PARADIGM BYTES

Newsletter for Paradigm 97

April 10, 2016

PARADIGM DEFINED:

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

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

MISSION STATEMENT

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

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SNIPPET

More of the World's People Are Now Obese Than Underweight

THURSDAY, March 31, 2016 (HealthDay News) -- More people worldwide are obese than underweight, a new study found.

The researchers added that about one-fifth of adults could be obese by 2025.

The number of obese people in the world rose from 105 million in 1975 to 641 million in 2014, with obesity rates rising from 3 percent to 11 percent among men and from 6 percent to 15 percent among women, the study found.

Over the same time, the proportion of underweight people fell from 14 percent to 9 percent of men and from 15 percent to 10 percent of women, according to the study.

More than one-quarter of severely obese men and nearly one-fifth of severely obese women in the world live in the United States, the researchers said.

On average, people worldwide have become an average of 1.5 kilograms (3.3 pounds) heavier each decade. At the current pace, about 18 percent of men and 21 percent of women will be obese, and more than 6 percent of men and 9 percent of women will be severely obese by 2025, the study found.

The findings were released online on March 31 in The Lancet. ...

https://www.nlm.nih.gov/medlineplus/news/fullstory_158065.html

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Definition:

Obesity often results from taking in more calories than are burned by exercise and normal daily activities.

Obesity occurs when a person's body mass index is 30 or greater. The main symptom is excessive body fat, which increases the risk of serious health problems.

The mainstay of treatment is lifestyle changes such as diet and exercise.

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Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Background

Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. ...

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30054-X/abstract

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Ten Factors ..leading causes of weight gain, obesity, et al.

1. Genetics

2. Engineered "hyperpalatable junk foods"

3. Food addiction

4. Aggressive marketing (especially towards children)

5. Insulinn

6. Certain medications

7 Liptin and liptin resistance

8. Food availability

9. Sugar

10. Misinformaion

https://authoritynutrition.com/10-causes-of-weight-gain/

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This from the American Heart Association:

Nearly 78 million adults and 13 million children in the United States deal with the health and emotional effects of obesity every day. The solution to their problem sounds deceptively simple — take in fewer calories a day, while cranking up the calorie-burning process with regular exercise.

But it’s not just a matter of obese people deciding they’re going to eat less, says Donna H. Ryan, M.D., co-chair of the committee that wrote the recent obesity guidelines and professor emerita at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge.

Not getting the cues

The body’s regulation of food consumption is a highly complex biologic system, designed to promote food intake and survival, she explains. Body organs like the stomach, intestines, fat and pancreas send signals to the brain that trigger hunger and make you want to eat. While you’re eating, signals tell the brain that you’re full and to stop eating. “This is called the homeostatic system,” Ryan said, and is why we get hungry at regular intervals during the day but don't get hungry at night when we’re sleeping.”

She adds that another system -- the reward system -- promotes food intake. When you see or smell appealing food, it can trigger the desire to eat whether or not you’re hungry. “Think of your experience in a restaurant after a meal when the dessert cart comes by,” Ryan said.

Recent studies show that obese individuals have less ability to resist food cues.

Stress, mildly low blood sugar and other factors also play a role.

Adding to the challenge, trying to eat less magnifies the body’s appetite regulating signals and when you start to lose weight, appetite is increased and satiety is decreased. ...

http://www.heart.org/HEARTORG/HealthyLiving/WeightManagement/Obesity/Understanding-the-American-Obesity-Epidemic_UCM_461650_Article.jsp#.Vv_eqfkrJkq

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INTERESTING READING

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

Painful endometriodis may boost risk for heart disease

(Reuters Health) – Women with an excess growth of uterine lining tissue may also be at higher risk of coronary heart disease, according to a new study.

The condition, called endometriosis, affects up to five million women in the U.S. Uterine tissue can grow on the ovaries, behind the uterus or on the bowels or bladder and can cause pain, infertility and very heavy periods.

“Many girls and women do not realize that distressing menstrual cramps and pelvic pain can be due to endometriosis,” said senior study author Stacey A. Missmer, director of Epidemiologic Research in Reproductive Medicine at Brigham and Women’s Hospital in Boston.

“Girls and women can be treated through surgery that removes the endometriosis lesions or by hormonal medications including oral contraceptives,” but there is no outright cure, Missmer told Reuters Health by email.

The researchers used data on more than 116,000 women in the Nurses’ Health Study II, which ran from 1989 to 2009 – including about 5,200 women with surgically confirmed endometriosis.

Those with endometriosis were more likely than others to suffer a heart attack, to have coronary bypass or stent surgery, or to have angina, the chest pain that can be a sign of coronary artery disease.

The increased risk for these conditions was highest for women up to age 40, who were about three times as likely to have any combination of the heart disease end points as those without endometriosis. The difference in heart disease risk shrank at older ages. ...

http://www.reuters.com/article/us-health-uterus-heart-risk-idUSKCN0WV2FT

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WHO sees scientific consensus on Zika as cause for disorders

Researchers around the world are now convinced the Zika virus can cause the birth defect microcephaly as well as Guillain-Barre syndrome, a rare neurological disorder that can result in paralysis, the World Health Organization said on Thursday.

The statement represented the U.N. health agency's strongest language to date on the connection between the mosquito-borne virus and the two maladies.

The WHO also reported the first sign of a possible rise in microcephaly cases outside Brazil, the hardest-hit country so far in an outbreak spreading rapidly in Latin America and the Caribbean. Neighboring Colombia is investigating 32 cases of babies born with microcephaly since January, and eight of them so far have tested positive for the Zika virus, the WHO said.

This number of microcephaly cases reported in Colombia so far represents an increase over the historical annual average of about 140 cases.

"Based on observational, cohort and case-control studies, there is a strong scientific consensus that Zika virus is a cause of GBS (Guillain-Barre syndrome), microcephaly and other neurological disorders," the WHO said on Thursday.

In its previous weekly report, the WHO had said Zika was "highly likely" to be a cause. The WHO in February declared the Zika outbreak an international health emergency, citing a "strongly suspected" relationship between Zika infection in pregnancy and microcephaly.

Although Zika has not been proven conclusively to cause microcephaly in babies, evidence of a link was based on a major spike in Brazil in cases of microcephaly, defined by unusually small head size that can result in severe developmental problems. ...

http://www.reuters.com/article/us-health-zika-who-idUSKCN0WX2DJ?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-04-01&utm_term=US%20Health%20Report

http://tinyurl.com/gt7q7cs

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FDA Approves Experimental Zika Test for Blood Donations

But agency still asks those who've possibly been exposed to the virus to forgo giving blood right now

WEDNESDAY, March 30, 2016 (HealthDay News) -- An experimental test to check blood donations for the Zika virus has been approved by the U.S. Food and Drug Administration.

The decision to allow use of the test in areas with active mosquito-borne transmission of the virus means that collections of whole blood and blood component donations will be able to resume in Puerto Rico, agency officials said.

"The availability of an investigational test to screen donated blood for Zika virus is an important step forward in maintaining the safety of the nation's blood supply, especially for those U.S. territories already experiencing active transmission," Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, said Wednesday.

"In the future, should Zika virus transmission occur in other areas, blood collection establishments will be able to continue to collect blood and use the investigational screening test, minimizing disruption to the blood supply," he explained in an FDA news release. ...

https://www.nlm.nih.gov/medlineplus/news/fullstory_158043.html

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Over 100 Zika Cases Confirmed in US, CDC Says

More than 100 cases of Zika virus have been confirmed in the United States, a new report finds.

The 116 residents who have now tested positive for the virus include one infant who was born with severe microcephaly, according to the report from the Centers for Disease Control and Prevention (CDC). All 116 cases ofZika were confirmed by lab tests at the CDC.

The report includes all Zika cases reported between Jan. 1, 2015, and Feb. 26, 2016, but more than three-quarters of the patients reported that their illness began in 2016, according to the report released today (March 18). The patients ranged in age from the newborn infant with microcephaly, up to 81 years old, the report said. [Zika Virus News: Complete Coverage Of The Outbreak]

Ten percent of the patients were children and adolescents younger than 18, and 65 percent of the cases were in females, according to the report. ...

http://www.livescience.com/54099-zika-cases-united-states-through-feb-2016.html

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Submit your paper to Journal of Research in Nursing


Co-Editors in Chief:
Professor Andree Le May, Formerly Professor of Nursing, University of 
Southampton, UK 
Dr Ann McMahon, Honorary Research Fellow, University of Glasgow, UK

The Journal of Research in Nursing is a leading peer reviewed journal that 

blends good  research with contemporary debates about policy and practice. 

The Journal of Research in Nursing contributes knowledge to nursing 
practice,research and local, national and international health and social care 
policy. 
Each issue contains a variety of papers and review commentaries within a 
specific theme.

Before submitting your manuscript, please ensure you carefully read and adhere to all the guidelines

 and instructions to authors that can be accessed from the journal homepage: http://jrn.sagepub.com/

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Students Opt for Healthy Foods After Hunger-Free Kids Act

School kids selected more nutritious, lower-calorie foods for lunch as a result of changes to the National School Lunch Program mandated by the Healthy Hunger-Free Kids Act (HHFKA), according to longitudinal study.

The mean adequacy ratio (MAR) increased from a mean of 58.7 (range, 49.6-63.1) prior to the act's implementation to a mean of 75.6 (range, 68.7-81.8) afterward among middle and high school students, reportedDonna Johnson, PhD, of the University of Washington in Seattle, and colleagues.

MAR was defined as the mean percentage of the daily requirement meals provided for six key nutrients (protein, vitamin C, vitamin A, calcium, iron, and dietary fiber). A perfect MAR score would be 100. ...

http://www.medpagetoday.com/PrimaryCare/DietNutrition/55531?xid=nl_mpt_DHE_2016-01-07&eun=g379846d0r

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Digital mammography may also reveal heart disease risk

Reuters Health - Mammograms performed to check the health of the breasts could also give clues to the health of the heart, researchers say.

That’s because the amount of calcium in the arteries of the breast, which can be seen on a digital mammogram, seems to reflect the amount of calcium in the coronary arteries, which supply blood to the heart.

Although women are commonly screened for breast cancer with mammography, there is no routine screening test for heart disease. Calcium in the coronary arteries is known to be an early sign of heart disease. Finding a link between calcium in the breast arteries and calcium in the coronary arteries is a reason to “pay attention,” study coauthor Dr. Jagat Narula from the Icahn School of Medicine at Mount Sinai in New York City told Reuters Health by email.

Narula and colleagues will report their findings April 3 at the American College of Cardiology annual scientific session in Chicago as well as in JACC: Cardiovascular Imaging.

For the study, the Mount Sinai team analyzed heart disease risk factors, such as high cholesterol, high blood pressure, high blood sugar and smoking, in 292 women who underwent both digital mammography and a chest computed tomography (CT) scan. ...

http://www.reuters.com/article/us-health-mammograms-heart-screening-idUSKCN0WQ2FH?feedType=nl&feedName=healthNews

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This article and subsequent discussion is from Barbara (BAcello) Thanks !

The first article below is from my local geographic area, so the nurses here have had a lot to say about hospice today. Some DONs complained about a hospice visiting in the evening when administration is gone and soliciting business with visiting families. Coincidentally, the GAO investigation became available today.

BA

Hospice owner accused of telling nurses to overdose, kill patients

The owner of a Texas hospice company has come under fire for allegedly encouraging employees to overdose patients and hasten their death in order to avoid the federal reimbursement cap for hospice stays.

Brad Harris, 34, owner of Novus Health Care Services Inc., allegedly told a nurse to overdose three patients on drugs such as morphine, and instructed another employee to give a patient four times the maximum dose allowed, according to an FBI affidavit obtained by a Dallas television station. In another instance, Harris texted an employee of the Frisco, TX-based company “you need to make this patient go bye-bye.”

http://tinyurl.com/gnrm9q2

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Hospices Inappropriately Billed Medicare Over $250 Million for General Inpatient Care

WHY WE DID THIS STUDY

Recent investigations by the Office of Inspector General have shown a number of instances in which hospices inappropriately billed Medicare for hospice general inpatient care (GIP). Misuse of GIP includes care being billed but not provided and beneficiaries receiving care they do not need. Such misuse has human costs for this vulnerable population as well as financial costs for Medicare.

We found that hospices billed one-third of GIP stays inappropriately, costing Medicare $268 million in 2012.

Hospices were more likely to inappropriately bill for GIP provided in skilled nursing facilities than GIP provided in other settings. For-profit hospices were more likely than other hospices to inappropriately bill for GIP. We also found that Medicare sometimes paid twice for drugs because they were paid for under Part D when they should have been provided by the hospice and covered under the hospice daily payment rate. Further, hospices did not meet all care planning requirements for 85 percent of GIP stays and sometimes provided poor-quality care. For example, one hospice provided GIP to a beneficiary with dementia for 16 days, but his pain was never brought under control.

Overview: http://oig.hhs.gov/oei/reports/oei-02-10-00491.asp

39 page report download http://oig.hhs.gov/oei/reports/oei-02-10-00491.pdf

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Thank you, Barbara (BAcello) for this article:

Department of Justice launches nursing home task forces
By Emily Mongan March 30, 2016

The Department of Justice announced plans Wednesday to create 10 regional task forces that will target nursing homes that provide "grossly substandard" care.The task forces, launched as part of the DOJ's Elder Justice Initiative, will include members from U.S. Attorney's offices, state Medicaid Fraud Control Units, state and local prosecutors' offices, the Department of Health and Human Services, state Adult Protective Services agencies, long-term care ombudsman programs and law enforcement. UPDATE:

http://tinyurl.com/j8lwhsw

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Again, thank you, Barbara (BAcello) for this article:

Texas hospital OR staff recorded mocking sedated patient

A woman recorded the conversations that took place while she was sedated for a medical procedure at a Texas hospital and was shocked at what she heard when she pressed play afterward. Ethel Easter of Houston decided to record her hernia surgery after her physician was rude to her when she scheduled the procedure. Ms. Easter told Fox26 she cried when her physician told her it would be two months before she could have the surgery. She became concerned when her physician snapped back at her, allegedly saying, "Who do you think you are? You have to wait like everybody else." - See more at:

http://tinyurl.com/zs8oet4

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Vets with PTSD may also face greater risk of heart attacks and strokes

  Reuters Health - Veterans with post-traumatic stress disorder (PTSD) may also have damaged blood vessels that increase their risk for heart attacks and strokes, a U.S. study suggests.

In a test, researchers found that the blood vessels of vets with PTSD dilated less when they should have, compared to the vessels of vets without the mental health condition.

That indicates their blood vessels also may not be able to expand when necessary to increase blood flow in response to activities like intense exercise or to maintain circulation when fatty deposits and other debris clog artery walls. When blood flow is restricted, they would be more susceptible to heart attacks or strokes, particularly if they also have other risk factors like high cholesterol, hypertension or diabetes, researchers say.

Scientists aren’t exactly sure how PTSD might affect the flexibility of blood vessels. But it’s possible stress harms the inner lining of the vessels through changes in hormones or inflammation, said lead study author Dr. Marlene Grenon of the University of California, San Francisco.

“It is very likely that this would also happen in non-veterans who suffer from PTSD or chronic stress,” Grenon said by email.

To explore the connection between PTSD and blood vessel health, Grenon and colleagues tested how well veterans’ arteries relaxed and expanded when a blood pressure cuff tightened on their arms.  ...

http://www.reuters.com/article/us-health-ptsd-blood-vessels-idUSKCN0WP2PR?feedType=nl&feedName=healthNews

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Nursing issues Quantitative study—other

Evid Based Nurs doi:10.1136/ebnurs-2015-102287

Home death versus hospital death: are they comparable at all?

Implications for practice and research

The findings of this study indicate that discussions about the patient's and relatives' preference relating to place of death, information about incurability and providing care at home including the possibility of respite for caregivers, increase the probability of home death.

Prospective studies including thorough multidimensional needs assessment are warranted along with randomised trials with interventions containing timely information of incurability and/or preference discussions.

Context

Many studies show that most terminally ill patients prefer home death.1–3 Home death has previously been associated with home care services,4 GP home visits5 along with age, income and social class in a population-based register study.6 However, …

To purchase full text:   http://ebn.bmj.com/content/early/2016/04/07/ebnurs-2015-102287.full

http://ebn.bmj.com/content/early/2016/04/07/ebnurs-2015-102287?papetoc

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STATISTICS:

Although March was the National kidney month, this information is interesting today.

200 liters Amount of blood the kidney filters every day.

1 in 3 At One in 3 Americans is at risk for kidney disease.Learn your risk.

26 million Number of Americans with kidney disease; most don't know they have it.

Source:https://www.kidney.org/news/monthly/Focus_KidneyMonth

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Keryx says anemia drug succeeds in study of kidney patients

Keryx Biopharmaceuticals Inc on Tuesday said its drug to treat iron deficiency anemia in chronic kidney disease patients not yet requiring dialysis met the goals of a late stage clinical trial, potentially paving the way for an expanded approval of the treatment.

In the 16-week study of 234 patients with moderate to severe kidney disease, 52 percent of those who received Keryx's ferric citrate saw their hemoglobin levels rise by at least 1 gram per deciliter (g/dl) of blood during the trial. That compared with 19 percent in the placebo group who experienced a 1g/dl increase.

The initial results for the oral, iron-based drug were both statistically significant and clinically meaningful, the company said.

Based on the study of patients who had not adequately responded to or were unable to tolerate current oral iron therapies, Keryx said it would apply in the third quarter for an expanded approval with U.S. regulators for ferric citrate in moderate to advanced chronic kidney patients not dependent on dialysis.

The drug was previously approved under the brand name Auryxia to lower the amount of phosphate in the blood of chronic kidney disease patients on dialysis.

An estimated 1.6 million people in the United States suffer from stage 3 to stage 5 non-dialysis dependent chronic kidney disease and iron deficiency anemia, Keryx said.

Side effects were primarily mild to moderate and included diarrhea, constipation and nausea. Twelve of 31 ferric citrate patients who discontinued treatment did so because of side effects, the company reported. ... ( Would very much hope that they can soon improve on this drug for those undergoing dialysis)

http://www.reuters.com/article/us-keryx-pharmaceuticals-anemia-idUSKCN0WV14B?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-03-29&utm_term=US%20Health%20Report

or

http://tinyurl.com/goml94t

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Because of the large presence of water in the Southern Hemisphere, climate in the Earth's southern half is more mild overall than the Northern Hemisphere.

RANDOM TIDBITS
When a camel uses the fat stored in its humps for energy, the humps start to get smaller and deflate. The humps grow again when the camel rehydrates.

Camels make the most of a meal. They can rehydrate faster than any other mammal, able to drink about 30 gallons (113 liters) of water in just 13 minutes.

Camels can run up to 40 mph for a short period of time. They can maintain 25 mph for longer making them about as fast as a horse.

Camels are known for spitting on people. In fact, the animals are throwing up the contents of their stomach along with spit. This is a defense tactic when the animals feel threatened.

The large beasts make a variety of moans, groans and deep, throaty bellows. One of the camel's noises was even used to voice the character Chewbacca in the Star Wars movies.

Camels have very thick lips allowing them to eat even very salty, bitter or thorny plants. If hungry, camels can even eat leather shoes.

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New York, March 28 : Higher rates of breastfeeding, use of vaccinations and lower rates of smoking by mothers have reduced the rates of ear infections during the first year of a baby, finds a new study.

"Prolonged breastfeeding was associated with significant reductions in both colds and ear infections, which is a common complication of the cold," said lead researcher Tasnee Chonmaitree, professor at University of Texas in US.

"It is likely that medical interventions in the past few decades, such as the use of pneumonia and flu vaccines and decreased smoking helped reduce ear infection incidences," he said.

Ear infections in young infants who are under six months old are at an increased risk of having the infection recurrently later in life.

The findings, published in the journal Pediatrics, revealed that the rates of ear infection dropped from 18 to 6 percent in three month olds, from 39 to 23 percent in six month olds and from 62 to 46 percent in one year olds.

For the study, 367 babies less than one month old were investigated from October 2008 to March 2014, till their first birthday.

The team collected nose and throat mucus samples throughout the study to seek out and identify infections and gathered information on family history of ear infections, cigarette smoke exposure and breast versus formula feeding. http://www.newkerala.com/news/2016/fullnews-41236.html

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48% of the internet users are robots!

A computer infected with a bot is often called a zombie.

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Brazil's confirmed, suspected microcephaly cases rise to 5,235

The number of confirmed and suspected cases of microcephaly in Brazil associated with the Zika virus rose to 5,235 in the week through March 25, from 5,200 a week earlier, the Health Ministry said on Tuesday.

Of these, the number of confirmed cases climbed to 944 from 907 a week earlier, while suspected ones slightly fell to 4,291 to from 4,293 in the same period, according to a ministry statement. Cases that have been ruled out hit 1,541 in the week through March 26, the statement added.

Brazil considered most of the cases of babies born with abnormally small heads to be related to Zika, though the link between the virus and the birth defects has not been scientifically established.

http://www.reuters.com/article/us-health-zika-brazil-idUSKCN0WV2I3?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-03-30&utm_term=US%20Health%20Report

http://tinyurl.com/j6fc94s

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Smoking Triggers Big Changes in Mouth Bacteria, Study Finds (and also in the eyes...can lead to macular degeneration, apparently)

TUESDAY, March 29, 2016 (HealthDay News) -- Smoking can dramatically change the balance of bacterial species in the mouth, which may affect the risk of mouth, lung and digestive system diseases, a new study says.

The research also found that the proper mix of bacteria in the mouth is restored if people quit smoking.

Researchers analyzed the mix of about 600 bacterial species in the mouths (oral microbiome) of more than 1,200 Americans. All were 50 or older. The group included smokers, former smokers and people who never smoked.

Current smokers had significantly increased growth of more than 150 bacterial species, while 70 other species showed sharp decreases in growth. For example, Proteobacteria species accounted for less than 5 percent of overall bacteria in the mouths of smokers, compared with about 12 percent in nonsmokers, the researchers reported.

Proteobacteria help break down toxic chemicals introduced by smoking, the researchers said.

Compared with nonsmokers, smokers had 10 percent more species of Streptococcus, which promotes tooth decay, the study authors said.

https://www.nlm.nih.gov/medlineplus/news/fullstory_158024.html

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FDA backs expanded use of medical abortion pill

American women will have cheaper and easier access to abortion by medication after a decision by the Food and Drug Administration on Wednesday to relax restrictions on the use of abortion pill Mifeprex that were in place for over a decade.

The change set off another front in the fight over abortion that has spilled into the U.S. presidential election campaign and come up again in the Supreme Court in recent weeks.

The FDA eased access to Mifeprex by updating the prescribing information on the drug's label, thus expanding use to 70 days of gestation from the current 49 days, cutting the recommended dose of the drug and reducing the number of required visits to a doctor.

In practice, many abortion providers had moved away from the previous restrictions over the years but states like Texas, North Dakota and Ohio have laws that restrict medication abortions by requiring prescription of the drug strictly according to the old label.

The FDA "has finally caught up to the evidence-based practice in the United States," said Vicki Saporta, president and chief executive of the National Abortion Federation, an organization of abortion providers. ...

http://www.reuters.com/article/us-fda-abortion-pill-idUSKCN0WW1ZU?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-03-31&utm_term=US%20Health%20Report

http://tinyurl.com/zsk86pk

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How much money is lost to email scams every year?

don't peek

Answer: 12 billion "Sure Nigerian Prince! I will send you $5,000 to get you out of Turkish prison!" When you say it out loud, it doesn't make any sense, but it has happened more times than most are probably willing to admit -- somewhere around 12 billion times to be specific. The newest one is called the "CEO scam" when a hacker uses a CEO's email address to have an employee wire money into an offshore account. So remember folks, the next time your CEO tells you he needs money wired to his house in Paraguay, but he spells the name of the company wrong, you may want to ask him about it in person.

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RANDOM FACTS:  Highest temperature recorded on Earth's surface: 135.8 degrees F - Al Aziziyah, Libya, September 13, 1922 (57.7 degrees C); lowest temperature recorded: -128.5 degrees F - Vostok, Antarctica, July 21, 1983 (-89.2 degrees C).
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Bonus Fact: The tallest mountain on Earth from base to peak - Mauna Kea, Hawaii: 33,480 feet (rising to 13,796 feet above sea level).

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Study shows how stress may raise risk of heart attack, stroke

THURSDAY, March 24, 2016 (HealthDay News) -- A new brain study might help explain why a high level of stress is linked to an increased risk of heart attack and stroke.

Increased activity in the amygdala -- the fear center of the brain -- appears to create an immune system reaction that increases inflammation in the arteries, researchers plan to report at the upcoming American College of Cardiology meeting in Chicago.

Such arterial inflammation is a precursor to heart disease, heart attack and stroke, said senior researcher Dr. Ahmed Tawakol, a cardiologist at Massachusetts General Hospital in Boston.

Tawakol and his colleagues followed nearly 300 people and found their amygdala activity -- as seen on brain scans -- indicated whether they would suffer a major cardiac event in the near future.

"By the end of the study, roughly 5 percent with low activity had events, compared to roughly 40 percent of the individuals with high amygdala activity," Tawakol said.

Doctors need to be aware of the heart-health consequences of current events such as the Syrian crisis and this week's terror attacks in Brussels, said Dr. Richard Becker, director of cardiovascular health and disease at the University of Cincinnati College of Medicine. He is also director of the university's Heart, Lung & Vascular Institute.Brain scans show stress can increase activity in the amygdala, or the fear center of the brain, causing arterial inflammation that may increase the risk of heart attack or stroke, according to a study to be presented at an American College of Cardiology meeting. Researchers said the study highlights the importance of stress reduction, which may come through meditation, exercise or friendships.

HealthDay News (3/24)

http://consumer.healthday.com/mental-health-information-25/stress-health-news-640/brain-scans-give-clues-to-stress-heart-attack-link-709330.html

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RANDOM FACTS: Your eyes are composed of more than 2 million working parts, and they focus on about 50 things per second.

Bonus Fact: The eye of a human can distinguish 500 shades of gray.

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Low Prenatal Vitamin D Linked to Later MS in Offspring

MONDAY, March 7, 2016 (HealthDay News) -- Children of mothers with too little vitamin D during their pregnancy may have a higher risk of developing multiple sclerosis when they reach adulthood, a new study suggests.

One expert in the United States said that the findings need to be interpreted with caution, however.

"We cannot say from this study that low vitamin D levels cause MS in women's offspring," said Dr. Daniel Skupski, chair of obstetrics and gynecology at NewYork-Presbyterian/Queens hospital in New York City. All the study points to is an association between the two, he stressed.

What the research does do, Skupski said, is "set the stage" for further research to see if getting more vitamin D in pregnancy might lower people's lifetime risk for multiple sclerosis.

Multiple sclerosis affects a person's brain and spinal cord by damaging the myelin sheath, the insulating layer that surrounds and protects nerve cells, according to the U.S. National Institutes of Health. This leads to symptoms such as muscle weakness, lack of coordination and balance, vision problems, and trouble with thinking and memory....

http://consumer.healthday.com/vitamins-and-nutrition-information-27/vitamin-and-mineral-news-698/low-levels-of-vitamin-d-in-pregnancy-linked-to-later-ms-in-offspring-708720.html

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Reuters Health - The proportion of older Americans taking at least five medications or supplements went up in a recent study.

The increase in people using multiple medications - known as polypharmacy - paralleled an increase in the number of older Americans at risk for major drug interactions, researchers found.

"That’s a concern from a public health standpoint, because it’s getting worse," said Dima Qato, the study's lead author from the University of Illinois at Chicago.

Qato and her colleagues previously reported that polypharmacy is common among older Americans. More than half were taking prescription and nonprescription medications between 2005 and 2006.

There have been a lot of changes in U.S. regulations and the pharmacy market since that time, however. Some of those changes include new and less expensive generic drugs and the implementation of Medicare Part D, which is the prescription component of the government-run health insurance program for the elderly or disabled. ...

http://www.reuters.com/article/us-health-polypharmacy-idUSKCN0WN24D

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VA expands hepatitis C treatment to all patients with the virus

The Veterans Affairs Department will begin providing hepatitis C treatment to all veterans in its health system who have the virus, regardless of their disease stage, VA officials said Wednesday.

Having received a boost in funding from Congress late last year for the costly medications needed to cure hepatitis C, the VA is now able to treat the 174,000 veterans in its health system who have the disease, according to a VA release.

VA Under Secretary for Health Dr. David Shulkin said that while the cost previously was too prohibitive to treat all but the sickest patients, VA now can treat all veterans with the virus who are eligible for VA health care, either in a VA facility or through the Veterans Choice program.

“We’re honored to be able to expand treatment for veterans who are afflicted with hepatitis C,” Shulkin said. “Additionally, if veterans are currently waiting on an appointment for community care through the Choice program, they can now turn to their local VA facility for this treatment or elect to continue to receive treatment through Choice.” ...

http://www.militarytimes.com/story/veterans/2016/03/09/va-expands-hepatitis-c-treatment-all-patients-virus/81547558/

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RANDOM TIDBITS

Any month that starts on a Sunday will have a Friday the 13th in it.

The world's first speed limit regulation was in England in 1903. It was 20 mph.

The metal instrument used in shoe stores to measure feet is called the Brannock device.

The linen bandages that were used to wrap Egyptian mummies averaged 1,000 yards in length.

The base of the Great Pyramid of Egypt is large enough to cover 10 football fields.

"Fortnight" is a contraction of "fourteen nights." In the US "two weeks" is more commonly used.

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HUMOR SECTION

Heavy snow had buried my van in our driveway. My husband, Scott, dug around the wheels, rocked the van back and forth and finally pushed me free. I was on the road when I heard an odd noise. I got on my cell and called home. "Thank God you answered," I said when Scott picked up. "There's this alarming sound coming under the van. For a minute I thought I was dragging you down the highway."

"And you didn't stop?"

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The following should be entitled: SO THERE !

An elderly woman died last month. Having never married, she requested no male pallbearers.

In her handwritten instructions for her memorial service, she wrote, "They wouldn't take me out while I was alive,

I don't want them to take me out when I'm dead."

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When asked on an application,"In case of emergency, who is to be notified ?" He put 'DOCTOR'.

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CEU SITES---(CME and CNE)

Those that are-----Free and Otherwise..........
Go to www.sharedgovernance.org for access to a free continuing education module about shared governance, written by Robert Hess, Forum’s founder, and Diana Swihart, Forum advisory board member.
Please follow me on Twitter as Dr Robert Hess. info@sharedgovernance.orgwww.sharedgovernance.org

Pay Only $34.99 for a full year of CONTACT HOURS
www.nurse.com for CNE offerings.

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

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

-------------------------

AJN, American Journal of Nursing:

April 2016 - Volume 116 - Issue 4 - pp 31,44

doi: 10.1097/01.NAJ.0000482142.20048.24

An Investigation into the Health-Promoting Lifestyle Practices of RNs 2.5 CE Test Hours:

http://journals.lww.com/ajnonline/Fulltext/2016/04000/2_5_CE_Test_Hours___An_Investigation_into_the.17.aspx

--------

CE: Critical Care Recovery Center: An Innovative Collaborative Care Model for ICU Survivors

A. Khan, Babar; Lasiter, Sue; A. Boustani, Malaz

2.5 CE Test Hours: Critical Care Recovery Center: An Innovative Collaborative Care Model for ICU Survivors

Contrada, Emily

CE: Early Localized Prostate Cancer

Katz, Anne

2.5 CE Test Hours: Early Localized Prostate Cancer

Contrada, Emily

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WEBSITES/ LINKS

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

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

Decubqueen's website: www.accuruler.com.

http://www.thebreastcancersite.com

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

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

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

Metric conversion calculators and tables for metric conversions

http://www.metric-conversions.org/

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MEDICAL RECALLS

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FDA MedWatch -

Sodium Bicarbonate Injection, USP by Hospira: Recall - Particulate Matter

Hospira, Inc. is recalling one lot of 8.4% Sodium Bicarbonate Injection, USP (NDC: 0409-6625-02, Lot 56-148-EV, Expiry 1AUG2017) at the hospital/retail level due to the presence of a particulate within a single–dose glass fliptop vial. The issue was identified through a confirmed complaint.

The product is packaged 50 mEq (1mEq/mL), 4.2 grams (84 mg/mL), 50mL, Single-dose, packaged 4 boxes of 25 vials per case. The lot was distributed nationwide in the U.S. to wholesalers and hospitals in December 2015.

If the particulate is not observed prior to IV administration and breaks off into smaller particulates, passing through the catheter, it may result in localized inflammation, allergic reaction, including anaphylaxis, granuloma formation or microembolic effects (IV only). Larger particulates may block the infusion of solution, potentially resulting in a delay in therapy.

Read the MedWatch safety alert, including a link to the press release, at:

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm491506.htm

- FDA approves new treatment for inhalation anthrax

On Friday, March 18, the U.S. Food and Drug Administration approved Anthim (obiltoxaximab) injection to treat inhalational anthrax in combination with appropriate antibacterial drugs. Anthim is also approved to prevent inhalational anthrax when alternative therapies are not available or not appropriate.

Inhalational anthrax is a rare disease that can occur after exposure to infected animals or contaminated animal products, or as a result of an intentional release of anthrax spores. It is caused by breathing in the spores of the bacterium Bacillus anthracis. When inhaled, the anthrax bacteria replicate in the body and produce toxins that can cause massive and irreversible tissue injury and death. Anthrax is a potential bioterrorism threat because the spores are resistant to destruction and can be spread by release in the air.

The safety of Anthim was evaluated in 320 healthy human volunteers. The most frequently reported side effects were headache, itching (pruritus), upper respiratory tract infections, cough, nasal congestion, hives, and bruising, swelling and pain at the infusion site.

Anthim carries a Boxed Warning alerting patients and health care providers that the drug can cause allergic reactions (hypersensitivity), including a severe reaction called anaphylaxis. Anthim should be administered in settings where patients can be monitored and treated for anaphylaxis. However, given that anthrax is a very serious and often deadly condition, the benefit of Anthim for treating anthrax is expected to outweigh this risk.

For more information, please visit: Anthim.

Fluconazole Injection, USP, (in 0.9 Percent Sodium Chloride) 200mg per 100ml: Recall - Elevated Impurity

BACKGROUND: The lot number being recalled is Lot 40608 which was distributed to hospitals, wholesalers and distributors nationwide from November 2014 through December 2014. Fluconazole Injection, USP, 200mg per 100mL is indicated, for the treatment of Oropharyngeal and esophageal candidiasis, cryptococcal meningitis, and is supplied in 100mL and 200mL flexible container bags ...

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm489316.htm

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Amikacin Sulfate Injection USP, 1 gram/4mL (250 mg/mL) Vials by Teva: Recall - Glass Particulate Matter

Teva Pharmaceuticals announced a voluntary recall of one lot of amikacin sulfate injection USP, 1 gram/4mL (250 mg/mL) vials due to the potential presence of particulate matter identified as glass in one vial. The recalled lot # is 4750915, Expiration Date 9/2017.

The administration of a glass particulate, if present in an intravenous drug, may result in local irritation or swelling in response to the foreign material. More serious potential outcomes would include blockage and clotting in blood vessels, which may be life-threatening if a critical organ is affected.

BACKGROUND: Amikacin sulfate injection USP is used in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria, and has also been shown to be effective in staphylococcal infections and may be considered as initial therapy under certain conditions in the treatment of known or suspected staphylococcal disease.

Amikacin sulfate injection is packaged in pharmacy bulk packages, containing ten 1 gram/4 mL (250 mg/mL) vials per shelf pack. Amikacin sulfate injection 250 mg/mL, 4 mL vials were distributed nationwide through wholesalers, retailers and pharmacies. ...

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm490119.htm

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Arrow International Intra-Aortic Balloon Catheter Kits and Percutaneous Insertion Kits by Teleflex Incorporated : Class I Recall - Sheath Body may become Separated from Sheath Hub Teleflex Incorporated (NYSE: TFX) announces worldwide recall of Arrow International Intra-Aortic Balloon Catheter Kits and Percutaneous Insertion Kits. On 9-Feb-2016, Teleflex Incorporated initiated a worldwide recall of 47,140 units distributed to hospitals, clinics, and medical centers throughout the United States and globally. The Arrow International Intra-Aortic Balloon Catheter Kits and Percutaneous Insertion Kits are being recalled because the sheath body may become separated from the sheath hub. If the separation occurs, the patient may bleed from the sheath. If bleeding is not promptly addressed, significant blood loss or exsanguination may occur. Interruption or loss of intra-aortic balloon pump treatment may also occur. At the time of the recall, there were 13 adverse events reported; including 6 serious injuries and 1 death.

A list of affected product codes and full list of affected lot numbers can be found in the Recall Notice and appendix.

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm490454.htm

FDA Warns About Posaconazole Prescribing Errors

Clinicians cannot substitute two different oral formulations of the antifungal posaconazole (Noxafil, Merck) for each other on a milligram per milligram basis lest patients experience adverse events, including death, the US Food and Drug Administration (FDA) warned today.

The two oral formulations are dosed differently, with the delayed-release tablet having a higher bioavailability than its oral suspension counterpart. Direct milligram to milligram substitution can result in underdoses or overdoses, the agency said in a safety communication.

The FDA has revised the labels of the two posaconazole formulations to highlight this potential problem. It said that prescribers should specify the dosage form, strength, and frequency on all scripts for posaconazole, and that pharmacists should request this information when it is not specified.

The agency approved the oral suspension version of the antifungal in 2006 and the delayed-release tablet in November 2013. Both are indicated to prevent invasive infections caused by the fungi Aspergillus and Candida in patients aged 13 years and older with weakened immune systems. The oral suspension version also is approved to treat thrush, a fungal infection of the mouth or throat caused by Candida....

http://www.medscape.com/viewarticle/856724

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ADVERTISEMENTS

from the members

This ad is from Decubqueen (Gerry)..........AccuRuler Accurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford.

Visit us at http://www.accuruler.com/.

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NEW MEMBERS

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

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NOTICE:

I attempt to send newsletters to your email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address. So, be certain to let me know when you change your address. RNFrankie@AOL.com

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EDITORIAL STAFF:

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

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PARADIGM 97 CO-FOUNDERS:

MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)

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

"Courage is not simply one of the virtues, but the form of every virtue at the testing point."

C.S. Lewis.

(1898-1963), novelist, poet, academic, medievalist, literary critic,

essayist, lay theologian, and Christian apologist.

Hope to hear from you..... Frankie

RNFrankie@AOL.com

Answer to Quiz Time:

c. Because of the high complexity of patient-care needs, different nursing delivery and care delivery models may exist within the same organization. To promote continuous appropriate staffing, organizations optimally should use a consistent and standardized structure.

Learn more by reading the continuing nursing education article “What every nurse should know about staffing.”

PARADIGM97

Blog Archive

About Me

Sunday, April 10, 2016

PARADIGM BYTES Newsletter for April

Background

Not getting the cues

Recent studies show that obese individuals have less ability to resist food cues.

Implications for practice and research

Context

RELATED STORIES

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Low Prenatal Vitamin D Linked to Later MS in Offspring

Sodium Bicarbonate Injection, USP by Hospira: Recall - Particulate Matter

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