March PARADIGM BYTES Newsletter

PARADIGM BYTES Newsletter for Paradigm 97 March 10, 2013 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. ***~~~***~~~***~~~*** SNIPPETS Nurses Denounce Court Ruling on Federal Labor Board Bid to Return to Era of Open Season on U.S. Workers The nation’s largest organization of nurses today condemned a conservative federal appeals court ruling overturning President Obama’s recess appointments to the National Labor Relations Board, a step taken by the President only after the refusal of Senate Republicans to restore a quorum on the board to enable it to function. “It is appalling that the court would reward the giant corporations and Wall Street, and the politicians they control in Washington, who have worked for years to overturn even modest protections for working people in the U.S.,” said RoseAnn DeMoro, executive director of the 185,000-member National Nurses United. “What that means in healthcare is a clear assault on the ability of nurses to act collectively to improve safety standards and public protections for patients,” said DeMoro. “If nurses are unable to speak out for patients and act together to safeguard conditions, all patients are threatened in an era in which most hospital employers place their bottom line above patient safety.” “When the board is not controlled by corporate-oriented appointees, as it has been most of the past four decades, the game plan of the anti-union crowd is to bar it from operating, either by refusing to confirm appointees, defunding or other destabilization tactics,” DeMoro noted. ... National Nurses United. 01/25/13 http://www.nationalnursesunited.org/press/entry/nurses-denounce-court-ruling-on-federal-labor-board/ ~~**~~**~~**~~**~~**~~ MEDICAL NEWS Bee Venom Kills HIV: Nanoparticles Carrying Toxin Shown To Destroy Human Immunodeficiency Virus A new study has shown that bee venom can kill the human immunodeficiency virus (HIV). Researchers at Washington University School of Medicine in St. Louis have demonstrated that a toxin called melittin found in bee venom can destroy HIV by poking holes in the envelope surrounding the virus, according to a news release sent out by Washington University. Visit Washington University's website to read more about the study. Nanoparticles smaller than HIV were infused with the bee venom toxin, explains U.S. News & World Report. A "protective bumper" was added to the nanoparticle's surface, allowing it to bounce off normal cells and leave them intact. Normal cells are larger than HIV, so the nanoparticles target HIV, which is so small it fits between the bumpers. “Melittin on the nanoparticles fuses with the viral envelope,” said research instructor Joshua L. Hood, MD, PhD, via the news release. “The melittin forms little pore-like attack complexes and ruptures the envelope, stripping it off the virus.” Adding, “We are attacking an inherent physical property of HIV. Theoretically, there isn’t any way for the virus to adapt to that. The virus has to have a protective coat, a double-layered membrane that covers the virus.” *************************** The American Nurses Association (ANA) is seeking YOUR input on the need for the Review of Code of Ethics for Nurses with Interpretive Statements This is for both members and non-members, http://nursingworld.org/MainMenuCategories/EthicsStandards/Codeof EthicsforNurses/Code-of-Ethics-Review.html Code of Ethics for Nurses with Interpretative Statements (the Code) to be reviewed and YOUR suggestions for revision. ANA’s Center for Ethics and Human Rights has undertaken this very important review. Ethics is integral to nursing practice, and the Code - one of ANA’s foundational documents - is essential for nursing practice. YOUR input is critical to the success of this review! The deadline for comments is March 15, 2013. The survey will take approximately 30 minutes to complete. It is best to complete the survey in one sitting, so please make sure you have ample time to complete the survey. All of the provisions and interpretive statements are embedded in the survey but the Preface and Afterword are not, so be sure you look at them before you begin the survey so you can address them. Learn more about the 2nd National Nursing Ethics Conference. The conference theme is Cultivating Ethical Awareness:Moments of Truth. The overall conference objective is to motivate and empower each participant with skills, courage and knowledge to speak confidently and be creative and steadfast while tackling ethical challenges. Contact us: ethics@ana.org. ****************** FROM A MEMBER Remember the article about the disposition of drugs? If you don't check out Feb's newsletter. This note is from MarGerlach (Marlene) who writes: OOps, wasn't a typo...BUT, I think it was misleading and the advice still potentially dangerous.. It said that some drugs can go in the trash, (okay) but some can be flushed. It said those that are potentially life threatening, etc...etc....whatever..... were on a list that could be flushed, supposedly keeping them out of people's hands when putting them in the household garbage, but it has always been my understanding that NOTHING should be flushed due to ground water contamination, etc,..etc...etc....I think all unused drugs should go into toxic waste, and especially the most dangerous ones. Am I way off base with this? Write in with your opinion, please.....this is an important issue. ~~**~~**~~**~~**~~**~~ INTERESTING READING Please remember that the REUTERS articles usually good for only 30 days This is an interesting article/survey from Rozalfaro (Roz)....try it: You can take a quiz on international eating etiquette. http://www.fekids.com/img/kln/flash/DontGrossOutTheWorld.swf ************************* U.S. recovers $4.2 billion from healthcare fraud probes: report (Reuters) - The Obama administration said on Monday that its efforts to combat fraud in the Medicare and Medicaid healthcare programs were paying off as the government recovered a record $4.2 billion in fiscal 2012 from individuals and companies trying to cheat the system. For every dollar spent investigating healthcare fraud over the past three years, the government recovered $7.90, according to a report released on Monday by Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius. This was the highest three-year average return on investment in the 16-year history of the federal Health Care Fraud and Abuse Program, the report said. ******** WORD ORIGINS: Greed *** "Greed" is one of the few words to enter English from the Gothic language, which was spoken in scattered pockets of eastern and northern Europe until the ninth century. Its original form, gredas, meant "hunger," a sense that later came to be applied to a kind of insatiable hunger of the soul. ************** What would you have done? (Thank you Barbara (BAcello) for sending this ) This independent living facility does not permit staff to do CPR. The dispatch tape broke my heart. With all the negative press, the BNE will probably investigate. The whole situation is unconscionable & I am ashamed to call this nurse a peer.................Barbara A 911 dispatcher pleaded with a nurse at a Bakersfield, Calif., senior living facility to save the life of an elderly woman by giving her CPR, but the nurse said policy did not allow her to, according to a newly released audiotape of the call. “Is there anybody there who is willing to help this lady and not let her die?” the dispatcher asked in a recording of the 911 call released by the Bakersfield Fire Department. “Not at this time,” the nurse said. http://abcnews.go.com/blogs/headlines/2013/03/elderly-woman-dies-after-nurse-refuses-to-give-her-cpr/ ************************** March 3-9 is Patient Safety Awareness Week, an awareness campaign led by the National Patient Safety Foundation. This year’s theme is “Patient Safety 7/365: 7 days of recognition, 365 days of commitment to safe care.” Here are some patient safety facts from the World Health Organization (WHO): 1 in 10: As many as one in 10 patients in developed countries is harmed while receiving hospital care. 1.4 million: At any given time, 1.4 million people worldwide suffer from infections acquired in hospitals.50%: 20: The risk of healthcare-associated infection in some developing countries is as much as 20 times higher than in developed countries. 50: Problems associated with surgical safety in developed countries account for half of the avoidable adverse events that result in death or disability. 1 in 1,000,000: The chance of a traveler being harmed while in an aircraft. 1 in 300: The chance of a patient being harmed during health care. Source: World Health Organization ************** One Man's Diagnosis Leads to Major Type 1 Diabetes Discovery Tuesday March 5, 2013, an ordinary patient visit recently led Swiss researchers to an extraordinary discovery: a single genetic mutation that causes type 1 diabetes, as reported today in the journal Cell Metabolism. The scientists are now exploring ways to translate their findings into clinical research, including a possible trial with drugs that activate the gene pathway, in the hopes of identifying new type 1 diabetes treatments. “This is the first time that a single gene was found that directly leads to type 1 diabetes,” says Marc Donath, MD, the study’s senior author and an endocrinologist at University Hospital Basel in Switzerland. “This gene was quite well-known from animal studies and was not expected to lead to this kind of disease.” Breakthrough that could benefit millions ************************ The Power of Pre-op and Surgical Checklists By Debra Wood, RN, contributor January 25, 2013 - Surgical teams learned several years ago that adhering to proven standards can improve safety and quality of care and employed checklists before starting a procedure to ensure nothing is missed. Now, research shows using checklists during crises situations can enhance clinicians’ response to the emergency, and teams in Washington State are investigating the use of pre-operative checklists in the clinic or surgeon’s office to improve outcomes. “Nurses have been doing checklists for a long time, and I agree there is value,” said Tanya Lecompte, MSN, ACNS-BS, CPAN, a clinical nurse specialist in perianesthesia at Mercy Medical Center in Baltimore. “But I am concerned we sometimes over-use them. However, I was very impressed with the critical elements checklist.” Boston researchers found while conducting a randomized clinical trial that when doctors, nurses and other hospital operating room staff, on 17 teams, follow a written safety checklist when responding to a simulation patient’s cardiac arrest, severe allergic reaction, bleeding followed by an irregular heartbeat or other crises during surgery, they were nearly 75 percent less likely to miss a critical clinical step than teams relying on memory alone. ... The Power of Pre-op and Surgical Checklists ************************* WORD ORIGINS: Chick-fil-A *** In 1946, an Atlanta-area restaurant called the Dwarf Grill began to serve chicken breast sandwiches, which, surprisingly, seems not to have been done elsewhere or earlier. Proprietor Truett Cathy thus holds claim to being the inventor of the treat, which he called "Chick-fil-A," a play on the work "fillet." Cathy established the first restaurant to bear the name in an Atlanta Mall. Today, there are more than 1,500 outlets across the country. ******************* FDA approves new use for Roche's Avastin in colon cancer treatment (Reuters) - The U.S. Food and Drug Administration on Wednesday approved the use of Roche's Avastin for patients whose colorectal cancer has worsened despite previous treatment with the drug. The new use will allow patients first treated with Avastin plus chemotherapy to be treated again with the biotechnology drug in combination with a different chemotherapy regimen. A pivotal clinical trial showed that such a treatment strategy improved survival. "The majority of people diagnosed with metastatic colorectal cancer receive Avastin plus chemotherapy as their initial treatment," Hal Barron, chief medical officer at Roche's Genentech unit, said in a statement. "These people now have the option to continue with Avastin plus a new chemotherapy after their cancer worsens, which may help them live longer than changing to the new chemotherapy alone." ************** Junk food is typically defined as foods with little nutritional value that are high in calories, fat, sugar, salt, or caffeine, and it is a staple in the American diet. Healthy or not, we love our junk food! RANDOM FACT: Doughnuts most likely originated in Germany and were brought to New York by Dutch settlers who called them olykoeks (oily cakes). The hole in the center was developed by the Pennsylvania Dutch perhaps because the shape provided easier dunking in coffee or made it easier to fry the donuts more thoroughly. Dunkin Donuts sells 6.4 million donuts per day (2.3 billion per year). *** Bonus Fact: In 1979, in what has become known as the 'Twinkie Defense,' Daniel White said he killed San Francisco mayor George Moscone and Harvey Milk because he ate too much junk food, such as Twinkies, candy bars, and cupcakes, which caused a chemical imbalance in his brain. He was still convicted and, in 1981, Congress outlawed the 'Twinkie Defense.' ************* Brain 'Pacemaker' May Help Ease Tough-to-Treat Anorexia WEDNESDAY, March 6 (HealthDay News) -- For people suffering from severe, tough-to-treat anorexia, having a biological "pacemaker" implanted in their brain may help ease the disorder, a small new study suggests. The researchers noted that anorexia is the psychiatric disorder with the highest mortality rate and, although therapies exist, not everyone benefits in the long term. The disorder is among the most common psychiatric ills diagnosed among teenage women. Up to 20 percent of patients do not respond to available treatments, which usually focus on behavioral change. The new study examined the effectiveness of an approach called deep brain stimulation (DBS), sometimes called a brain pacemaker. ... Brain 'Pacemaker' May Help Ease Tough-to-Treat Anorexia ********************* Anorexics Can't Judge Own Body Size: Study THURSDAY, Aug. 23 (HealthDay News) -- People with the eating disorder anorexia have difficulty judging their own body size but are able to size up others accurately, a small new study finds. The study included 25 people with anorexia and 25 people without the disorder who were shown a door-like opening and asked to judge whether they or other people in the room could pass through it. In earlier experiments, people with anorexia felt they could not pass through the door even if it was easily wide enough. In this study, people with anorexia were more accurate at judging whether other people could fit through the door than whether they could. The researchers also found a link between the anorexia patients' ability to fit through the door and their body size prior to becoming anorexic. This suggests that people with anorexia may still think of themselves as having their previous size, said study author Dewi Guardia, of the University Hospital of Lille in France. The study was published Aug. 22 in the journal PLoS One. Anorexics Can't Judge Own Body Size: Study ********************* FACTS: 1. Cucumbers contain most of the vitamins you need every day, just one cucumber contains Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B5, Vitamin B6, Folic Acid, Vitamin C, Calcium, Iron, Magnesium, Phosphorus, Potassium and Zinc. 2. Feeling tired in the afternoon, put down the caffeinated soda and pick up a cucumber. Cucumbers are a good source of B Vitamins and Carbohydrates that can provide that quick pick-me-up that can last for hours. 3. Tired of your bathroom mirror fogging up after a shower? Try rubbing a cucumber slice along the mirror, it will eliminate the fog and provide a soothing, spa-like fragrance. 4. Are grubs and slugs ruining your planting beds? Place a few slices in a small pie tin and your garden will be free of pests all season long. The chemicals in the cucumber react with the aluminum to give off a scent undetectable to humans but drive garden pests crazy and make them flee the area. ****************** As nurses, we’re proud of the expert care we provide patients. But we also know that just doing our job isn’t enough to advance our careers. Mastering good communication skills is essential for all nurses at all career stages—especially with today’s flatter organizational structures and more participatory management styles. Knowing how to communicate in a professional manner can give you the edge you need for career advancement. Opportunity rarely knocks any more. Instead it may present as a phone call, voice mail, e-mail, or text message. Be sure to use proper etiquette with all communication forms. Speaking with managers When dealing with your manager, use a solution-focused approach. Don’t be a complainer. Some communication experts point out that people complain about things they can do something about—not things they have no power over. For example, they don’t complain about their foot size because there’s nothing they can do about it. Yet people often complain about their jobs because they’re unwilling to take the risk of making a change. ... How to keep your communications professional *********************** Tips to Improve your caregiving skills......... (Thanks, Roz Rozalfaro@AOL.com) http://www.nursezone.com/Nursing-News-Events/more-news/Tips-to-Improve-Your-Caregiving-Skills_41044.aspx ************ ********************** RANDOM FACTS: Approximately 800 tornadoes are reported in the United States each year, causing eighty fatalities and 1,500 injuries. A tornado can happen in any season and at any hour, from mountains to urban areas. *** Bonus Fact: Lightning is a leading cause of weather-related injury and even death in the United States. Lightning strikes the Earth more than 5,000 times every minute. Your odds of being struck by lightning in America are 1 in 700,000 in any given year. About 10 percent of lightning-strike victims are killed. ********************** Study: lumpectomy survival rates good for early breast cancer Reuters) - A new U.S. study examining survival rates for women with early stage breast cancer found that surgery such as lumpectomy that preserves the rest of the breast may offer survival odds as good as, or even better than, mastectomies. Despite clinical trials showing lumpectomy, or removal of the cancer only, to be as effective as mastectomies in treating early breast cancers, the number of women choosing breast removal has been on the rise, wrote lead researcher E. Shelley Hwang in the journal Cancer. "It was kind of an exciting and hopeful message that women don't have to go off to get a mastectomy to do better," said Hwang, from the Duke Cancer Institute in Durham, North Carolina. "I think a lot of women were making that decision (for mastectomy) because they thought the lumpectomy was not enough. In that context, we wanted to know if lumpectomy works just as well as mastectomy in the modern era." ... http://www.reuters.com/article/2013/02/01/us-breastcancer-idUSBRE91003320130201?feedType=RSS&feedName=healthNews ******************* Diet Sodas: Changing Your Brain And Your Waistline Diet sodas may not be helping you lose weight—in fact, these and other artificially sweetened foods may sabotage your diet by confusing and rewiring your brain’s reward centers. This study from the journal Physiology & Behavior is yet another example of how lifestyle choices can alter your brain—negatively or positively. Scanning diet soda drinkers' brains The University of San Diego study followed 24 young adults: half the group drank at least one serving of diet soda every day, while the other half avoided the artificially sweetened drinks. These adults were then hooked up to brain scanning equipment while scientists fed them water alternately flavored by natural and artificial sweeteners—then the researchers sat back and watched what unfolded in the brain. The results, according to University of California San Diego researchers Green and Murphy, were pronounced: “[Diet soda drinkers] who consumed a greater number of diet sodas had reduced caudate head activation. These findings may provide some insight into the link between diet soda consumption and obesity.” https://www.lumosity.com/blog/diet-soda/?utm_source=SilverpopMailing&utm_medium=email&utm_campaign=RMKTG_DietSoda_2012.10.16_A&utm_content=&ll_src=RMKTG_DietSoda_2012.10.16_A&ll_ch=EMAIL&ll_u=18261521&spMailingID=9661449&spUserID=MjA0OTQ3NzA2NTYS1&spJobID=206096646&spReportId=MjA2MDk2NjQ2S0 ********************** RANDOM FACTS : On November 19, 1863, at the dedication of a military cemetery at Gettysburg, Pennsylvania, during the American Civil War, President Abraham Lincoln delivers one of the most memorable speeches in American history. In just 272 words, he brilliantly and movingly reminded a war-weary public why the Union had to fight, and win, the Civil War. Bonus Fact: Also on this date; for the first time in eight years, the leaders of the Soviet Union and the United States hold a summit conference. Meeting in Geneva, President Ronald Reagan and Soviet leader Mikhail Gorbachev produced no earth-shattering agreements. However, the meeting boded well for the future, as the two men engaged in long, personal talks and seemed to develop a sincere and close relationship. *************** WORD ORIGINS: Atlanta*** Georgia's chief city came into being thanks to the railroad, which began to work its way through the area in 1836. A planned line from Chattanooga, Tennessee, to the northwest was to shunt at a place noted on the map simply as "Terminus." A few years later, a railroad official suggested naming the growing town around this point "Atlantica-Pacifica." The name stuck until 1847, when a resident suggested the shortened form "Atlanta," made official that year. ************* Hospital-acquired pressure ulcers: results from the national Medicare Patient Safety Monitoring System study. Lyder CH; Wang Y; Metersky M; Curry M; Kliman R; Verzier NR; Hunt DR School of Nursing, University of California at Los Angeles, Los Angeles, California 90095, USA. clyder@sonnet.ucla.edu OBJECTIVES: To determine the national and state incidence levels of newly hospital-acquired pressure ulcers (PUs) in Medicare beneficiaries and to describe the clinical and demographic characteristics and outcomes of these individuals. DESIGN: Retrospective secondary analysis of the national Medicare Patient Safety Monitoring System (MPSMS) database. SETTING: Medicare-eligible hospitals across the United States and select territories. PARTICIPANTS: Fifty-one thousand eight hundred forty-two randomly selected hospitalized fee-for-service Medicare beneficiaries discharged from the hospital between January 1, 2006, and December 31, 2007. ... J Am Geriatr Soc. 2012: 60(9): 1603 -8 (ISSN: 1532-5415) http://reference.medscape.com/medline/abstract/22985136?src=nlbest ***************** Medscape Medical News GI Bleeds: Withholding Transfusions Boosts Survival Withholding transfusions until hemoglobin levels are lower than 7%, rather than 9%, improves overall survival by 45% in patients with acute upper gastrointestinal (GI) bleeding, according to a study published in the January 3 issue of the New England Journal of Medicine. "[This study] provides long-awaited evidence to guide practice and justify current recommendations for the management of upper gastrointestinal bleeding," asserts Loren Laine, MD, from the Yale University School of Medicine in New Haven and the VA Connecticut Healthcare System in West Haven, in an accompanying editorial. Although prior meta-analyses have largely excluded the potential for benefit with a liberal transfusion strategy, only 1% or less of included patients had acute GI bleeds, Dr. Laine writes.... http://www.medscape.com/viewarticle/777187 *********************** Catheter hub decontamination requires a thorough scrub and compliance varies. This study evaluates the effectiveness of a disinfection cap with 70% alcohol in preventing contamination/infection. ( the full article is also available at this link) Methods A 3-phased, multifacility, quasi-experimental study of adult patients with central lines divided into P1 (baseline), when the standard scrub was used; P2, when the cap was used on all central lines; and P3, when standard disinfection was reinstituted. House-wide central-line associated bloodstream infection (CLABSI) rates are reported with catheter-associated urinary tract infections (CAUTI) as a control measure. Adults with peripherally inserted central catheters inserted during hospitalization having 5+ consecutive line-days gave consent and were enrolled, and 1.5 mL of blood was withdrawn from each lumen not in use and quantitatively cultured. Results Contamination was 12.7% (32/252) during P1; 5.5% (20/364) in P2 (P = .002), and 12.0% (22/183; P = 0.88 vs P1 and P = .01 vs P2) in P3 (P = .001 vs P2). The median colony-forming units per milliliter was 4 for P1, 1 for P2 (P = .009), and 2 for P3 (P = .05 vs P2). CLABSI rates declined from 1.43 per 1,000 line-days (16/11,154) to 0.69 (13/18,972) in P2 (P = .04) and increased to 1.31 (7/5,354) in P3. CAUTI rates remained stable between P1 and P2 (1.42 and 1.41, respectively, P = .90) but declined in P3 (1.04, P = .03 vs P1 and P2). Conclusion Disinfecting caps reduce line contamination, organism density, and CLABSIs. http://www.ajicjournal.org/article/S0196-6553%2812%2901023-1/abstract?utm_campaign=Weekly_eNewsletter_Week_of_January_7th_2013&utm_medium=email&utm_source=BenchmarkEmail ************ A Patient Teaching Moment: Grapefruit may turn more drugs deadly, scientists find More than 85 drugs that interact with whole grapefruit, grapefruit concentrate or fresh grapefruit juice have been identified, though not all have serious consequences. Those that do, however, can cause problems that include acute kidney failure, respiratory failure, gastric bleeding -- and worse. A complete list of drugs that interact with grapefruit: http://www.cmaj.ca/content/suppl/2012/11/26/cmaj.120951.DC1/grape-bailey-1-at.pdf ***************************** Ivermectin hair lotion found effective against lice (Reuters Health) - A single 10-minute hair application of a drug used in oral form since the 1980s to control river blindness and other parasitic diseases eliminated head lice in nearly three of four children in a new study. The lotion contains ivermectin and is sold under the brand name Sklice by Sanofi Pasteur, which paid for the study. The U.S. Food and Drug Administration used the results to approve topical ivermectin lotion in February. "The advantage of it is, it's a one-application, one-shot treatment," lead author Dr. David Pariser of Eastern Virginia Medical School, in Norfolk, told Reuters Health. ... http://www.reuters.com/article/2012/10/31/us-ivermectin-hair-idUSBRE89U1Q920121031?feedType=RSS&feedName=healthNews ******************* Quiz Time For a patient with dilated cardiomyopathy, which type of pacing should you anticipate? a. Epicardial pacing b. Transvenous pacing c. Noninvasive transcutaneous pacing d. Biventricular pacing. (answer at end of Newsletter) Reprinted with permission from: Production/Electronic Channels Coordinator HealthCom Media 259 Veterans Lane Doylestown, PA 18901 ******************** New Hold-n-Place Adhesive Patch The Dale Hold-n-Place Foley Catheter Holder is an adhesive patch which has a clear, skin-friendly base and a locking tab that features a dual holding system of adhesive and Velcro to secure indwelling catheters. Designed for short-term use, the adhesive patch can remain in place for up to three days. http://dalemed.com/ContactUs/RequestAdditionalInformation.aspx **************** Help kiss metabolic syndrome goodbye just by touching your lips to a glass of this: grape juice. Seems that resveratrol -- a compound found in red grapes, red wine, and grape juice -- starts a helpful chain reaction that could keep metabolic syndrome in check. And that's a very good thing, because metabolic syndrome significantly increases the likelihood of heart disease. Resveratrol Benefits Here's how it works: In an animal cell study, researchers watched it all go down. Seems that resveratrol triggers a process that results in a hormone called adiponectin -- and this hormone is something special. Resveratrol benefits include protecting the lining of blood vessels from inflammation, enhancing the function of insulin, increasing glucose tolerance, and putting an end to the development of both metabolic syndrome and heart disease. Pretty hot stuff. Especially for people who are struggling with their weight, since arterial inflammation and insulin and glucose problems can be a real problem for obese people. Not only that, but obese people tend to have lower adiponectin levels to begin with. (Related: Does obesity run in your family? http://www.realage.com/information-on-diabetes/reduce-metabolic-syndrome-with-resveratrol?eid=1010643037&memberid=31741808 ******************* Looking for a pill-free way to ease back pain? A survey recently revealed the top six. And none of the alternative therapy methods for back pain treatment requires surgery. They are chiropractic care, massage, acupuncture, herbal therapy, relaxation training, and stretching-based Eastern exercises (think yoga and tai chi). Ache-Alleviating Alternatives In a large national survey, 60% of people who had used one of these alternative therapy methods in the previous year said that it brought them a "great deal" of relief from their low back pain. And, in fact, more was better. People who used a combination of one or more of these therapies tended to experience even greater back pain relief compared with people who used just one. (Related: Discover what dangerous health condition may be ameliorated by massage.) ... http://www.realage.com/chronic-pain-management/reduce-back-pain-complementary-therapies?eid=1010643037&memberid=31741808 ~~**~~**~~**~~**~~**~~ HUMOR SECTION The reception area of the doctor's office was fllled to capacity, but the doctor was working at a snail's pace. After waiting for two hours, an old man slowly stood up and headed for the door. When everyone stopped talking to look at him, he announced, "I guess I will just go home to die a natural death." ***** A naked man was admitted to the ER suffering a large bump on his head and a severely scratched scrotum. He was diagnosed with a concussion. The nurses wondered why he wasn't dressed...why he had all the scratches on his scrotum, but since he was still unconscious, those answers would have to be on hold. Finally, the second day he was aware enough to hold a conversation and the questions were finally asked. He said that he was a day sleeper. He had been awakened by a dripping faucet and couldn't go back to sleep without checking it out. As he was under the sink looking for the drip, his cat came up and started batting at his swaying scrotum. This it really hurt and he was startled into leaping up, resulting in bumping his head so hard, that he became unconscious. The next he knew, he was in the hospital. ~~**~~**~~**~~**~~**~~ CEU SITES---(CME and CNE) Those that are-----Free and Otherwise.......... Go to www.sharedgovernance.org for access to a just released, free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member. Please follow me on Twitter as Dr Robert Hess. Pay Only $34.99 for a full year of CONTACT HOURS www.nurse.com for CNE offerings. Free CEs http://www.myfreece.com/welcome.asp https://nursing.advanceweb.com/CE/TestCenter/Main.aspx ~~**~~**~~**~~**~~**~~ WEBSITES/ LINKS Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com. This is an excellent nursing site, check it out: http://nursingpub.com/ Robert Hess, RN, PhD, FAAN (856) 424-4270 (610) 805-8635 (cell) Founder, Forum for Shared Governance info@sharedgovernance.org www.sharedgovernance.org Decubqueen's website: www.accu-ruler.com http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2 http://www.nationalnurse3.blogspot.com/ The Nursing Site http://thenursingsite.com . http://www.snopes.com http://www.solutionsoutsidethebox.net/ Raconte's website http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3 Rozalfaro's website: http://www.alfaroteachsmart.com/articles.htm Metric conversion calculators and tables for metric conversions http://www.metric-conversions.org/ ******************************************************* ******************************************** * MEDICAL RECALLS * ******************************************* ****************************************************** Ad-Tech Macro Micro Subdural Electrodes FDA and Ad-Tech notified healthcare professionals of a Class 1 recall due to concern the microelectrodes are defective and may cause injury to the brain. These devices are intended for temporary (less than 30 days) use on patients with epilepsy for the recording, monitoring and stimulation of electrical signals on the surface level of the brain. There is the potential for abrasion of brain tissue and for broken pieces to remain in the brain tissue when the physician removes the electrode. This may lead to hemorrhaging or a seizure, as well as death. BACKGROUND: There has been one reported serious injury that may have been related to the use of the device. On Dec. 18, 2012, the firm sent its customers an "Urgent Medical Device Recall" letter. The letter described the reason for recall, the risk to health, actions to be taken by the customers, product and distribution information, and type of action taken by the firm. The recalled products were manufactured from June 2006 to March 2012, and distributed from June 8, 2006 to March 14, 2012. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm342834.htm ********************* Samsca (tolvaptan): Drug Warning - Potential Risk of Liver Injury Otsuka and FDA notified healthcare professionals of significant liver injury associated with the use of Samsca. In a double-blind, 3-year, placebo-controlled trial in about 1400 patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) and its open-label extension trial, 3 patients treated with the drug developed significant increases in serum alanine aminotransferase (ALT) with concomitant, clinically significant increases in serum total bilirubin. In the trials the maximum daily dose of Samsca administered (90 mg in the morning and 30 mg in the afternoon) was higher than the maximum 60 mg daily dose approved for the treatment of hyponatremia. Most of the liver enzyme abnormalities were observed during the first 18 months of therapy. Following discontinuation of treatment, all 3 patients improved. An external panel of liver experts assessed these 3 cases as being either probably or highly likely to be caused by tolvaptan. These findings indicate that Samsca (tolvaptan) has the potential to cause irreversible and potentially fatal liver injury. These data are not adequate to exclude the possibility that patients receiving Samsca for its indicated use of clinically significant hypervolemic and euvolemic hyponatremia are at a potential increased risk for irreversible and potentially fatal liver injury. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm336669.htm ********************* FDA approves new silicone gel-filled breast implant Agency requires post-approval safety studies to assess rare events The U.S. Food and Drug Administration today approved the Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Gel Filled Breast Implant to increase breast size (augmentation) in women at least 22 years old and to rebuild breast tissue (reconstruction) in women of any age. Natrelle 410 implants are manufactured by Allergan, Inc. The silicone gel in the Natrelle 410 implant contains more cross-linking compared to the silicone gel used in Allergan’s previously approved Natrelle implant. This increased cross-linking results in a silicone gel that’s firmer. Cross-linking refers to the bonds that link one silicone chain to another. The clinical significance of this type of silicone gel is not known. ... http://www.fda.gov/ForConsumers/byAudience/ForWomen/default.htm ********************** Omontys (peginesatide) Injection by Affymax and Takeda: Recall of All Lots - Serious Hypersensitivity Reactions Affymax, Inc. and Takeda Pharmaceutical Company Limited along with the U.S. Food and Drug Administration (FDA) are informing the public of a voluntary recall of all lots of OMONTYS® (peginesatide) Injection to the user level as a result of new postmarketing reports regarding serious hypersensitivity reactions, including anaphylaxis, Omontys (peginesatide) Injection is indicated for the treatment of anemia due to chronic kidney disease in adult patients on dialysis and is packaged in 10 mg and 20 mg Multi-dose vials: 10mg Multi-dose Vials - NDC 64764-610-10 Lots C18685, C18881, C19258 20mg Multi-dose vials - NDC 64764-620-20 Lots C18686, C18696 All lots of Omontys are affected by this recall and distributed nationwide, including Puerto Rico and Guam, to dialysis centers via specialty distributors. Dialysis organizations are instructed to discontinue use. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm340895.htm ~~**~~**~~**~~**~~**~~ 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/. ~~**~~**~~**~~**~~**~~ NEW MEMBERS Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com WELCOME TO: tsherryeddie@msn.com (Sherry) February 16, 2013 bwillis@archbold.org (Beth) February 27, 2013 ~~**~~**~~**~~**~~**~~ ADDRESS CHANGE: FROM: Chousm@AOL.com TO: chousm@bendbroadband.com Thank you for letting me know. ~~**~~**~~**~~**~~**~~ EDITORIAL STAFF: GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan) ~~**~~**~~**~~**~~**~~ PARADIGM 97 CO-FOUNDERS: MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~ DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views. ~~**~~**~~**~~**~~**~~ THOUGHT FOR THE DAY "Nursing should not be a sacrifice, but one of the highest delights of life." ~ Florence Nightingale Answer to Quiz Time: Correct answer: d. Biventricular pacing (also called cardiac resynchronization therapy) is indicated for patients with heart failure, dilated cardiomyopathy, prolonged ventricular conduction, or a reduced ejection fraction. Hope to hear from you..... Frankie RNFrankie@AOL.com