PARADIGM BYTES
Newsletter for Paradigm 97
May 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
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
Global health officials are racing to better understand the Zika virus behind a major outbreak that began in Brazil last year and has spread to many countries in the Americas.
The following are some questions and answers about the virus and current outbreak:
How do people become infected?
Zika is transmitted to people through the bite of infected female mosquitoes, primarily the Aedes aegypti mosquito, the same type that spreads dengue, chikungunya and yellow fever. The Pan American Health Organization (PAHO) said Aedes mosquitoes are found in all countries in the Americas except Canada and continental Chile, and the virus will likely reach all countries and territories of the region where Aedes mosquitoes are found.
How do you treat Zika?
There is no treatment or vaccine for Zika infection. Companies and scientists are racing to develop a safe and effective vaccine for Zika, but the World Health Organization (WHO) had said it would take at least 18 months to start large-scale clinical trials of potential preventative shots.
How dangerous is it?
The U.S. Centers for Disease Control and Prevention concluded that infection with the Zika virus in pregnant women is a cause of the birth defect microcephaly and other severe brain abnormalities in babies. The CDC said now that the causal relationship has been established, several important questions must still be answered with studies that could take years.
According to the World Health Organization, there is strong scientific consensus that Zika can cause the birth defect microcephaly in babies, a condition defined by unusually small heads that can result in developmental problems. In addition, the agency said it could cause Guillain-Barre syndrome, a rare neurological disorder that can result in paralysis. Conclusive proof of the damage caused by Zika may take months or years.
Brazil has confirmed 1,198 cases of microcephaly, and considers most of them to be related to Zika infections in the mothers. Brazil is investigating an additional 3,710 suspected cases of microcephaly. Colombia has confirmed two cases of microcephaly linked to Zika.
Brazil registered 91,387 likely cases of the Zika virus from February until April 2.
Current research in Brazil indicates the greatest microcephaly risk is associated with infection during the first trimester of pregnancy, but health officials have warned an impact could be seen in later weeks. Recent studies have shown evidence of Zika in amniotic fluid, placenta and fetal brain tissue.
What are the symptoms of Zika infection?
People infected with Zika may have a mild fever, skin rash, conjunctivitis, muscle and joint pain and fatigue that can last for two to seven days. But as many as 80 percent of people infected never develop symptoms. The symptoms are similar to those of dengue or chikungunya, which are transmitted by the same type of mosquito.
How can Zika be contained?
Efforts to control the spread of the virus focus on eliminating mosquito breeding sites and taking precautions against mosquito bites such as using insect repellent and mosquito nets. U.S. and international health officials have advised pregnant women to avoid travel to Latin American and Caribbean countries where they may be exposed to Zika. Cases of sexual transmission have also been reported, prompting health officials to advise use of condoms, or abstaining from sex, to prevent infection between partners.
How widespread is the outbreak?
Active Zika outbreaks have been reported in at least 43 countries or territories, most of them in the Americas, according to the U.S. Centers for Disease Control and Prevention (CDC). Brazil has been the country most affected. (1.usa.gov/1ovAJyh)
Africa (1): Cape Verde
Americas (35): Aruba, Barbados, Belize, Bolivia, Bonaire, Brazil, Colombia, Costa Rica, Cuba, Curaçao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Puerto Rico, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, St. Maarten, Suriname, Trinidad and Tobago, U.S. Virgin Islands and Venezuela
Oceania/Pacific Islands (7): American Samoa, Fiji, Kosrae, Federated States of Micronesia, Marshall Islands, New Caledonia, Samoa, and Tonga.
What is the history of the Zika virus?
The Zika virus is found in tropical locales with large mosquito populations. Outbreaks of Zika have been recorded in Africa, the Americas, Southern Asia and the Western Pacific. The virus was first identified in Uganda in 1947 in rhesus monkeys and was first identified in people in 1952 in Uganda and Tanzania, according to the WHO.
Can Zika be transmitted through sexual contact?
The World Health Organization (WHO) said sexual transmission is "relatively common" and has advised pregnant women not to travel to areas with ongoing outbreaks of Zika virus.
The U.S. CDC is investigating about a dozen cases of possible sexual transmission. All cases involve possible transmission of the virus from men to their sex partners. The WHO has also identified Zika cases in Argentina, Chile, France, Italy and New Zealand as likely caused by sexual transmission.
British health officials reported Zika was found in a man's semen two months after he was infected, suggesting the virus may linger in semen long after infection symptoms fade.
The PAHO said Zika can be transmitted through blood, but this is an infrequent transmission mechanism. There is no evidence Zika can be transmitted to babies through breast milk.
What other complications are associated with Zika?
Zika has also been associated with other neurological disorders, including serious brain and spinal cord infections. The long-term health consequences of Zika infection are unclear. Other uncertainties surround the incubation period of the virus and how Zika interacts with other viruses that are transmitted by mosquitoes, such as dengue.
(Compiled by the Americas Desk) http://www.reuters.com/article/us-health-zika-qanda-factbox-idUSKCN0XN2TQ?mod=related&channelName=healthNews
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Brazilian scientists find new Zika-linked brain disorder in adults Scientists in Brazil have uncovered a new brain disorder associated with Zika infections in adults: an autoimmune syndrome called acute disseminated encephalomyelitis, or ADEM, that attacks the brain and spinal cord.
Zika has already been linked with the autoimmune disorder Guillain-Barre syndrome, which attacks peripheral nerves outside the brain and spinal cord, causing temporary paralysis that can in some cases require patients to rely on respirators for breathing.
The new discovery now shows Zika may provoke an immune attack on the central nervous system as well.
The findings add to the growing list of neurological damage associated with Zika.
According to the World Health Organization, there is a strong scientific consensus that, in addition to Guillain-Barre, Zika can cause the birth defect microcephaly, though conclusive proof may take months or years. Microcephaly is defined by unusually small heads that can result in developmental problems.
Brazil said it has confirmed more than 940 cases to be related to Zika infections in the mothers. Brazil is investigating nearly 4,300 additional suspected cases of microcephaly.
In addition to autoimmune disease, some researchers also have reported patients with Zika infections developing encephalitis and myelitis - nerve disorders typically caused by direct infections in nerve cells. ... http://www.reuters.com/article/us-health-zika-brain-idUSKCN0X70VP?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-04-11&utm_term=US%20Health%20Report
or http://tinyurl.com/hn7p975
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| Brazil says Zika-linked microcephaly cases stable at 4,908 |
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| BRASILIA (Reuters) - The number of confirmed and suspected cases of microcephaly in Brazil associated with the Zika virus remained stable at 4,908 in the week through April 23, just one case more than a week earlier, the Health Ministry said on Tuesday. http://www.reuters.com/article/us-health-zika-brazil-idUSKCN0XN2NP?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-04-27&utm_term=US%20Health%20Report or: http://tinyurl.com/hbtqz9f ***********
This is from CDC Emergency Partners Newsletter:
Zika virus (Zika) outbreaks are occurring in many countries and territories. Please share the following information with those who may find it useful.
Types of Transmission
Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus). To date, Zika has not been spread by mosquitoes in the continental United States. However, lab tests have confirmed Zika virus in travelers returning to the United States from areas with Zika. Zika virus can also bespread during sex by a man infected with Zika to his male or female partners. Some non-travelers in the United States have become infected with Zika through sex with a traveler.
With the recent outbreaks in the Americas, the number of Zika cases among travelers visiting or returning to the United States will likely increase. CDC is not able to predict how much Zika virus would spread in the continental United States. Many areas in the United States have the type of mosquitoes that can become infected with and spread Zika virus. However, recent outbreaks in the continental United States of chikungunya and dengue, which are spread by the same type of mosquito, have been relatively small and limited to a small area.
Not having sex is the only way to prevent sexual transmission of Zika. Couples with men who live in or travel to areas with Zika can prevent the spread of Zika by using condoms every time they have sex, or by not having sex. To be effective, condoms must be usedcorrectly (warning: this link contains sexually graphic images) from start to finish, every time you have vaginal, anal, or oral (mouth-to-penis) sex.
Birth Defects
Zika virus can be passed from a pregnant woman to her fetus during pregnancy or around the time of birth. Zika infection during pregnancy is a cause of microcephaly, a severe birth defect that is a sign of a problem with brain development, and other severe brain defects.
In addition to microcephaly, other problems have been detected among fetuses and infants infected with Zika virus before birth, such as hearing deficits and impaired growth. Although Zika virus has been linked with these other problems in infants, there is more to learn. Researchers are collecting data to better understand the extent of Zika virus’ impact on pregnant women and their birth outcomes.
Guillain-Barré Syndrome
Guillain-Barré syndrome (GBS) is an uncommon sickness of the nervous system in which a person’s own immune system damages the nerve cells, causing muscle weakness, and sometimes, paralysis.
Symptoms
The most common symptoms of Zika virus disease are
Most people infected with Zika virus won’t even know they have the disease because they won’t have symptoms. The sickness is usually mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.
Treatment
There is no vaccine or medicine for Zika.
The following steps can reduce the symptoms of Zika:
To prevent others from getting sick, strictly follow steps to prevent mosquito bites during the first week of illness. See your doctor or other healthcare provider if you develop symptoms.
Prevention
The best way to prevent diseases spread by mosquitoes is to protect yourself and your family from mosquito bites.
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
The Centers for Disease Control and Prevention announced Wednesday that one infectious disease now kills more Americans than all others combined. Hepatitis C now kills more Americans than any other infectious disease
New data shows hepatitis C killed nearly 20,000 people in 2014. Even more worrying for doctors is that an estimated 3.5 million people in the U.S. have the hepatitis C virus, but half of them don't even know. Hepatitis C symptoms, like fever, nausea and joint pain are often too mild to warrant a trip to the doctor, so it sometimes goes undiagnosed.
The virus can usually be knocked out with a 12-week pill regimen, but if left untreated, it can cause cirrhosis or cancer in the liver.Most of those killed by hepatitis C are baby boomers because the virus was unknown to doctors when they were kids.
http://www.aol.com/article/2016/05/04/hepatitis-c-now-kills-more-americans-than-any-
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STATISTICS
20 On May 20, wear blue to celebrate.
1969 NearlyYear American Association of Cardiovascular Nurses established; name changes to American Association of Critical-Care Nurses in 1971.
Sources: http://www.sccm.org/About-SCCM/Collaborations/Pages/NCCARM.aspx http://aacn.org/wd/publishing/content/pressroom/historyofaacn.
pcms?menu=aboutus
pcms?menu=aboutus
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(Reuters Health) - People who occasionally work night shifts may be at a slightly increased risk of heart disease, according to a new study.
Nurses in the study who worked at least three nights per month were more likely to develop heart problems over the next 24 years than nurses who stuck to daytime shifts.
"I think it’s an important message because it’s a potentially modifiable risk factor," said lead author Celine Vetter, of Harvard Medical School and Brigham and Women's Hospital in Boston.
For the new study, Vetter and her colleagues used data from more than 189,000 women. About 40 percent were participating in the Nurses' Health Study (NHS), which began in 1988. The others were in NHS2, which began in 1989.
The women entered the studies between the ages of 25 and 55. At the start, none of them had coronary heart disease, which is when the arteries that carry blood to heart muscle become narrowed or blocked.
NHS participants were only asked once about their history of working night shifts, but NHS2 participants were asked about their night shifts every two years.
During the follow-up period, there were 7,303 cases of coronary heart disease problems - like heart attacks, chest pain and bypass surgeries - in the NHS study and 3,519 cases in the NHS2.
Overall, the risk went up with the number of years women spent covering night shifts, the researchers report in JAMA. ... http://www.reuters.com/article/us-health-shifts-heart-idUSKCN0XN2TX
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This article is by our newest member: Kathy Quan. She wrote it at the request of ANA. I consider healthcare illiteracy a very serious problem; I have encountered it many times. Each time, was surprised that the individual had no idea what the ramifications of his disease were. We all should be "on our toes" watching for this illiteracy since it impinges on our patient's getting well.
Noncompliance or healthcare illiteracy? The health care industry is focused on reducing costs and improving performance to maximize reimbursement. Inherent in the success of this is patient education and assumption of responsibility for their own outcomes. Health care illiteracy will affect every aspect of this issue.
Patient education is a key factor in helping patients improve their health status by learning how to prevent hospitalizations and complications from chronic diseases. Nurses are charged with providing the majority of the patient education.
Barriers to learning
To do so effectively, nurses need to understand barriers to learning. In health care, one of the most dramatic and significant barriers is health care illiteracy. This does not mean patients cannot read and write, as many will have advanced degrees and experience. Health care illiteracy can affect anyone of any age and education level.
Understanding how the health care system works is one of the first and most intimidating barriers to learning and one of the best examples of health care illiteracy. Figuring out what to ask when you don’t have a clue what you don’t know can be daunting at best, and a significant factor in determining outcomes. ... https://americannursetoday.com/blog/noncompliance-healthcare-illiteracy/
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RANDOM FACT:
The fall and spring equinoxes are the only two times during the year when the sun rises due east and sets due west.
The early Egyptians built the Great Sphinx so that it points directly toward the rising sun on the spring equinox.
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Bonus Fact:
According to Greek myth, the return of spring coincides with the return of Persephone, the daughter of Demeter, who is the goddess of plants and fertility.
At Chichen Itza, Mexico, the Mayan celebrate the first day of spring with 'The Return of the Sun Serpent.' On the evening on the spring equinox, the setting sun creates a triangular shadow on the El Castillo pyramid that looks like a descending snake, or the feather serpent god Kukulkan.
Every year on the first day of spring, people in Poland gather to burn an effigy and throw it in the river to bid winter farewell.
*************************** More evidence links heartburn drugs to serious kidney problems
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The fall and spring equinoxes are the only two times during the year when the sun rises due east and sets due west.
The early Egyptians built the Great Sphinx so that it points directly toward the rising sun on the spring equinox.
Bonus Fact:
According to Greek myth, the return of spring coincides with the return of Persephone, the daughter of Demeter, who is the goddess of plants and fertility.
At Chichen Itza, Mexico, the Mayan celebrate the first day of spring with 'The Return of the Sun Serpent.' On the evening on the spring equinox, the setting sun creates a triangular shadow on the El Castillo pyramid that looks like a descending snake, or the feather serpent god Kukulkan.
Every year on the first day of spring, people in Poland gather to burn an effigy and throw it in the river to bid winter farewell.
*************************** More evidence links heartburn drugs to serious kidney problems
(Reuters Health) - People taking common heartburn medications known as proton pump inhibitors (PPIs) are at increased risk of new and severe kidney disease, according to a U.S. study.
Among hundreds of thousands of patients in Department of Veterans Affairs (VA) databases, new users of PPIs without kidney disease were 30 percent more likely to develop chronic kidney disease over the course of five years. Their risk of kidney failure was doubled.
PPIs like Nexium and Prevacid are prescribed to treat ulcers, heartburn and acid reflux and are some of the most effective forms of treatment available, the study authors write in the Journal of the American Society of Nephrology.
These drugs are generally viewed as safe and may be overprescribed and continued for long periods without being necessary, they note.
“We suggest judicious use of PPI, and that use be limited to when it is medically necessary and to the shortest duration possible,” said senior author Dr. Ziyad Al-Aly, associate chief of staff for research and education at the VA Saint Louis Health Care System.
The study team analyzed data in national VA databases on 20,270 people who had recently started taking PPIs. They compared this group to 173,321 people who had started taking H2 blockers, a group of drugs that reduce stomach acid by a different mechanism, blocking histamines in the stomach. ...
http://www.reuters.com/article/us-health-ppis-kidney-disease-idUSKCN0XJ2IW?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-04-25&utm_term=US%20Health%20Report
or
http://tinyurl.com/z9cp6sr
Thank you, Barbara (BAcello) for the following article :
Largest addition of quality measures to Nursing Home Compare since 2003
Today, the Centers for Medicare & Medicaid Services (CMS) added six new quality measures to its consumer-based Nursing Home Compare website (https://www.medicare.gov/nursinghomecompare/search.html). Three of these six new quality measures are based on Medicare-claims data submitted by hospitals, which is significant because this is the first time CMS is including quality measures that are not based solely on data that are self-reported by nursing homes. These three quality measures measure the rate of rehospitalization, emergency room use, and community discharge among nursing home residents. They include:
Percentage of short-stay residents who were successfully discharged to the community (Medicare claims- and MDS-based)
Percentage of short-stay residents who have had an outpatient emergency department visit (Medicare claims- and MDS-based)
Percentage of short-stay residents who were re-hospitalized after a nursing home admission (Medicare claims- and MDS-based)
Percentage of short-stay residents who made improvements in function (MDS-based)
Percentage of long-stay residents whose ability to move independently worsened (MDS-based)
Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based)
“These new quality measures broaden the set of quality measures already on the site so that patients, their family members, and caregivers have more meaningful information when they consider facilities,” said CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., MSc.
With today’s quality measure updates, CMS is nearly doubling the number of short-stay measures, which reflect care provided to residents who are in the nursing home for 100 days or less, on Nursing Home Compare. CMS is also providing information about key short-stay outcomes, including the percentage of residents who are successfully discharged and the rate of activities of daily life (ADL) improvement among short-stay residents.
Beginning in July 2016, CMS will incorporate all of these measures, except for the antianxiety/hypnotic medication measure, into the calculation of the Nursing Home Five-Star Quality Ratings. CMS is not incorporating the antianxiety/hypnotic medication measure because it has been difficult to determine appropriate nursing home benchmarks for the acceptable use of these medications.
Nursing Home Compare is the agency’s public information website that provides information on how well Medicare- and Medicaid-certified nursing homes provide care to their residents. With today’s update, it now reports information on 24 quality measures for 15,655 nursing home providers on Nursing Home Compare.
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How many children are reported missing in the U.S. annually?
- 1,000
- 25,000
- 100,000
- 800,000
ANSWER:
This stark number may surprise you, but over 800,000 children are reported missing in the U.S. every year- that's roughly 2,000 children a day! There is a silver lining: Amber Alerts reduced the number of missing children last year by around 11,800. So the next time your phone buzzes at 4 am, don't grumble! We probably just saved a child. Source: ABC News
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Medical Errors: A Hidden Killer An analysis of eight years of US data shows more than 250,000 people died annually due to medical errors. A Johns Hopkins University team analyzed four studies that looked at medical deaths from 2000 to 2008 and used hospital admission rates from 2013 to predict the rate of deaths due to medical errors. The authors argue that 9.5% of all US deaths each year can be attributed to a medical error, which would make it the third leading cause of death in the US. ...
https://consumer.healthday.com/senior-citizen-information-31/misc-death-and-dying-news-172/medical-errors-one-of-leading-causes-of-u-s-deaths-study-710574.html
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QUIZ TIME
Which statement about 2, 3 DPG is accurate?
a. It decreases in the presence of epinephrine.
b. It increases as a person ages.
c. It forms when red blood cells synthesize glucose to make adenosine triphosphate.
d. It forms when red blood cells break down glucose to make adenosine triphosphate.
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Little known Facts:
The world's largest pyramid is not in Egypt. It is in Cholula de Rivadabia near Mexico City.
U.S. teen births hit historic low with plunge in minority rate
The human tooth has about 55 miles of canals in it.
A lightning bolt strikes so quickly it could circle the globe eight times in just one second. Very plausible fact: since the speed of light is 186,300+ mi/sec
The principal use for nicotine other than for cigarettes is in insecticide .
Australia is the only continent without an active volcano
Hawaii moves toward Japan four inches every year.
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The birth rate among teenagers in the United States has fallen to a historic low, with births by black and Hispanic teens down by nearly half over the past decade, the Centers for Disease Control and Prevention (CDC) said on Thursday.
Birth rates for all American teenagers are down 40 percent since 2006, thanks in part to prevention programs that address socioeconomic conditions such as unemployment and lower education levels, the CDC said.
But officials said the U.S. teen birth rate was still too high, especially for minorities, and more work was needed.
The annual survey shows the continuation of a downward trend that began in 2006 and continued through 2014, the latest year of complete data, when nearly 250,000 babies were born to girls and women aged 15 to 19.
The birth rate of 24.2 per 1,000 women in this age group is down 9 percent from 2013 and the lowest among 15- to 19-year-olds since 1940, the CDC said.
For black teens the 2014 rate was 34.9 per 1,000 and for Hispanics it was 38.0. ...
http://www.reuters.com/article/us-usa-teens-births-idUSKCN0XP31W?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-04-29&utm_term=US%20Health%20Report
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 |
| The Amber Alert was named for Amber Hagerman, a 9-year-old abducted and murdered in Arlington, Texas, in 1996. |
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A modification to the Valsalva manoeuvre improves its effectiveness in treating supraventricular tachycardia
- Correspondence to: Leszek Pstras, Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Ks. Trojdena 4, Warsaw 02-109, Poland; lpstras@ibib.waw.pl
Commentary On:
Implications for practice and research
- In patients with stable supraventricular tachycardia (SVT), a 15 s, 40 mm Hg Valsalva strain in the semirecumbent position should be followed by supine positioning and passive leg elevation immediately after the strain release (as long as it can be undertaken safely).
- Research needs to be carried out on whether such a postural modification of the Valsalva manoeuvre (VM) is superior to the manoeuvre performed in the fully supine position.
Context
One of the many applications of the VM is its use for arresting episodes of SVT based on the relatively sudden reduction of heart rate in response to the increased venous return and
http://ebn.bmj.com/content/early/2016/04/15/ebnurs-2016-102329?papetoc
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Women May Not Be Aware of Heart Disease Risks
Many American women have heart disease risk factors, but few are properly informed of their risk by doctors, a new study finds.
Researchers conducted an online survey of 1,000 women nationwide and found that 74 percent had at least one heart disease risk factor, including high blood pressure, high cholesterol, diabetes, irregular menstrual cycle, early menopause or a family history of heart disease.
Women who were younger, lower-income or minority were the least likely to be aware of their heart disease risk factors. These same groups of women were also least likely to know that heart disease is the number one killer of both men and women, the researchers said.
Only 16 percent of those women were told by a doctor that they were at risk for heart disease. About one-third were advised to lose weight, the study revealed.
Nearly half of the women in the study said they had canceled or postponed a health appointment until they could lose weight, which suggests that a focus on women's weight could interfere with proper health care, the researchers said.
They explained that anyone with a heart disease risk factor should receive regular blood pressure and cholesterol checks, along with counseling on smoking and heart-healthy living. ...
http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/women-may-not-be-aware-of-heart-disease-risks-709185.html
or
http://tinyurl.com/zboxw5j
RANDOM FACTS:
Laughing lowers levels of stress hormones and strengthens the immune system. Six-year-olds laugh an average of 300 times a day. Adults only laugh 15 to 100 times a day.
Bonus Fact:
The color blue has a calming effect. It causes the brain to release calming hormones.
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HUMOR SECTION
(Three this month)
A police officer called the station on his radio.
"I have a bit of a problem here. An old lady just shot her husband for stepping on the floor she just mopped."
"What's the problem?" came the response. "Have you arrested the woman yet?"
"Not yet. The floor's still wet." (smart man)
"I have a bit of a problem here. An old lady just shot her husband for stepping on the floor she just mopped."
"What's the problem?" came the response. "Have you arrested the woman yet?"
"Not yet. The floor's still wet." (smart man)
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When Diane found out she was pregnant, she told the good news to anyone who would listen. But her 4-year-old son overheard some of her parents' private conversations. One day when Diane and her 4-year-old were shopping a woman asked the little boy if he was excited about the new baby.
"Yes!" the 4-year-old said, "and I know what we are going to name it, too. If it's a girl we're going to call her Christina, and if it's another boy we're going to call it quits!"
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Seven months pregnant, my hand on my aching back, I stood in line at the post office for what seemed an eternity.
"Honey," said a woman behind me, "I had back pain during my pregnancy. I was bedridden for four months because my baby was sitting on a nerve."
Then the man in front of me piped up....
"You'd better get used to it now. Once those kids get on your nerves, they can stay there till they're 18."
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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
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.
www.nurse.com for CNE offerings.
Free CEs http://www.myfreece.com/welcome.asp
This was sent in by Rozalfaro.....thank you !
This free course is intended for nursing staff and emphasize antimicrobial stewardship. If you would like to check out the course, you may enroll here (be sure to read instructions below):
When prompted about the institution, enter Case Western Reserve
Please enter the following password for the course access code
(all lowercase letters): able
To earn 3.0 Nursing Contact Hours (free), please complete
the pre-course survey, the 6 modules and the post-course survey.
(all lowercase letters): able
To earn 3.0 Nursing Contact Hours (free), please complete
the pre-course survey, the 6 modules and the post-course survey.
If you like this and think it would be of interest to your colleagues
and staff, please forward this email to them. They may sign up using
the same link and password above.
Here is a link to check the software requirements for CourseSites,
which hosts the course.
which hosts the course.
Contact
Robin Jump, robinjump@gmail.com
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WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to: RNFrankie@AOL.com.
This is an excellent nursing site, check it out:http://nursingpub.com/
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
Learn how the AETCs support the National HIV/AIDS Strategy by building clinician capacity and expertise along the HIV Care Continuum throughout the United States. http://aidsetc.org/
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MEDICAL RECALLS
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(Nothing new for this issue)
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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.
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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
Do not follow where the path may lead.
Go, instead, where there is no path and leave a trail.
Ralph Waldo Emerson
Hope to hear from you..... Frankie
d. A phosphate found in the blood, 2,3-DPG forms when red blood cells break down glucose to make adenosine triphosphate. It decreases hemoglobin’s affinity for oxygen, promoting oxygen release in the tissues.
To learn more, read the continuing nursing education article “ Decoding the oxyhemoglobin dissociation curve.”
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