PARADIGM BYTES
Newsletter for Paradigm 97
January 5, 2008
First NOTICE: We will have our Eleventh Anniversary on January 20, 2008 !!!
AMAZING, isn't it?
Second Notice: Months ago I was designated as the representative to distribute an excellent monthly Newsletter entitled...ISMP NurseERR. It comes in pdf form. It downloads beautifully and is fully legible...can be printed out. My problem is that I do not own the $800 dollar Acrobat for deciphering the pdf and converting it to HTML to be copied and pasted in this Newsletter. I have re-typed it many times (but am getting lazy). So...... I am going to include links to it and to several articles dating back to September. I can also ATTACH this ISMP newsletter to an individual e-mail or to the notification that another newsletter is on the website. IF you so desire to read the ISMP newsletter ...and I strongly suggest that you do.... let me know your opinion....PLEASE. thanks, Frankie
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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/
~~**~~**~~**~~**~~**~~
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.
~~**~~**~~**~~**~~**~~
Please drop in ...the AOL chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PSTNow, the Paradigm97 chatroom is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....and invite your friends in for a little chat Let me know if you want others involved.
***~~~***~~~***~~~***
SNIPPETS
Sent in by several members and is posted separately...check it out.
~~**~~**~~**~~**~~**~~
MEDICAL NEWS
Parity Legislation Could Reduce Access To Mental Health Treatment If Out-Of-Network Benefits Are Not Guaranteed, Researchers Warn Congress is on the verge of passing legislation mandating that health plans cover mental health (MH) and substance abuse treatment to the same extent that they cover other medical and surgical treatment. In a study published today on the Health Affairs Web site, researchers say that passage of either the Senate or House version of this legislation would be a major step forward, but they also warn that ³parity² legislation could actually reduce access to MH treatment for some patients if it does not facilitate treatment by providers outside insurers¹ networks.
The study finds that in 2005, only a minority of mental health providers in the national capital area participated in networks affiliated with the Federal Employees Health Benefit program, Medicare, Medicaid, or private insurance coverage. ³Our study shows that even in an area relatively rich in mental health resources such as Washington, D.C., and its surroundings, plan networks are not equipped to meet the full need for mental health treatment,² said lead author Darrel Regier. ³ Maintaining the out-of-network option is essential to ensuring access to treatment.² .......
You can read the study by Regier, the executive director of the American Psychiatric Institute for Research and Education, and coauthors at
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.1.w70
~~**~~**~~**~~**~~**~~
FROM THE MEMBERS
The following was sent in by Raconte@AOL.com (Genevieve) who wrote: " I was wondering if you know any nurses in either Iowa or New Hampshire, or if there are any members of Paradigm97 that are from these two states" ? Geneviève
***************
This opinion was submitted by Raconte (Genevieve) to the Pasadena newspaper . She writes:
Newsletter for Paradigm 97
January 5, 2008
First NOTICE: We will have our Eleventh Anniversary on January 20, 2008 !!!
AMAZING, isn't it?
Second Notice: Months ago I was designated as the representative to distribute an excellent monthly Newsletter entitled...ISMP NurseERR. It comes in pdf form. It downloads beautifully and is fully legible...can be printed out. My problem is that I do not own the $800 dollar Acrobat for deciphering the pdf and converting it to HTML to be copied and pasted in this Newsletter. I have re-typed it many times (but am getting lazy). So...... I am going to include links to it and to several articles dating back to September. I can also ATTACH this ISMP newsletter to an individual e-mail or to the notification that another newsletter is on the website. IF you so desire to read the ISMP newsletter ...and I strongly suggest that you do.... let me know your opinion....PLEASE. thanks, Frankie
~~**~~**~~**~~**~~**~~
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/
~~**~~**~~**~~**~~**~~
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.
~~**~~**~~**~~**~~**~~
Please drop in ...the AOL chatroom is "manned" by GingerMyst for 45 min on Tuesday evenings: 9 pm EST, 8 pm CST, 7 pm MST, 6 pm PSTNow, the Paradigm97 chatroom is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....and invite your friends in for a little chat Let me know if you want others involved.
***~~~***~~~***~~~***
SNIPPETS
Sent in by several members and is posted separately...check it out.
~~**~~**~~**~~**~~**~~
MEDICAL NEWS
Parity Legislation Could Reduce Access To Mental Health Treatment If Out-Of-Network Benefits Are Not Guaranteed, Researchers Warn Congress is on the verge of passing legislation mandating that health plans cover mental health (MH) and substance abuse treatment to the same extent that they cover other medical and surgical treatment. In a study published today on the Health Affairs Web site, researchers say that passage of either the Senate or House version of this legislation would be a major step forward, but they also warn that ³parity² legislation could actually reduce access to MH treatment for some patients if it does not facilitate treatment by providers outside insurers¹ networks.
The study finds that in 2005, only a minority of mental health providers in the national capital area participated in networks affiliated with the Federal Employees Health Benefit program, Medicare, Medicaid, or private insurance coverage. ³Our study shows that even in an area relatively rich in mental health resources such as Washington, D.C., and its surroundings, plan networks are not equipped to meet the full need for mental health treatment,² said lead author Darrel Regier. ³ Maintaining the out-of-network option is essential to ensuring access to treatment.² .......
You can read the study by Regier, the executive director of the American Psychiatric Institute for Research and Education, and coauthors at
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.1.w70
~~**~~**~~**~~**~~**~~
FROM THE MEMBERS
The following was sent in by Raconte@AOL.com (Genevieve) who wrote: " I was wondering if you know any nurses in either Iowa or New Hampshire, or if there are any members of Paradigm97 that are from these two states" ? Geneviève
***************
This opinion was submitted by Raconte (Genevieve) to the Pasadena newspaper . She writes:
I truly believe our erstwhile elected officials were more concerned about their legacy on this issue of health care than really making a difference in the lives of Californians. I came to this conclusion because, in the end, they failed to do the real heavy lifting, which was to attach a budget to the plan so it could be debated on the Assembly floor.
Instead, Assembly Speaker Fabian Nunez, et al, played yet one more shell game approving a plan, all the while ignoring our looming and ever-growing budget deficit.
Meanwhile, they expect the electorate to approve a series of tax increases that they themselves were unwilling to even bring up for a debate. Now that's leadership for you... "
http://www.pasadenastarnews.com/rds_search/ci_7831679?IADID=Search-www.pasadenastarnews.com-www.pasadenastarnews.com
~~**~~**~~**~~**~~**~~
INTERESTING READING
Please remember that the REUTERS articles are good for 30 days only
IF you want to see what the Joint Commission is "up to"...here is the link:
http://www.jointcommission.org/Library/jconline/jcol_12_07.htm
**************************
Ozone Links Heat, Higher Cardio Death Risk Ozone may prove the key to the link between high temperature and the increased risk of death from heart disease or stroke, suggests research published in Occupational and Environmental Medicine.
The researchers base their findings on a population of almost 100 million people in 95 geographical areas across the U.S. during the months of June to September.
During this period, 4 million heart attacks or strokes occurred, and when the authors plotted daily deaths against fluctuations in temperature during one day, they found that ozone was a common link.... http://NW.advanceweb.com/Newsletter.aspx
*********************
Vitamin E Could Help Diabetics Ward Off MIs Vitamin E supplements can significantly reduce the risk of myocardial infarction (MI) and related deaths for diabetics who carry a particular version of a gene, according to researchers at the Technion-Israel Institute of Technology and the Clalit Health Services in Israel.
After 18 months of treatment, people with the haptoglobin (Hp) 2-2 gene who took 400 International Units (IU) of vitamin E daily had more than 50 percent fewer MIs, strokes and related deaths than Hp 2-2 patients who took a placebo pill. Forty percent of individuals with diabetes carry the Hp 2-2 gene.
The full study appeared in the Nov. 21 online edition of the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
*******************
FDA Clears First Quick Test for Drug-Resistant Staph Infections ---Test Identifies MRSA Bacterium in Two Hours The U.S. Food and Drug Administration (FDA) today announced it has cleared for marketing the first rapid blood test for the drug-resistant staph bacterium known as MRSA (methicillin-resistant Staphylococcus aureus), which can cause potentially deadly infections.
Methicillin is an antibiotic that has been used successfully to treat infections from the Staphylococcus aureus bacterium. Over the years, the staph bacterium mutated and spawned MRSA, a strain of staph bacterium that is resistant to methicillin and which has a higher rate of being fatal.
The BD GeneOhm StaphSR Assay uses molecular methods to identify whether a blood sample contains genetic material from the MRSA bacterium or the more common, less dangerous staph bacterium that can still be treated with methicillin.... http://www.fda.gov/bbs/topics/NEWS/2007/NEW01768.html
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Win-R Study Demonstrates Weight-Based REBETOL Plus PEG-INTRON Improve Efficacy and Lower Relapse Rates, Particularly in Very Heavy Patients and in African-Americans With Most Difficult-to-Treat Form of the Disease NEW YORK (Dec. 27, 2007) — As reported recently in the journal Hepatology, WIN-R, a multicenter study of over 5,000 patients with hepatitis C virus (HCV) showed treatment with weight-based REBETOL® (ribavirin, USP) (RBV) in combination with pegylated interferon (PEG-IFN) alfa-2b achieved significantly higher rates of sustained virologic response (SVR) and lower relapse rates compared to combination therapy using a flat dose of RBV 800 mg/day. Superior response was found particularly in patients with the most difficult-to-treat form of the disease, genotype 1 HCV. Efficacy was consistent across all weight groups.... http://www.med.cornell.edu/
****************
FDA to clear cloned livestock for consumers NEW YORK (Reuters1/3) - The U.S. Food and Drugs Administration (FDA) is expected to declare as early as next week that meat and milk from cloned animals and their offspring is safe to eat, the Wall Street Journal reported on Thursday. http://www.reuters.com/article/healthNews/idUSN0326923720080104?feedType=nl&feedName=ushealth1100
Instead, Assembly Speaker Fabian Nunez, et al, played yet one more shell game approving a plan, all the while ignoring our looming and ever-growing budget deficit.
Meanwhile, they expect the electorate to approve a series of tax increases that they themselves were unwilling to even bring up for a debate. Now that's leadership for you... "
http://www.pasadenastarnews.com/rds_search/ci_7831679?IADID=Search-www.pasadenastarnews.com-www.pasadenastarnews.com
~~**~~**~~**~~**~~**~~
INTERESTING READING
Please remember that the REUTERS articles are good for 30 days only
IF you want to see what the Joint Commission is "up to"...here is the link:
http://www.jointcommission.org/Library/jconline/jcol_12_07.htm
**************************
Ozone Links Heat, Higher Cardio Death Risk Ozone may prove the key to the link between high temperature and the increased risk of death from heart disease or stroke, suggests research published in Occupational and Environmental Medicine.
The researchers base their findings on a population of almost 100 million people in 95 geographical areas across the U.S. during the months of June to September.
During this period, 4 million heart attacks or strokes occurred, and when the authors plotted daily deaths against fluctuations in temperature during one day, they found that ozone was a common link.... http://NW.advanceweb.com/Newsletter.aspx
*********************
Vitamin E Could Help Diabetics Ward Off MIs Vitamin E supplements can significantly reduce the risk of myocardial infarction (MI) and related deaths for diabetics who carry a particular version of a gene, according to researchers at the Technion-Israel Institute of Technology and the Clalit Health Services in Israel.
After 18 months of treatment, people with the haptoglobin (Hp) 2-2 gene who took 400 International Units (IU) of vitamin E daily had more than 50 percent fewer MIs, strokes and related deaths than Hp 2-2 patients who took a placebo pill. Forty percent of individuals with diabetes carry the Hp 2-2 gene.
The full study appeared in the Nov. 21 online edition of the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
*******************
FDA Clears First Quick Test for Drug-Resistant Staph Infections ---Test Identifies MRSA Bacterium in Two Hours The U.S. Food and Drug Administration (FDA) today announced it has cleared for marketing the first rapid blood test for the drug-resistant staph bacterium known as MRSA (methicillin-resistant Staphylococcus aureus), which can cause potentially deadly infections.
Methicillin is an antibiotic that has been used successfully to treat infections from the Staphylococcus aureus bacterium. Over the years, the staph bacterium mutated and spawned MRSA, a strain of staph bacterium that is resistant to methicillin and which has a higher rate of being fatal.
The BD GeneOhm StaphSR Assay uses molecular methods to identify whether a blood sample contains genetic material from the MRSA bacterium or the more common, less dangerous staph bacterium that can still be treated with methicillin.... http://www.fda.gov/bbs/topics/NEWS/2007/NEW01768.html
**********************
Win-R Study Demonstrates Weight-Based REBETOL Plus PEG-INTRON Improve Efficacy and Lower Relapse Rates, Particularly in Very Heavy Patients and in African-Americans With Most Difficult-to-Treat Form of the Disease NEW YORK (Dec. 27, 2007) — As reported recently in the journal Hepatology, WIN-R, a multicenter study of over 5,000 patients with hepatitis C virus (HCV) showed treatment with weight-based REBETOL® (ribavirin, USP) (RBV) in combination with pegylated interferon (PEG-IFN) alfa-2b achieved significantly higher rates of sustained virologic response (SVR) and lower relapse rates compared to combination therapy using a flat dose of RBV 800 mg/day. Superior response was found particularly in patients with the most difficult-to-treat form of the disease, genotype 1 HCV. Efficacy was consistent across all weight groups.... http://www.med.cornell.edu/
****************
FDA to clear cloned livestock for consumers NEW YORK (Reuters1/3) - The U.S. Food and Drugs Administration (FDA) is expected to declare as early as next week that meat and milk from cloned animals and their offspring is safe to eat, the Wall Street Journal reported on Thursday. http://www.reuters.com/article/healthNews/idUSN0326923720080104?feedType=nl&feedName=ushealth1100
(I am sure it is okay to trust cloned livestock as being safe...because the.FDA says it is
Oh Yeah, Right ! )
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Group sues U.S. in push for new antibiotic warning Washington (Reuters 1/3) - A consumer group asked a U.S. court on Thursday to force regulators to decide if stronger warnings should be added to certain antibiotics to alert doctors and patients about the risks of tendon rupture. http://www.reuters.com/article/healthNews/idUSN0324877420080103?feedType=nl&feedName=ushealth1100
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Two J & J drugs do not work LONDON (Reuters 1/3) - Two Johnson & Johnson antipsychotic drugs long used to treat aggressive behavior in people with limited intelligence do not work and should not be prescribed for these patients, researchers said on Friday. http://www.reuters.com/article/healthNews/idUSL0358278920080104?feedType=nl&feedName=ushealth1100
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The following was sent in by Rosalfaro (Roz)...thank you ! I checked with Urban Legends/Snopes and found no reference to this informational tidbit.
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Group sues U.S. in push for new antibiotic warning Washington (Reuters 1/3) - A consumer group asked a U.S. court on Thursday to force regulators to decide if stronger warnings should be added to certain antibiotics to alert doctors and patients about the risks of tendon rupture. http://www.reuters.com/article/healthNews/idUSN0324877420080103?feedType=nl&feedName=ushealth1100
******************
Two J & J drugs do not work LONDON (Reuters 1/3) - Two Johnson & Johnson antipsychotic drugs long used to treat aggressive behavior in people with limited intelligence do not work and should not be prescribed for these patients, researchers said on Friday. http://www.reuters.com/article/healthNews/idUSL0358278920080104?feedType=nl&feedName=ushealth1100
*************************
The following was sent in by Rosalfaro (Roz)...thank you ! I checked with Urban Legends/Snopes and found no reference to this informational tidbit.
This is a 3 1/2 minute video produced by the Broward County, FL Sheriff's Office. Identity thieves are at it again, this time targetin people at the gas stations. This sort of crime never occurred to me, especiatlly since many of us never leave the side of our car when pumping gas anymore. That has apparently not improved our safety, especially for women who carry purses. The footage of the actual crime being committed is shocking in how easy it is to pull off. Click on the link below and pass this information on: http://video.sheriff.org/psa_cartheft.shtml
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Possible Parkinson's Trigger Identified LONDON (Reuters 1/3) - A glitch in the way cells clear damaged proteins could be the trigger for the symptoms of Parkinson's disease, researchers said in a finding that could lead to new treatments for the incurable condition.
The U.S. team focused on a process called autophagy in which cells digest and recycle damaged molecules, including proteins, that develop as cells grow older. This system essentially renews cells to keep them functioning properly.
This mechanism is also important for nerve cells in the brain where defective proteins can kill cells and cause the debilitating symptoms of Parkinson's, such as tremors, said Ana Maria Cuervo, a cell biologist who led the study.... http://www.reuters.com/article/healthNews/idUSL2843428320080103?feedType=nl&feedName=ushealth1100
********************
Free Drug Samples go to Wealthy and Insured WASHINGTON (Reuters 1/2) - Insured and wealthy Americans were more likely than the poor to get billions of dollars in free drug samples distributed by pharmaceutical companies to win patient and doctor loyalty, a study released on Wednesday showed.
The pharmaceutical industry contends that the samples help the uninsured and people with low incomes, but the study of prescription use by nearly 33,000 U.S. residents during 2003 found that the neediest were least likely to get samples.
"Our findings suggest the free samples serve as a marketing tool, not a safety net," said Dr. Sarah Cutrona, co-author of the report to be published in the February issue of the American Journal of Public Health....
http://www.reuters.com/article/healthNews/idUSN3158060620080103?feedType=nl&feedName=ushealth1100
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Defibrillator Shocks Often Late in U.S. Hospitals BOSTON (Reuters 1/2) - Nearly a third of patients with misfiring or quivering hearts in U.S. hospitals do not get the life-saving defibrillator shocks they need within the critical first two minutes of cardiac arrest, a study published on Wednesday said.
The study confirming the importance of the two-minute period for survival was published in the New England Journal of Medicine, which also ran an accompanying editorial indicating a person might be better off suffering cardiac arrest in a casino than a hospital. ... http://www.reuters.com/article/healthNews/idUSN0263929020080102?feedType=nl&feedName=ushealth1100
***********************
Drug Found Better at Suppressing Hepatitis B Virus HONG KONG (Reuters 1/3) - Two international studies of a new drug, telbivudine, have produced potentially good news for hepatitis B patients, showing that it suppresses the virus that damages the liver faster and better than other treatments.
Chronically infected people are at high risk of death from cirrhosis of the liver and liver cancer, diseases that kill about one million people a year, the World Health Organization says.
Reducing the amount of hepatitis B virus in the blood is critical to limiting the adverse effects of chronic hepatitis B, which affects at least 360 million people and is the 10th leading cause of death worldwide....
http://www.reuters.com/article/healthNews/idUSHKG19637020080103?feedType=nl&feedName=ushealth1100
***********************
Standard Intelligence Test The keepers of the nation's secrets soon will be evaluated against common standards on how well they analyze problems, share information and stand behind their professional judgments.
Those job performance standards and others will apply to all rank-and-file civil service employees in the government's intelligence community, according to a directive issued last month by the director of national intelligence, Mike McConnell.
It marks the first time that the employees, across 16 agencies, will be evaluated according to the same performance requirements.... http://www.washingtonpost.com/wp-dyn/content/article/2008/01/02/AR2008010202945.html?wpisrc=newsletter&wpisrc=newsletter
******************
Nurse-patient ratios changing in California Hospitals Hospitals in California must increase the number of nurses on duty in relation to patient load as of Tuesday under changes mandated by a state law.
It marks the fifth year of a five-year plan to increase nurse-to-patient ratios to meet state mandates for minimum safe care.
Ratios differ by hospital area, such as a minimum of no less than one registered nurse for every five patients in general medical or post-surgical care units, 1:4 in pediatrics, and 1:4 in emergency rooms.
The ratios are a floor, not a ceiling, with hospitals also required to increase registered nurse staffing as needed based on individual patient illness or acuity.... http://www.centralvalleybusinesstimes.com/stories/001/?ID=7434
*********************************
Changing Population Age-Mix Affects Health Care Costs Only Modestly The changing age-mix of the U.S. population has had only a modest effect on the growth of health care spending, and that trend is expected to continue even as the nation ages dramatically over the next four decades, experts at
the federal government¹s Centers for Medicare and Medicaid Services (CMS) report today in a Health Affairs Web Exclusive.
Per person personal health care spending for the population age 65 and older was $14,797 in 2004 -- 5.6 times higher than spending per child ($2,650 in 2004) and 3.3 times spending per working-age person ($4,511 in 2004). Consistent with other studies, the authors found that per capita health
spending grew faster for those under age 65 than for those age 65 and older, although the difference -- 0.2 percent annually between 1987 and 1999 -- was much less than previously reported....
You can read the article by Micah Hartman and coauthors at
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.1.w1
***********************
This is an excellent read........please take the time for it.
***********************
Possible Parkinson's Trigger Identified LONDON (Reuters 1/3) - A glitch in the way cells clear damaged proteins could be the trigger for the symptoms of Parkinson's disease, researchers said in a finding that could lead to new treatments for the incurable condition.
The U.S. team focused on a process called autophagy in which cells digest and recycle damaged molecules, including proteins, that develop as cells grow older. This system essentially renews cells to keep them functioning properly.
This mechanism is also important for nerve cells in the brain where defective proteins can kill cells and cause the debilitating symptoms of Parkinson's, such as tremors, said Ana Maria Cuervo, a cell biologist who led the study.... http://www.reuters.com/article/healthNews/idUSL2843428320080103?feedType=nl&feedName=ushealth1100
********************
Free Drug Samples go to Wealthy and Insured WASHINGTON (Reuters 1/2) - Insured and wealthy Americans were more likely than the poor to get billions of dollars in free drug samples distributed by pharmaceutical companies to win patient and doctor loyalty, a study released on Wednesday showed.
The pharmaceutical industry contends that the samples help the uninsured and people with low incomes, but the study of prescription use by nearly 33,000 U.S. residents during 2003 found that the neediest were least likely to get samples.
"Our findings suggest the free samples serve as a marketing tool, not a safety net," said Dr. Sarah Cutrona, co-author of the report to be published in the February issue of the American Journal of Public Health....
http://www.reuters.com/article/healthNews/idUSN3158060620080103?feedType=nl&feedName=ushealth1100
*******************************
Defibrillator Shocks Often Late in U.S. Hospitals BOSTON (Reuters 1/2) - Nearly a third of patients with misfiring or quivering hearts in U.S. hospitals do not get the life-saving defibrillator shocks they need within the critical first two minutes of cardiac arrest, a study published on Wednesday said.
The study confirming the importance of the two-minute period for survival was published in the New England Journal of Medicine, which also ran an accompanying editorial indicating a person might be better off suffering cardiac arrest in a casino than a hospital. ... http://www.reuters.com/article/healthNews/idUSN0263929020080102?feedType=nl&feedName=ushealth1100
***********************
Drug Found Better at Suppressing Hepatitis B Virus HONG KONG (Reuters 1/3) - Two international studies of a new drug, telbivudine, have produced potentially good news for hepatitis B patients, showing that it suppresses the virus that damages the liver faster and better than other treatments.
Chronically infected people are at high risk of death from cirrhosis of the liver and liver cancer, diseases that kill about one million people a year, the World Health Organization says.
Reducing the amount of hepatitis B virus in the blood is critical to limiting the adverse effects of chronic hepatitis B, which affects at least 360 million people and is the 10th leading cause of death worldwide....
http://www.reuters.com/article/healthNews/idUSHKG19637020080103?feedType=nl&feedName=ushealth1100
***********************
Standard Intelligence Test The keepers of the nation's secrets soon will be evaluated against common standards on how well they analyze problems, share information and stand behind their professional judgments.
Those job performance standards and others will apply to all rank-and-file civil service employees in the government's intelligence community, according to a directive issued last month by the director of national intelligence, Mike McConnell.
It marks the first time that the employees, across 16 agencies, will be evaluated according to the same performance requirements.... http://www.washingtonpost.com/wp-dyn/content/article/2008/01/02/AR2008010202945.html?wpisrc=newsletter&wpisrc=newsletter
******************
Nurse-patient ratios changing in California Hospitals Hospitals in California must increase the number of nurses on duty in relation to patient load as of Tuesday under changes mandated by a state law.
It marks the fifth year of a five-year plan to increase nurse-to-patient ratios to meet state mandates for minimum safe care.
Ratios differ by hospital area, such as a minimum of no less than one registered nurse for every five patients in general medical or post-surgical care units, 1:4 in pediatrics, and 1:4 in emergency rooms.
The ratios are a floor, not a ceiling, with hospitals also required to increase registered nurse staffing as needed based on individual patient illness or acuity.... http://www.centralvalleybusinesstimes.com/stories/001/?ID=7434
*********************************
Changing Population Age-Mix Affects Health Care Costs Only Modestly The changing age-mix of the U.S. population has had only a modest effect on the growth of health care spending, and that trend is expected to continue even as the nation ages dramatically over the next four decades, experts at
the federal government¹s Centers for Medicare and Medicaid Services (CMS) report today in a Health Affairs Web Exclusive.
Per person personal health care spending for the population age 65 and older was $14,797 in 2004 -- 5.6 times higher than spending per child ($2,650 in 2004) and 3.3 times spending per working-age person ($4,511 in 2004). Consistent with other studies, the authors found that per capita health
spending grew faster for those under age 65 than for those age 65 and older, although the difference -- 0.2 percent annually between 1987 and 1999 -- was much less than previously reported....
You can read the article by Micah Hartman and coauthors at
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.1.w1
***********************
This is an excellent read........please take the time for it.
THE CHECKLIST The damage that the human body can survive these days is as awesome as it is horrible: crushing, burning, bombing, a burst blood vessel in the brain, a ruptured colon, a massive heart attack, rampaging infection. These conditions had once been uniformly fatal. Now survival is commonplace, and a large part of the credit goes to the irreplaceable component of medicine known as intensive care.
It’s an opaque term. Specialists in the field prefer to call what they do “critical care,” but that doesn’t exactly clarify matters. The non-medical term “life support” gets us closer. Intensive-care units take artificial control of failing bodies. Typically, this involves a panoply of technology—a mechanical ventilator and perhaps a tracheostomy tube if the lungs have failed, an aortic balloon pump if the heart has given out, a dialysis machine if the kidneys don’t work. When you are unconscious and can’t eat, silicone tubing can be surgically inserted into the stomach or intestines for formula feeding. If the intestines are too damaged, solutions of amino acids, fatty acids, and glucose can be infused directly into the bloodstream.... http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande
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NEW! Pocket Guide to Blood Pressure Measurement in Children This colorful, laminated card takes the scientific information from NHLBI’s The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (Fourth Report) and converts it into a readily accessible, easy-to-use screening tool. You can go directly from measuring a child’s height and blood pressure to categorizing the blood pressure status for that child. The new Pocket Guide to Blood Pressure Measurement in Children (Pocket Guide) covers ages 3 through 17 with separate tables for boys and girls organized by age and height in centimeters. The Pocket Guide uses the cut points from the Fourth Report for stages of pediatric hypertension for age, sex and height. Categories of hypertension defined in the Fourth Report are given directly in the tables of the Pocket Guide.
Category
Normal: Less than 90 th percentile
Prehypertension: > or = 90 th percentile to <> or = 95 th %tile to < or =" 99"> 99 th %tile + 5 mmHg
Because diastolic hypertension rarely occurs without systolic hypertension in children, and because the Pocket Guide is a screening tool, it lists systolic pressures only. If, on screening, a child is classified with any stage of hypertension, the diastolic values should be determined from the full tables in the Fourth Report. Order the Pocket Guide for ONLY $1.50 each. (item #07-5268) at http://emall.nhlbihin.net/ product2.asp?sku=07-5268
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Colon Cancer Risk Traced to Common Ancestor LONDON (Reuters 1/2/08) - A married couple who sailed to America from England around 1630 are the reason why thousands of people in the United States are at higher risk of a hereditary form of colon cancer, researchers said on Wednesday.
Using a genetic fingerprint, a U.S. team traced back a so-called founder genetic mutation to the couple found among two large families currently living in Utah and New York.... http://www.reuters.com/article/healthNews/idUSL2856779820080102?feedType=nl&feedName=ushealth1100
*****************
Miscarriage ups risk of trouble in next pregnancy NEW YORK (Reuters Health 1/1/08) - Pregnant women who suffer a miscarriage in the second-trimester are at high risk during a subsequent pregnancy of a spontaneous preterm birth and repeat second-trimester miscarriage, a study indicates.
Dr. Michal A. Elovitz and associates studied three groups of women: 30 women who had a spontaneous second-trimester miscarriage; 76 women with a spontaneous preterm birth; and 76 women with full-term deliveries. All of the women had a subsequent pregnancy beyond 14 weeks' gestation.... http://www.reuters.com/article/healthNews/idUSPAR16576020080101?feedType=nl&feedName=ushealth1100
*********************
How to cure hiccups This was sent in by a fellow nurse who writes: " Take a glass of water and use a metal item such as an iced tea spoon, table knife, etc. that is long enough to reach the water and the temple (either side). Drink the water with the metal touching the water and the
temple simultaneously.
She writes "It has worked for me and I pass this on to patients and families on occasion. For me, the hiccups stop immediately after taking only one sip of water in this highly unusual fashion".
********************
Outcomes of Interventions to Improve Hospital Nursing Work Environments
The impact of interventions designed to improve the nursing work environment on patient and nurse outcomes was examined...Findings in this study highlight the importance of understanding factors in the work environment that influence patient and nurse outcomes ... (you need to acquire the Journal for all the information from the research)... Journal of Nursing Administration. 38(1):40-46, January 2008. Hall, Linda McGillis PhD, RN, FAAN; Doran, Diane PhD, RN; Pink, Leah MN, RN
http://www.jonajournal.com/pt/re/jona/abstract.00005110-200801000-00008.htm;jsessionid=H6NHdmWsvGnDnph9ZdvcL6mNhz0P7jcbYQXdhFWhCpNvkjlFJx6w!901085598!181195628!8091!-1
*********************
When your blood pressure (BP) creeps up, help knock it down with this simple change in diet.
Get 20 percent of your daily calories from whole-grain, high-fiber foods instead of refined "white" carbs. It could drop your systolic BP 4 to 8 points and your diastolic BP another 6 to 8 points. Start with these fiber-rich recipes below. Double Trouble High blood pressure and high cholesterol are double trouble. Both put you at risk for cardiovascular disease, and they frequently occur together. If you have borderline high cholesterol (200-239 mg/dL) and prehypertension (120-139/80-89 mm Hg), it's time to take action.
...Both soluble and insoluble fiber were shown to lower blood pressure in middle-aged people with the unfortunate combo of borderline high cholesterol and prehypertension. Soluble fiber does double duty by lowering cholesterol, too. (You should have at least 14 grams of fiber for every 1000 calories that you eat every day. Read the label on food packages to find out how much fiber a serving of a food will provide. Foods containing more than 20% of the daily value of fiber per serving are considered high in fiber.) Reference: Whole-grain diets reduce blood pressure in mildly hypercholesterolemic men and women. Behall, K. M., Scholfield, D. J., Hallfrisch, J., Journal of the American Dietetic Association 2006 Sep;106(9):1445-1449.
*******************
Fishing around for a slimmer you.. No doubt you’ve started thinking about all the salads you’re going to eat when you start trimming down next year. But those salads might work better if you add a little salmon.
Here’s why: It seems that fish oil, besides boosting your heart health, may also help you burn fat. And if you add fish oil to your diet and you exercise, you could really boost your calorie burning! Omega-3s, Please
Fish oil is full of anti-inflammatory and artery-clearing omega-3 fatty acids that help protect your ticker. But these fatty acids may also help fuel your metabolism.
In a study, overweight people who took fish oil supplements daily and walked 3 days a week for 12 weeks lost a significant amount of weight and body fat. Still, most people can do their heart and body right by eating one or two servings a week of omega-3-rich fish that is relatively low in mercury. Unfortunately, most fish contain some mercury, thanks to industrial processing. But the less time fish spend simply living in a mercury-laden environment or eating other fish containing mercury, the lower the contamination levels will be. So for low-mercury fish, we're talking small fish that don't eat many other fish (or fish meal) and don't have a long life span. Here are five good choices:
1. Salmon (wild): 1 gram of omega-3 fatty acids per 2 ounces of fish;* 0.014 parts per million mercury concentration
2. Herring: 1 gram of omega-3 fatty acids per 1 ounce of fish;* 0.044 parts per million mercury concentration
3. Sardines: 1 gram of omega-3 fatty acids per 2-3 ounces of fish;* 0.016 parts per million mercury concentration
4. Trout (freshwater): 1 gram of omega-3 fatty acids per 3-4 ounces of fish;* 0.072 parts per million mercury concentration
5. Pollock: 1 gram of omega-3 fatty acids per 6.5 ounces of fish;* 0.041 parts per million mercury concentration
*Oil content varies widely, depending on species, season, environment, diet, and packing and cooking methods.
Here's the list of fish to avoid:
• King mackerel: 0.73 parts per million mercury concentration
• Shark: 0.99 parts per million mercury concentration
• Swordfish: 0.98 parts per million mercury concentration
• Tilefish (Gulf of Mexico): 1.45 parts per million mercury concentration
So where does the beloved tuna fall? Pretty close to the middle of the road, actually, with mercury concentration ranging from 0.12 to 0.69 parts per million... Reference: Combining fish-oil supplements with regular aerobic exercise improves body composition and cardiovascular disease risk factors. Hill, A. M., Buckley, J. D., Murphy, K. J., Howe, P. R., American Journal of Clinical Nutrition 2007 May;85(5):1267-1274.
****************
Combo Therapy Surpasses Single Drug for Severe COPD LONDON, Dec. 28 -- Combination drug therapy with salmeterol (Serevent), a long-acting inhaled bronchodilator, and fluticasone (Flovent) improved survival and led to fewer treatment withdrawals compared with single-drug therapy in severe COPD.
A multicenter head-to-head study found a 52% reduction in the risk of all-cause mortality at any time during the study for the combo treatment compared with single-drug treatment, Jadwiga A. Wedzicha, M.D., of Royal Free & University College Medical School here, and colleagues reported in the first January issue of the American Journal of Critical Care Medicine ...
http://www.medpagetoday.com/Pulmonary/SmokingCOPD/tb/7815
***************************
Studies show yoga has multiple benefits CHANNAI, India (Reuters Health 12/31) - Yoga induces a feeling of well-being in healthy people, and can reverse the clinical and biochemical changes associated with metabolic syndrome, according to results of studies from Sweden and India. Metabolic syndrome is a cluster of heart disease risk factors such as high blood pressure, obesity and high blood sugar.
Dr. R.P. Agrawal, of the SP Medical College, Bikaner, India, and colleagues evaluated the beneficial effects of yoga and meditation in 101 adults with features of metabolic syndrome. In the study, 55 adults received three months of regular yoga including standard postures and Raja Yoga, a form of transcendental meditation daily, while the remaining received standard care.
Waist circumference, blood pressure, blood sugar, and triglycerides were significantly lower, and "good" HDL cholesterol levels were higher in the yoga group as compared to controls, Agrawal's team reports in the journal Diabetes Research and Clinical Practice.... http://www.reuters.com/article/healthNews/idUSSAT87408420071231?feedType=nl&feedName=ushealth1100
*******************
Lack of deep sleep may raise diabetes risk CHICAGO (Reuters 12/31) - Deep, restful sleep may be important for keeping type 2 diabetes at bay, U.S. researchers said on Monday.
They said slim, healthy young adults who were deprived of the deepest stage of sleep known as slow-wave sleep developed insulin resistance -- a trait linked to type 2 diabetes -- after just three nights.... http://www.reuters.com/article/healthNews/idUSN3158826720071231?feedType=nl&feedName=ushealth1100
*************************
Restless Legs Linked with Heart Problems CHICAGO (Reuters 12/31) - People with restless legs syndrome or RLS are twice as likely to have a stroke or heart disease and those with the most severe symptoms are at greatest risk, U.S. researchers said on Monday.
"The association of RLS with heart disease and stroke was strongest in those people who had RLS symptoms at least 16 times per month," Dr. John Winkelman, a sleep researcher at Harvard Medical School and Brigham & Women's Hospital in Boston, said in a statement.
"There was also an increased risk among people who said their RLS symptoms were severe compared to those with less bothersome symptoms," said Winkelman, whose study appeared in Neurology, the medical journal of the American Academy of Neurology.
Restless legs syndrome is marked by a strong, irresistible urge to move the legs that is often associated with an itching, tugging or gnawing feeling. These symptoms tend to worsen when resting, causing difficulty in falling or staying asleep.... http://www.reuters.com/article/healthNews/idUSN3159019220071231?feedType=nl&feedName=ushealth1100
*************************
"Swish-and-Spit " test screens for cancer WASHINGTON (Reuters 1/1/08) - A simple mouth rinse may provide a new way to screen for head and neck cancers in people at high risk for these diseases, researchers said on Tuesday.
Scientists at the Johns Hopkins Kimmel Cancer Center in Baltimore are developing a saliva test -- inexpensive, easy to perform and painless -- that could spot diseases like mouth and throat cancer in heavy smokers, heavy drinkers and others at high risk.
The screening test focuses on finding cells with genetic signatures suggesting the presence of these cancers.... http://www.reuters.com/article/healthNews/idUSN3141180820080101?feedType=nl&feedName=ushealth1100
***************
Perception of rejecting and neglectful parenting in childhood relates to lifetime suicide attempts for females-- but not for males Ehnvall A et al. - To examine the hypothesis that lifetime suicide attempts in a sample of depressed individuals is greater among those who remember their parents as rejecting or neglecting in childhood...Perception of rejecting/neglectful parents was associated with lifetime suicide attempts in females only, inviting research explicating any such gender specificity... Acta Psychiatrica Scandinavica, 12/28/07
http://www.ingentaconnect.com/content/mksg/acp/2008/
It’s an opaque term. Specialists in the field prefer to call what they do “critical care,” but that doesn’t exactly clarify matters. The non-medical term “life support” gets us closer. Intensive-care units take artificial control of failing bodies. Typically, this involves a panoply of technology—a mechanical ventilator and perhaps a tracheostomy tube if the lungs have failed, an aortic balloon pump if the heart has given out, a dialysis machine if the kidneys don’t work. When you are unconscious and can’t eat, silicone tubing can be surgically inserted into the stomach or intestines for formula feeding. If the intestines are too damaged, solutions of amino acids, fatty acids, and glucose can be infused directly into the bloodstream.... http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande
****************************
NEW! Pocket Guide to Blood Pressure Measurement in Children This colorful, laminated card takes the scientific information from NHLBI’s The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (Fourth Report) and converts it into a readily accessible, easy-to-use screening tool. You can go directly from measuring a child’s height and blood pressure to categorizing the blood pressure status for that child. The new Pocket Guide to Blood Pressure Measurement in Children (Pocket Guide) covers ages 3 through 17 with separate tables for boys and girls organized by age and height in centimeters. The Pocket Guide uses the cut points from the Fourth Report for stages of pediatric hypertension for age, sex and height. Categories of hypertension defined in the Fourth Report are given directly in the tables of the Pocket Guide.
Category
Normal: Less than 90 th percentile
Prehypertension: > or = 90 th percentile to <> or = 95 th %tile to < or =" 99"> 99 th %tile + 5 mmHg
Because diastolic hypertension rarely occurs without systolic hypertension in children, and because the Pocket Guide is a screening tool, it lists systolic pressures only. If, on screening, a child is classified with any stage of hypertension, the diastolic values should be determined from the full tables in the Fourth Report. Order the Pocket Guide for ONLY $1.50 each. (item #07-5268) at http://emall.nhlbihin.net/ product2.asp?sku=07-5268
***********************
Colon Cancer Risk Traced to Common Ancestor LONDON (Reuters 1/2/08) - A married couple who sailed to America from England around 1630 are the reason why thousands of people in the United States are at higher risk of a hereditary form of colon cancer, researchers said on Wednesday.
Using a genetic fingerprint, a U.S. team traced back a so-called founder genetic mutation to the couple found among two large families currently living in Utah and New York.... http://www.reuters.com/article/healthNews/idUSL2856779820080102?feedType=nl&feedName=ushealth1100
*****************
Miscarriage ups risk of trouble in next pregnancy NEW YORK (Reuters Health 1/1/08) - Pregnant women who suffer a miscarriage in the second-trimester are at high risk during a subsequent pregnancy of a spontaneous preterm birth and repeat second-trimester miscarriage, a study indicates.
Dr. Michal A. Elovitz and associates studied three groups of women: 30 women who had a spontaneous second-trimester miscarriage; 76 women with a spontaneous preterm birth; and 76 women with full-term deliveries. All of the women had a subsequent pregnancy beyond 14 weeks' gestation.... http://www.reuters.com/article/healthNews/idUSPAR16576020080101?feedType=nl&feedName=ushealth1100
*********************
How to cure hiccups This was sent in by a fellow nurse who writes: " Take a glass of water and use a metal item such as an iced tea spoon, table knife, etc. that is long enough to reach the water and the temple (either side). Drink the water with the metal touching the water and the
temple simultaneously.
She writes "It has worked for me and I pass this on to patients and families on occasion. For me, the hiccups stop immediately after taking only one sip of water in this highly unusual fashion".
********************
Outcomes of Interventions to Improve Hospital Nursing Work Environments
The impact of interventions designed to improve the nursing work environment on patient and nurse outcomes was examined...Findings in this study highlight the importance of understanding factors in the work environment that influence patient and nurse outcomes ... (you need to acquire the Journal for all the information from the research)... Journal of Nursing Administration. 38(1):40-46, January 2008. Hall, Linda McGillis PhD, RN, FAAN; Doran, Diane PhD, RN; Pink, Leah MN, RN
http://www.jonajournal.com/pt/re/jona/abstract.00005110-200801000-00008.htm;jsessionid=H6NHdmWsvGnDnph9ZdvcL6mNhz0P7jcbYQXdhFWhCpNvkjlFJx6w!901085598!181195628!8091!-1
*********************
When your blood pressure (BP) creeps up, help knock it down with this simple change in diet.
Get 20 percent of your daily calories from whole-grain, high-fiber foods instead of refined "white" carbs. It could drop your systolic BP 4 to 8 points and your diastolic BP another 6 to 8 points. Start with these fiber-rich recipes below. Double Trouble High blood pressure and high cholesterol are double trouble. Both put you at risk for cardiovascular disease, and they frequently occur together. If you have borderline high cholesterol (200-239 mg/dL) and prehypertension (120-139/80-89 mm Hg), it's time to take action.
...Both soluble and insoluble fiber were shown to lower blood pressure in middle-aged people with the unfortunate combo of borderline high cholesterol and prehypertension. Soluble fiber does double duty by lowering cholesterol, too. (You should have at least 14 grams of fiber for every 1000 calories that you eat every day. Read the label on food packages to find out how much fiber a serving of a food will provide. Foods containing more than 20% of the daily value of fiber per serving are considered high in fiber.) Reference: Whole-grain diets reduce blood pressure in mildly hypercholesterolemic men and women. Behall, K. M., Scholfield, D. J., Hallfrisch, J., Journal of the American Dietetic Association 2006 Sep;106(9):1445-1449.
*******************
Fishing around for a slimmer you.. No doubt you’ve started thinking about all the salads you’re going to eat when you start trimming down next year. But those salads might work better if you add a little salmon.
Here’s why: It seems that fish oil, besides boosting your heart health, may also help you burn fat. And if you add fish oil to your diet and you exercise, you could really boost your calorie burning! Omega-3s, Please
Fish oil is full of anti-inflammatory and artery-clearing omega-3 fatty acids that help protect your ticker. But these fatty acids may also help fuel your metabolism.
In a study, overweight people who took fish oil supplements daily and walked 3 days a week for 12 weeks lost a significant amount of weight and body fat. Still, most people can do their heart and body right by eating one or two servings a week of omega-3-rich fish that is relatively low in mercury. Unfortunately, most fish contain some mercury, thanks to industrial processing. But the less time fish spend simply living in a mercury-laden environment or eating other fish containing mercury, the lower the contamination levels will be. So for low-mercury fish, we're talking small fish that don't eat many other fish (or fish meal) and don't have a long life span. Here are five good choices:
1. Salmon (wild): 1 gram of omega-3 fatty acids per 2 ounces of fish;* 0.014 parts per million mercury concentration
2. Herring: 1 gram of omega-3 fatty acids per 1 ounce of fish;* 0.044 parts per million mercury concentration
3. Sardines: 1 gram of omega-3 fatty acids per 2-3 ounces of fish;* 0.016 parts per million mercury concentration
4. Trout (freshwater): 1 gram of omega-3 fatty acids per 3-4 ounces of fish;* 0.072 parts per million mercury concentration
5. Pollock: 1 gram of omega-3 fatty acids per 6.5 ounces of fish;* 0.041 parts per million mercury concentration
*Oil content varies widely, depending on species, season, environment, diet, and packing and cooking methods.
Here's the list of fish to avoid:
• King mackerel: 0.73 parts per million mercury concentration
• Shark: 0.99 parts per million mercury concentration
• Swordfish: 0.98 parts per million mercury concentration
• Tilefish (Gulf of Mexico): 1.45 parts per million mercury concentration
So where does the beloved tuna fall? Pretty close to the middle of the road, actually, with mercury concentration ranging from 0.12 to 0.69 parts per million... Reference: Combining fish-oil supplements with regular aerobic exercise improves body composition and cardiovascular disease risk factors. Hill, A. M., Buckley, J. D., Murphy, K. J., Howe, P. R., American Journal of Clinical Nutrition 2007 May;85(5):1267-1274.
****************
Combo Therapy Surpasses Single Drug for Severe COPD LONDON, Dec. 28 -- Combination drug therapy with salmeterol (Serevent), a long-acting inhaled bronchodilator, and fluticasone (Flovent) improved survival and led to fewer treatment withdrawals compared with single-drug therapy in severe COPD.
A multicenter head-to-head study found a 52% reduction in the risk of all-cause mortality at any time during the study for the combo treatment compared with single-drug treatment, Jadwiga A. Wedzicha, M.D., of Royal Free & University College Medical School here, and colleagues reported in the first January issue of the American Journal of Critical Care Medicine ...
http://www.medpagetoday.com/Pulmonary/SmokingCOPD/tb/7815
***************************
Studies show yoga has multiple benefits CHANNAI, India (Reuters Health 12/31) - Yoga induces a feeling of well-being in healthy people, and can reverse the clinical and biochemical changes associated with metabolic syndrome, according to results of studies from Sweden and India. Metabolic syndrome is a cluster of heart disease risk factors such as high blood pressure, obesity and high blood sugar.
Dr. R.P. Agrawal, of the SP Medical College, Bikaner, India, and colleagues evaluated the beneficial effects of yoga and meditation in 101 adults with features of metabolic syndrome. In the study, 55 adults received three months of regular yoga including standard postures and Raja Yoga, a form of transcendental meditation daily, while the remaining received standard care.
Waist circumference, blood pressure, blood sugar, and triglycerides were significantly lower, and "good" HDL cholesterol levels were higher in the yoga group as compared to controls, Agrawal's team reports in the journal Diabetes Research and Clinical Practice.... http://www.reuters.com/article/healthNews/idUSSAT87408420071231?feedType=nl&feedName=ushealth1100
*******************
Lack of deep sleep may raise diabetes risk CHICAGO (Reuters 12/31) - Deep, restful sleep may be important for keeping type 2 diabetes at bay, U.S. researchers said on Monday.
They said slim, healthy young adults who were deprived of the deepest stage of sleep known as slow-wave sleep developed insulin resistance -- a trait linked to type 2 diabetes -- after just three nights.... http://www.reuters.com/article/healthNews/idUSN3158826720071231?feedType=nl&feedName=ushealth1100
*************************
Restless Legs Linked with Heart Problems CHICAGO (Reuters 12/31) - People with restless legs syndrome or RLS are twice as likely to have a stroke or heart disease and those with the most severe symptoms are at greatest risk, U.S. researchers said on Monday.
"The association of RLS with heart disease and stroke was strongest in those people who had RLS symptoms at least 16 times per month," Dr. John Winkelman, a sleep researcher at Harvard Medical School and Brigham & Women's Hospital in Boston, said in a statement.
"There was also an increased risk among people who said their RLS symptoms were severe compared to those with less bothersome symptoms," said Winkelman, whose study appeared in Neurology, the medical journal of the American Academy of Neurology.
Restless legs syndrome is marked by a strong, irresistible urge to move the legs that is often associated with an itching, tugging or gnawing feeling. These symptoms tend to worsen when resting, causing difficulty in falling or staying asleep.... http://www.reuters.com/article/healthNews/idUSN3159019220071231?feedType=nl&feedName=ushealth1100
*************************
"Swish-and-Spit " test screens for cancer WASHINGTON (Reuters 1/1/08) - A simple mouth rinse may provide a new way to screen for head and neck cancers in people at high risk for these diseases, researchers said on Tuesday.
Scientists at the Johns Hopkins Kimmel Cancer Center in Baltimore are developing a saliva test -- inexpensive, easy to perform and painless -- that could spot diseases like mouth and throat cancer in heavy smokers, heavy drinkers and others at high risk.
The screening test focuses on finding cells with genetic signatures suggesting the presence of these cancers.... http://www.reuters.com/article/healthNews/idUSN3141180820080101?feedType=nl&feedName=ushealth1100
***************
Perception of rejecting and neglectful parenting in childhood relates to lifetime suicide attempts for females-- but not for males Ehnvall A et al. - To examine the hypothesis that lifetime suicide attempts in a sample of depressed individuals is greater among those who remember their parents as rejecting or neglecting in childhood...Perception of rejecting/neglectful parents was associated with lifetime suicide attempts in females only, inviting research explicating any such gender specificity... Acta Psychiatrica Scandinavica, 12/28/07
http://www.ingentaconnect.com/content/mksg/acp/2008/
00000117/00000001/art00008;jsessionid=
2qknt6ope15le.victoria
**********************
This is from the May 3rd edition of ISMP Nurse ERR Newsletters. Action needed to prevent dangerous heparin-insulin confusion The New Jersey (NJ) Department of Health and Senior Services’ Patient Safety Initiative recently issued an alert to NJ hospitals after learning of an incident involving a bag of total parenteral nutrition (TPN) that contained insulin instead of heparin. A blood glucose level of 17 mg/dL was reported for a premature baby in the NICU, 6 hours after a TPN infusion had been started. Despite multiple bolus doses of dextrose and an infusion of dextrose 20% in sodium chloride 0.45%, the hypoglycemia did not completely resolve until discontinuing the TPN. The neonatologist asked that the remaining TPN be sent for analysis, which showed that the fluid contained insulin, not heparin. The long-term impact on the neonate has not been determined. This hospital receives TPN from a national vendor and an investigation into the event is underway. ... http://www.ismp.org/Newsletters/acutecare/articles/20070503.asp?ptr=ya
***********************
Transient ischemic attack (TIA), commonly known as mini-stroke, formerly was considered fairly benign because its stroke-like symptoms last less than 24 hours and do not cause permanent damage. Experts now say this brief neurologic deficit is a warning sign of a future stroke and should be treated just as seriously.
About 30% of people who experience a TIA will have a major stroke within five years unless they receive preventive treatment, according to the American Stroke Association (ASA), a division of the American Heart Association. The chance of having a stroke within 90 days of a TIA is as high as 17%, the association reports. .... http://include.nurse.com/apps/pbcs.dll/article?AID=/20071119/ALL02/711190303
********************
Unified Health Communication 101: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency is a free on-line learning experience that will help you improve your patient communication skills
increase your awareness and knowledge of the three main factors that affect your communication with patients: health literacy, cultural competency and low English proficiency implement patient-centered communication practices that demonstrate cultural competency and appropriately address patients with limited health literacy and low English proficiency
You may choose to take the course for credit (CEU/CE, CHES, CME, CNE) or not for credit.
The course has five modules and is estimated to take a total of 5 hours to complete. You may complete the course at your own pace. http://www.hrsa.gov/healthliteracy/training.htm
******************
AHA says heart and stroke deaths declining in U. S. WASHINGTON
2qknt6ope15le.victoria
**********************
This is from the May 3rd edition of ISMP Nurse ERR Newsletters. Action needed to prevent dangerous heparin-insulin confusion The New Jersey (NJ) Department of Health and Senior Services’ Patient Safety Initiative recently issued an alert to NJ hospitals after learning of an incident involving a bag of total parenteral nutrition (TPN) that contained insulin instead of heparin. A blood glucose level of 17 mg/dL was reported for a premature baby in the NICU, 6 hours after a TPN infusion had been started. Despite multiple bolus doses of dextrose and an infusion of dextrose 20% in sodium chloride 0.45%, the hypoglycemia did not completely resolve until discontinuing the TPN. The neonatologist asked that the remaining TPN be sent for analysis, which showed that the fluid contained insulin, not heparin. The long-term impact on the neonate has not been determined. This hospital receives TPN from a national vendor and an investigation into the event is underway. ... http://www.ismp.org/Newsletters/acutecare/articles/20070503.asp?ptr=ya
***********************
Transient ischemic attack (TIA), commonly known as mini-stroke, formerly was considered fairly benign because its stroke-like symptoms last less than 24 hours and do not cause permanent damage. Experts now say this brief neurologic deficit is a warning sign of a future stroke and should be treated just as seriously.
About 30% of people who experience a TIA will have a major stroke within five years unless they receive preventive treatment, according to the American Stroke Association (ASA), a division of the American Heart Association. The chance of having a stroke within 90 days of a TIA is as high as 17%, the association reports. .... http://include.nurse.com/apps/pbcs.dll/article?AID=/20071119/ALL02/711190303
********************
Unified Health Communication 101: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency is a free on-line learning experience that will help you improve your patient communication skills
increase your awareness and knowledge of the three main factors that affect your communication with patients: health literacy, cultural competency and low English proficiency implement patient-centered communication practices that demonstrate cultural competency and appropriately address patients with limited health literacy and low English proficiency
You may choose to take the course for credit (CEU/CE, CHES, CME, CNE) or not for credit.
The course has five modules and is estimated to take a total of 5 hours to complete. You may complete the course at your own pace. http://www.hrsa.gov/healthliteracy/training.htm
******************
AHA says heart and stroke deaths declining in U. S. WASHINGTON
(Reuters 12/18/07) - Death rates from heart disease and stroke are falling in the United States, but heart and artery disease remains the leading cause of death, the American Heart Association (AHA) said on Monday.
An estimated 869,724 people died from heart disease in 2004, compared to 911,163 in 2003, the AHA said.
Cancer was the second-biggest killer, taking 553,888 lives in 2004. Stroke, when considered separately from other cardiovascular diseases, was the third leading killer, taking 150,074 lives.
The group predicts that in 2008, 770,000 people in the United States will have a heart attack and 430,000 will have a recurrent attack. Another 175,000 will have a silent first heart attack.
The group projected that 770,000 people will have a stroke in 2008, about 600,000 for the first time.
"These statistics make it clear that cardiovascular disease remains, by far, our greatest public health challenge," said Dr. Donald Lloyd-Jones, chair of the association's statistics committee.... http://www.reutershealth.com/archive/2007/12/18/eline/links/20071218elin007.html
**********************
INDIANAPOLIS – In a study entitled “Medical Myths Even Doctors Believe” published in the Christmas issue of the British Medical Journal, Indiana University School of Medicine researchers explored seven commonly held medical beliefs.
The researchers explored various myths including:
People only use 10 percent of their brains
Hair and fingernails continue to grow after we die
Eating turkey makes you sleepy
These beliefs are commonly accepted, not only by the general population, but also by many physicians. The authors’ surprising findings, when they reviewed medical literature – all the beliefs were unproven or untrue.
"We got fired up about this because we knew that physicians accepted these beliefs and were passing this information along to their patients. And these beliefs are frequently cited in the popular media. We didn’t set out to become myth busters,” said co-author Aaron Carroll, M.D., M.S., assistant professor of pediatrics and a Regenstrief Institute, Inc. affiliated scientist. ... http://www.eurekalert.org/pub_releases/2007-12/iu-mme121907.php
****************
An estimated 869,724 people died from heart disease in 2004, compared to 911,163 in 2003, the AHA said.
Cancer was the second-biggest killer, taking 553,888 lives in 2004. Stroke, when considered separately from other cardiovascular diseases, was the third leading killer, taking 150,074 lives.
The group predicts that in 2008, 770,000 people in the United States will have a heart attack and 430,000 will have a recurrent attack. Another 175,000 will have a silent first heart attack.
The group projected that 770,000 people will have a stroke in 2008, about 600,000 for the first time.
"These statistics make it clear that cardiovascular disease remains, by far, our greatest public health challenge," said Dr. Donald Lloyd-Jones, chair of the association's statistics committee.... http://www.reutershealth.com/archive/2007/12/18/eline/links/20071218elin007.html
**********************
INDIANAPOLIS – In a study entitled “Medical Myths Even Doctors Believe” published in the Christmas issue of the British Medical Journal, Indiana University School of Medicine researchers explored seven commonly held medical beliefs.
The researchers explored various myths including:
People only use 10 percent of their brains
Hair and fingernails continue to grow after we die
Eating turkey makes you sleepy
These beliefs are commonly accepted, not only by the general population, but also by many physicians. The authors’ surprising findings, when they reviewed medical literature – all the beliefs were unproven or untrue.
"We got fired up about this because we knew that physicians accepted these beliefs and were passing this information along to their patients. And these beliefs are frequently cited in the popular media. We didn’t set out to become myth busters,” said co-author Aaron Carroll, M.D., M.S., assistant professor of pediatrics and a Regenstrief Institute, Inc. affiliated scientist. ... http://www.eurekalert.org/pub_releases/2007-12/iu-mme121907.php
****************
You know what they say about strong hands, don't you? Better blood pressure! That's right. Hypertensive people in a small study slashed their systolic blood pressure by 15 points after doing handgrip exercises for just 8 weeks. Having trouble opening those jelly jars? Here are three quick ways to start getting a better grip:
Behind the Strength Researchers don't yet understand exactly how hand exercises help blood pressure. More research is needed before they could be considered a legitimate part of blood-pressure-lowering therapies. (Here's an eating plan that's proven to lower blood pressure.)
In the meantime, we do know for sure that superior hand strength is great for several reasons. One of the most important? People with strong hands tend to be more able-bodied later in life. (Here's another way to see how able-bodied you are.)
3 Handy Exercises
Get a grip! Here are three simple hand exercises to choose from.
1. Squeeze a tennis ball. Try two or three sets of 10 squeezes per hand every other day.
2. After reading them, roll each page of your newspaper into the smallest ball possible. (Then recycle, of course!)
3. For more advanced fitness fiends, try doing a few fingertip push-ups.
Get a grip! On your hand strength and blood pressure, that is, with the Gripmaster Hand Exerciser. Choose your color, choose your resistance, and put the squeeeeeeze on hypertension.
Check yourself: Answer these six questions to find out if your last blood pressure reading may have been off.
Get a grip! On your hand strength and blood pressure, that is, with the Gripmaster Hand Exerciser. Choose your color, choose your resistance, and put the squeeeeeeze on hypertension. References: Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives. McGowan, C. L., Visocchi, A., Faulkner, M., Verduyn, R., Rakobowchuk, M., Levy, A. S., McCartney, N., MacDonald, M. J., European Journal of Applied Physiology 2007 Feb;99(3):227-234.
Midlife hand grip strength as a predictor of old age disability. Rantanen, T., Guralnik, J. M., Foley, D., Masaki, K., Leveille, S., Curb, J. D., White, L., JAMA 1999 Feb 10;281(6):558-560.
Is grip strength associated with health-related quality of life? Findings from the Hertfordshire Cohort Study. Sayer, A. A., Syddall, H. E., Martin, H. J., Dennison, E. M., Roberts, H. C., Cooper, C., Age and Ageing 2006 Jul;35(4):409-415.
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Bill Gates recently gave a speech at a High School about 11 things they did not and will not learn in school. He talks about how feel-good, politically correct teachings created a generation of kids with no concept of reality and how this concept set them up for failure in the real world.
Rule 1: Life is not fair - get used to it!
Rule 2: The world won't care about your self-esteem. The world will expect you
to accomplish something BEFORE you feel good about yourself.
Rule 3 : You will NOT make $60,000 a year right out of high school.
You won't be a vice president with a car phone until you earn both.
Rule 4: If you think your teacher is tough, wait 'til you get a boss.
Rule 5: Flipping burgers is not beneath your dignity. Your Grandparents had a
different word for burger flipping: they called it opportunity.
Rule 6: If you mess up, it's not your parents' fault, so don't whine about your mistakes,
learn from them.
Rule 7 : Before you were born, your parents weren't as boring as they are now.
They got that way from paying your bills, cleaning your clothes, and listening to you
talk about how cool you thought you were. So before you save the rain forest from
the parasites of your parent's generation, try delousing the closet in your own room.
Rule 8: Your school may have done away with winners and losers,
but life HAS NOT. In some schools, they have abolished failing grades and
they'll give you as MANY TIMES as you want to get the right answer.
This doesn't bear the slightest resemblance to ANYTHING in real life.
Rule 9 : Life is not divided into semesters. You don't get summers off and very few employers are interested in helping you FIND YOURSELF.
Do that on your own time.
Rule 10: Television is NOT real life. In real life, people actually have to leave the coffee shop and go to jobs.
Rule 11 : Be nice to nerds. Chances are you'll end up working for one.
~~**~~**~~**~~**~~**~~
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/
http://www.nurse.com/ce/
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com
Behind the Strength Researchers don't yet understand exactly how hand exercises help blood pressure. More research is needed before they could be considered a legitimate part of blood-pressure-lowering therapies. (Here's an eating plan that's proven to lower blood pressure.)
In the meantime, we do know for sure that superior hand strength is great for several reasons. One of the most important? People with strong hands tend to be more able-bodied later in life. (Here's another way to see how able-bodied you are.)
3 Handy Exercises
Get a grip! Here are three simple hand exercises to choose from.
1. Squeeze a tennis ball. Try two or three sets of 10 squeezes per hand every other day.
2. After reading them, roll each page of your newspaper into the smallest ball possible. (Then recycle, of course!)
3. For more advanced fitness fiends, try doing a few fingertip push-ups.
Get a grip! On your hand strength and blood pressure, that is, with the Gripmaster Hand Exerciser. Choose your color, choose your resistance, and put the squeeeeeeze on hypertension.
Check yourself: Answer these six questions to find out if your last blood pressure reading may have been off.
Get a grip! On your hand strength and blood pressure, that is, with the Gripmaster Hand Exerciser. Choose your color, choose your resistance, and put the squeeeeeeze on hypertension. References: Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives. McGowan, C. L., Visocchi, A., Faulkner, M., Verduyn, R., Rakobowchuk, M., Levy, A. S., McCartney, N., MacDonald, M. J., European Journal of Applied Physiology 2007 Feb;99(3):227-234.
Midlife hand grip strength as a predictor of old age disability. Rantanen, T., Guralnik, J. M., Foley, D., Masaki, K., Leveille, S., Curb, J. D., White, L., JAMA 1999 Feb 10;281(6):558-560.
Is grip strength associated with health-related quality of life? Findings from the Hertfordshire Cohort Study. Sayer, A. A., Syddall, H. E., Martin, H. J., Dennison, E. M., Roberts, H. C., Cooper, C., Age and Ageing 2006 Jul;35(4):409-415.
~~**~~**~~**~~**~~**~~
HUMOR SECTION
Bill Gates recently gave a speech at a High School about 11 things they did not and will not learn in school. He talks about how feel-good, politically correct teachings created a generation of kids with no concept of reality and how this concept set them up for failure in the real world.
Rule 1: Life is not fair - get used to it!
Rule 2: The world won't care about your self-esteem. The world will expect you
to accomplish something BEFORE you feel good about yourself.
Rule 3 : You will NOT make $60,000 a year right out of high school.
You won't be a vice president with a car phone until you earn both.
Rule 4: If you think your teacher is tough, wait 'til you get a boss.
Rule 5: Flipping burgers is not beneath your dignity. Your Grandparents had a
different word for burger flipping: they called it opportunity.
Rule 6: If you mess up, it's not your parents' fault, so don't whine about your mistakes,
learn from them.
Rule 7 : Before you were born, your parents weren't as boring as they are now.
They got that way from paying your bills, cleaning your clothes, and listening to you
talk about how cool you thought you were. So before you save the rain forest from
the parasites of your parent's generation, try delousing the closet in your own room.
Rule 8: Your school may have done away with winners and losers,
but life HAS NOT. In some schools, they have abolished failing grades and
they'll give you as MANY TIMES as you want to get the right answer.
This doesn't bear the slightest resemblance to ANYTHING in real life.
Rule 9 : Life is not divided into semesters. You don't get summers off and very few employers are interested in helping you FIND YOURSELF.
Do that on your own time.
Rule 10: Television is NOT real life. In real life, people actually have to leave the coffee shop and go to jobs.
Rule 11 : Be nice to nerds. Chances are you'll end up working for one.
~~**~~**~~**~~**~~**~~
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/
http://www.nurse.com/ce/
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com
TheNursingSite.com
The Nursing Site Blog http://nursingsite.blogspot.com
http://www.snopes.com /
http://www.nationalnurse3.blogspot.com/
IF you want to see what the Joint Commission is "up to"...here is the link:
http://www.jointcommission.org/Library/jconline/jcol_12_07.htm
*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
Despite warnings from the FDA, manufacturers, and various patient safety agencies, fentanyl transdermal patches continue to be prescribed inappropriately to treat acute pain in opiate-naïve patients, sometimes in large doses or in combination with oral or intravenous opiates. Some of these prescribing errors have occurred in hospitals; others have originated in physician offices or ambulatory surgery centers, where well-meaning but misinformed primary care physicians or surgeons have prescribed the drug for opiate-naïve patients under contraindicated circumstances such as acute post-operative pain. Unfortunately, pharmacists have often filled these prescriptions without question, and nurses caring for patients have applied the patches without recognizing the prescribing error. ISMP is deeply troubled by these practices and alarmed by what appears to be a steady stream of reports of adverse events with fentanyl patches—including fatalities—caused by inappropriate prescribing, dispensing, and administration of the drug. ... http://www.ismp.org/Newsletters/acutecare/articles/20070628.asp?ptr=y
********************
www.fda.gov/medwatch/safety/2007/safety07.htm#Fentora
www.accessdata.fda.gov/psn/transcript.cfm?show=68#7
www.fda.gov/medwatch/safety/2007/Rocephin_HCP_august2007.pdf
*********************
Potential problem with EXACTACAIN spray (benzocaine 14%, butamben 2%, tetracaine 2%) (14) Problem: Some Exactacain applicator straws have been"popping off into patients' throats." Recent product changes to the spray release button necessitated re-sizing applicator straws. Straws for use with the original Exactacain spray release button are not compatible with newly designed spray release button and will pop off during use.
Recommendation: Use only the straws packaged with each Exactacain container, not leftover straws from the older container. Discard leftover straws when starting a new container. view a free FDA Patient Safety Video on this topic at: www.accessdata.fda.gov/psn/transcript.cfm?show=68#6 .
********************
Super Shangai, Strong Testis, Shangai Ultra, Shangai Ultra X, Lady Shangai, Shangai Regular (also known as Shangai Chaojimengnan) [Posted 12/31/2007] FDA notified consumers and healthcare professionals not to buy or use Super Shangai, Strong Testis, Shangai Ultra, Shangai Ultra X, Lady Shangai, and Shangai Regular (also known as Shangai Chaojimengnan) products. The products are marketed as dietary supplements and used for the treatment of erectile dysfunction (ED) and for sexual enhancement. The products do not qualify as dietary supplements because they contain undeclared active ingredients of FDA-approved prescription drugs for ED. The products are thus drugs that are illegal because they lack FDA approval. Additionally, because the manufacturing source of the active ingredients in these products is unknown, consumers should be aware that the safety, efficacy, and purity of the ingredients can not be validated.
The undeclared ingredients in the referenced products may interact with nitrates found in some prescription drugs (such as nitroglycerin) and can lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take products containing nitrates. http://www.fda.gov/medwatch/safety/2007/safety07.htm#Shangai
*******************
Cardinal Health notified its customers of a voluntary recall for all Alaris Pump modules, model 8100 (formerly known as Medley Pump module), shipped prior to September 27, 2007. The recall covers Alaris Pump modules that were distributed to 46 States, the District of Columbia, Canada, Guam, Puerto Rico and Saudi Arabia. The pump module was recalled because the units may contain misassembled occluder springs (bent, broken, nested or missing) that occurred during manufacturing. Misassembled springs could lead to overinfusion that could result in serious adverse health consequences or death. Overinfusion may be difficult to detect because the misassembled springs can work intermittently, and there is no warning or notification of an overinfusion. See the manufacturer's press release for a list of the serial numbers for the affected devices and how the manufacturer will work with customers to minimize disruption while completing an inspection of the devices...
http://www.fda.gov/medwatch/safety/2007/safety07.htm#cardinal
***********************
Pre-Filled Heparin Lock Flush Solution- Nationwide Recall: Syringes Contaminated with Serratia Marcescens
AM2 PAT, Inc., and FDA informed healthcare professionals and consumers of a nationwide recall of one lot of Pre-Filled Heparin Lock Flush Solution (5 ml in 12 mL Syringes), Lot # 070926H. The heparin IV flush syringes have been found to be contaminated with Serratia marcescens, which have resulted in patient infections. This type of bacterial infection could present a serious adverse health consequence that could lead to life-threatening injuries and/or death. Consumers and user facilities should stop using the product immediately, quarantine the affected product, and return it to the distributor immediately. http://www.fda.gov/medwatch/safety/2007/safety07.htm#HeparinLock
~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
Here are two hints with different approaches to the same problem.
This first one may be difficult to use because of finding the right "white-out " ink.
When using a Doppler ultrsound stethoscope, try marking the patient's peripheral pulses by applying white liquid correction fluid to the skin. The fluid won't dissolve, as ink does, with frequent applications of the gel used to obtain Doppler readings. Linda Graves Allen, RN, BSN
Locating pedal and postibial pulses can be time-consuming. After I find them, I use a felt tip pen to make an X over a papable pulse, and a D over a pulse that's detectable only by a Doppler ultrasound stethoscope. 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 /.
~~**~~**~~**~~**~~**~~
This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Welcome to: teri@nationalnurse (Teri)
The Nursing Site Blog http://nursingsite.blogspot.com
http://www.snopes.com /
http://www.nationalnurse3.blogspot.com/
IF you want to see what the Joint Commission is "up to"...here is the link:
http://www.jointcommission.org/Library/jconline/jcol_12_07.htm
*******************************************************
********************************************
*
MEDICAL RECALLS
*
*******************************************
******************************************************
Despite warnings from the FDA, manufacturers, and various patient safety agencies, fentanyl transdermal patches continue to be prescribed inappropriately to treat acute pain in opiate-naïve patients, sometimes in large doses or in combination with oral or intravenous opiates. Some of these prescribing errors have occurred in hospitals; others have originated in physician offices or ambulatory surgery centers, where well-meaning but misinformed primary care physicians or surgeons have prescribed the drug for opiate-naïve patients under contraindicated circumstances such as acute post-operative pain. Unfortunately, pharmacists have often filled these prescriptions without question, and nurses caring for patients have applied the patches without recognizing the prescribing error. ISMP is deeply troubled by these practices and alarmed by what appears to be a steady stream of reports of adverse events with fentanyl patches—including fatalities—caused by inappropriate prescribing, dispensing, and administration of the drug. ... http://www.ismp.org/Newsletters/acutecare/articles/20070628.asp?ptr=y
********************
www.fda.gov/medwatch/safety/2007/safety07.htm#Fentora
www.accessdata.fda.gov/psn/transcript.cfm?show=68#7
www.fda.gov/medwatch/safety/2007/Rocephin_HCP_august2007.pdf
*********************
Potential problem with EXACTACAIN spray (benzocaine 14%, butamben 2%, tetracaine 2%) (14) Problem: Some Exactacain applicator straws have been"popping off into patients' throats." Recent product changes to the spray release button necessitated re-sizing applicator straws. Straws for use with the original Exactacain spray release button are not compatible with newly designed spray release button and will pop off during use.
Recommendation: Use only the straws packaged with each Exactacain container, not leftover straws from the older container. Discard leftover straws when starting a new container. view a free FDA Patient Safety Video on this topic at: www.accessdata.fda.gov/psn/transcript.cfm?show=68#6 .
********************
Super Shangai, Strong Testis, Shangai Ultra, Shangai Ultra X, Lady Shangai, Shangai Regular (also known as Shangai Chaojimengnan) [Posted 12/31/2007] FDA notified consumers and healthcare professionals not to buy or use Super Shangai, Strong Testis, Shangai Ultra, Shangai Ultra X, Lady Shangai, and Shangai Regular (also known as Shangai Chaojimengnan) products. The products are marketed as dietary supplements and used for the treatment of erectile dysfunction (ED) and for sexual enhancement. The products do not qualify as dietary supplements because they contain undeclared active ingredients of FDA-approved prescription drugs for ED. The products are thus drugs that are illegal because they lack FDA approval. Additionally, because the manufacturing source of the active ingredients in these products is unknown, consumers should be aware that the safety, efficacy, and purity of the ingredients can not be validated.
The undeclared ingredients in the referenced products may interact with nitrates found in some prescription drugs (such as nitroglycerin) and can lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take products containing nitrates. http://www.fda.gov/medwatch/safety/2007/safety07.htm#Shangai
*******************
Cardinal Health notified its customers of a voluntary recall for all Alaris Pump modules, model 8100 (formerly known as Medley Pump module), shipped prior to September 27, 2007. The recall covers Alaris Pump modules that were distributed to 46 States, the District of Columbia, Canada, Guam, Puerto Rico and Saudi Arabia. The pump module was recalled because the units may contain misassembled occluder springs (bent, broken, nested or missing) that occurred during manufacturing. Misassembled springs could lead to overinfusion that could result in serious adverse health consequences or death. Overinfusion may be difficult to detect because the misassembled springs can work intermittently, and there is no warning or notification of an overinfusion. See the manufacturer's press release for a list of the serial numbers for the affected devices and how the manufacturer will work with customers to minimize disruption while completing an inspection of the devices...
http://www.fda.gov/medwatch/safety/2007/safety07.htm#cardinal
***********************
Pre-Filled Heparin Lock Flush Solution- Nationwide Recall: Syringes Contaminated with Serratia Marcescens
AM2 PAT, Inc., and FDA informed healthcare professionals and consumers of a nationwide recall of one lot of Pre-Filled Heparin Lock Flush Solution (5 ml in 12 mL Syringes), Lot # 070926H. The heparin IV flush syringes have been found to be contaminated with Serratia marcescens, which have resulted in patient infections. This type of bacterial infection could present a serious adverse health consequence that could lead to life-threatening injuries and/or death. Consumers and user facilities should stop using the product immediately, quarantine the affected product, and return it to the distributor immediately. http://www.fda.gov/medwatch/safety/2007/safety07.htm#HeparinLock
~~**~~**~~**~~**~~**~~
NURSING HINTS CORNER
Here are two hints with different approaches to the same problem.
This first one may be difficult to use because of finding the right "white-out " ink.
When using a Doppler ultrsound stethoscope, try marking the patient's peripheral pulses by applying white liquid correction fluid to the skin. The fluid won't dissolve, as ink does, with frequent applications of the gel used to obtain Doppler readings. Linda Graves Allen, RN, BSN
Locating pedal and postibial pulses can be time-consuming. After I find them, I use a felt tip pen to make an X over a papable pulse, and a D over a pulse that's detectable only by a Doppler ultrasound stethoscope. 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 /.
~~**~~**~~**~~**~~**~~
This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Welcome to: teri@nationalnurse (Teri)
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
~~**~~**~~**~~**~~**~~
NOTICE:
I attempt to send newsletters to your current 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, ok? RNFrankie@AOL.com
Old Address: mickunas@comcast.net New Address: mickunas14@verizon.net
~~**~~**~~**~~**~~**~~
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)
Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN@AOL.com (Sue) E thru I section,
RNFrankie @AOL.com (Frankie) J thru K section,
Jntcln@AOL.com (Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section
Schulthe@AOL.com (Susan) R thru T section
Sandy1956@AOL.com (Sandy) U thru Z section.
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
~~**~~**~~**~~**~~**~~
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY
You gain strength, courage & confidence by every experience
in which you really stop to look fear in the face. You must
do the thing which you think you cannot do.
--Anna Eleanor Roosevelt
Hope to see you online..... Frankie
(RNFrankie@AOL.com )
~~**~~**~~**~~**~~**~~
NOTICE:
I attempt to send newsletters to your current 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, ok? RNFrankie@AOL.com
Old Address: mickunas@comcast.net New Address: mickunas14@verizon.net
~~**~~**~~**~~**~~**~~
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)
Membership BIO Committee...(if you haven't sent in your BIO....Please send it to the appropriate section below) : Check by your screen name's first letter.........
BCK131 @AOL.com (Chris) A thru B section,
Dick515 @AOL.com (Eileen) C thru D section,
GALLO RN@AOL.com (Sue) E thru I section,
RNFrankie @AOL.com (Frankie) J thru K section,
Jntcln@AOL.com (Janet) L thru M section,
GALLO RN @AOL.com (Sue) N thru Q section
Schulthe@AOL.com (Susan) R thru T section
Sandy1956@AOL.com (Sandy) U thru Z section.
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)
~~**~~**~~**~~**~~**~~
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY
You gain strength, courage & confidence by every experience
in which you really stop to look fear in the face. You must
do the thing which you think you cannot do.
--Anna Eleanor Roosevelt
Hope to see you online..... Frankie
(RNFrankie@AOL.com )
