Thursday, December 15, 2016

PARADIGM BYTES December 2016 issue


PARADIGM BYTES

Newsletter for Paradigm 97
December 15, 2016

PARADIGM DEFINED:

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

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

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

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SNIPPET


Nurses' 'Scrubs' Pick Up Bad Hospital GermsSuperbug MRSA, other disease-causing bacteria detected on uniforms in ICU
By Robert Preidt
Thursday, October 27, 2016
THURSDAY, Oct. 27, 2016 (HealthDay News) -- The "scrubs" of intensive care unit (ICU) nurses often pick up disease-causing germs, including those resistant to antibiotics, a new study reports.
"We know there are bad germs in hospitals, but we're just beginning to understand how they are spread," said study lead author Dr. Deverick Anderson, an associate professor of medicine at Duke University School of Medicine in Durham, N.C.
These bad germs spread from patients to the nurses' uniforms (usually the sleeves and pockets) and objects around the room, most often to bed railings, the researchers found.
"This study is a good wake-up call that health care personnel need to concentrate on the idea that the health care environment can be contaminated," said Anderson.
"Any type of patient care, or even just entry into a room where care is provided, truly should be considered a chance for interacting with organisms that can cause disease," he added in a university news release.
The study included 40 intensive care unit nurses at Duke University Hospital. Samples were collected from their scrubs before and after each 12-hour shift. Samples were also collected from all the patients the nurses cared for and items in the patients' rooms.
The researchers focused on five pathogens known to cause hard-to-treat infections, including an antibiotic-resistant superbug called methicillin-resistant Staphylococcus aureus (MRSA).
The study found 22 instances when at least one of the five germs was transmitted from the patient or the room to a nurse's scrubs. In six incidents, the germs spread from patient to nurse and room to nurse, and in 10 instances, bacteria was transmitted from the patient to the room.
There were no nurse-to-patient or nurse-to-room transmissions, according to the findings. ...
SOURCE: Duke University, news release, Oct. 27, 2016
HealthDay         https://medlineplus.gov/news/fullstory_161724.html


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EDITORIAL COLUMN


Just to remind all of you about the Changing of the guard effective with the February Newsletter:  Raconte (Genevieve) will be taking over the Editor/Publisher of PARADIGM  BYTES Newsletter.  Please support her endeavor.  This 17 years that I was the Editor/publisher were wonderful ones........so much learning and so many friends made.  Thanks to all of you for your support.



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

 Short turnaround between shifts may increase sick leave



(Reuters Health) – Workers who get less than 11 hours of rest between shifts may be more likely to take sick leave, a Norwegian study suggests.


“Quick returns,” defined as breaks shorter than 11 hours between the end of one shift and the beginning of another, were tied to a 21 percent increase in the odds of nurses taking sick leave the following month.


“Recent studies suggest these rapid changeovers can be associated with equal or even worse effects on sleep and fatigue than night work,” said lead study author Oystein Vedaa of the University of Bergen.


“Our study also suggests short time for rest between shifts predicts sick leave and night shifts do not,” Vedaa told Reuters Health by email. “The importance of rest time between shifts has received little attention in previous research.”


Vedaa and colleagues looked at shift work and sick leave data for 3,700 nurses and nurses’ assistants at Haukeland University Hospital, one of four public hospitals in western Norway. They asked nurses who worked more than 18 hours per week to participate in a survey, and 1,538 answered questions about themselves as well as their work schedules and sick leave. ...  

http://www.reuters.com/article/us-health-sickleave-short-shifts-idUSKBN13J231?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-11-25&utm_term=US%20Health%20Report
  
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Brain Implant Lets 'Locked-In' ALS Patient Communicate


MONDAY, Nov. 14, 2016 (HealthDay News) -- A high-tech implant has enabled a paralyzed woman with late-stage ALS (amyotrophic lateral sclerosis) to communicate through brain signaling, researchers say.
The degenerative disease robbed Hanneke De Bruijne, 58, of all voluntary muscle control -- including the ability to speak -- while leaving her mind intact.
But an experimental implant-software program allows the "locked-in" Dutch woman to type words without assistance.
The brain implant "lets her remote-control a computer with her brain, at home, without any help from researchers," said study co-author Nick Ramsey.
"She can spell two letters per minute," said Ramsey, a professor of cognitive neuroscience at University Medical Center Utrecht in the Netherlands. In this way, she can convey her needs to her caregivers, he said.   ...
https://medlineplus.gov/news/fullstory_162008.html

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WHO advises proper washing, no shaving in fight against hospital superbugs

By Kate Kelland | LONDON

Patients going for surgery should bathe or shower beforehand but their surgical site should not be shaved, and antibiotics should be used to prevent infections before and during surgery, but not afterwards, the World Health Organization said on Thursday.

In new guidelines aimed at halting the spread of potentially deadly superbug infections in hospitals and clinics worldwide, the WHO said obsessive dedication to cleanliness and hygiene was crucial, as was the careful use of anti-infectives.

Surgical site infections are caused by bacteria getting in to the body through incisions made during surgery. They put millions of patients worldwide at risk each year and exacerbate the spread of antibiotic resistant superbugs such as MRSA.  ...


http://www.reuters.com/article/us-health-infections-idUSKBN12X2QB?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-11-03&utm_term=US%20Health%20Report

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ICU overprescribing of Antibiotics for CAP Still a Problem

NEW ORLEANS, LA—Overprescription of antibiotics in the intensive care unit (ICU) for patients with community-acquired pneumonia (CAP) "remains a significant problem," according to authors of a study presented at IDWeek 2016.
"Our study shows that in patients admitted with CAP to the ICU, P. aeruginosa is rare and coverage against this organism may not be indicated in the absence of cystic fibrosis or prior pseudomonal infection," said lead study author Rorak Hooten, MD, from the University of Arizona in Tucson, AZ. 
"Our results suggest that coverage against MRSA [methicillin-resistant Staphylococcus aureus] be reserved for selected patients, such as those with necrotizing pneumonia and/or a history of positive MRSA swab," he said.
The Infectious Diseases Society of America (IDSA) currently recommends adding vancomycin to the standard fluoroquinolones or beta-lactam + macrolide inpatient therapy for patients with CAP in the ICU in order to address MRSA. Many clinicians also prescribe antibiotics for Pseudomonas aeruginosa, he noted....

http://www.empr.com/idweek-2016--adult-infectious-diseases/icu-overprescribing-of-antibiotics-for-cap-still-a-problem/article/560459/

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Zika causes infertility, lasting harm to testes in mice: U.S. study

 A study of mice infected with Zika showed the virus caused lasting damage to key cells in the male reproductive system, resulting in shrunken testicles, lower levels of sex hormones and reduced fertility, U.S. researchers said on Monday.

So far, the findings are only in mice, but the result is worrisome enough to warrant further study because of possible implications for people, said Dr. Michael Diamond of Washington University in St. Louis, whose research was published in the journal Nature.

"It has to be corroborated," Diamond, a professor of pathology, immunology and molecular microbiology, said in a telephone interview.

Much of the global effort to fight Zika has focused on protecting pregnant women from infection because of the grave implications for their unborn children.

http://www.reuters.com/article/us-health-zika-testes-idUSKBN12V1T0?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-11-01&utm_term=US%20Health%20Report

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Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of November 23, 2016)§

http://www.cdc.gov/zika/intheus/maps-zika-us.html

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 All Countries & Territories with Active Zika Virus Transmission

 The following countries and territories have reported mosquito-borne Zika virus transmission and includes countries with current travel notices issued for Zika.
These maps do not include countries and territories that have reported only travel-associated cases, nor do they include countries and territories with past transmission of Zika virus. ...

http://www.cdc.gov/zika/geo/active-countries.html

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 Surgeon general sounds the alarm on teens and e-cigarettes

The nation's top doctor is sounding the alarm on e-cigarettes, especially when used by teens and young adults.
"These products are now the most commonly used form of tobacco among youth in the United States, surpassing conventional tobacco products, including cigarettes, cigars, chewing tobacco and hookahs," wrote Dr. Vivek H. Murthy, the US surgeon general, in a report released Thursday. In fact, use of e-cigarettes among high school students increased by 900% from 2011 to 2015, according to the report.
    Specifically, among middle and high school students, use of e-cigarettes has more than tripled since 2011, the report indicates. Meanwhile, after a period of relative stability from 2011 to 2013, vaping among young adults between 18 and 24 years old more than doubled from 2013 to 2014.
    Yet nicotine can damage the developing teen brain while leading to addiction.
    "Compared with older adults, the brain of youth and young adults is more vulnerable to the negative consequences of nicotine exposure," noted Murthy. ...


    http://www.cnn.com/2016/12/08/health/surgeon-general-report-on-e-cigarettes/index.html 
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    The Opioid Epidemic 
    • 78 Americans die every day from an opioid overdose
    • At least half of all opioid overdoses involved a prescribed medicine
    • Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014, but the overall amount of pain Americans report has not changed
    • Heroin-related overdose deaths have more than tripled since 2010
    Learn more and find wide variety of resources and information from ANA.





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     Portions of the brain fall asleep and wake back up all the time 


    When we are in a deep slumber our brain's activity ebbs and flows in big, obvious waves, like watching a tide of human bodies rise up and sit down around a sports stadium. It's hard to miss.
    Now, Stanford researchers have found, those same cycles exist in wake as in sleep, but with only small sections sitting and standing in unison rather than the entire stadium. It's as if tiny portions of the brain are independently falling asleep and waking back up all the time.
    What's more, it appears that when the neurons have cycled into the more active, or "on," state they are better at responding to the world. The neurons also spend more time in the on state when paying attention to a task. This finding suggests processes that regulate brain activity in sleep might also play a role in attention.
    "Selective attention is similar to making small parts of your brain a little bit more awake," said Tatiana Engel, a postdoctoral fellow and co-lead author on the research, which is scheduled to publish Dec. 1 in Science. Former graduate student Nicholas Steinmetz was the other co-lead author, who carried out the neurophysiology experiments in the lab of Tirin Moore, a professor of neurobiology and one of the senior authors. ...


    https://www.sciencedaily.com/releases/2016/12/161202101326.htm


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    FACT:   If you hold your breath and put your face in cold water, your heart will immediately slow down by 25%.

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     Tests may help spot brain damage after even mild concussions


     (Reuters Health) - Brain scans may help identify athletes who suffer from brain damage after mild concussions, a small study of current and former professional football players suggests.
                                                                                                                                                                                                                    Researchers examined results from what’s known as positron emission tomography (PET) scans for four current and 10 former National Football League (NFL) players who had at least one previous concussion as well as for 16 similar men who weren’t athletes and had no history of concussions.

    They measured levels of a substance called translocator protein 18KDa (TSPO), which are thought to rise when the brain responds to traumatic injuries.

    Compared with men who weren’t in the NFL, the football players had higher levels of TSPO and greater changes in the brain’s white matter, the study found.

    “The study showed that there is a measurable degree of this biomarker of brain injury and repair even in young NFL players, suggesting that the insult to their brains could have occurred long before they were scanned for the study – perhaps dating to collegiate or pre-collegiate play,” said senior study author Dr. Martin Pomper, a researcher at Johns Hopkins Medical School in Baltimore.  ...  

    http://www.reuters.com/article/us-health-brain-concussions-idUSKBN13N2C6?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-11-29&utm_term=US%20Health%20Report
    QUESTION:    Approximately how much does the average cloud weigh?
    • 11 pounds
    • 204 pounds
    • 110,000 pounds
    • 1.1 million pounds
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    Monsanto Is Scrambling To Bury This Breaking Story – Don’t Let This Go Unshared!

    A FDA-registered food safety laboratory tested iconic American food for residues of the weed killer glyphosate (aka Monsanto’s Roundup) and found ALARMING amounts.
    Just to give you an idea of how outrageous these amounts are, independent research shows that probable harm to human health begins at really low levels of exposure – at only 0.1 ppb of glyphosate. Many foods were found to have over 1,000 times this amount! Well above what regulators throughout the world consider “safe”.   

     Here is why we all should be concerned about eating glyphosate:

    • Independent research links glyphosate to cancer (sources: 12345) and it has been deemed a probable human carcinogen by the World Health Organization’s team of international cancer experts. The childhood cancer rate is steadily rising and experts say that they don’t know why. Why are they not taking a closer look at these facts?
    • It binds with vital nutrients in the soil (like iron, calcium, manganese, zinc) and prevents plants for taking them up. Glyphosate is thereby making food less nutritious!
     There is a chart with this information and my favorite breakfast cereal is one that is high in glyphosate !  Now I am forced to look elsewhere.   Please read this and definitely share this with your friends/neighbors...it is that important !  Frankie

    http://foodbabe.com/2016/11/15/monsanto/

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    Glyphosate, the active ingredient in Monsanto's Roundup herbicide, is the most used agricultural chemical in history.
    In 2014, farmers sprayed enough glyphosate to apply 0.8 pounds of the chemical toevery acre of cultivated cropland in the U.S. and nearly 0.5 a pound of glyphosate to all cropland worldwide.1
    Yet, mysteriously, the U.S. Department of Agriculture's (USDA) National Residue Program, which is tasked with monitoring pesticide residues in the U.S. food supply, does not test for glyphosate residues.
    As more health risks emerge — in March 2015 the International Agency for Research on Cancer (IARC) determined glyphosate is a "probable carcinogen" — more people are starting to wonder just how much glyphosate is in our food.
    The signs so far are not reassuring. Glyphosate has been detected in blood, breastmilk and urine samples.
    Further, U.S. women had maximum glyphosate levels that were more than eight times higher than levels found in urine of Europeans, according to laboratory testing commissioned by the organizations Moms Across America and Sustainable Pulse.2
    The Alliance for Natural Health (ANH) recently conducted its own research to determine if glyphosate is found in commonly consumed breakfast foods and their tests revealed the worst — that "our food system has been saturated with glyphosate, reaching even into some organic products."3   ...

    http://articles.mercola.com/sites/articles/archive/2016/05/03/glyphosate-food.aspx

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     ADA Issues Guidelines for Psychosocial Care in Diabetes

    The American Diabetes Association (ADA) released its first position statement that includes detailed guidelines for psychosocial assessments and care based on factors including age, type of diabetes, and family support system. 
    The specific recommendations are available in "Psychosocial Care for People with Diabetes: A Position Statement of the America Diabetes Association" which will be published in Diabetes Care.
    The ADA's guidelines address the most common psychological factors affecting patients with type 1 and type 2 diabetes, including diabetes distress, depression, anxiety and eating disorders. It emphasizes that diabetes management is more successful when lifestyle and emotional status are integrated into diabetes care. 
    *****    I have always wished that  psychological counseling was offered to those diabetics who would be undergoing amputations and also offered post-op counseling.  I consider this omission a very serious error of the health care personnel.*****
    http://www.empr.com/news/ada-issues-guidelines-for-psychosocial-care-in-diabetes/article/574868/ 

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     Quiz Time


    A sign or symptom that might indicate a patient with spinal cord injury may be in neurogenic shock is 

    a. hyperthermia.

    b. hypothermia.

    c. heart rate of 70 beats/minute.

    d. heart rate of 100 beats/minute.
     
    Answer at end of newsletter


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     Elder Abuse Often Missed In ER

    FRIDAY, Nov. 25, 2016 (HealthDay News) -- About 10 percent of American seniors suffer elder abuse, yet the problem is often missed in hospital emergency departments, a new study finds.
    Researchers reviewed national data and found that emergency doctors make a formal diagnosis of such cases in only 1 of 7,700 visits by seniors.
    "These findings indicate that the vast majority of victims of elder abuse pass through the emergency department without the problem being identified," study senior author Dr. Timothy Platts-Mills, an assistant professor of emergency medicine at the University of North Carolina's School of Medicine, said in a school news release.
    "Emergency physicians strive to make sure that for each patient who comes through the door, all serious and life-threatening conditions are identified and addressed. For elder abuse, EDs across the country are falling short," he added. Platts-Mills is also co-director of the division of geriatric emergency medicine at the university.   ...
    https://medlineplus.gov/news/fullstory_162221.html
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     TUESDAY, Nov. 29, 2016 (HealthDay News) -- All smokers face a higher risk of heart attack, but the threat is particularly high among those under 50, a new study finds.

    Compared to former smokers and nonsmokers in their age group, heart attack risk was nearly 8.5 times higher for smokers younger than 50, British researchers found.
    One expert in smoking and health who reviewed the report said the findings underline the importance of keeping youth and cigarettes apart.
    "Through comprehensive tobacco-control programs that include environmental smoking bans, high taxes on cigarettes, and anti-tobacco media campaigns, we can decrease the rates of smoking/tobacco use, heart disease and many other health conditions," said Patricia Folan. She directs the Center for Tobacco Control at Northwell Health in Great Neck, N.Y.
    The study found that smokers at older ages faced higher heart risks, as well. Compared to former smokers and nonsmokers in their age group, smokers aged 50 to 65 were at five times higher risk of heart attack, and smokers over 65 had a three times higher risk, the findings showed. ...   
     https://consumer.healthday.com/cardiovascular-health-information-20/heart-attack-news-357/younger-smokers-at-greatest-risk-for-heart-attack-study-717234.html
      
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     Having Trouble Hearing? Maybe It's Not Your Ears 

    TUESDAY, Nov. 29, 2016 (HealthDay News) -- Seniors who struggle to make out what people are saying around the dinner table or on a noisy street may have perfectly "normal" hearing. The problem could actually be in the brain, a new study suggests.
    Trouble processing conversations in a loud setting may indicate that the brain's ability to quickly and easily process speech is diminished.
    The findings demonstrate that "separately from any typical hearing loss that might occur as we age, our brains also get worse at processing the sound of talking when there are other sounds at the same time," said study co-author Jonathan Simon. He's an associate professor at the University of Maryland's Institute for Systems Research.
    "The background noise may not even be considered especially loud by younger listeners," he noted.  
    https://medlineplus.gov/news/fullstory_162263.html
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     Insulin Prices Skyrocket, Putting Many Diabetics in a Bind

     TUESDAY, Nov. 29, 2016 (HealthDay News) -- Insulin, a life-saving medication used to treat diabetes, was discovered nearly 100 years ago, yet the price of the drug has now spiked by 700 percent in just two decades.
    In early November, Sen. Bernie Sanders, the Vermont Democrat, pointed out that certain insulins had risen from $21 a vial in 1996 to $255 a vial in 2016.
    Some have likened the insulin price boosts to the recent price hikes for EpiPen -- the life-saving medication needed when someone has a serious allergic reaction.  
    American Diabetes Association asks Congress to investigate the matter  ... 

    https://medlineplus.gov/news/fullstory_162261.html 
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     The doctor school dropout    ( Thank you Sandy Summers...)


    NCIS: Los Angeles investigates nursing stereotypes
    October 23, 2016 -- In tonight's episode, the popular CBS drama NCIS: Los Angeles engaged briefly with some nursing stereotypes, especially those that apply to men in nursing. In the episode, Special Agent Kensi Blye has been partly paralyzed in a helicopter crash and lies in a coma in the hospital. Her work and life partner is Detective Marty Deeks, whose mother is concerned enough about Kensi to monitor her in the hospital. When Mom calls Deeks from a hospital hallway, a male nurse politely tells Mom that under hospital policy, she's not allowed to use the cell phone there. Mom informs the nurse that she's on "official police business" and asks why he doesn't "go empty a bedpan or something." The nurse is taken aback, but promptly disappears from the scene. However, Deeks overhears on the phone and takes it upon himself to ask Mom not to say that, because it's "condescending." Mom claims that the nurse was "rude" and adds: "What man becomes a nurse, huh? A doctor school dropout, that's who." Deeks responds: "OK, that is sexist, and wrong on so many levels. Also, it's called medical school." The nurse scene actually seems like it may have been in part an effort by NCIS-LA to show some support for men in nursing, with Deeks pushing back against his mother's ignorant slurs. Unfortunately, the show really does nothing to disprove the assumptions underlying those slurs. Neither that nurse character nor any other gets a chance to demonstrate that he is not, in fact, a physician wannabe whose duties consist mainly of emptying bedpans.







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    Here is a listing of the products which are GMO foods- Corn and/or soy are the most common GMO foods, over 85% of America’s crops are GMO. One or both of these ingredients, in some form, are in almost all packaged goods, and even breads. Unless it says Organic or Non-GMO on the label, there is a high probability that it contains GMO’s if it is one of these foods, or if any of these ingredients are included: Alfalfa, Amino Acids, Ascorbic Acid, Aspartame (also Called Aminosweet, Nutrasweet, Equal Spoonful, Canderel, Benevia, E951 (U.K. & European Code), Baking Powder, Canola Oil (Rapeseed Oil), Caramel Color, Cellulose, Citric Acid, Cobalamin (Vitamin B12), Colorose, Condensed Milk, Confectioners Sugar, Corn, Corn Flour, Corn Gluten, Corn Masa, Cornmeal, Corn Starch, Corn Syrup, Cottonseed Oil, Cyclodextrin, Cystein, Dextrin, Dextrose, Diacetyl, Diglyceride, Erythritol, Equal, Food Starch, Flavorings (“natural” & “artificial”), Fructose (Any Form), Glucose, Glutamate, Glutamic Acid, Glycerides, Glycerin, Glycerol, Glycerol Monooleate, Glycine, Hemicellulose, High Fructose Corn Syrup (HFCS), Hydrogenated Starch, Hydrolyzed Vegetable Protein... For the best health tips on the internet, visit GreenSmoothieGirl.com! ----------------------------------------- ------------------------ ------------------------
     LOOK FOR: Certified Organic (will also be non-GMO), and/or Non-GMO Project labels ...Inositol, Inverse Syrup, Inversol, Invert Sugar, Isoflavones, Lactic Acid, Lecithin, Leucine, Lysine, Malitol, Malt, Malt Syrup, Malt Extract, Maltodextrins, Maltose, Mannitol, Methylcellulose, Milk Powder, Milo Starch, Modified Food Starch, Modified Starch, Molasses, Monosodium Glutamate (MSG), Nutrasweet, Oleic Acid, Phenylalanine, Phytic Acid, Protein Isolate, Shoyu, Sodium Ascorbate, Sodium Citrate, Sorbitol, Soy, Soy Flour, Soy Isoflavones, Soy Isolates, Soy Lecithin, Soy Milk, Soy Oil, Soy Protein, Soy Sauce, Squash (yellow & zucchini), Starch, Stearic Acid, Sucrose, Sugar (Unless Specified As Cane Sugar), Sugar from Sugar Beets, Tamari, Tempeh, Teriyaki Marinade, Textured Vegetable Protein (TVP), Threonine, Tocopherols (Vitamin E), Tofu, Trehalose, Triglyceride, Vegetable Fat & Margarines (made with Soy, Corn, Cottonseed, and/or Canola), Vegetable Oil, Vitamins (B12, C & E), Whey, Xanthan Gum, Yeast Products.  
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    RenovaCare Device Delivers Stem Cells to Grow New Human Skin
    Burn victims whose injuries require skin grafts face a long recovery even when the procedure is successful. Removing skin from one part of the body and transplanting it to injured area leaves the patient with two sites that need to heal. Grafted skin can restrict joint movement, as it is unable to grow with the patient. The procedure also leaves scarring and patients typically need physical therapy afterward.
    Medical technology startup RenovaCare is trying to overcome the drawbacks of skin grafts by harnessing the body’s own regenerative abilities. The RenovaCare procedure requires a tiny skin sample, about the size of a postage stamp, which is used to isolate the patient’s stem cells. Those cells are suspended in solution and gently sprayed on the wound. Within days, those cells will form new skin that looks and functions as the patient’s original skin, CEO Thomas Bold explained.. ... 
    http://www.mddionline.com/blog/devicetalk/renovacare-device-delivers-stem-cells-grow-new-human-skin-08-19-16
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     Vital role of school nursing
    1. Correspondence to:

    2. Fiona Smith, Royal College of Nursing, London W1G 0RN, UK; fiona.smith@rcn.org.uk
    Cuts in public health funding risk widening child health inequalities. A recent review by theHealth Service Journal highlights children and young people are bearing the brunt of the cuts in local authority budgets,1 with school nursing services as a result being significantly reduced in many parts of the country.
    School nursing is a universally accessible service that is non-stigmatising, with school nurses having a key role in promoting the health and well-being of children and young people. Essentially, the school nurse functions as health promoter and health educator, working in collaboration with families, teachers, youth workers and counsellors.2 ,3 The result of removing school nurses can have a serious impact on children and young people's health and 

    http://ebn.bmj.com/content/early/2016/11/29/eb-2016-102549?papetoc
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    Robotic Surgical Tools Tough to Keep Clean 

    Findings suggest better cleaning procedures, more monitoring of instruments would help


    TUESDAY, Nov. 1, 2016 (HealthDay News) -- Even with repeated cleanings, it's virtually impossible to remove all contamination from robotic surgical instruments, a new study suggests.
    "One of the top priorities for hospitals is to treat patients safely and with minimal risk of infection," said study author Yuhei Saito, an assistant professor at the University of Tokyo Hospital in Japan.
    "Our results show that surgical instruments could be placing patients at risk due to current cleaning procedures. One way to address this issue is to establish new standards for cleaning surgical instruments, including multi-part robotic tools," Saito said in a news release from the Society for Healthcare Epidemiology of America.
    Over the course of 21 months, the researchers assessed protein residue on 132 robotic and standard surgical instruments that were cleaned according to manufacturers' instructions.
    The cleanings were 99.1 percent effective for standard instruments and 97.6 percent effective for robotic instruments, the investigators found. ...


    https://medlineplus.gov/news/fullstory_161798.html
      
     
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    Every Day in the Womb Boosts Babies' Brain Development: Study

     MONDAY, Oct. 31, 2016 (HealthDay News) -- Carrying a baby as close to full term as possible is better for the baby's brain development, a new study suggests.
    "What this study shows us is that every day and every week of in utero development is critical," said study senior author Catherine Limperopoulos. She directs the Developing Brain Research Laboratory at Children's National Health System in Washington, D.C.
    "If at all possible, we need to keep fetuses in utero to protect them from the hazards that can occur in the extra uterine environment," she said in a hospital system news release.
    The researchers said that during the third trimester of pregnancy, the fetal brain grows exponentially. The brain increases fourfold in size during this time, the researchers added.  ...

    https://medlineplus.gov/news/fullstory_161778.html

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    More U.S. middle school students dying of suicide than car crashes

        The suicide rate among U.S. middle school students doubled from 2007 to 2014, surpassing for the first time the incidence of youngsters aged 10 to 14 who died in car crashes, a federal report released on Thursday said.

    The steady seven-year rise in middle school suicides, from an annual rate of 0.9 to 2.1 per 100,000, came as traffic deaths among the same age group declined to 1.9 per 100,000, according to the Centers for Disease Control and Prevention in Atlanta.

    The motor vehicle mortality rate reported for 2014, the latest year for which such data was available, marked a 60 percent decline from 1999, when the government began tracking such figures.

    In aggregate numbers, 425 young people 10 to 14 years of age took their own lives in 2014, compared with 384 who perished in automobile accidents that year, according to the CDC.  ...
    http://www.reuters.com/article/us-usa-suicide-teenagers-idUSKBN12Z08Q?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-11-04&utm_term=US%20Health%20Report

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    NIH News Releases:    Seven substances added to 14th Report on Carcinogens    

       Today’s release (November 3) of the U.S. Department of Health and Human Services 14th Report on Carcinogens includes seven newly reviewed substances, bringing the cumulative total to 248 listings.

    The chemical trichloroethylene (TCE), and the metallic element cobalt and cobalt compounds that release cobalt ions in vivo, are being added to the list, as well as five viruses that have been linked to cancer in humans. The five viruses include human immunodeficiency virus type 1, human T-cell lymphotropic virus type 1, Epstein-Barr virus, Kaposi sarcoma-associated herpesvirus, and Merkel cell polyomavirus.
    “Given that approximately 12 percent of human cancers worldwide may be attributed to viruses, and there are no vaccines currently available for these five viruses, prevention strategies to reduce the infections that can lead to cancer are even more critical,” said Linda Birnbaum, Ph.D., director of the National Institute of Environmental Health Sciences (NIEHS) and National Toxicology Program (NTP). “The listings in this report, particularly the viruses, bring attention to the important role that prevention can play in reducing the world’s cancer burden. There are also things people can do to reduce their exposure to cobalt and TCE.” (Check out the chart )   ...
    https://www.nih.gov/news-events/news-releases/seven-substances-added-14th-report-carcinogens

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    Deadly Superbug Linked To Four Deaths In The U.S.

     A deadly new drug-resistant fungus has been linked to the deaths of four hospital patients in the U.S., according to a report released Friday from the Centers for Disease Control and Prevention.
    The fungus, called Candida auris, preys on the sickest patients and can spread in hospitals. Although doctors have been concerned about the spread of antibiotic-resistant bugs for many years, this fungus is relatively new on the world scene. It was first identified in Japan in 2009 and has since spread around the globe, emerging in South America, the Middle East, Africa and Europe, according to the CDC.
    The CDC first identified the fungus as a potential threat in 2013, based on a possible case in the U.S., and has been on the lookout for the fungus since June. In its new report, the CDC said the fungus has been detected in a total of 13 patients since May 2013; the agency provided details on the first seven cases, which were reported in New York, Illinois, Maryland and New Jersey. ...

    http://khn.org/news/deadly-superbug-linked-to-four-deaths-in-the-u-s/

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    Palatin female sexual desire drug succeeds in trials; shares soar

    A drug meant to boost the libido of pre-menopausal women distressed by lack of sexual desire met the main goals of a pair of late stage clinical trials, according to initial results released on Tuesday by its developer, Palatin Technologies Inc (PTN.A), and its shares rose 66 percent.
    Palatin said the experimental drug, bremelanotide, demonstrated statistically significant improvement versus placebo on scales measuring levels of desire and distress in 24-week studies of more than 1,200 women diagnosed with hypoactive sexual desire disorder (HSDD).
    "The distress component of HSDD reflects the profound negative impact that this condition can have on women's' self-image, relationships and quality of life well outside the bedroom," Sheryl Kingsberg, one of the study's investigators, said in a statement.
    "In the Phase 3 trials we saw significant reduction in distress with use of bremelanotide," added Kingsberg, a professor of reproductive biology at Case Western Reserve University School of Medicine in Ohio. ...

    http://www.reuters.com/article/us-palatin-sex-idUSKBN12W4YO?feedType=nl&feedName=healthNews&utm_source=Sailthru&utm_medium=email&utm_campaign=US%20Health%20Report%202016-11-02&utm_term=US%20Health%20Report

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                                                                  ~~**~~**~~**~~**~~**~~
    HUMOR SECTION

    Husband and Wife Christmas Shopping

    A couple were in a busy shopping center just before Christmas. The wife suddenly noticed that her husband was missing and as they had a lot to do, so she called him on the mobile.
    The wife said " Where are you, you know we have lots to do."
    He said "You remember the jewelers we went into about 10 years ago, and you fell in love with that diamond necklace? I could not afford it at the time and I said that one day I would get it for you?"
    Little tears started to flow down her cheek and she got all
    choked up…
    "Yes, I do remember that shop." she replied.
    "Well I am in the gun shop next door to that."



       











    ~**~**~~**~~**~~**~~**~~

    CEU SITES---(CME and CNE)

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


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




     

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

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

                                                                          Decubqueen's websitewww.accuruler.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




    Metric conversion calculators and tables for metric conversions



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    *
    MEDICAL RECALLS
    *
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     FDA MedWatch - Sterile Drug Products by Cantrell Drug Company: Recall - Lack of Sterility Assurance  
    ISSUE: Cantrell Drug Company is voluntarily recalling certain unexpired sterile drug products due to lack of sterility assurance. Administration of a drug product intended to be sterile that is not sterile could result in serious infections that may be life-threatening. 
    Read the MedWatch safety alert, including a link to the press release, at:

    ***********************
     FindrWIRZ Guidewire System by SentreHeart: Class I Recall - Coating Separation

     SentreHeart is recalling the FindrWIRZ Guidewire System because the PTFE coating may separate (e.g., peel, flake, shed, delaminate, slough off) from the packaging and potentially cause serious injuries to patients. Coating separation may be caused by issues with the device design or manufacturing processes. Lot Numbers 01160568, 02160586, 07160639 -150, distributed between June 1, 2016 - September 26, 2016 and manufactured between January 4, 2016 - July 22, 2016 are affected.
    Small pieces of the coating could break away and travel elsewhere in the body, or the exposed wire beneath the coating could cause dangerous blood clots in the patient’s bloodstream and can lead to serious adverse health consequences including embolism, stroke, or death.
    BACKGROUND: The FindrWIRZ Guidewire System is intended for use during minimally invasive procedures in the cerebrovascular, cardiovascular and peripheral vascular systems. The system helps the positioning of over-the-wire catheters through the insertion of a thin flexible tube into arteries of the leg or wrist. This device has a hydrophilic lubricious coating, polytetrafluoroethylene (PTFE), to reduce friction between the device and blood vessels. Read the MedWatch safe3ty alert, including a link to the recall notice, at:

    ************************
     ISSUE: Essure labeling now includes the addition of a boxed warning and a Patient Decision Checklist, both intended to support patient counseling and understanding of benefits and risks associated with Essure, as well as what to expect during and after the Essure procedure. The boxed warning includes safety statements to clearly communicate significant side effects or adverse outcomes associated with this device and information about the potential need for removal. 
    The Patient Decision Checklist provides key information about the device, its use, and safety and effectiveness outcomes, of which the patient should be aware and discuss with her doctor as she considers her sterilization options. Bayer also incorporates important modifications to the patient counseling and device removal sections of the labeling to provide physicians with additional guidance in these critical areas.
    BACKGROUND: Bayer revised the physician instructions for use and patient labeling consistent with FDA’s recently finalized guidance: Labeling for Permanent Hysteroscopically-Placed Tubal Implants Intended for Sterilization.  
    RECOMMENDATION: The FDA recommends that health care providers thoroughly discuss available sterilization and birth control methods with their patients, including their benefits and risks. The Decision Checklist included in the Final Guidance can help to facilitate these discussions and ensure patients understand the benefits and risks. 
    Patients are encouraged to discuss all available sterilization and birth control options with their health care providers before making treatment decisions. The addition of the Patient Decision Checklist can be used to facilitate these important discussions.
    Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
    • Complete and submit the report Online: www.fda.gov/MedWatch/report
    • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
    For more information, please visit:

    **************

    Convenience Kits Containing Multi-Med Single Lumen Catheters by Centurion: Class I Recall - Excess Material May Split or Separate

     Centurion is recalling the Centurion Convenience Kits containing Multi-Med Single Lumen Catheters. The catheters have a potential for excess material to remain at the tip of the catheter from the manufacturing process. If this occurs, the excess material may separate from the catheter during use and could enter the patient’s bloodstream. This can result in serious adverse health consequences such as the development of blood clots, embolism of the excess material to vital organs, or death.
    See the Recall Notice for a listing of affected lot numbers.
    Distribution Dates: May 23, 2016 to October 18, 2016
    Devices Recalled in the U.S.: 1,000 kits
       

     http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm532629.htm
                                                                                     

                                                               ~~**~~** ~~**~~**~~**~~
    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.

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

    No new members with this issue. 


    ~~**~~**~~**~~**~~**~~
    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 addressSo, be certain to let me know when you change your address. RNFrankie@AOL.com

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

    ~~**~~**~~**~~**~~**~~
    PARADIGM 97 CO-FOUNDERS:
    MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie)

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



    Let us not seek to fix the blame for the past -- let us accept our own responsibility for the future.

    John F. Kennedy,
    35th US president



    Hope to hear from you..... Frankie

    Correct answer: b. Neurogenic shock results in hypothermia, vasodilation, and profound bradycardia. 

    To learn more, read the continuing nursing ed
    ucation article: 


    Answer to Question about the clouds' weight:

    They may look all light and fluffy, but the reality is that clouds are actually pretty heavy. Researchers have calculated that the average cumulus cloud - which is that nice, white fluffy kind you see on a sunny day - weighs an incredible 1.1 million pounds! This means that at any given moment, there are millions of pounds of water floating above your head. That’s the equivalent of 100 elephants. So, how does that much weight stay afloat? For one thing, the weight is spread out into millions of droplets over a really big space. Some of the droplets are so small that you would need a million of them to make a single raindrop.

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