PARADIGM BYTES
Newsletter for Paradigm 97
August 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
Noncompliance or healthcare illiteracy?
Kathy Quan is a member of Paradigm97..... Thank you, Kathy
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.
Once a person leaves behind their visits to a pediatrician, unless they contract an illness or have an injury, they may see no need for health care until something thrusts them into the system many years later. Even then it may only be for flu or other short-term illness for which they may be given antibiotics and told to rest a few days and then return to their usual routine. ...
https://americannursetoday.com/blog/noncompliance-healthcare-illiteracy/
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As healthcare professionals, we may forget how to be a patient. We love our patients, we sometimes get frustrated with our patients, and occasionally we will BE patients. I had the opportunity to be an inpatient at the hospital I worked at. I found out several things during this experience I would like to share with you. Perhaps you can relate.
1 ) The ER is scary, and while my nurse was pleasant, the doctor intimidated me. The waiting room was busy with frightened patients, angry patients, and crying children. I could barely concentrate on my forms and felt terrible and dizzy and nauseated. I had just found out my H & H was very low when I attempted to donate blood. The doctor looked at me like I had lost my mind, which is understandable. I had just thought I was
2 ) I admired the amazing IV and bloodwork skills, but finally understood how uncomfortable the IV catheter is in the antecubital space. It was like a huge splinter that annoyed me whenever I made the mistake of moving my arm. Once I was on the floor, I had my RN re-stick me in the forearm. She said she understood how I felt—she’d had IV’s placed in the AC too.
3 ) It is very embarrassing when the hospitalist ordered an occult blood sample x 3. I did not want my caretakers to see my poop. I never thought twice when I collected stools from patients, but I felt embarrassed.
4 ) I didn’t want food before the NPO status, but as soon as I knew I couldn’t eat, I felt ravenously hungry.
5 ) Everything and everyone looks different from a supine position.
6 ) Hospital gowns are horrible. The prep for my procedure was horrible. Having funny, compassionate nurses and nursing assistants make the most awful things a little better.
7 ) The IV “colonoscopy cocktail” is the best thing ever—except it makes you tell the whole truth to whoever will listen. If there’s something you don’t want everyone to know, plan your visitors accordingly.
8 ) Having a list of medications you’re taking makes life so much easier for everyone involved.
9 ) Laughter is good medicine. I know everyone differs, but I loved laughing with my coworkers. It calmed me down and made me feel normal—even in the horrible gown, even when I was choking down
10 ) It is very hard to look good in the hospital. My hair was a rat’s nest, I was very pale, and and my skin felt oily. I worried about how I smelled. I wished I had a razor, or had taken care of shaving my legs before my hospital visit. I wanted my teeth brushed before anyone assessed me, every day. As you may know, assessments happen all the time.
11 ) You can’t lie about your weight when you get weighed daily. Nor can you hide the smell of your GI bleed poop.
12 ) I realized that to be a good and competent nurse, I needed to “practice what I preached”. I took better care of myself because I was aware of how easily health can slip away. I know it seems obvious, but I also know I’m not the only nurse that does this.
I realized how truly exposed you feel as a patient. I still get nervous going to the doctor—even for check-ups. Kindness, professionalism, and humor matter. I think that my experience as a patient made me a better nurse.
1 ) The ER is scary, and while my nurse was pleasant, the doctor intimidated me. The waiting room was busy with frightened patients, angry patients, and crying children. I could barely concentrate on my forms and felt terrible and dizzy and nauseated. I had just found out my H & H was very low when I attempted to donate blood. The doctor looked at me like I had lost my mind, which is understandable. I had just thought I was
2 ) I admired the amazing IV and bloodwork skills, but finally understood how uncomfortable the IV catheter is in the antecubital space. It was like a huge splinter that annoyed me whenever I made the mistake of moving my arm. Once I was on the floor, I had my RN re-stick me in the forearm. She said she understood how I felt—she’d had IV’s placed in the AC too.
3 ) It is very embarrassing when the hospitalist ordered an occult blood sample x 3. I did not want my caretakers to see my poop. I never thought twice when I collected stools from patients, but I felt embarrassed.
4 ) I didn’t want food before the NPO status, but as soon as I knew I couldn’t eat, I felt ravenously hungry.
5 ) Everything and everyone looks different from a supine position.
6 ) Hospital gowns are horrible. The prep for my procedure was horrible. Having funny, compassionate nurses and nursing assistants make the most awful things a little better.
7 ) The IV “colonoscopy cocktail” is the best thing ever—except it makes you tell the whole truth to whoever will listen. If there’s something you don’t want everyone to know, plan your visitors accordingly.
8 ) Having a list of medications you’re taking makes life so much easier for everyone involved.
9 ) Laughter is good medicine. I know everyone differs, but I loved laughing with my coworkers. It calmed me down and made me feel normal—even in the horrible gown, even when I was choking down
10 ) It is very hard to look good in the hospital. My hair was a rat’s nest, I was very pale, and and my skin felt oily. I worried about how I smelled. I wished I had a razor, or had taken care of shaving my legs before my hospital visit. I wanted my teeth brushed before anyone assessed me, every day. As you may know, assessments happen all the time.
11 ) You can’t lie about your weight when you get weighed daily. Nor can you hide the smell of your GI bleed poop.
12 ) I realized that to be a good and competent nurse, I needed to “practice what I preached”. I took better care of myself because I was aware of how easily health can slip away. I know it seems obvious, but I also know I’m not the only nurse that does this.
I realized how truly exposed you feel as a patient. I still get nervous going to the doctor—even for check-ups. Kindness, professionalism, and humor matter. I think that my experience as a patient made me a better nurse.
Last edit by Joe V on Jul 1, '15
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INTERESTING READING
Please remember that the REUTERS articles usually good for only 30 days
New crop of robots to vie for space in the operating room
Even though many doctors see need for improvement, surgical robots are poised for big gains in operating rooms around the world.
Within five years, one in three U.S. surgeries - more than double current levels – is expected to be performed with robotic systems, with surgeons sitting at computer consoles guiding mechanical arms. Companies developing new robots also plan to expand their use in India, China and other emerging markets.
Robotic surgery has been long dominated by pioneer Intuitive Surgical Inc, which has more than 3,600 of its da Vinci machines in hospitals worldwide and said last week the number of procedures that used them jumped by 16 percent in the second quarter compared to a year earlier.
The anticipated future growth - and perceived weaknesses of the current generation of robots - is attracting deep-pocketed rivals, including Medtronic Inc and a startup backed by Johnson & Johnson and Google. Developers of the next wave aim to make the robots less expensive, more nimble and capable of performing more types of procedures, company executives and surgeons told Reuters.
Although surgical robots run an average of $1.5 million and entail ongoing maintenance expenses, insurers pay no more for surgeries that utilize the systems than for other types of minimally-invasive procedures, such as laparoscopy.
Still, most top U.S. hospitals for cancer treatment, urology, gynecology and gastroenterology have made the investment. The robots are featured prominently in hospital marketing campaigns aimed at attracting patients, and new doctors are routinely trained in their use.
Surgical robots are used in hernia repair, bariatric surgery, hysterectomies and the vast majority of prostate removals in the United States, according to Intuitive Surgical data. Doctors say they reduce fatigue and give them greater precision. ...
http://www.reuters.com/article/us-health-robots-idUSKCN1080CK?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-07-29&utm_term=US%20Health%20Report
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Core Practice Outcomes for Clinical Nurse Specialists: A Revalidation Study
- Measuring outcomes of clinical nurse specialist (CNS) practice is essential for demonstrating accountability and effectiveness.
- •This descriptive study was carried out to assess CNSs' perceptions of the ongoing validity of outcomes published by the National Association of Clinical Nurse Specialists (NACNS).
- •Findings demonstrated concordance between identified outcomes and actual CNS practice.
- •Being accountable for an outcome and recognizing the outcome as important predicted whether the outcome was monitored.
- •Outcomes published by NACNS have potential for use as a conceptual framework for guiding future CNS outcome investigations and ongoing monitoring systems.
Measuring outcomes of clinical nurse specialist (CNS) practice is essential for demonstrating accountability. Literature is limited with respect to the scope of reported CNS outcomes. The National Association of Clinical Nurse Specialists' (NACNS) published listing of CNS outcomes could serve as an outcome measurement framework. ...
http://www.professionalnursing.org/article/S8755-7223(15)00148-9/abstract?elsca1=etoc&elsca2=email&elsca3=8755-7223_201607_32_4_&elsca4=Nursing
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Information gaps in medication communication during clinical handover calls for a different approach
Implications for practice and research
- Structured handover tools, clear explicit language and active communication can minimise risk for mis-communication or gaps in medication-related content of handover.
- Research must shift from current reliance on verbal handover communication to examine complementary strategies to increase the reliability of handover information used to transfer responsibility and accountability for ongoing patient care.
Context
Medication and communication errors during clinical handover are well recognised as significant contributors to preventable patient harm worldwide. This study by Braaf et aladdresses the link between 2 of the 10 patient safety issues given prominence in the National Safety and Quality Health Service Standards1 introduced into the Australian health system in 2011: medication safety and clinical handover. …
http://ebn.bmj.com/content/early/2016/07/26/ebnurs-2016-102316?papetoc
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Zika Now Tied to Miscarriage
WEDNESDAY, July 27, 2016 (HealthDay News) -- Dutch researchers are reporting a case of miscarriage tied to maternal infection with the mosquito-borne Zika virus.
The virus is best known for its links to a devastating fetal birth defect known as microcephaly, where babies are born with smaller-than-expected heads and brains. But Zika's links to miscarriage haven't been clear.
"Data linking Zika virus infection to fetal death have been reported in only a handful of cases," wrote a team led by Dr. Annemiek van der Eijk, of Erasmus Medical Center in Rotterdam, the Netherlands.
The researchers said a 31-year-old Dutch woman lost her baby at 11 weeks' gestation, after contracting Zika on a trip to the South American country of Suriname. Suriname borders Brazil, which has been hit hard by thousands of cases of Zika-linked microcephaly.
The report was published online July 27 in the New England Journal of Medicine. In it, the researchers described how the pregnant woman became ill with headache, joint pain and rash the day after she returned to the Netherlands after more than three weeks in Suriname. ...
https://medlineplus.gov/news/fullstory_160101.html
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Is Non-Celiac Gluten Sensitivity Real?
FRIDAY, July 29, 2016, (HealthDay News) -- Gluten sensitivity appears to be a real medical problem, and not a figment of the popular imagination conjured up by the gluten-free craze, a new study contends.
Some people suffer changes within their bodies after eating gluten that are separate and distinct from those that accompany either celiac disease or wheat allergy, researchers report.
"We don't know what is triggering this response, but this study is the first to show that there are clear biological changes in these individuals," said senior researcher Armin Alaedini. He is an assistant professor of medicine at Columbia University in New York City.
"Based on our findings, we hope there would be greater recognition of this condition. This is a real condition. There are individuals who may not have celiac disease or wheat allergy, but still have a sensitivity to wheat," Alaedini said.
People with non-celiac wheat sensitivity appear to suffer from a weakened intestinal barrier, which leads to an immune response after they eat foods that contain the gluten protein -- typically wheat, rye or barley.
Their symptoms involve bloating, abdominal pain and diarrhea, but also include fatigue, headache, anxiety, and problems with memory and thinking skills, the study showed. ...
https://medlineplus.gov/news/fullstory_160153.html
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Stress management during cardiac rehabilitation is key to long-term recover Cardiac rehabilitation is an essential part of recovery from a heart attack, cardiac surgery or other adverse event. Traditional cardiac rehab includes physical activity, adapting a heart-friendly diet and taking medications to manage high blood pressure and high cholesterol.
But what if there were another aspect to the recovery process that was equally important? What about the mental and psychosocial aspects of recovery? A clinical trial of 151 coronary heart disease patients conducted by Duke Health and UNC Health Care studied patients who received traditional regimens of cardiac rehabilitation for 3 months. In addition, half of the patients attended weekly 90-minute stress management group classes. Those meetings consisted of cognitive behavioral therapy, muscle relaxation exercises, group support and other techniques to lower stress.
Positive AdditionsThree years later, 33% of the patients who received just cardiac rehabilitation had suffered from a second adverse event, like hospitalization due to chest pain, heart attack, stroke, bypass surgery, or death from any cause. Eighteen percent of the cohort who additionally received stress management support had suffered cardiac events.
To validate the overall importance of cardiac rehabilitation, researchers also looked at similar sized sample group of eligible patients who chose not to receive any form of rehabilitation. Forty-seven percent of that group suffered a second incident or died from any cause. 1 ...
http://nursing.advanceweb.com/Features/Articles/Stop-Stressing.aspx
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Sleep apnea tied to heart risk even after arteries are cleared (Reuters Health) - For people who have had a procedure to open blocked heart arteries, untreated sleep-breathing problems like snoring or apnea may raise the risk of a future heart attack or stroke, researchers say.
Patients in Japan who had the artery-clearing procedure after experiencing chest pain or a heart attack were more than twice as likely to have heart failure, a heart attack or a stroke in the next five years if they also had sleep-breathing problems.
Intermittent low-oxygen periods during sleep may increase stress or activate inflammatory responses that damage the heart, said lead author Dr. Toru Mazaki of the department of cardiology at Kobe Central Hospital in Japan.
Obstructive sleep apnea, the most common form of sleep apnea, is a condition where breathing stops for several seconds during sleep because tissue in the throat collapses, blocking the airway. This can happen dozens of times a night, interrupting sleep and leaving the person feeling tired during the day. ...
http://www.reuters.com/article/us-health-heart-sleep-apnea-idUSKCN0Z12M1?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-06-16&utm_term=US%20Health%20Report
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MONDAY, Aug. 1, 2016 (HealthDay News) --
If you turn to red meat as your main source of protein, you could be shortening your life, a new study suggests.
People who get more of their protein from plant sources have an overall lower risk of dying early than those who consume a lot of animal protein, the researchers said.
However, not all animal proteins carry the same level of risk, said lead researcher Dr. Mingyang Song. He is a nutrition research fellow with the Harvard T.H. Chan School of Public Health in Boston.
And many of the red meat eaters also had unhealthy habits such as drinking and smoking, the researchers said.
"We found protein from red meat, particularly processed red meat, is strongly associated with mortality," he said. "The protein from fish or chicken is not really associated with mortality."
The study findings make a case for including more plant protein in your daily diet: ...
https://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/could-lots-of-red-meat-shorten-your-life-span-713395.html
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THURSDAY, July 28, 2016 (HealthDay News) -- The injectable drug Adlyxin (lixisenatide) has been approved to treat adults with type 2 diabetes, the U.S. Food and Drug Administration says.
The once-daily injection is to be used along with diet and exercise to improve patients' blood sugar levels.
The FDA reviewed 10 clinical trials on the safety and effectiveness of Adlyxin. These studies included 5,400 people with type 2 diabetes. The drug was also specifically tested for heart issues in an additional 6,000 people at risk of heart disease, the FDA said Thursday in a news release.
The FDA concluded that Adlyxin helps normalize blood sugar levels. And it doesn't appear to increase the risk of heart problems.
Adlyxin is in a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Other GLP-1 drugs include liraglutide (Victoza), exenatide (Byetta, Bydureon) and dulaglutide (Trulicity), according to the American Diabetes Association.
Adlyxin shouldn't be used to treat people with type 1 diabetes. It also shouldn't be used by anyone with increased ketones (a sign that the body isn't getting enough insulin) in their blood or urine, or extremely elevated ketones (diabetic ketoacidosis), the FDA said.
Common side effects of Adlyxin included nausea, vomiting, headache, diarrhea and dizziness, the findings showed. Low blood sugar (hypoglycemia) occurred in patients who took both Adlyxin and other diabetes drugs such as sulfonylureas and/or a long-acting (basal) insulin, the agency said.
Some people who took Adlyxin had severe hypersensitivity reactions, including serious allergic reactions (anaphylaxis), the agency said.
The FDA said it's requiring drug maker Sanofi-Aventis to conduct post-marketing studies of Adlyxin. ...
https://medlineplus.gov/news/fullstory_160132.html
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I had no idea that this was in the U.S....200% increase. due to the immigrants, I suppose.
The Center for Control and Prevention of Disease (CDC) estimates that number of women and girls in the United States who are “at risk of or may have been subjected” to female genital mutilation/cutting (FGM/C) has increased three-fold over the past decades,” however the crime is rarely investigated or prosecuted, according to the Government Accountability Office.
The government attributes the growing incidents of this brutal practice in the U.S. to increased immigration from countries — largely in Africa and the Middle East — where FGM/C is practiced.
According to recent estimates, in 2012, 513,000 women and girls in the U.S. were subjected to or at risk of FGM/C, vastly higher than the 168,000 estimated in 1990.
In a report publicly released Monday, the GAO examined the federal response to the domestic practice of FGM/C, determining that while the crime of FGM/C is growing in the U.S. it has inspired few actual investigations.
“There have been few FGM/C-related investigations or prosecutions. Law enforcement and child protection officials we spoke with said this may be due, in part, to instances not being reported,” GAO reported.
GAO concluded that, while there are some efforts to educate immigrants about the prohibition of FGM/C in the U.S., the information dissemination is not widespread and “gaps exist.” Currently, the State Department provides “fact sheets” just to certain types of immigrants from countries where FGM/C is practiced, immigrants from those counties who come to the U.S. on temporary visas, however, do not receive the “fact sheets.” ...
http://www.breitbart.com/big-government/2016/08/02/prevalence-female-genital-mutilation-u-s-increased-200-since-1990/
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Addicts Who Can’t Find Painkillers Turn to Anti-Diarrhea Drugs
They call it the poor man’s methadone.
The epidemic of opioid addiction sweeping the country has led to another form of drug abuse that few experts saw coming: Addicts who cannot lay hands on painkillers are instead turning to Imodium and other anti-diarrhea medications.
The active ingredient, loperamide, offers a cheap high if it is consumed in extraordinary amounts. But in addition to being uncomfortably constipating, it can be toxic, even deadly, to the heart.
A report published online in Annals of Emergency Medicine recently described two deaths in New York after loperamide abuse. And overdoses have been linked to deaths or life-threatening irregular heartbeats in at least a dozen other cases in five states in the last 18 months.
Most physicians just recently realized loperamide could be abused, and few look for it. There is little if any national data on the problem, but many toxicologists and emergency department doctors suspect that it is more widespread than scattered reports suggest. ... http://www.nytimes.com/2016/05/11/health/imodium-opioid-addiction.html?emc=edit_tnt_20160510&nlid=1675735&tntemail0=y
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RANDOM FACT: Field hockey is one of the oldest competitive sports which is recorded way back into Ancient Greek Olympic games. There has been found of drawings in a tomb like place in Beni-Hasen in the Nile Valley of Egypt showing males playing this sport.
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Bonus Fact: Originally made of mulberry wood, field hockey sticks are now manufactured from a variety of materials, including fiberglass, graphite, Kevlar and other composites.
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HINT: Do you remember that there are holes on each end of the aluminum foil, cut-right, Saranwrap, and Clingright etc.? Open the holes and force the cardboard into the holes of the foil etc. This keeps the roll inside the box, instead of "flipping out" each time you use it.
Bonus Fact: Originally made of mulberry wood, field hockey sticks are now manufactured from a variety of materials, including fiberglass, graphite, Kevlar and other composites.
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HINT: Do you remember that there are holes on each end of the aluminum foil, cut-right, Saranwrap, and Clingright etc.? Open the holes and force the cardboard into the holes of the foil etc. This keeps the roll inside the box, instead of "flipping out" each time you use it.
More little known facts:
The oceans cover 71% (and rising) of the Earth's surface and contain 97% of the Earth's water. Less than 1% is fresh water, and 2-3% is contained in glaciers and ice caps (and decreasing).
The oceans cover 71% (and rising) of the Earth's surface and contain 97% of the Earth's water. Less than 1% is fresh water, and 2-3% is contained in glaciers and ice caps (and decreasing).
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The pressure at the deepest point in the ocean is more than 22 thousand pounds, or the equivalent of one person trying to support 50 jumbo jets.
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The pressure at the deepest point in the ocean is more than 22 thousand pounds, or the equivalent of one person trying to support 50 jumbo jets.
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The highest tides in the world are at the Bay of Fundy, which separates New Brunswick from Nova Scotia. At some times of the year the difference between high and low tide is taller than a three-story building.
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The lowest known point on Earth, called the Challenger Deep, is 36,201 feet deep, in the Marianas Trench in the western Pacific. To get an idea of how deep that is, if you could take Mt. Everest and place it at the bottom of the trench there would still be over a mile of ocean above it.
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The Pacific Ocean, the world's largest water body, occupies a third of the Earth's surface. The Pacific contains about 25,000 islands (more than the total number in the rest of the world's oceans combined), almost all of which are found south of the equator.
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A mouthful of seawater may contain millions of bacterial cells, hundreds of thousands of phytoplankton and tens of thousands of zooplankton.
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A mouthful of seawater may contain millions of bacterial cells, hundreds of thousands of phytoplankton and tens of thousands of zooplankton.
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Trivia Quiz:
Francis Scott Key wrote "The Star-Spangled Banner" during a battle of which war?
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"The Star-Spangled Banner" is the national anthem of the United States of America. The lyrics come from "Defence of Fort McHenry", a poem written in 1814 by the 35-year-old lawyer and amateur poet, Francis Scott Key, after witnessing the bombardment of Fort McHenry by the British Royal Navy ships in Chesapeake Bay during the Battle of Fort McHenry in the War of 1812. More than a century after its first publication, the song was adopted as the American national anthem, first by an Executive Order from President Woodrow Wilson in 1916 and then by a Congressional resolution in 1931, signed by President Herbert Hoover.
Contralateral Prophylactic Mastectomy Discouraged: ASBrS
Women diagnosed with breast cancer who are at average risk should be discouraged from undergoing a contralateral prophylactic mastecotomy (CPM), because the majority of women will obtain no oncologic benefit, says a new consensus statement from the American Society of Breast Surgeons (ASBrS).
The ASBrS notes that it is endorsing a previous statement issued by the American Board of Internal Medicine's Choosing Wisely campaign that women with cancer in a single breast should not undergo prophylactic mastectomy unless the woman is well informed about the risks associated with CPM and makes her decision on the basis of facts and not fear.
The ASBrS consensus statement consists of two parts. The firstoutlines the effect that CPM has on relevant clinical outcomes and which patients might be appropriate candidates for CPM. The second concerns issues such as how patients feel about CPM. Both position statements were published online July 28 in the Annals of Surgical Oncology. ...
http://www.medscape.com/viewarticle/866867
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Famous Nurses:
Mary Breckinridge dedicated her life to rural public health care, but it wasn't until after she suffered a series of personal tragedies, including the deaths of her two young children, that she heard the call to nursing.
She studied at St. Luke's Hospital in New York, and became a registered nurse in 1910. Nursing took her to Boston and Washington, D.C., and even to France as part of the American Committee for Devastated France after World War I. While in France, Breckinridge was introduced to French and British nurse-midwives, a path Breckinridge decided dovetailed perfectly with her desire to bring health care to rural poor families in America. When she was in her early 40s, Breckinridge studied midwifery in London and is credited with introducing nurse-midwifery to America [source: Frontier Nursing Service].
In 1925, Breckinridge founded the Frontier Nursing Service (FNS), a team of nurse-midwives devoted to bringing general and maternal care (including prenatal and postnatal care) to people living in the Appalachian mountains of eastern Kentucky. The FNS nurses traveled by horseback to deliver babies and provide family care, accepting little money (or barter) as payment.
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Please forgive me for the following layouts...this one refused to cooperate and affected the spacing that follows.
http://www.cdc.gov/media/releases/2016/s0718-zika-utah-investigation.html
CDC assisting Utah investigation of Zika virus infection apparently not linked to travel CDCis assisting in the investigation of a case of Zika in a Utah resident who is a family contact of the elderly Utah resident who died in late June. The deceased patient had traveled to an area with Zika and lab tests showed he had uniquely high amounts of virus—more than 100,000 times higher than seen in other samples of infected people—in his blood. Laboratories in Utah and at the Centers for Disease Control and Prevention (CDC) reported evidence of Zika infection in both Utah residents State and local public health disease control specialists, along with CDC, are investigating how the second resident became infected. The investigation includes additional interviews with and laboratory testing of family members and health care workers who may have had contact with the person who died and trapping mosquitoes and assessing the risk of local spread by mosquitoes...
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| 07/12/2016 FDA approves new medication for dry eye disease- Drug Information Update |
The U.S. Food and Drug Administration approved Xiidra (lifitegrast ophthalmic solution) for the treatment of signs and symptoms of dry eye disease, on Monday, July 11, 2016. Xiidra is the first medication in a new class of drugs, called lymphocyte function-associated antigen 1 (LFA-1) agonist, approved by the FDA for dry eye disease.
The most common side effects of Xiidra include eye irritation, discomfort or blurred vision and an unusual taste sensation (dysgeusia).
Dry eye disease does not routinely occur in children. Safety and efficacy in pediatric patients below the age of 17 years has not been studied.
Dry eye disease includes a group of conditions in which the eye does not produce an adequate volume of tears or when the tears are not of the correct consistency. The chance of experiencing dry eye increases with age, affecting approximately five percent of the adult population age 30-40 and 10 to 15 percent of adults over age 65, and is more common among women. When severe and left untreated, this condition can lead to pain, ulcers or scars on the part of the eye called the cornea. Dry eye can make it more difficult to perform some activities, such as using a computer or reading for an extended period of time, and it can decrease tolerance for dry environments, such as the air inside an airplane....
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm510720.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
This is one of my conditions....I wrote about it several years ago. It seems that tears have 3 layers/components...and if one or two are missing, the diagnosis of Dry Eye
is established....I use Restasis one gtt twice a day....and now need ReFresh (Only) for lubrication.
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Doctors devise care plan for babies as Zika threat looms in U.S.
Pediatricians and other health care experts convened at a CDC-sponsored meeting to create care recommendations for treating infants exposed to the Zika virus during gestation. The number of pregnant women with evidence of infection with the Zika virus in the US increased to 400 from 346 in the previous week and three more infants had Zika-related birth defects, bringing the total to 12 cases, according to the CDC, which has approved $60 million in additional funding for Zika virus preparedness efforts as well as an additional $10 million for states and territories to come Aug. 1.Reuters (7/22) So far, 400 pregnant women in the continental United States have evidence of Zika infection, up from 346 from a week ago, the CDC reported on Thursday. All of those were related to travel or sex with an infected person who had traveled.
Three more babies have been born in the United States with birth defects linked to Zika infections in their mothers, bringing the total to 12, CDC said.
Zika has been proven to cause microcephaly, a severe birth defect marked by small head size and undersized brains that requires a complex network of care providers and social workers to treat and provide support to parents.
But microcephaly is just the tip of the iceberg, according to experts speaking at a CDC-sponsored workshop on Thursday. They said many babies exposed in utero who appear normal at birth may have developmental problems down the road, including hearing and vision problems. ...
http://www.reuters.com/article/us-health-zika-usa-idUSKCN1012YL
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HINT:
Are your towels not as absorbent as they use to be?
Skip the fabric softener next few times you do laundry. The chemicals in the softener, in both liquid and sheets, can build up in the fabric, which causes them to lose their absorbency. A few softener-free washes will have them as good as new.
Quiz Time
Which diagnostic biomarker is detectable in the urine within 12 hours after renal tubular cells are injured?
a. Neutrophil gelatinase-associated lipocalin
b. Cystatin C
c. Tissue inhibitor metalloproteinase-2
d. Glomerular filtration rate
a. Neutrophil gelatinase-associated lipocalin
b. Cystatin C
c. Tissue inhibitor metalloproteinase-2
d. Glomerular filtration rate
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5 Diet Drugs: Which Ones Work?
TUESDAY, June 14, 2016 (HealthDay News) -- Any of the prescription weight-loss drugs on the market can help obese people shed pounds, although some seem more effective than others, a new study finds.
Currently, five drugs are approved in the United States for managing obesity. But little has been known about how they stack up against one another, said Dr. Siddharth Singh, the lead researcher on the new study.
The findings -- based on more than 29,000 people in total -- show all five drugs can work. But people on certain drugs tended to be more successful, at least over one year.
Specifically, people using Qsymia (phentermine-topiramate) or Saxenda (liraglutide) had the highest odds of shedding at least 5 percent of their initial weight. Those taking Xenical (orlistat) had the lowest odds.
However, there is no single drug that's "best" for everyone, stressed Singh, an assistant clinical professor at the University of California, San Diego. ...
https://medlineplus.gov/news/fullstory_159359.html
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Take the time to check this one out........very interesting to learn.
Flavonoids are a large family of over 5,000 hydroxylated polyphenolic compounds that carry out important functions in plants, including attracting pollinating insects; combating environmental stresses, such as microbial infection; and regulating cell growth (1). Their bioavailability and biological activities in humans appear to be strongly influenced by their chemical nature. Since the 1990s, there has been a growing interest in dietary flavonoids due to their likely contribution to the health benefits of fruit- and vegetable-rich diets. ...
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Babies' Sleep 'Twitching' May Aid Their Development
TUESDAY, Aug. 2, 2016 (HealthDay News) -- When parents watch babies sleep, they often assume that the tiny twitches they see are a response to a dream. But researchers believe that twitching may actually be part of a baby's motor skills development.
When a baby's body twitches during rapid eye movement (REM) sleep, it's triggering circuits throughout the brain to teach newborns about their limbs and how to use them, University of Iowa researchers believe.
Along with increasing knowledge about early development, learning more about early sensory and motor (sensorimotor) skills development could help improve understanding of certain developmental disorders, such as autism and schizophrenia, the researchers said. ...
https://medlineplus.gov/news/fullstory_160211.html
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| As many as 3 of every 4 women suffer from PMS. |
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Women With Migraine May Face Higher Threat of Heart Disease, Stroke
https://consumer.healthday.com/head-and-neck-information-17/migraine-news-477/women-with-migraine-may-have-higher-risk-of-heart-disease-stroke-711475.html
TUESDAY, May 31, 2016 (HealthDay News) -- Women who suffer from migraine headaches may have a slightly increased risk of heart disease or stroke, a new study suggests.
"Migraine should be considered a marker for increased risk of cardiovascular disease, at least in women," said lead researcher Dr. Tobias Kurth, director of the Institute of Public Health at Charite-Universitatsmedizin in Berlin, Germany.
But, Kurth cautioned that this study can't prove that migraines cause heart attack or stroke, only that they may make these events more likely.
Also, men may be similarly affected. "We have no reason to believe that this is limited to women," Kurth said.
Migraines are headaches marked by intense throbbing or pulsing, often accompanied by nausea, vomiting and sensitivity to light and sound. They had previously been linked to an increased risk for stroke, but this new study also ties them to possible heart attack, death and the need for heart surgery, the researchers noted.
"Physicians should be aware of the association between migraine and cardiovascular disease, and women with migraine should be evaluated for their risk," Kurth said.
For the study, researchers analyzed data on more than 116,000 U.S. women who took part in the Nurses' Health Study II. At the start of the study, the women were age. ...
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Gilead wins U.S. nod for drug for all types of hepatitis C U.S. health regulators on Tuesday approved a combination drug by Gilead Sciences Inc that is the first available treatment for all six major forms of hepatitis C, advancing the company's leadership in the field and sending its shares up more than 4 percent.
Gilead said in a separate statement that it priced the drug at $74,760 for a 12-week regimen.
Gilead has dominated the hepatitis C market over rivals AbbVie and Merck & Co with its high-priced and highly effective treatments Sovaldi and the combination drug Harvoni. The new treatment, to be sold under the brand name Epclusa, combines Sovaldi (sofosbuvir), which was approved in 2013, with a new anti-viral drug velpatasvir.
Epclusa costs less than the $84,000 that Sovaldi sold for when it launched in late 2013. Gilead now offers discounts and rebates on that older drug, which was at the center of a national uproar over soaring drug costs.
Epclusa is approved for patients with and without cirrhosis, a form of scarring seen in patients with advanced disease that can lead to liver failure and need for a transplant. For those with moderate to severe cirrhosis, Epclusa must be taken with the older drug ribavirin, the Food and Drug Administration said. ... http://www.reuters.com/article/us-gilead-sciences-fda-idUSKCN0ZE1U6
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All pandas in the world are on loan from China.
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HUMOR SECTION
Jonathon was having trouble in school.
His teacher was always yelling at him,
"You're driving me crazy, Jonathon, can't you learn anything!!?
One day, Jonathon's mother came to school to check on how he was doing. The teacher told her honestly, that her son was simply a disaster, getting very low marks, and that, in her entire teaching career, she had never seen such a stupid boy. The mom was so shocked at the feedback that she withdrew her son from school and moved out of the city, relocating to a school in the nearby suburbs.Twenty years later, the teacher was diagnosed with an almost incurable cardiac disease. Doctors strongly advised her to have open-heart surgery, which only the outstanding surgeon at the Brigham and Women’s Heart Clinic could perform. Left with no other options, the teacher decided to have the operation, which was remarkably successful.When she opened her eyes after the surgery, she saw a handsome young doctor smiling down at her. She wanted to thank him, but could not talk. Her face started to turn blue, she raised her hand, trying to tell him something, but quickly died. The doctor was shocked, wondering what went wrong so suddenly.
Then he turned around and saw it was Jonathon, a janitor in the Clinic,
who had unplugged the life-support equipment in order to connect his vacuum cleaner.
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The boss of a big company needed to call one of his employees about an urgent problem with one of the main computers. He dialed the employee's home phone number and was greeted with a child's whispered, "Hello?"
Feeling put out at the inconvenience of having to talk to a youngster, the boss asked, "Is your Daddy home?"
"Yes" whispered the small voice.
"May I talk with him?" the man asked.
To the surprise of the boss, the small voice whispered, "No."
Wanting to talk with an adult, the boss asked, "Is your Mommy there?"
"Yes" came the answer.
"May I talk with her?"
Again, the small voice whispered, "No"
Knowing that it was not likely that a young child would be left home alone, the boss decided he would just leave a message with the person who should be there watching over the child. "Is there any one there besides you?" the boss asked the child.
"Yes" whispered the child, "a policeman."
Wondering what a cop would be doing at his employee's home, the boss asked, "May I speak with the policeman?"
"No, he's busy" said the little voice.
"Busy doing what?" asked the boss.
"Talking to Daddy and Mommy and the fireman." came the whispered answer.
Growing concerned and even worried as he heard the sound of a helicopter through the ear piece on the phone the boss asked, "What is that noise?"
"A hello-copper" answered the whispering little voice.
"What is going on there?!" asked the boss, now getting alarmed.
In an awed whispering voice the child answered,
"They just landed the hello-copper."
Alarmed, concerned and more than just a little frustrated, the boss asked, "What are they searching for?!"
Still whispering, the young voice replied along with a muffled giggle, "Me!"
Feeling put out at the inconvenience of having to talk to a youngster, the boss asked, "Is your Daddy home?"
"Yes" whispered the small voice.
"May I talk with him?" the man asked.
To the surprise of the boss, the small voice whispered, "No."
Wanting to talk with an adult, the boss asked, "Is your Mommy there?"
"Yes" came the answer.
"May I talk with her?"
Again, the small voice whispered, "No"
Knowing that it was not likely that a young child would be left home alone, the boss decided he would just leave a message with the person who should be there watching over the child. "Is there any one there besides you?" the boss asked the child.
"Yes" whispered the child, "a policeman."
Wondering what a cop would be doing at his employee's home, the boss asked, "May I speak with the policeman?"
"No, he's busy" said the little voice.
"Busy doing what?" asked the boss.
"Talking to Daddy and Mommy and the fireman." came the whispered answer.
Growing concerned and even worried as he heard the sound of a helicopter through the ear piece on the phone the boss asked, "What is that noise?"
"A hello-copper" answered the whispering little voice.
"What is going on there?!" asked the boss, now getting alarmed.
In an awed whispering voice the child answered,
"They just landed the hello-copper."
Alarmed, concerned and more than just a little frustrated, the boss asked, "What are they searching for?!"
Still whispering, the young voice replied along with a muffled giggle, "Me!"
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Laundry Lament
Laundry Lament
Based on the amount of laundry that
I do each week,
I am going to assume that
there are people who live here
That I have yet to meet.
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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
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
Diagnosis and Treatment of Familial Hypercholesterolemia
- Fetal Alcohol Syndrome Disorders: Prevention, Identification, and Intervention
- Major Histopathologic Diagnoses of Chronic Wounds
- The Lived Experience of Social Media by Young Adult Burn Survivors
- Human Papillomavirus-Related Oropharyngeal Cancer: A Review of Nursing Considerations
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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
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MEDICAL RECALLS
*
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Use associated with disabling and potentially permanent side effects of the tendons, muscles, joints, nerves, and central nervous system that can occur together in the same patient. Posted 07/26/2016
Including the following currently available fluoroquinolones
Avelox (moxifloxacin) ,Cipro (ciprofloxacin), Cipro extended-release (ciprofloxacin extended-release), Factive (gemifloxacin),
Levaquin (levofloxacin) ,Ofloxacin (generic brand)
Levaquin (levofloxacin) ,Ofloxacin (generic brand)
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm513065.htm
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AVEA Ventilator by CareFusion: Class I Recall - Electrical Issue May Cause Unexpected Shutdown
CareFusion is recalling the AVEA Ventilator because of a faulty fuse on the ventilators’ alarm board, which may cause the ventilator to unexpectedly shut down. If the ventilator shuts down, a patient may not receive necessary oxygen. The use of affected product may cause serious adverse health consequences, including death.
- Manufacturing Dates: November 13, 2016 to January 4, 2016
- Distribution Dates: to December 16, 2016 to February 15, 2016
- Devices Recalled in the U.S.: 501 units distributed nationwide
Posted: July 28, 2016
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm513810.htm
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Angiodynamics Soft Vu Omni Flush Angiographic Catheter by Stryker Sustainability Solutions (formerly Ascent Healthcare Solutions): Class I Recall - Tip Separation
Stryker Sustainability Solutions (formerly Ascent Healthcare Solutions) is recalling Angiodynamics Soft Vu Omni Flush Angiographic Catheters due to reports of separation of the tip of the catheter from the main body. Tip separation leads to loss of device function, possible surgical intervention to retrieve a separated segment, or other complications such as blocking blood flow to bodily organs.
Tip separation can also lead to internal organ injury and cause stroke, kidney failure, and intestinal failure among other serious adverse health consequences, including death.
The recalled products include manufacturing dates: November 7, 2003 to October 18, 2008, and distribution dates January 5, 2004 to December 3, 2008. See the FDA Recall Notice for a listing of affected lot numbers. ... Posted: 7/22/2016
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm512644.htm
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Amikacin Sulfate Injection USP 500 mg/2 mL (250 mg/mL) and 1 Gram/4 mL (250 mg/mL) Vials by Teva: Recall - Glass Particulate Matter
AUDIENCE: Pharmacy, Nursing
ISSUE: Teva Pharmaceuticals announced a voluntary recall of seven lots of Amikacin Sulfate Injection USP, 500 mg/2mL (250 mg/mL) and 1 gram/4mL (250 mg/mL) vials due to the potential for the presence of glass particulate matter. 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. See thepress release for a listing of affected lot numbers.
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 250 mg/mL, 2 mL & 4 mL vials were distributed nationwide through wholesalers, retailers, and pharmacies.
fda@service.govdelivery.com
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FDA MedWatch - Comfort Shield Barrier Cream Cloths by Sage Products: Recall - Product Contamination
AUDIENCE: Consumer, Nursing (notwithstanding this issue, I have found that the SAGE products to be excellent ones)
ISSUE: Sage Products is voluntarily initiating a nationwide recall of one lot of Comfort Shield Barrier Cream Cloths to the distributor and health care facility/user level. The recall is being initiated due to product contamination with the bacteria, Burkholderia cepacia. Topical administration of a product with B. cepacia may cause serious infections in patients whose bodies cannot fight disease or in hospitalized patients, as well as certain other patient groups. These infections could be life-threatening.
This recall affects the following lot of Comfort Shield Barrier Cream Cloths: Product Code 7503; NDC Number 53462-915-50; Lot Number 53957; Expiration Date 3/6/2018. The affected lot was distributed to customers between March 31, 2016 and June 8, 2016.
BACKGROUND: Comfort Shield Barrier Cream Cloths is a non-sterile, topical skin protectant used to treat and prevent moisture associated skin irritation caused by urine and/or stool exposure.
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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
Character is like a tree and reputation like its shadow.
The shadow is what we think of it; the tree is the real thing.
Abraham Lincoln (1809-1865), Lincoln's Own Stories
Hope to hear from you..... Frankie
c. Tissue inhibitor metalloproteinase-2 (TIMP-2) appears in the urine within 12 hours after renal tubular cells are injured from ischemia or sepsis. In one study, urinary TIMP-2 testing showed certain patients had seven times the risk of developing acute kidney injury.
Learn more by reading the continuing nursing education article “Acute kidney injury: Causes, phases, and early detection.”
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