Thursday, October 8, 2009

Paradigm97


PARADIGM BYTES
Newsletter for Paradigm 97
October 8, 2009

PARADIGM DEFINED: 1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.Our website...... http://paradigm97.blogspot.com/ Please copy, paste, and bookmark it.
MISSION STATEMENT

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

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SNIPPETS

DRY EYE SYNDROME
My ophalmologist stated that I had dry eye syndrome, I almost laughed because I was plagued with rivers of tears. I would wake up with puddles of tears at the corner of my eyes and often had to blot my eyes for no reason I could find.
Decreased production of fluids from your tear glands can destabilize the tear film, allowing it to break down rapidly and create dry spots on the surface of your eyes. An imbalance in the substances that make up the tear film also causes dry eyes.
Normal tears that cover the corneal surface comprise three layers:
the lipid, or oil layer, produced by the Melbomian glands which are located at the lower part of the eye near the lacrimal glands. This lipid later which is the outer layer of the tear film and helps prevent the lacrimal layer beneath it from evaporating or overflowing the lower eyelid
the lacrimal, or watery layer, which is the middle layer and contains salts, proteins, cleanses the ey and an enzyme called lysozyme that actually protect and nourish the eye
the mucoid, or mucus layer which is produced by the conjunctivea, is the bottom layer of tears. It contains cells called goblet cells that cause the tears to adhere to the eye thereby maintaining the moistness of the eye.
All three layers of tears are necessary for proper lubrication. http://www.visionrx.com/library/enc/enc_tears.asp
Dry eyes are a common source of discomfort. The usual symptoms include:
* stinging or burning eyes; * scratchiness; * stringy mucus in or around the eyes; * excessive eye irritation from smoke or wind; * excess tearing; and/or * discomfort when wearing contact lenses.
Treatment of dry eyes aims to restore a more normal tear film to minimize dryness, blurred vision and discomfort. The eye depends on the flow of tears to provide constant moisture and lubrication to maintain vision and comfort. Tears are a combination of water, for moisture; oils, for lubrication; mucus, for even spreading; and antibodies and special proteins, for resistance to infection. When there is an imbalance in this tear system, a person may experience dry eyes.
Sometimes, a person with dry eye syndrome will have excess tears running down the cheeks, which may seem confusing to them. This happens when the eye isn't getting enough lubrication. The eye sends a distress signal through the nervous system for more lubrication. In response, the eye is flooded with tears to try to compensate for the underlying dryness. However, these tears are mostly water and do not have the lubricating qualities or the rich composition of normal tears. They will wash debris away, but they will not coat the eye surface properly. In addition, because these emergency tears tend to arrive too late, the eye needs to regenerate and treatment is necessary.
Tear glands and tear ducts Tears are much more than just water. They're a complex mixture of water, fatty oils, proteins, electrolytes, bacteria-fighting substances and growth factors that regulate various cell processes. This mixture helps make the surface of your eyes smooth and clear. Without tears, good vision is impossible.For some people, the cause of dry eyes is an imbalance in the composition of their tears. Other people don't produce enough tears to keep their eyes comfortably lubricated. Eyelid problems, medications and other causes, such as environmental factors, also can lead to dry eyes.
As mentioned previously, tears are comprised of three layers. The mucus layer coats the cornea, the eye’s clear outer window, forming a foundation so the tear film can adhere to the eye. The middle aqueous layer provides moisture and supplies oxygen and other important nutrients to the cornea. This layer is made of 98 percent water along with small amounts of salt, proteins and other compounds. The outer lipid layer is an oily film that seals the tear film on the eye and helps to prevent evaporation.
Tears are formed in several glands around the eye. The water layer is produced in the lacrimal gland, located under the upper eyelid. Several smaller glands in the lids make the oil and mucus layers. With each blink, the eyelids spread the tears over the eye. Excess tears flow into two tiny drainage ducts in the corner of the eye by the nose. These ducts lead to tiny canals that connect to the nasal passage. The connection between the tear ducts and the nasal passage is the reason that crying causes a runny nose. In addition to lubricating the eye, tears are also produced as a reflex response to outside stimulus such as an injury or emotion. However, reflex tears do little to soothe a dry eye, which is why someone with watery eyes may still complain of irritation. http://www.ayurhelp.com/articles/dry-eye-syndrome.htm
The opthmologist diagnoses the syndrome from an exam of the eyes. Schirmer tear test involves placing filter-paper strips under the lower eyelids to measure the rate of tear production under various conditions. another test uses fluorescein or rose bengal (diagnostic drops) to look for certain patterns of dryness on the surfact of the eye.
Artificial tears e.g. Systane, Optive, etc. gts lubricate the eyes and help maintain moisture. These products (tears) must be applied several times a day to maintain the moisture. Systane also offers an ointment to be used at bedtime in case the patient does not adequately close their lids. Another treatment is Restasis which must be used concurrent with the artificial tears. This is a cyclosporine which is used to increase tear production d/t (keratoconjuctivitis) the chronic dry eye. Published reports suggest that it acts by reducing inflammatory cells like activated lymphocytes in theconjunctiva (Arch Ophthalmal 2000: 118; 1489-96) as well as increasing the number of mucin secreting goblet cells (Arch Ophthalmol 2002; 120:330-7) Restasis is FDA approved and is available by prescription, only. It may require several weeks of Restasis treatment (1 gt/ twice daily) to produce the therapeutic effect and up to six months for maximum improvement. http://www.agingeye.net/mainnews/newscan2.php
Sjogren's Syndrome - Sjogren's syndrome causes symptoms that include arthritis, dry mouth, lips and eyes, leading to eye pain. Read about diagnosis, Schirmer testing, treatment and medications. Sjogren's syndrome is an autoimmune disease. Sjogren's syndrome that is also associated with a connective tissue disease, such as rheumatoid arthritis, systemic lupus erythematosus, or scleroderma, is referred to as secondary Sjogren's syndrome.
A common disease that is occasionally associated with Sjogren's syndrome is autoimmune thyroiditis (Hashimoto's thyroiditis), which can lead to abnormal thyroid hormone levels detected by thyroid blood tests. Heartburn and difficulty swallowing can result from gastroesophageal reflux disease (GERD).... http://www.medicinenet.com/dry_eyes/article.htm http://www.medicinenet.com/dry_eyes/glossary.htm
http://www.aao.org (American Academy of ophthalmology)
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MEDICAL NEWS

9/3/09 Update on Vicki Galle and Anne Mitchell - the two nurses who were criminally indicted for reporting a physician to the Texas Medical Board because of their concern the physician's practice was below an acceptable standard of care.

A. Status of Case:The nurses' attorney filed several pretrial motions including a motion to dismiss the indictment as not sufficiently alleging an offense, two motions to suppress evidence because of an illegal search, and a motion to dismiss for prosecutorial vindictiveness. The judge has:denied the first three motionsnot ruled on the motion to dismiss for prosecutorial vindictiveness.

No trial date has been set but it is anticipated the trial will be in very late September or the first half of October -- assuming the judge does not grant the motion to dismiss because of prosecutorial vindictiveness.

On August 28, the attorneys for Vicki and Anne filed a civil lawsuit in federal court against both Winkler County and Winkler County Memorial Hospital, and also individually against the sheriff, hospital administrator, county attorney, district attorney, and the physician. The lawsuit alleges not only illegal retaliation against the nurses, but also civil rights and due process violations.

B. Fundraising EffortsAlmost $30,000 has been raised386 individuals from 36 states have contributed17 organizations have contributed

C. TNA Web SiteTNA is posting information about the case on its web site at www.texasnurses.org

At the pretrial hearing and both Vicki and Anne were overwhelmed by the support from their nursing colleagues. They asked to pass along how this support has helped them get through this ordeal. If you would like to send letters of support to Vicki and Anne, please email them to governmentalaffairs@texasnurses.org
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WASHINGTON (Reuters 9/24) - An experimental AIDS vaccine made from two failed products has protected people for the first time, reducing the rate of infection by about 30 percent, researchers said on Thursday.
Developers said they were now debating how to test the limited amounts of vaccine they have left to find out if there are ways to make it work better.
Scientists said they were unsure how or why the vaccines worked when used together in the trial, which took place in Thailand, and will study the volunteers to find out.... http://www.reuters.com/article/healthNews/idUSTRE58N1AX20090925?feedType=nl&feedName=ushealth1100
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FROM THE MEMBERS

(the following is from Laregis@AOL.com (Laura) all about swine flu) Thank you !

This is huge! Many hospitals are mandating employees to take the vaccine when it comes out next month. Lots of questions out there from both the health professional consumer and the lay consumer. People are scared of the 'new vaccine'. I have made the decision to take the vaccine when it becomes available to the public even though I am not at the bedside. My friend (in her late 50's and healthy) who contracted the swine flu last summer is still suffering from the effects with muscle pain and lethargy after multiple doses of antibiotics and steroids. Not pretty
Flu News (Everything you wanted to know about H1N1 and were afraid to ask)
Flu Nightmare: In Severe Pandemic, Officials Ponder Disconnecting Ventilators From Some Patients — Article from ProPublica.
WHO Worries About Swine Flu Deaths with No Underlying illness — Article from AFP.
2009 H1N1 Pandemic Influenza: Update – Outlook – Preparedness — Article by Bill Peckham from Home Dialysis Central.
H1N1 Pandemic Flu 2009: Preparation, Prevention and Treatment — Article by Peter Laird, MD from KidneyTimes™.
1 Swine Flu Shot Enough for Older Kids — Article from HealthDay.
Flu Boosts Heart-Attack Risk: Study — Article from AFP.
Swine Flu Virus Has Not Mutated: WHO Chief — Article from AFP.
H1N1 Vaccine Production Far Less Than Forecast-WHO — Article from Reuters.
CMS H1N1 Information Page
HHS Office of the Inspector General Reports on H1N1:
State and Local Pandemic Influenza Preparedness: Medical Surge - (37-page pdf)
Local Pandemic Influenza Preparedness: Vaccine and Antiviral Drug Distribution and Dispensing - (57 page pdf)
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This is from Sandy Summers....... ssummers@truthaboutnursing.org
Saving Lives -- Educating society about the value of nursing Our new book Saving Lives: Why the Media's Portrayal of Nurses Puts Us All at Risk uses striking examples and an irreverent style to explore nursing stereotypes from TV shows to the news media. We hope every nurse will read it and consider the role the media plays in nursing today--and how we can improve the profession's public image. But the book also explains nursing in compelling terms to the public and decision-makers. We want as many non-nurses as possible to read it.
September 17, 2009 -- The Truth's exeuctive director Sandy Summers was heavily quoted in the article "Real-life nurses talk about how they're portrayed on TV" in the Star-News North Carolina. Spring/Summer 2009 -- Ann M. Gothler reviewed our book Saving Lives in this recently released issue of The Journal of the New York Nurses Association (scroll to p. 26). Among her comments:
"The authors present ideas that are clearly valuable to registered nurses, particularly in areas of orientation and staff development. The conversation that they document could also be useful to increase insight and spur discussion among undergraduate and graduate nursing students. ... Overall, the book is very convincing to the reader". ssummers@truthaboutnursing.org
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INTERESTING READING

Please remember that the REUTERS articles usually good for only 30 days
LONDON (Reuters 9/6) - Scientists have found three new major genetic links to Alzheimer's, affecting up to 20 percent of people with the brain-wasting disease, and said on Sunday it was the most significant such discovery in 15 years.
Two large studies found that the three new genes join the better-known APOE4 gene as significant risk factors for the most common cause of dementia.... http://www.reuters.com/article/healthNews/idUSTRE5851AG20090906?feedType=nl&feedName=ushealth1100
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Vaccines could halve sickle cell deaths in Africa LONDON (Reuters 09/09/09) - Vaccination against bacterial infections using vaccines readily available in developed countries could save the lives of thousands of children with sickle-cell anemia in Africa, researchers said on Thursday.
Tom Williams, an expert in tropical diseases from the Kenya Medical Research Institute (KEMRI), said 90 percent of children born with sickle-cell anemia in Africa die before they are diagnosed and can get treatment, and half of those lives could be saved if sufferers were protected from bacterial infections.
"The problem here in Africa is that there is hardly anyone doing any screening," Williams said. "So, as a result, most of the children in Africa who are born with sickle-cell anemia are dead before they are even diagnosed." http://www.reuters.com/article/healthNews/idUSTRE58870920090909?feedType=nl&feedName=ushealth1100
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RANDOM FACT Venus is the only planet that rotates clockwise.
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Review: Menstrual migraine: therapeutic approaches The City of London Migraine Clinic, London, UK, Research Centre for Neuroscience within the Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK,
The development of diagnostic criteria has enabled greater recognition of menstrual migraine as a highly prevalent and disabling condition meriting specific treatment. Although few therapeutic trials have yet been undertaken in accordance with the criteria, the results of those published to date confirm the efficacy of acute migraine drugs for symptomatic treatment. If this approach is insufficient, the predictability of attacks provides the opportunity for perimenstrual prophylaxis. Continuous contraceptive strategies provide an additional option for management, although clinical trial data are limited. Future approaches to treatment could explore the genomic and nongenomic actions of sex steroids. MacGregor 2(5):327 anne.macgregor@migraineclinic.org.uk http://tan.sagepub.com/cgi/content/abstract/2/5/327
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RANDOM FACT: If Barbie were life-size, her measurements would be 39-23-33. She would stand seven feet, two inches tall. Barbie's full name is Barbara Millicent Roberts.
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"I like getting to prevent things": August 9, 2009 -- Nurse practitioners have not received the attention they deserve in connection with the ongoing U.S. health reform debates. But two recent press articles do a generally good job of highlighting the key role NPs play in providing excellent, cost-effective primary care. And the stories suggest that NPs might well play a much bigger role in a health system reformed to increase access to care yet cut costs. Kelly Brewington's lengthy story "Nurse practitioners pick up the slack in providing primary care," which ran in today's Baltimore Sun, gives readers a sense of what NPs already do at a time when fewer physicians are choosing family practice, and suggests that NPs' work might expand if more people had health insurance.... http://www.truthaboutnursing.org/news/2009/aug/09_nps.html
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THRIFTY TIP: Murphy's Oil soap mixed with a bit of water (or using the spray bottle that it is now available in) right on stains on fabrics will break down grease stains. Simply rub the area with lots of Murhphy's and rinse the area clean with a warm water. Great for laundry, couches, jackets and even denim jeans! (it is wonderful as mixed above for all woods including kitchen cabinets ..wipe down with a dry cloth)
HANDY HINTS: Apply olive oil to soften dry skin Rub olive oil daily on dry areas, such as feet or elbows, especially after a shower,shaving, or waxing.
Use plastic grocery bags to keep plants warm. Tie a plastic grocery Bag around plants in cold weather to protect from frost.
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Protecting Your Nurse License: Helpful Hints for a Nurse in Trouble Getting a certified letter informing you that a complaint has been filed against your license, is a frightening, embarrassing, anger producing, and intimidating situation. The effects of a complaint with the Nursing Board on your license, your career and your physical and mental health, can be minimized with proper actions.
The following are tips that she has found, in her years of practice before the Nursing Boards, to be helpful: http://www.nursetogether.com/tabid/102/itemid/840/Protecting-Your-Nurse-License-Helpful-Hints-for-a.aspx
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RANDOM FACT: TYPEWRITER is the longest word that can be made using the letters only on one row of the keyboard.
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Coach training can improve the self-efficacy of neonatal nurses. A pilot study Ammentorp J et al. – Coaching can improve nurses’ self–efficacy in relation to meet the needs of the mothers and fathers. Coaching could be a method that can maximize the personal and professional potential of the staff, and prepare them for the mindful being–in–relation approach that increasingly is being requested. This should be confirmed in a bigger study....
http://www.pec-journal.com/article/PIIS0738399109004145/abstract?rss=yes
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Healthier Fast Food Picks Nurses, are you tired and hungry after a long shift but don’t feel like cooking? You can always stop at that fast food restaurant on the way home and in within a few minutes have hot, inexpensive and satisfying food. Hmmm, so good! As you eat the last of the tries in the bag, never mind that your meal was high in calories, fat, and sodium and incredibly low in nutritional value. It provided instant gratification, which of course, is an important link to forming habits. If you are eating fast food more than once a week, your waistline, as well as how you feel, are most likely being affected.... http://www.nursetogether.com/tabid/100/itemid/1455/Nurses-Healthier-Fast-Food-Picks.aspx

Read Alice's related articles: The Truth About Process Foods Being Active Regardless of Your Weight Liquid Calories may be Sabotaging Your Diet
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A government program that brings extra scrutiny to poorly performing nursing homes leaves out hundreds of troubled facilities, ... http://www.google.com/hostednews/ap/article/ALeqM5jiCJhCZbfrHhw ATTfYLB0Ub4_S2wD9AVLK2G1
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Don't Knock Nurses (UK problems mirror US problems) Uncaring, slapdash staff; patients left in pools of vomit or faeces; falls resulting in cranial bleeds, despite the supervision of nurses. The Patients Association’s recent dossier of nasty nurses is scary stuff, and it has made hearts sink all over the National Health Service. ......

None of this excuses bad care, but it does make it more likely. When I started in medicine, nurses used to go around the ward at regular intervals, taking temperatures and blood pressures themselves. They would spot a dressing that needed changing and would learn who felt sick, or who was desperate for the commode. Now these duties are relegated to a nursing assistant, who may be kind and caring, but has little training and is not a nurse. ... http://www.ft.com/cms/s/a944a9d0-a715-11de-bd14-00144feabdc0.html
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RANDOM TIDBITS: Nutrients are divided into two major groups: macronutrients and micronutrients. Macronutrients include protein, carbohydrates, water, and fats. Micronutrients are vitamins and minerals.
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The term “vitamin” was coined by Polish-American chemist Casimir Funk and is derived from vital (necessary for life) and amine (a compound containing nitrogen and hydrogen).
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Vitamins are grouped according to the solubility in either fat or water. Vitamins A, D, E, and K are fat soluble, meaning they need fat to be absorbed into the body and can be stored in the body. Vitamin B complexes and Vitamin C are water soluble and, because they cannot be stored in the body, they must be replaced every day.
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Injectable Vaccines More Effective for Adult Flu Than Nasal Sprays Results may be different in children and in H1N1 swine flu vaccines, researchers say WEDNESDAY, Sept. 23 (HealthDay News) -- If you have the choice between a seasonal flu vaccine that comes in a nasal spray or an injection, go for the injection, new research shows.
In a study of adults tracked over one flu season, vaccines made from inactivated, or "killed," flu virus -- the injectable form -- provided better protection against the seasonal flu than vaccines made from live attenuated virus, the type of vaccine available in a nasal spray.... http://www.healthday.com/Article.asp?AID=631239
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Three new ways to fight a cold this winter You might seriously slash your risk of catching a cold this season if you adopt this immune-enhancing trio: salmon, sunshine, and a vitamin D supplement.
That's right. Prioritizing all three this winter will dramatically boost your vitamin D levels, and that in turn may curtail your risk for upper respiratory tract infections (like the common cold).
Make Room for DIn a large study, people with low blood levels of vitamin D were 55 percent more likely to develop a cold than people with three times as much D in their blood. Yep, it's time to make more room in your life for vitamin D. But getting enough from foods and sunshine can be tricky. In fact, anywhere from 40 to 85 percent of us may have a deficiency.... http://www.realage.com/tips/three-new-ways-to-fight-colds-this-winter
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Try this buttery treat for your pancreas Creamy, luscious, buttery-smooth -- and it may be good for your pancreas, too. We're talking about the avocado. Why? Because it's got plant fats. And recent research shows that getting more of your dietary fat from plants instead of animals could offer a protective edge against pancreatic cancer.
Don't Give Up the FatIn a 6-year study of more than half a million people, those with the highest intake of saturated fat -- particularly if it was from red meat and dairy sources -- had the greatest risk of pancreatic cancer. But here's the good news: People who got most of their fats from plant sources had no increased risk. Start your meal off right with the plant fats in these appealing appetizers.
http://www.realage.com/tips/try-this-buttery-treat-for-your-pancreas
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HANDY HINT: To remove soap scum when washing plastics (such as shower curtains or plastic tablecloths) add a little water softener to the final rinse.
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MONTREAL—Researchers Find Gene That Causes Insulin Resistance Researchers have uncovered a new gene that could lead to better treatment of type 2 diabetes, as well as a better understanding of how this widespread disease develops, according to a study published September 6 in Nature Genetics. Unlike most of the genes that have been shown to cause diabetes, the new gene, called Insulin Receptor Substrate 1 (IRS1), doesn’t ... 9/9/2009 http://www.renalbusiness.com/hotnews/gene-causes-insulin-resistance.html

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Nurses' Responses to Medication Errors: Suggestions for the Development of Organizational Strategies to Improve Reporting Covell CL et al. – The findings suggest that nurses use a decision–making process when reporting medication errors. Medication error reporting may be improved by instituting a problem–solving approach to respectfully manage the event and providing nurses with clear guidelines, remedial education, and timely feedback.... Journal of Nursing Care Quality 09/30/09 http://journals.lww.com/jncqjournal/Abstract/2009/10000/Nurses__ Responses_to_Medication_Errors_.4.aspx
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Blueberry juice fights fat_diabetes MONTREAL—Juice extracted from North American lowbush blueberries, biotransformed with bacteria from the skin of the fruit, holds promise as an anti-obesity and anti-diabetic agent. For the study, published in the International Journal of Obesity, researchers from the University of Montreal tested the effects of biotransformed juices compared to regular blueberry drinks on mice.The scientists tested the effect of biotransformed blueberry ... http://www.renalbusiness.com/hotnews/blueberry-juice-fights-fat--diabetes.html
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Eight surprising contributors to high blood pressure Most of us know about the genetic and dietary links to high blood pressure, but research is bearing out additional, surprising aggravators. In recent studies and news reports, air pollution, combat exposure, busy roads and sleep deprivation have been linked to high blood pressure. Earlier research tied hot tubs, certain cold medications, birth control pills and certain pregnancies to the heart risk. Managing your blood pressure day by day
Eat healthfully and lose weightObesity causes and aggravates several cardiovascular disease, type 2 diabetes and some types of cancer. For many people, weight gain can only be remedied by eating a balanced diet and by getting more exercise in their daily routine.Experts recommend a gradual and systematic program of weight loss with a typical goal of losing 10 percent of weight within a six-month period. For example, a person weighing 170 pounds would strive to lose 17 pounds in the next six months. To lose a half pound a week, a person has to reduce daily intake by 250 calories. To lose a pound a week, reduce intake by 500 calories (and so on).Be wary of supplementsConsult with your doctor before taking diet pills. Most of these drugs contain caffeinelike stimulants that can do serious harm to the cardiovascular system, such as elevating blood pressure and causing abnormal heart rhythms (arrhythmias). Weight loss requires a commitment to a healthful diet and regular exercise.lth problems, including high blood pressure, Follow the DASH planThe National Heart, Lung, and Blood Institute (NHLBI) has released guidelines designed to help prevent and treat high blood pressure. The guidelines recommend that Americans follow the Dietary Approaches to Stop Hypertension (DASH) plan, which involves eating a diet rich in fruits, vegetables and nonfat dairy products. The NHLBI also recommends several types of lifestyle changes. These include losing excess weight, becoming physically active, limiting alcoholic beverages and following a heart-healthy diet, including cutting back on salt and other forms of sodium. ... http://yourtotalhealth.ivillage.com/high-blood-pressure-dealing-day-to-day.html?nlcid=hr09-25-2009
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Here are two easy ways to feel full faster on less food: use a smaller fork and chew your food longer. Turns out these two tactics have some science behind them. In a study, people who snacked on pudding ate less when they took small bites and savored the flavor for a while.
Savor the Flavor Yep, the pudding snackers not only took little bites, but they let the bites roll around on their tongues for a full 9 seconds. The result? They ate much less pudding than the folks who took big bites and swallowed them in 3 seconds. So next time you get the munchies, try eating with less gusto . . . Watch this 1-minute video to learn how to pick exactly the right-size food portion.
Two Easy Ways to Cut Your Appetite Here are two easy ways to feel full faster on less food: use a smaller fork and chew your food longer.
Turns out these two tactics have some science behind them. In a study, people who snacked on pudding ate less when they took small bites and savored the flavor for a while.
Savor the Flavor Yep, the pudding snackers not only took little bites, but they let the bites roll around on their tongues for a full 9 seconds. The result? They ate much less pudding than the folks who took big bites and swallowed them in 3 seconds. So next time you get the munchies, try eating with less gusto . . . Watch this 1-minute video to learn how to pick exactly the right-size food portion.
Hunger-Busting 101 Related research suggests that the longer a particular food stays in your mouth, the more quickly your taste buds will tire of its flavor -- which in turn makes you want less of the food. Another vote for taking mini bites and eating slowly. Try these additional hunger-busting tools: ... http://www.realage.com/tips/two-easy-ways-to-cut-your-appetite
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Nurse Working Conditions and Nursing Unit Costs Policy, Politics, & Nursing Practice Mark BA et al. – After controlling for relevant hospital, nursing unit, and patient characteristics, the authors found that good working conditions did not increase nursing unit costs. Teaching status was associated with higher costs, whereas larger unit size was associated with lower costs. Higher proportions of registered nurses and licensed practical nurse staffing were also associated with higher costs. Patient variables were not significantly related to costs. The authors suggest a variety of strategies that managers may use to improve working conditions. http://ppn.sagepub.com/cgi/content/abstract/10/2/120
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RANDOM TIDBITS According to the National Electronic Injury Surveillance System, 125,312 people are injured a year while in or around a bed. These injuries resulted from such mishaps as tripping over the bed, hurting oneself on the headboard, or simply falling out of bed. ***
The American Speech and Hearing Association estimates that more than 40 million Americans are exposed daily to dangerously loud noises, not all of which are machine made. For instance, the screaming of a baby has a higher decibel level (90 dB) and hence is more damaging to the delicate inner ear than an alarm clock (80 dB a vacuum cleaner (70 dB or heavy traffic (75 dB). ***
Physicians at the Walter Reed Army Medical Center estimate that of the more than 500,000 men who were receiving military combat training, more than half would sustain permanent hearing loss due to the noise of the weaponry.
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NEW YORK (Reuters 9/26/09) - If you take antidepressants such as fluoxetine (marketed as Prozac) early in your pregnancy, you may be doubling the risk that your newborn will be born with a heart defect, according to a new study.
However, the vast majority of children born to women who take such antidepressants - known as selective serotonin reuptake inhibitors (SSRIs) - do not have such defects, the researchers are quick to note. ... http://www.reuters.com/article/healthNews/idUSTRE58O39F20090925?feedType=nl&feedName=ushealth1100
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Seizure drug helps women with hot flashes sleep NEW YORK (Reuters 9/14) - Gabapentin, a drug used to treat seizures, improves the quality of sleep in menopausal women bothered by hot flashes, University of Rochester Medical Center researchers report in the Journal of Women's Health....
http://www.reuters.com/article/healthNews/idUSTRE58D5H320090914?feedType=nl&feedName=ushealth1100
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This is really important to read....please !
Tamiflu (oseltamivir) for Oral Suspension: Potential Medication Errors FDA issued a Public Health Alert to notify prescribers and pharmacists about potential dosing errors with Tamiflu (oseltamivir) for Oral Suspension. U.S. health care providers usually write prescriptions for liquid medicines in milliliters (mL) or teaspoons, while Tamiflu is dosed in milligrams (mg). The dosing dispenser packaged with Tamiflu has markings only in 30, 45 and 60 mg. The Agency has received reports of errors where dosing instructions for the patient do not match the dosing dispenser. Health care providers should write doses in mg if the dosing dispenser with the drug is in mg. Pharmacists should ensure that the units of measure on the prescription instructions match the dosing device provided with the drug. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm183714.htm
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Nurse anesthetists Address Propofol Abuse 9/14 Michael Jackson’s suspected death from propofol (Diprivan) on June 25 came just three days after the American Association of Nurse Anesthetists called on hospitals to more closely control the sedative/anesthetic because of an increase of abuse and diversion among healthcare professionals.... http://news.nurse.com/article/20090914/NATIONAL01/90911001/-1/frontpage
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Peridontal disease linked to head and neck cancer NEW YORK (Reuters 9/11 ) - The health hazards associated with chronic periodontitis (gum disease) extend way beyond the mouth. For years people have been warned that persistent periodontitis can cause heart disease. Now a new study suggests that gum disease may also be a risk factor for cancers of the head and neck. ...
http://www.reuters.com/article/healthNews/idUSTRE58A5UD20090911?feedType=nl&feedName=ushealth1100
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RANDOM FACT The drive-through line on opening day at the McDonald's restaurant in Kuwait City, Kuwait was at times seven miles long.
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U.S. Trials confirm one dose of H1N1 vaccine works WASHINGTON (Reuters 9/11) - U.S. trials of Sanofi- Pasteur SA's and CSL Ltd's H1N1 swine flu vaccines confirm that only one dose is needed to protect people, U.S. health officials said on Friday. ...
http://www.reuters.com/article/healthNews/idUSTRE58A4VS20090911?feedType=nl&feedName=ushealth1100
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New Enforcement Powers and Incentives Aimed at Medicaid Fraud ...Linex Legal (registration) Previously CMS only relied on state Medicaid Fraud Control Units, which are part of the state Attorney General Offices. The federal government is taking a ... http://www.linexlegal.com/transit.php?content_id=115157&id8=1
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The ban on smoking in public places, such as bars and restaurants, has been one of the greatest public health debates of the early 21st century. Now, two large studies suggest that communities that pass laws to curb secondhand smoke get a big payoff -- a drop in heart attacks... http://www.cnn.com/2009/HEALTH/09/22/moh.healthmag.smoking.heart/index.html
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New Chemo Regimen May Benefit Ovarian Cancer Patients Sept. 20 (HealthDay News) -- Dose-dense chemotherapy improves survival in women with advanced ovarian cancer, Japanese researchers say.
Currently, paclitaxel and carboplatin given every three weeks is considered standard first-line chemotherapy for advanced epithelial ovarian cancer. However, dose-dense weekly treatment with paclitaxel is seen as a way to increase progression-free and overall survival in these patients, according to the new study findings. http://www.healthday.com/Article.asp?AID=631141
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HUMOR SECTION

A man is recovering from minor surgery when his nurse comes in to check on him. "How are you feeling?" she asks. "I'm okay," he says, "but I didn't like the four-letter word the surgeon used during the surgery." "What word did he say?" the nurse asked. "Oops."
and: "Short guy and Biker"

A short guy is sitting at a bar just staring at his drink for half an hour when this big trouble-making biker steps next to him, grabs his drink, gulps it down in one swig and then turns to the guy with a menacing stare as if to say, "What'cha gonna do about it?"

The poor little guy starts crying. "Come on man, I was just giving you a hard time," the biker says. "I didn't think you'd CRY. I can't stand to see a man crying."

"This is the worst day of my life," says the little guy between sobs. "I can't do anything right. I overslept and was late to an important meeting, so my boss fired me. When I went to the parking lot, I found my car was stolen and I don't have any insurance. I left my wallet in the cab I took home." He continues, crying even harder. "Then I found my wife in bed with the gardener and my dog bit me. So, I came to this bar trying to work up the courage to put an end to my life, and then you show up and drink the damn poison."
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........

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

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

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

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

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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com.
Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org
Decubqueen's website: www.accu-ruler.com

Professional Ethics: Beyond the Clinical Competency Zohreh Vanaki, Robabeh Memarianpages 285-291
http://www.professionalnursing.org/article/S8755-7223%2809%2900019-2/abstract
http://www.nationalnurse3.blogspot.com/

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

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

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

The Nursing Site
http://thenursingsite.com .

http://www.snopes.com

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

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

National Do Not Call Registry

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

This is a sampling of the offers on : Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm
Critical Thinking is More Than Problem Solving Critical Thinking: Not Usually Rapid Fire
Should Clinical Courses Get a Letter Grade?
Metric conversion calculators and tables for metric conversions
http://www.metric-conversions.org/

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MEDICAL RECALLS
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Penumbra Neuron 5F Select Catheter Penumbra and FDA notified healthcare professionals of the Class 1 recall of the Neuron 5F Select Catheter, used to remove blood clots or foreign objects from blood vessels. Due to a manufacturing error, the catheters may contain pin holes and exposed wire braids which may result in a brain clot or a blood vessel puncture, and this may lead to possible death. The device was distributed from May 5, 2009 through June 12, 2009. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm181725.htm
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Philips Avalon Fetal Monitors FDA issued a Dear Healthcare Provider Letter to notify healthcare professionals and facilities of a number of complaints of inaccurate readings when using the Philips Avalon Fetal Monitors, Models FM20, FM30, FM40, and FM50 with the ultrasound transducer. On September 4, 2009, Philips issued an Important Device Safety Alert. Inaccurate output readings, if not properly addressed, may lead to unnecessary interventions, failure to identify the need for interventions, and failure to identify fetal distress. The complaints most commonly occur during the second stage of labor. Recognizing these conditions and responding appropriately is important to avoiding serious adverse health consequences. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlerts forHumanMedicalProducts/ucm181505.htm
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Neocate Infant Specialized Formula - Recall Nutricia and FDA notified healthcare professionals of the voluntary recall of one lot [# P91877] of the specialized infant formula product, Neocate, a hypoallergenic dry powder formula distributed to pharmacies, health care professionals and consumers nationwide. Due to a blending error, Neocate contained protein levels lower than that declared on the label. Although short-term consumption of product from the affected batch is very unlikely to cause immediate nutritional issues, longer term consumption might influence the healthy growth curve in certain infants. Neocate is not intended for general use and is usually given to infants in the care of health care professionals. The affected cans were distributed between September 1 and September 11, 2009 and the lot number can be found at the bottom of each can and on the right hand side of the case label. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm184129.htm
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Myfortic (mycophenolic acid) Novartis and FDA notified healthcare professionals that cases of Pure Red Cell Aplasia (PRCA) have been reported in patients treated with mycophenolate mofetil (MMF) in combination with other immunosuppressive agents. MMF is metabolized to mycophenolic acid (MPA), the active ingredient in Myfortic and the active form of the drug. The WARNINGS and ADVERSE REACTIONS sections of the Myfortic Prescribing Information have been revised to reflect this new safety information.
PRCA is a type of anemia in which there is a selective reduction of red blood cell precursors on bone marrow examination. Patients with PRCA may present with fatigue, lethargy, and/or abnormal paleness of the skin (pallor). In some cases, PRCA was found to be reversible with dose reduction or cessation of MMF therapy. In transplant patients, however, reduced immunosuppression may place the graft at risk. Related MedWatch Alert: [08/14/2009 - CellCept (mycophenolate mofetil)] http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm181306.htm
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FDA notified healthcare professionals of the Class 1 recall of Medtronic SC Catheters and Revision Kit Models: 8709SC, 8731SC, 8578, and 8596SC when paired with the Medtronic IsoMed Pump Model 8472, due to a design incompatibility resulting in a physical interference between the SC catheter connector and the IsoMed pump. This may prevent the SC catheter from completely connecting to the IsoMed pump, even though it may appear to be connected and feel secure and may lead to disruptions of therapy and revision surgery, which pose a risk of serious injury or death.

SC catheters are not compatible with IsoMed pumps but are compatible with Medtronic SynchroMed II and SynchroMed EL pumps. To dayte, Medtronic has received ten reports worldwide related to improper commection of an SC catheter to an IsoMed pump. In all ten reports, medical intervention was required to correct the condition. Medtronic has provided recommendations in their Medical Device Correctin Letter (see link)
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedical Products/ucm183753.htm
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Children's and Infants' Tylenol Oral Suspension Products - Recall
McNeil Consumer Healthcare and FDA notified consumers of a nationwide recall of certain Tylenol products as a precautionary measure because of potential manufacturing problems. The company initiated a recall of certain oral suspension products distributed between March 2008 and May 2008 due to the potential of bacteria in raw materials used to manufacture the finished product. There are no illnesses reported by patients using this product. The full list of recalled product lots can be accessed on the company’s website at http://www.tylenolprofessional.com/assets/TYLENOL_Letter_091809.pdf. McNeil is advising parents and caregivers who have administered affected product to their child or infant and have concerns to contact their healthcare providers. Parents and caregivers can find the lot numbers on the bottom of the box containing the product and also on the sticker that surrounds the product bottle. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlerts forHumanMedicalProducts/ucm183924.htm
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Sitagliptin (marketed as Januvia and Janumet) - acute pancreatitis FDA notified healthcare professionals and patients of revisions to the prescribing information for Januvia (sitagliptin) and Janumet (sitagliptin/metformin) to include information on reported cases of acute pancreatitis in patients using these products. Eighty-eight post-marketing cases of acute pancreatitis, including two cases of hemorrhagic or necrotizing pancreatitis in patients using sitagliptin, were reported to the Agency between October 2006 and February 2009. It is recommended that healthcare professionals monitor patients carefully for the development of pancreatitis after initiation or dose increases of sitagliptin or sitagliptin/metformin. Sitagliptin has not been studied in patients with a history of pancreatitis. Therefore, it is not known whether these patients are at an increased risk for developing pancreatitis and the medication should be used with caution and with appropriate monitoring in patients with a history of pancreatitis. Considerations for healthcare professionals, information for patients, and a Data Summary are provided. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm183800.htm
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Exjade (deferasirox) - Early Communication FDA notified healthcare professionals of an Early Communication regarding an ongoing review of safety issues with Exjade (deferasirox). New safety data suggests there may be a greater number of adverse events and deaths in patients using Exjade who are over sixty years old who have myelodysplastic syndrome (MDS). Exjade, an iron chelator, is an oral medication approved in 2005 for patients aged two and older with chronic anemia (low red blood cell counts) and iron overload as a result of receiving blood transfusions.
FDA is working with Novartis to add new information in the Contraindications, Warnings, and Precautions sections of the prescribing information, to alert healthcare professionals of the risks and adverse events, including acute renal failure and gastrointestinal hemorrhages that in rare cases, especially in older patients with blood-related malignancies and/or low platelet counts, have been fatal. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm183840.htm
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ConMed Linvatec - Universal Cables and Power Pro Handpieces FDA notified healthcare professionals of the Class 1 recall of two ConMed Linvatec surgical service products due to reports of a switch problem resulting in unintended self-activation of these powered tools, continued running after trigger release and tool movement in unintended directions. The products are:
Power Pro, Power ProMax, and MPower 1 Handpieces, powered surgical handpieces in which a number of surgical tools (such as drills, blades, and small cutting devices) can be attached and are used during orthopedic surgical procedures.
Universal Cables, MC5057, the cable connects Linvatec MicroChoice Small Bone, MicroChoice, Advantage and APEX Shaver System and Power Pro Electric I and II Large Bone System electric handpieces to the power source.
The handpieces were distributed from March 29, 2002 through June 24, 2009. The cables were distributed from January 24, 2001 through February 27, 2009. ConMed has instructed users to stop using the cable immediately if the handpiece self-activates or an intermittent operation occurs and to return the handpiece and cable to the company for evaluation. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsfor HumanMedicalProducts/ucm181833.htm
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Covidien Pedi-Cap End-Tidal CO2 Detector FDA notified healthcare professionals of a Class I recall of Pedi-Cap End-Tidal CO2 Detector (Pedi-Cap and Pedi-Cap 6), because the device may increase the resistance of the flow of air into the lungs, resulting in ineffective ventilation and the inability to verify the correct placement of a breathing tube when inserting it into the windpipe. This device is used in pediatric patients, weighing 2.2-33 pounds, during the process of exchanging oxygen for carbon dioxide (ventilation) in healthcare settings. There is a reasonable probability that use of the recalled PediCap will cause serious adverse health consequences or death. Covidien informed their distributors and customers to stop selling/using the affected devices and to return them to the company. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm181878.htm
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Portex Uncuffed Pediatric-Sized Tracheal Tubes Smiths Medical and FDA notified healthcare professionals about a nationwide voluntary recall of Portex Uncuffed Pediatric-sized Tracheal Tubes (Sizes 2.5, 3.0, and 3.5 mm). A small number of tubes were manufactured with internal diameters slightly smaller than indicated on the labeling, which may create the potential for the clinician to experience difficulty passing through or withdrawing the suction catheter. The health consequences that may result from use of the defective device include the inability to remove secretions from the device and from the patient's airway, which may result in partieal or complete obstruction of the arway and an inability to ventilate the patient. In addition, this defect may increase airway resistance and compromise the ability to ventilate the patient. There is a reasonable probability of serious injury and/or death.
Smiths Medical is instructing customers to return all unused Tracheal Tubes and in their press release has provided recommendations for management of recalled product that is currently in use. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHuman MedicalProducts/ucm182084.htm
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NURSING HINTS CORNER
A pediatric patient who came to our unit after eye surgery had post/op orders for ice packs on both eyes, 30 minutes on and 30 minutes off, for 6 hours. When we tried to comply with the orders, the patient balked at the discomfort. We, then, discovered a suitable alternative.
We soaked several cotton balls in water, froze them, and substituted them for the ice packs. We had to change them frequently, but the patinet didn't mind because they were softer, smaller, and not as heavy as regular ice packs. Nancy McStay, RN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p.86, Springhouse Corporation/www.springnetcom. ~~**~~**~~**~~**~~**~~
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.Visit us at http://www.accu-ruler.com /.
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NEW MEMBERS
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com

A VERY BIG WELCOME TO:


debra.baker@sgmc.org (Debra) August 5, 2009

kurtullman@sprintmail.com (Kurt) September 10, 2009

quitta17@hotmail.com (Quitta) September 11, 2009

beth.green64@yahoo.com (Beth) September 14, 2009

Nursedt@bellsouth.net (Devonne) September 15, 2009

nanaR@windstream.net (Ann) September 25, 2009
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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
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EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
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PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie/Frances) ~~**~~**~~**~~**~~**~~
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
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THOUGHT FOR THE DAY
Nobody knows the age of the human race,
but everybody agrees that it is old enough to know better.
Anonymous

(sent in by Kurt Ullman-- one of our six new members)

Hope to see you online..... Frankie /Frances

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