she wrapped up her argument by saying, "What makes a natural born citizen any more qualified to lead this country than one born by C-section?"

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

Pay Only $34.99 for a full year of CONTACT HOURS http://www.nursingspectrum.com /

Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx

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

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

Back issues of the newsletter are available at: http://www.ismp.org/Newsletters/nursing/backissues.asp.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell)
Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com

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

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

RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007

http://www.washingtonwatch.com/bills/show/110_HR_2123.html

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

The Nursing Site http://thenursingsite.com .
http://www.snopes.com

Ten Great Public Health Achievements --- United States, 2001--2010
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5.htm?s_cid=mm6019a5_w
http://www.solutionsoutsidethebox.net/ Raconte's website

http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3

National Do Not Call Registry

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

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?

Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/
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Simply thick may cause serious bowel condition.FDA notified parents, caregivers and health care providers not to feed SimplyThick, a thickening agent for management of swallowing disorders, to infants born before 37 weeks. The product may cause necrotizing enterocolitis (NEC), a life-threatening condition characterized by inflammation and death of intestinal tissue.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm256257.htm
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On May 25, 2011, FDA granted tentative approval for a generic formulation of tenofovir disoproxil fumarate tablets, 300 mg under the expedited review provisions for the President’s Emergency Plan for AIDS Relief (PEPFAR).
This formulation, indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients (≥12 years of age and ≥35 kg); and for the treatment of chronic hepatitis B in adults, is manufactured by Strides Arcolab Limited, of Bangalore, India.
"Tentative approval" means that FDA has concluded that a drug product has met all required quality, safety and efficacy standards, but is not eligible for marketing in the U.S. because of existing patent protections. Tentative approval does, however, make the product eligible for purchase outside the United States under the PEPFAR program.
This product is a generic version of Viread Tablets, 300 mg, manufactured by Gilead Sciences.
As with all generic applications, FDA conducts an on-site inspection of each manufacturing facility, and of the facilities performing the bioequivalence studies, to evaluate the ability of the manufacturer to produce a quality product and to assess the quality of the bioequivalence data supporting the application prior to granting approval or tentative approval to these applications.
You can find a complete list of all Approved and Tentatively Approved Antiretrovirals in Association with the President's Emergency Plan on the FDA web site.

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Birth Control Pills Containing Drospirenone: Possible Increased Risk of Blood Clots

FDA is aware of two newly published studies that evaluated the risk of venous thromboembolism (VTE) in women who use birth control pills that contain drospirenone. The two recently published studies looked at whether there is a higher risk of blood clots in women taking birth control pills containing the progestin drospirenone when compared to similar women taking birth control pills containing a different progestin called levonorgestrel. These two new studies reported that there is a greater risk of VTE associated with birth control pills that contain drospirenone. This risk is reported to be up to 2 to 3 times greater than the risk of VTE associated with using levonorgestrel-containing pills. Other studies have not reported an increase in risk. The FDA is currently evaluating the conflicting results from these studies and will look at all currently available information to fully assess the risks and benefits of drospirenone-containing birth control pills.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm257337.htm

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Angiotensin Receptor Blockers (ARBs): Drug Safety Communication - Drug Safety Review Completed
FDA's meta-analysis of 31 randomized controlled trials comparing ARBs to other treatment found no evidence of an increased risk of incident (new) cancer, cancer-related death, breast cancer, lung cancer, or prostate cancer in patients receiving ARBs.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm219185.htm
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Aidapak Services Repackaged Pharmaceuticals: Recall - Potential Cross Contamination with Beta Lactam Products
FDA and Aidapak Services notified healthcare professionals and hospital pharmacies of a nationwide recall of multiple repackaged drug products after learning of the potential cross contamination of non-penicillin drug products that were repackaged in the same facility. There is the potential for serious anaphylactic reaction in patients with known hypersensitivity to beta-lactam or penicillin products that could result from using these recalled products.
Please click on the link in the firm press release to view a complete listing of products affected by this recall. All products affected by this recall are stamped with Aidapak's packaging stamp.
Hospitals, Emergency rooms, clinics and other healthcare facilities should stop distributing these products immediately and quarantine the products, and then contact Aidapak Services for return instructions.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm257723.htm

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NURSING HINTS CORNER

Catheter care comfort Here is a tip for catheterizing a female patient who has a fractured hip or who finds the dorsal recumbent position uncomfortable.
Turn the patient on her left side in the Sims' position, with the right knee and thigh drawn up, if possible. Place a sterile drape over her buttocks, covering the rectal area. The separate the labia and proceed to catheterize her.
Elderly patients especially, find this position more comfortable than the traditional position. Sonja Feist, RN, MS

Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.39, Springhouse Corporation/

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

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NEW MEMBERS

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

WELCOME TO:

phutchisonpadron@yahoo.com (Peggy) June 2, 2011

scoggins3@earthlink.net (Joan) June 6, 2011

loreerutherford@yahoo.com (Loree) June 10, 2011

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NOTICE

I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address.... Please send me your new name/address, okay? RNFrankie@AOL.com

Old E-mail Address: aznitern@msn.com
New E-mail Address: aznitern@q.com

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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

People grow through experience if they meet life honestly
and courageously. This is how character is built.

--Eleanor Roosevelt (1884 - 1962), My Day

Hope to see you online...or, better yet, write me !.. Frankie
RNFrankie@AOL.com