PARADIGM BYTES
Newsletter for Paradigm 97
July 10, 2008
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/
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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Please drop in . the Paradigm97 chatroom is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....and invite your friends in for a little chat. Let me know if you want others involved.
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SNIPPETS
Part Three of Four--- Nursing comes of age In the early 1990s, nursing research was ready to come into its own, led by Ada Sue Hinshaw, RN, PhD, FAAN, the first permanent director of the National Center of Nursing Research. In 1993, the center was elevated into the National Institute of Nursing Research (NINR) at the National Institutes of Health, a huge coup for the nursing profession.“Nursing research advanced rapidly because of its legitimacy and credibility, stable funding, and the sense that nursing is a science that the NIH [designation] gave it,” says Hinshaw, who is the recently appointed dean of the Uniformed Services University of the Health Sciences Graduate School of Nursing in Bethesda, Md.Today, the NINR collaborates with other NIH institutes and centers in investigations to improve the nation’s health. In this endeavor, nurses have an important contribution to make because they bring both clinical and research expertise to the research table, Hinshaw says.“The whole discovery process is exciting because there is an outcome and a contribution to make at the end,” says Hinshaw. NINR-funded scientists are currently impacting nursing practice and promoting good health through studying how to prevent and control high blood pressure in young African-American men, helping youth to control their diabetes, and assisting Spanish speakers in self-management of chronic diseases. They also are involved in researching symptom management, including improving quality of life after organ transplantation, determining the role of gender in easing pain, supporting family caregivers, and reducing end-of-life symptoms and stresses. She advises nurses who have an idea or topic they would like to investigate, but who do not have research experience or a doctoral education, to contact local schools of nursing and ask to partner with a nurse researcher.“It’s through staff nurses who work with nurse researchers that we gain strong research programs because they know the issues at the bedside and ask the questions that are important to patients and families,” she says.
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.
~~**~~**~~**~~**~~**~~
Please drop in . the Paradigm97 chatroom is always there....door open, lights on, waiting for you to come in. Check your Buddy List.....and invite your friends in for a little chat. Let me know if you want others involved.
***~~~***~~~***~~~***
SNIPPETS
Part Three of Four--- Nursing comes of age In the early 1990s, nursing research was ready to come into its own, led by Ada Sue Hinshaw, RN, PhD, FAAN, the first permanent director of the National Center of Nursing Research. In 1993, the center was elevated into the National Institute of Nursing Research (NINR) at the National Institutes of Health, a huge coup for the nursing profession.“Nursing research advanced rapidly because of its legitimacy and credibility, stable funding, and the sense that nursing is a science that the NIH [designation] gave it,” says Hinshaw, who is the recently appointed dean of the Uniformed Services University of the Health Sciences Graduate School of Nursing in Bethesda, Md.Today, the NINR collaborates with other NIH institutes and centers in investigations to improve the nation’s health. In this endeavor, nurses have an important contribution to make because they bring both clinical and research expertise to the research table, Hinshaw says.“The whole discovery process is exciting because there is an outcome and a contribution to make at the end,” says Hinshaw. NINR-funded scientists are currently impacting nursing practice and promoting good health through studying how to prevent and control high blood pressure in young African-American men, helping youth to control their diabetes, and assisting Spanish speakers in self-management of chronic diseases. They also are involved in researching symptom management, including improving quality of life after organ transplantation, determining the role of gender in easing pain, supporting family caregivers, and reducing end-of-life symptoms and stresses. She advises nurses who have an idea or topic they would like to investigate, but who do not have research experience or a doctoral education, to contact local schools of nursing and ask to partner with a nurse researcher.“It’s through staff nurses who work with nurse researchers that we gain strong research programs because they know the issues at the bedside and ask the questions that are important to patients and families,” she says.
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Part Four of Four Driving Genetics Studies Forward Under the leadership of the current NINR director, Patricia A. Grady, RN, PhD, FAAN, the NINR has more than doubled the institute’s budget and significantly increased the number of nursing research and training grants awarded. Grady has supported several major NINR initiatives, including pain management, end-of-life care, self-management of chronic illness, and caregiving or bedside research.Grady, an internationally recognized researcher on stroke prevention, also has supported the development of research and training opportunities, including the NINR Summer Genetics Institute (SGI). This hands-on program helps foster interest in genetics and related research for nursing faculty, graduate students, and advanced practice nurses and helps get nurses in on the ground floor of genetics research, which will become the foundation for personalized medicine in the future, Grady says.“Genetics is a new, exploding field that’s important in identifying genetic predispositions for conditions,” she says. “Nursing is at the cross-roads of becoming the most important force in driving this forward. We are getting in there early, and the students that finish this course are putting the information to work and are having a high success rate at getting research funding.”Grady also is dedicated to the goal of making the research process understandable and within the reach of nurses of all educational levels and backgrounds. “Then it becomes less mysterious and more attainable and becomes more a part of you and your practice,” she says.
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This is an excellent paper from BAcello@AOL.com (Barbara) I just had to include it here.
Part Four of Four Driving Genetics Studies Forward Under the leadership of the current NINR director, Patricia A. Grady, RN, PhD, FAAN, the NINR has more than doubled the institute’s budget and significantly increased the number of nursing research and training grants awarded. Grady has supported several major NINR initiatives, including pain management, end-of-life care, self-management of chronic illness, and caregiving or bedside research.Grady, an internationally recognized researcher on stroke prevention, also has supported the development of research and training opportunities, including the NINR Summer Genetics Institute (SGI). This hands-on program helps foster interest in genetics and related research for nursing faculty, graduate students, and advanced practice nurses and helps get nurses in on the ground floor of genetics research, which will become the foundation for personalized medicine in the future, Grady says.“Genetics is a new, exploding field that’s important in identifying genetic predispositions for conditions,” she says. “Nursing is at the cross-roads of becoming the most important force in driving this forward. We are getting in there early, and the students that finish this course are putting the information to work and are having a high success rate at getting research funding.”Grady also is dedicated to the goal of making the research process understandable and within the reach of nurses of all educational levels and backgrounds. “Then it becomes less mysterious and more attainable and becomes more a part of you and your practice,” she says.
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This is an excellent paper from BAcello@AOL.com (Barbara) I just had to include it here.
Challenging nursing's sacred cows Carol A. Rauen, MS, CCNS, PCCN; Kathleen Vollman, MS, MSN, CCNS; Richard B. Arbour, MSN, CCRN, CNRN; and Marianne Chulay, PhD, RN, FAAN
Until recently, healthcare practitioners have answered questions about clinical practices with their best guesses, intuition, and tradition. But evidence-based practice (EBP) compels us to use solid scientific evidence instead, and to base nursing protocols on this evidence. As defined by the Institute of Medicine, EBP is the integration of the best research, clinical expertise, and patient values when making decisions about patient care. This article discusses three commonly performed acute-care nursing practices that are not based on evidence:
Until recently, healthcare practitioners have answered questions about clinical practices with their best guesses, intuition, and tradition. But evidence-based practice (EBP) compels us to use solid scientific evidence instead, and to base nursing protocols on this evidence. As defined by the Institute of Medicine, EBP is the integration of the best research, clinical expertise, and patient values when making decisions about patient care. This article discusses three commonly performed acute-care nursing practices that are not based on evidence:
• instilling normal saline solution (NSS) into the patient’s endotracheal tube before suctioning
• turning critically ill patients manually every 2 hours
• relying on the Glasgow Coma Scale (GCS) alone for routine neurologic assessment.
When these practices were introduced, no research supported them. Yet many practitioners keep performing them, despite recent research that suggests they should be changed. This article examines these three practices critically.Instilling NSS before ET suctioning: Helpful or harmful? For years, nurses and respiratory therapists have been taught to instill 5 ml of sterile NSS into a patient’s endotracheal (ET) tube before suctioning. According to the traditional theory, this practice decreases mucosal viscosity, eases secretion removal, and improves oxygenation. Although at one time the theory seemed to make sense, research from the past 20 years shows it’s incorrect. Here’s what current research (primarily involving adults) tells us:
• Instilling NSS before suctioning decreases oxygen saturation and forced expiratory volume (a sign of bronchospasm).
• This practice may increase the risk of hospital-acquired pneumonia (HAP), as bacteria from the nurse’s thumb may contaminate the rim of the NSS vial when the vial top is popped off. (even with gloves ?) • Successful humidification requires small particle size in the form of ultrasonic nebulization, not bolus administration.• No studies show that NSS instillation yields benefits. On the contrary, studies prove that this practice can lower oxygenation levels and increase the risk of HAP. Consequently, the current EBP recommendation is not to instill NSS during routine ET suctioning.
Mobility matters: Are we moving critically ill patients enough? For years, nurses have recognized that proper patient positioning helps prevent skin breakdown, mobilizes secretions, and provides comfort. But many nurses fail to consider the impact of various positioning strategies on pulmonary gas exchange, ventilator weaning outcomes, and prevention of muscle deconditioning in intensive care unit (ICU) patients. A busy healthcare environment can pose a challenge to frequent repositioning—especially with critically ill patients. One prospective longitudinal observational study of a critical care unit found that over an 8-hour period, only 2.7% of observed patients experienced position changes every 2 hours, and more than half were supine for 4 to 8 hours. The solution is to improve nurses’ awareness of the importance of proper positioning on both short- and long-term patient outcomes. If we don’t pay enough attention to this care activity, it’s likely to be neglected. Evidence shows that for many critically ill patients, turning every 2 hours isn’t frequent enough to preserve the lung’s oxygenating ability or prevent HAP. When a patient is at risk for HAP or ventilator-acquired pneumonia (VAP), continuous lateral rotation therapy (CLRT) should be used. Research on the positioning of critically ill patients tells us that:
• for patients with consolidated pneumonia in one lung, positioning with the “good” lung down improves oxygenation. The goal is to match alveoli with perfused capillaries. Despite mechanical restriction in the downward position, the healthy lung has enough functioning alveoli to match gravity-dependent perfusion and thus promote effective gas exchange.
• mobilizing intubated patients progressively from a dangling position to standing and then to walking is safe.
• breathing and oxygenation improve at higher elevations of the head of the bed, as long as the elevation is hemodynamically tolerable.
• during ventilator weaning, patients with large abdomens seem to breathe more easily and have larger spontaneous tidal volumes when the head of the bed is elevated 45 degrees and the bed is in reverse Trendelenburg position.
• prone positioning improves oxygenation, but has not been shown to affect mortality risk. Consider prone positioning if conventional strategies for lung recruitment have failed.
• in ICU survivors, the deconditioning that occurs during hospitalization can lead to functional physical limitation that proves to be a major complication 1 year later. Barriers to mobility Hemodynamic instability is the main reason why critically ill patients stay in the supine position for extended periods. When you consider the factors that affect tolerance of position changes, you realize these patients are clearly at risk for such negative effects as hypotension. After a change in the body’s gravitational plane, the cardiovascular system normally tries to adjust in two ways: • The shift in plasma volume may send messages to the autonomic nervous system telling it to change vascular tone.• An inner ear or vestibular response affects the cardiovascular system. Critically ill patients commonly have poor vascular tone, a dysfunctional autonomic feedback loop, or low cardiovascular reserve. Also, they’ve established equilibrium in a single position over time. For those who become hemodynamically unstable after manual turning, the solution is to gradually retrain them, using CLRT, to tolerate a position change. Clearly, we don’t have all the answers on when and how often these patients should be turned, but we do know that ensuring patient mobility makes a difference. The evidence shows that making mobility a core component of care reduces patients’ feelings of powerlessness, promotes secretion management, helps prevent muscle wasting, improves gas exchange, and decreases the incidence of atelectasis and VAP.
Glasgow Coma Scale: Is it enough for a comprehensive neurologic assessment? For decades, we’ve known that neurologic assessment is the best way to detect onset or progression of brain injury. Assessment findings reflect pathophysiology and response to both progression of injury and therapeutic interventions. Optimally, earlier identification of responses to or progression of injury and to therapeutic interventions should guide the direction of care. The GCS was introduced in 1974 as a way to standardize patient evaluation and improve communication among healthcare workers about a patient’s neurologic status. Over the last few decades, the GCS has been used extensively and has been incorporated into many critical care flowsheets, emergency medicine documentation forms, and other clinical grouping systems. It’s widely used to predict neurologic and clinical outcomes. The GCS assigns a separate numerical value to a patient’s response in three spheres—motor response, verbal response, and eye opening. Such responses reflect how movement is stimulated in the extremities, the patient’s ability to interact, and the brain’s arousal mechanisms. Each response is scored individually; then the three scores are totaled. The lowest total score is 3; the highest is 15, which indicates the patient is alert; oriented to person, place, and time; and able to follow simple commands.Where the GCS falls short Although the GCS has distinct benefits, scoring hinges on the patient’s ability to respond to stimulation and interact with the clinician. The GCS doesn’t assess brainstem reflexes, and has limited value for patients with deep sedation, neuromuscular blockade, intubation and controlled ventilation, and some psychiatric or metabolic disorders. A patient receiving deep sedation and analgesia has a drug-induced depression of consciousness. In this case, relying solely on the GCS may lead to an incomplete neurologic evaluation. When given in appropriate doses, neuromuscular blocking agents produce a state of skeletal muscle relaxation in which the patient could be awake and responsive, yet appear to be otherwise because the drug prevents a response to stimulation. Depending on the GCS in this case is inadequate. Also, the GCS doesn’t uniformly assess verbal response in intubated patients. Tracheal intubation and controlled ventilation interfere with verbal response to the GCS, as the artificial airway impedes speech. Thus, a fully awake and interactive patient may have a misleadingly low verbal response score. To address this, clinicians should focus on arousal, consciousness, and patient interaction; if the patient is interactive and communicative, document this fact accordingly. Such disorders as delirium, catatonia, and psychogenic coma also can interfere with valid GCS determination. Delirium is a cognitive disorder; catatonia and psychogenic coma can occur in certain psychiatric disorders. The GCS may not even detect these states. To compensate for these shortcomings, other neurologic assessment tools have been developed. For instance, the FOUR (Full Outline of UnResponsiveness) Score scale evaluates eye response, motor response, brainstem reflexes, and respiration. Easy to use, it provides information the GCS doesn’t, yielding a more comprehensive picture of a patient’s degree of responsiveness. In particular, it recognizes such disorders as locked-in syndrome (in which the patient is aware but unable to respond except by tracking or blinking). It also can help predict in-hospital mortality. For optimal neurologic evaluation, the best EBP recommendation is to use the GCS with greater accuracy and consistency—while using additional neurologic assessment tools that yield information that the GCS alone can’t. More evidence means better outcomes, All nurses want to provide the best possible patient care. To do this, we must change our practices when the research shows that such a change would better serve patients. Nursing practice is always evolving. We must constantly ask ourselves whether we’re providing the best care possible given the current available evidence. If the answer is no, we must work to change that practice and implement protocols and standards that will bring greater patient benefit.
Selected references NSS instillation Ackerman M, Mick D. Instillation of normal saline before suctioning in patients with pulmonary infections: a prospective randomized controlled trial. Am J Crit Care. 1998;7:261-266.Raymond S. Normal saline instillation before suctioning: helpful or harmful? A review of the literature. Am J Crit Care. 1995;2:467-473.Patient positioning Bailey P, Thomsen GE, Spuhler V, et al. Early activity is feasible and safe in respiratory failure patients. Crit Care Med. 2007;35:139-145. Vollman K. Ventilator-associated pneumonia and pressure ulcer prevention as targets for quality improvement in the ICU. Crit Care Nurs Clin North Am. 2006;18:453-467. Glasgow Coma Scale Arbour R. Intracranial hypertension: monitoring and nursing assessment. Crit Care Nurse. 2004;24(5):19-34. Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. 1974;2:81-84.Visit www.AmericanNurseToday.com/journal for a complete list of selected references. Carol A. Rauen is an Independent Clinical Nurse Specialist and Education Consultant and a staff nurse at the Washington Hospital Center in Washington, D.C. Kathleen Vollman is a Clinical Nurse Specialist, educator, and consultant with Advancing Nursing, LLC in Northville, Mich. Richard B. Arbour is a Clinical Nurse Specialist at Albert Einstein Medical Center in Philadelphia, Pa. Marianne Chulay is a consultant in clinical research and critical care, as well as coeditor of AACN Advanced Critical Care, based in Gainesville, Fla.
http://www.americannursetoday.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=54BA87F51E9D4D0FB4F353789D99BB1C
http://www.americannursetoday.com/ME2/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=54BA87F51E9D4D0FB4F353789D99BB1C
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FROM THE MEMBERS
JANNARN@AOL.com Janna has written the following:" As a school nurse now, I'd like to network with ER and other school nurses to compare notes and stay current". Please write her/ network with her especially anyone who is a school/ER nurse.......or if you think you can help her. That is what we are all here for ......support of one another !!! Thank you .
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Another communication from a member.....Please contact her/ the website
She writes: " Dear Frankie: This is one of our family of nurses with her son ..... Can you pass this web site so that maybe nurses around the area can help them get her child some help. I know you have a big address book of nurses. This is a friend of mine and the little boy is the most precious boy you could meet. www.helpbrendan.com Thanks, Annie Gadsdengirlie14@AOL.com
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In reference to the article in last month's newsletter, MarGerlach (Marlene) asks: "What would happen to health care workers, doctors, nurses, lab people, etc...if they were found to be MRSA carriers? Would they lose their jobs, not be allowed to practice any more?"
You will remember the quote: One in Every 20 Healthcare Workers is a MRSA Carrier GENEVA, April 15 -- One in every 20 healthcare workers carries methicillin-resistant Staphylococcus aureus (MRSA), researchers here said. But the vast majority is without symptoms and only 5.1% have full-blown clinical infections, ... Are there any responses to her question???
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This is sent in by Veracidad@AOL.com Why do we not have enough nurses in FL ?!!
If everybody knows that this job is stressful per sé...If we are working short all the time...If the corporations are not paying enough......If we can be fired for any reason (Policy is observed or not depending also of your relationship with the "Bosses")...if we don't have administrative incentives since administrations change almost yearly and they usually prefer bringing somebody from outside known by them than promote the older employees...If the state during a survey follows a nurse and in order to have a good evaluation. it takes 20 min to give meds. through a GT to one patient, and another 20 min to take care of a patient with a trach., and 15 min to give Bp meds. and insulin to a third one (doing every thing "by the book"), and they already know that the nurse has an assignment of 26-30 patients (so is impossible to finish med pass, if we follow state regulations, in 2 hours) but in their survey conclusions all that is not even mentioned...if we work 9-10 hours taking no break...If we have to take care of Labs., Pharmx, Doctor's orders, family members, dining room, even the door; with little or no help ...If in the Nursing Homes & Rehab Centers, the acute level of care is higher every day...if the level of knowledge of the DONs is lower every day because in order to get out of the floor they accept less money that the fine prepared nurses......How in the world do we not have enough nurses in FL?? !!!
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INTERESTING READING
Please remember that the REUTERS articles are usually good for only 30 days
TODAY'S RANDOM FACTS ...
Despite its hump... camels have a straight spine. and they also have three eyelids.
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FROM THE MEMBERS
JANNARN@AOL.com Janna has written the following:" As a school nurse now, I'd like to network with ER and other school nurses to compare notes and stay current". Please write her/ network with her especially anyone who is a school/ER nurse.......or if you think you can help her. That is what we are all here for ......support of one another !!! Thank you .
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Another communication from a member.....Please contact her/ the website
She writes: " Dear Frankie: This is one of our family of nurses with her son ..... Can you pass this web site so that maybe nurses around the area can help them get her child some help. I know you have a big address book of nurses. This is a friend of mine and the little boy is the most precious boy you could meet. www.helpbrendan.com Thanks, Annie Gadsdengirlie14@AOL.com
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In reference to the article in last month's newsletter, MarGerlach (Marlene) asks: "What would happen to health care workers, doctors, nurses, lab people, etc...if they were found to be MRSA carriers? Would they lose their jobs, not be allowed to practice any more?"
You will remember the quote: One in Every 20 Healthcare Workers is a MRSA Carrier GENEVA, April 15 -- One in every 20 healthcare workers carries methicillin-resistant Staphylococcus aureus (MRSA), researchers here said. But the vast majority is without symptoms and only 5.1% have full-blown clinical infections, ... Are there any responses to her question???
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This is sent in by Veracidad@AOL.com Why do we not have enough nurses in FL ?!!
If everybody knows that this job is stressful per sé...If we are working short all the time...If the corporations are not paying enough...
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INTERESTING READING
Please remember that the REUTERS articles are usually good for only 30 days
TODAY'S RANDOM FACTS ...
Despite its hump... camels have a straight spine. and they also have three eyelids.
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Sent in by FNPMSN....Cindy Thanks Nurse Practitioner for Renowned Orthopedic Clinic on Florida's West Coast Orthopedic clinic is looking for NP with one or more years experience to work in their clinic. This clinic is renowned for its advanced outpatient spine surgeries and has patients come from all over the country for their expertise and successful procedures. This area has world famous beaches and great weather year round. You will feel like you are on vacation all year round. You will prepare patients for exams; document updates and write prescriptions. All procedures are done in the clinic which includes lumbar thoracic spines and neurology. Mon. to Fri. days - No nights or weekends. Competitive salary with great benefits and reloction assistance. For more information please call Martie Cunningham at 866-782-9029 x 5873. or email resume to martie.cunningham@comphealth.com
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Automated drug-dispensing improves care at nursing homes Dallas Morning News - Dallas,TX,USA "We hope the result will be a revolution in how nursing homes dispense drugs." OnSiteRx caught the attention of hundreds of nursing home administrators at ... http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-drugs_08bus.ART0.State.Edition1.4620e4c.html
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ATLANTA, Georgia --Quote: " Imagine my surprise when, in the course of doing research for this story, I stumbled upon my own personal health information online. There it was in black, white, and hypertext blue. My annual mammograms; the visits to the podiatrist for the splinter in my foot; the kind of birth control I use -- it was all on my health insurance company's Web site. And that's not all: The prescriptions drugs I use were listed on the Web site where I get my prescription drug insurance. I had no idea this was all on the World Wide Web. Welcome to the 21st century", says Dr. Steven Schwaitzberg, associate professor of surgery at Harvard Medical School and a medical informatics expert. "There's more information out there about people than could ever possibly be realized," he says.... http://www.cnn.com/2008/HEALTH/06/05/ep.online.records/index.html
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Check this out....really good suggestions. Rozalfaro@AOL.com (Roz) sent in the following: She wrote: "This person is my nursing school classmate--- and fellow basketball team member in 1969 --- Dr Marie Savard (they never say she was a nurse before (becoming) a doc). She's the new medical correspondent and did a great job on this topic today".
Conventional wisdom assumed losing your mental edge was just part of aging, but that may be incorrect. Scientists believe working out your brain -- just like you would your body to keep in shape -- could ward off the dulling of mental faculties and strengthen connections between newly-generated brain cells, which people make throughout life.
Use it or lose it. Neurobics may help maintain your mental reserves and ensure you'll keep your mental edge clear into your elderly years. It's like cross training, and researchers have found it's never too late to start, even in people who have some degree of dementia.
"Good Morning America" medical contributor Dr. Marie Savard breaks down the things you can do to keep your mind in tip-top shape, and what bad habits may harm you.... http://abcnews.go.com/GMA/OnCall/story?id=5023860&page=1
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NEW YORK (Reuters 6/09) - Microsoft Corp and Kaiser Permanente, the biggest U.S. health maintenance organization (HMO), are working on a patient information exchange pilot program to help give patients more control over their health records, The Wall Street Journal said on Monday.
Similar efforts are underway at companies such as Revolution Health Group LLC and Google Inc, which launched its online healthcare service, Google Health, in February.
Data kept in Kaiser's personal health records, which includes patients' test results, prescriptions and immunizations, will be shifted to Microsoft's HealthVault, a Web-based service that allows patients to store and manage medical data from a variety of websites and selectively share information with them, the paper reported.... http://www.reuters.com/article/healthNews/idUSN0939925320080609?feedType=nl&feedName=ushealth1100
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Low vitamin D common with rheumatic diseases... PARIS (Reuters 6/12) - Nearly three quarters of patients seen at a rheumatology clinic, which focuses on diseases affecting the joints, muscles, bones, and tendons, have a vitamin D deficiency, researchers based in Ireland found.
Dr. Muhammad Haroon and associates at South Infirmary-Victoria University Hospital, Cork, assessed the occurrence of vitamin D deficiency in all new patients seen at their rheumatology clinic between January and June 2007. The research team's findings were reported at the European Union League Against Rheumatism 2008 meeting here in Paris.
Of 264 patients seen during this time period, 231 agreed to have their levels of vitamin D measured and other related tests performed. Overall, 162 patients (70 percent) had low vitamin D levels and 26 percent had a severe deficiency. Little difference was seen in the percentage of younger and older patients who were deficient....
http://news.yahoo.com/s/nm/20080612/hl_nm/low_vitamin_d_dc;
_ylt=AjbRql72CiHBZ9Kp5RgPQ6LVJRIF
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Scientist say garlic can beat "superbug" MRSA The killer superbug MRSA can be beaten with garlic, scientists have claimed.
Trials showed that allicin, a natural compound which gives garlic its distinctive smell, can cure patients suffering from the antibiotic-resistant infection.
In a trial, all 52 patients who took allicin capsules or sprayed a liquid on to their wounds recovered fully within four to 12 weeks. Leader Dr Ron Cutler, of the University of East London, said: "This is a breakthrough in the fight against MRSA."
The infection officially kills almost 2,000 hospital patients a year, although experts believe the true toll is closer to 5,000.... http://www.mirror.co.uk/news/topstories/2008/06/10/scientists-say-garlic-can-beat-superbug-mrsa-89520-20601849/
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Overactive bladder affects many aspects of life NEW YORK (Reuters 6/12) - An overactive bladder has a considerable effect on the quality of life, work productivity, sexuality and the emotional well-being of men and women, U.S. and European researchers report in the journal BJU International.
Dr. Karin S. Coyne of United BioSource Corporation, Bethesda, Maryland and colleagues conducted a secondary analysis of data from a telephone survey involving participants from five countries.
The researchers matched 1,434 subjects who had an overactive bladder, with or without other lower urinary tract symptoms, to another 1,434 participants without overactive bladder or stress urinary incontinence who acted as a comparison group, or the "controls. "
The overactive bladder patients subjects reported significantly greater rates of chronic constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. There were also significant differences between the patients and controls in all reported lower urinary tract symptoms.... http://www.reuters.com/article/healthNews/idUSTON27713720080612
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The next three articles were submitted by MJSolon@AOL.com (Melva) Thanks
Antibiotics Reduce Risk for Postpartum Perineal Wound Complications June 11, 2008 — Women who received antibiotic prophylaxis vs placebo had reduced rates of perineal wound complications by 2 weeks postpartum, according to the results of a prospective, randomized controlled trial reported in the June issue of Obstetrics & Gynecology.
"The anal sphincter is susceptible to trauma during a vaginal delivery," write Neena Duggal, MD, from Santa Clara Valley Medical Center in San Jose, California, and colleagues. "The use of operative vaginal delivery, especially in combination with midline episiotomy, has been associated with a significantly increased risk of anal sphincter trauma in both nulliparous and multiparous women."
The goal of this study was to determine whether prophylactic antibiotics at the time of repair of third-degree or fourth-degree perineal tears after vaginal delivery would reduce the risk for wound infection and breakdown.... http://www.medscape.com/viewarticle/575875
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Hospitals peer into patients' credit reports Financially squeezed by shrinking reimbursements and expanding uninsured patient rolls, some Atlanta hospitals are using tools to peek into patient credit reports to gauge their ability, and willingness, to pay medical bills.
Hospitals say the information helps quickly identify broke patients who qualify for charity, or free, care. Figuring out who they are early saves the hospital millions of dollars in collection costs -- processing billing statements and making follow-up calls, hospitals say. Armed with the additional information, hospitals also have better leverage in negotiating payment plans with those patients who do have the ability to pay.
But critics say access to patient financial information can lead to abuse. Hospitals might deny non-emergency care to patients with a poor credit history. Overzealous billing personnel might nudge patients to tap into available lines-of-credit to pay for care... http://www.msnbc.msn.com/id/25087914/
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WEDNESDAY, June 11 (HealthDay News) -- Children with bigger necks are more likely to develop a sleep-related breathing disorder, says a University of Virginia study.
Researchers looked at 215 children, aged 18 months to 18 years, who were referred to a pediatric sleep center. Of these children, 37.3 percent were obese and had an increased frequency of snoring.
The children's neck size, in the sitting and neutral head position, was measured and apena-hypopnea index (AHI) and mean oxygen saturation values were used as indicators of the severity of the sleep-related breathing disorder.
Age-adjusted neck size correlated with body-mass index (BMI) and weight and showed a higher correlation with AHI than did BMI, weight or tonsil size. Neck size also showed a strong inverse correlation with mean oxygen saturation and was a better predictor of mean oxygen saturation than BMI, weight or tonsil size, the study found.
http://news.yahoo.com/s/hsn/20080612/hl_hsn/childrensnecksizeassociatedwithsleepdisorders;_
ylt=ApBTU11h15iRTbObJbaTVjHVJRIF
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Promising drug fights Alzheimer's in three ways WASHINGTON (Reuters 6/11) - A type of drug that may offer promise in treating Alzheimer's disease works in three ways to fight the formation of "plaques" in the brain that are a hallmark of the ailment, scientists said on Wednesday.
The researchers looked at a kind of drug called a gamma-secretase modulator, or GSM, now being tested to see if it slows Alzheimer's disease progression. One GSM drug now being tested in people with Alzheimer's is Myriad Genetics's Flurizan, also called tarenflurbil. A series of lab experiments showed these drugs inhibit production of long pieces of amyloid beta protein in the brain, block them from forming clumps, and boost production of shorter pieces that can make the longer ones less likely to stick together, the researchers said.... http://www.reuters.com/article/healthNews/idUSN1146894920080611?feedType=nl&feedName=ushealth1100
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Diet, exercise can delay diabetes for years: study LONDON (Reuters 5/22) - Drinking less alcohol, eating more vegetables and exercising can prevent or delay the onset of diabetes, researchers said on Friday in a study showing that lifestyle changes can make a big difference.
Diet and exercise reduced the incidence of diabetes by about 43 percent over 20 years among 577 high-risk Chinese adults, the researchers reported in the journal Lancet.
At the end of the 20 years, 80 percent of those who changed what they ate and exercised more had diabetes, compared with 93 percent who made no changes, said Guangwei Li of the China-Japan Friendship Hospital in Beijing and Ping Zhang at the U.S. Centers for Disease Control and Prevention.... http://www.reuters.com/article/healthNews/idUSL2293949320080522?feedType=nl&feedName=ushealth1100
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Wounds Prof. Michelle Pascone, MD; Giovanni Papa, MD; Alessandro Ranieri, MD Abstract: Debridement is a fundamental step in the management of all chronic and acute cutaneous wounds. Versajet™ Hydrosurgery System (Smith & Nephew, Hull, UK) is a novel waterjet dissection device designed to surgically debride difficult wounds. The authors used this new system on a variety of difficult chronic and acute lesions of different etiology (eg, necrotic infected traumatic and chronic wounds, burns, and post-surgical wounds), which were then managed with adequate dressings or different wound closure techniques such as skin grafting, use of dermal substitutes, negative pressure wound therapy (V.A.C.®, KCI, San Antonio, Tex), or treatment by secondary intention. Debridement can be safely accomplished in a brief operating time with sufficient tissue selectivity and eclecticism. Satisfactory results often were obtained with a single operating session. After debridement, the quality of the wound bed was ideal for accelerating endogenous wound healing or maximizing the effectiveness of other therapeutic measures. The authors believe this hydrosurgery device (Versajet) is a selective, safe, and innovative tool for debridement that allows for better control, can reduce collateral damage, and subsequently achieve overall better outcomes than conventional debridement techniques.... http://www.woundsresearch.com/article/8709
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From IV placement to blood draws to injection of medication, millions of needlesticks are performed on children each year - and for the child, parents and healthcare providers alike, the experience frequently is an unpleasant one.
Although techniques and interventions are available to make the process easier, they often are not employed because of barriers such as lack of awareness, time limitations or availability of supplies.
Recognizing the importance of improving needle pain management in pediatrics, RN VOICE (Registered Nurses for Venipuncture Optimization through Increased Comfort and Education) was established to facilitate solutions.
"There's plenty of information available about the impact of needle pain on children, but there's a huge gap between knowledge and practice," explained Sarah Leahy, BA, RN, RSCN, manager of the Center for Pain Relief at Children's Healthcare of Atlanta and member of the RN VOICE steering committee. "You can give people the knowledge but they still don't actually change their practice; the change has to become institutionalized to really be successful."
To bridge the gap from information to implementation, RN VOICE assembled a community of practitioners - nurses, child life specialists, pharmacists and physicians - from across the nation to promote improved needle pain management strategies. The result is a network of experts and a new resource - ManageIVpain.com - through which healthcare providers can access the tools they need to systemize needle pain management measures in their workplaces.... http://nursing.advanceweb.com/editorial/content/editorial.aspx?cc=114285
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WASHINGTON (Reuters 5/20) - The U.S. Medicare program may expand reimbursement for bariatric surgery for the obese, in light of a study that found the treatment can help reverse diabetes, the agency said on Monday. Recent research found the surgery can completely reverse type 2 diabetes, a metabolic condition spurred by weight gain and suffered by millions of Americans.
Medicare, the government health plan for the nation's 44 million elderly, "will assess the nature of the scientific evidence supporting surgery for the treatment of diabetes," the agency said on its Web site.... http://www.reuters.com/article/healthNews/idUSN1914912220080520?feedType=nl&feedName=ushealth1100
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You really can fight wrinkles from the inside out. And there's a fruit that can lead the charge. It's papaya. What makes papaya so perfect? Easy. Vitamin C. Papaya has loads of it, and getting lots of vitamin C may mean more youthful skin -- fewer wrinkles and less thinning and dryness. A recent study in women over 40 confirmed it. The Mysteries of C Vitamin C is a natural friend to skin. The nutrient is essential for making collagen, the protein fibers that give skin its strength and resiliency. And being a powerful antioxidant, C also disarms free radicals that would otherwise chip away and weaken collagen. (Did you know? Vitamin C helps protect skin from this sun scourge, too.)
More Food for Your Face A little extra vitamin C isn't all it takes to plump your complexion. Here are a few more food tips that can help keep your face fresh:
Munch on walnuts. In the vitamin C study, researchers also noted that diets rich in linoleic acid -- an essential fatty acid in walnuts -- meant moister, plumper skin. (Bonus: Walnuts will make this happy, too.)
Ease up on fats and refined carbs. Scientists found both were linked to aging skin. Discover the dark side of processed foods with this article.
Think whole grains. The magnesium and B vitamins you get from them help with the regeneration of skin cells. Find out what foods are mostly whole grains.
Keep the fruits and veggies coming. To stay smooth and healthy, your skin needs a whole slew of antioxidant-rich produce. Like this root vegetable.
Read this article for a complete chart of healthy food choices for your skin. Yes! Eat some papaya today! Beyond its lode of vitamin C, papaya has enzymes that help with digestion and immune function. For recipes and more, pore through Papaya.
Reference: Dietary nutrient intakes and skin-aging appearance among middle-aged American women. Cosgrove, M. C., Franco, O. H., Granger, S. P., Murray, P. G., Mayes, A. E., American Journal of Clinical Nutrition 2007 Oct;86(4):1225-1231.
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Whatever their color, bell peppers are brimming with age-fighting antioxidants. But which bell has the most -- red, orange, yellow, or green? If you're going to pick just one, you might be better off red. A study recently showed that reds were the bell of the ball when it came to disease-fighting phenol content. Phenol Defenders, and MorePhenols aren't the only feather in a red bell pepper's cap. According to another study, red bells are also highest in vitamin C -- that mighty antioxidant that helps keep your skin and blood vessels young. (Discover how the vitamin C in red and yellow peppers may help save lives.) Color Me HealthyBut don't chuck your green, yellow, or orange bell peppers. For maximum RealAge benefits, you want a colorful and diverse diet -- so you get the broadest antioxidant protection. To keep yourself colorful, follow the simple rules of this diversity diet. Go green . . . grow red . . . in your own organic garden. Whether it takes up an acre or sits in a window box, a garden can provide super nutritious foods fairly cheaply. Add these heirloom red pepper plants, a little sun, a little water, and -- presto! You’ve got big beautiful bells. Roast, grill, skewer, slice, and chop . . . Perfecto.Reference: Characterization and quantitation of antioxidant constituents of sweet pepper (Capsicum annuum L.). Marin, A., Ferreres, F., Tomas-Barberan, F. A., Gil, M. I., Journal of Agricultural and Food Chemistry 2004 Jun 16;52(12):3861-3869.
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"We have a 'perfect storm' of a healthcare crisis in this country, and we all have to get ready and act now," warned Terry Fulmer, PhD, RN, FAAN, the Erline Perkins McGriff Professor and Dean of the College of Nursing at New York University, New York City.
"What I mean by the 'perfect storm' is we have the first baby boomers turning 65 in 2011, and that situation will create not only a larger number of older people experiencing chronic disease, but a significant exodus from the workforce at the time of our greatest need. That creates a gap behind those retirements in terms of people prepared to care for the projected 78 million people over the age of 65."
As one of 14 committee members who wrote the Institute of Medicine (IOM) report, Retooling for an Aging America: Building the Health Care Workforce, Fulmer described one of the most pressing questions in healthcare today: "What can we do to adequately care for those older adults?"... http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?cc=117141
(this is my opinion....as I have expressed many times before.... nurses are leaving even those who are in their 60's (who could work longer) ...because of the patient to nurse ratios, the total lack of support, and the indifference paid to the nurses' working situation).
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Electronic health record standards agreed WASHINGTON (Reuters 6/26) - A major consumer group, insurers together with Google Inc and Microsoft Corp said on Wednesday they have agreed to standards intended to speed adoption of personal electronic health records.
The electronic medical record field remains in its infancy. While U.S. privacy laws govern actions by medical providers such as doctors, there is little in the way of other established privacy, security and data usage standards despite decades of industry efforts.
Backers, which also include some doctors and employer groups, said they hope to break a stalemate in moving medical records online, sparked by consumer fears that their personal information will be abused, or held against them.... http://www.reuters.com/article/healthNews/idUSN2520650720080626?feedType=nl&feedName=ushealth1100
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NEW YORK (Reuters 6/26) - A sudden loss of hearing can be an early warning of impending stroke, according to results of a study released Thursday.
Dr. Herng-Ching Lin and colleagues at Taipei Medical University identified 1423 adult patients hospitalized in 1998 with a first episode of sudden hearing loss and matched each "case" patient to four "control" patients.
Patients in the hearing loss group were significantly more likely to have hypertension (high blood pressure), diabetes, and elevated cholesterol levels, the investigators note.
Over the next 5 years, 180 hearing-loss patients (13 percent) and 441 control patients (8 percent) suffered a stroke. After adjusting for gender, income, level of urbanization, and comorbid illnesses, the risk of stroke was 1.64 times greater in the hearing-loss patients.... http://www.reuters.com/article/healthNews/idUSTON67358320080626?feedType=nl&feedName=ushealth1100
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This is for patient teaching : CDC Recommends Shingles Vaccine for MillionsShot Usually Prevents Condition That Can Be Unbearable Important health news for you or a loved one: The U.S. Centers for Disease Control and Prevention is now recommending that people age 60 or older get vaccinated against shingles. The shot is effective about two-thirds of the time. A common skin disease caused by the chickenpox virus, shingles ranges from mild to severe and debilitating. It sometimes damages vision and hearing and can lead to an excruciatingly painful chronic nerve condition called post-herpetic neuralgia. More:
Is the shingles virus related to genital herpes? How shingles affects other infections
Why did a healthy woman get shingles? How your family affects your risk
Surprising number of shingles patients report severe pain
Three medications that may ease the pain This enjoyable exercise could help prevent shingles
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A best place to walk A walk on a treadmill or a walk in the park? Either one will get you fit, but the walk in the park may make you feel a whole lot better! Research confirms it: Exercising in a green environment puts you in a better frame of mind than working out in a sterile gym. Go figure! The Green SceneIn a study, people walked on a treadmill and viewed pictures of urban areas or images of rural scenes with lots of green spaces. The result? Besides bringing down blood pressure, viewing the green scenery improved energy and activity levels, raised self-esteem, and boosted mood. Double the pleasure of walking outside: Catch up on a good book, too. Playaway Digital's tiny audiobooks (they're smaller than an Altoids tin) come complete with headphones, battery, and book pod. Listen to the #1 best-seller, and then return for a new title. The miles will fly by.
Reference: The mental and physical health outcomes of green exercise. Pretty, J., Peacock, J., Sellens, M., Griffin, M., International Journal of Environmental Health Research 2005 Oct;15(5):319-337.
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Looks like there may be yet another reason to kick sugar and white flour out of your diet: eye health. Cutting back on processed carbs could lower your risk of advanced age-related macular degeneration (AMD), a leading cause of blindness in people 60 and older. The Carb ConnectionWhat makes refined carbs so bad for your peepers? Seems their high glycemic index may be partly to blame. High-glycemic-index foods boost a whole bunch of bad things linked to AMD -- like increases in oxidative stress, inflammation, and blood-fat levels. See the FutureAlong with replacing the "bad" carbs in your diet with high-fiber whole grains, try these other sight-saving steps:
Make sure your diet includes these four super eye nutrients.
Figure out if changes in your vision are normal. (This article can tell you what's normal when your eyes age -- and what's not.)
See if it's time for a checkup. Answer the questions in this Disease Prevention Checklist.
Reference: Association between dietary glycemic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study. Chiu, C. J., Milton, R. C., Gensler, G., Taylor, A., American Journal of Clinical Nutrition 2007 Jul;86(1):180-188.
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Scientists test brain pacemakers for depression; Experiments with so-called deep brain stimulation are in their infancy WASHINGTON - It's a new frontier for psychiatric illness: Brain pacemakers that promise to act as antidepressants by changing how patients' nerve circuitry fires. Scientists already know the power of these devices to block the tremors of Parkinson's disease and related illnesses; more than 40,000 such patients worldwide have the implants.... http://www.msnbc.msn.com/id/24829527/
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Whole Milk is Effective, Cost-Effective as an Oral Contrast Agent An item commonly found in many homes - whole milk - is just as effective, costs less and is easier on the patient than a diluted (0.1 percent) barium suspension that is also commonly used as an oral contrast agent in conjunction with CT to examine the gastrointestinal tract, a new study finds.
The study included 215 patients undergoing abdominal and pelvic CT, said Chi Wan Koo, MD, lead author of the study. All patients were given an IV contrast media; 115 were also given whole milk as an oral contrast agent; 100 received a 0.1 percent barium suspension. Two radiologists reviewed all the images and scored them based on degree of bowel distension and bowel wall visibility. Adequate bowel distension is necessary to optimize resolution of the bowel wall and contents, said Dr. Koo.
The study found that the images taken of patients who were given whole milk were just as useful as the images that were taken of patients given the diluted barium, she said. ...
http://nursing.advanceweb.com/editorial/content/editorial.aspx?cc=117266
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TODAY'S RANDOM FACT... Broccoli is the only vegetable that is also a flower.
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Studies link lead to adult crime, brain damage WASHINGTON (Reuters 5/27) - Exposure to lead in early childhood or in the womb can cause permanent brain damage that may even cause criminal behavior, researchers reported on Tuesday.
Two studies showed that people with high levels of lead in childhood grew up with blocks of missing brain cells -- and they also were far more likely to be arrested for crimes, especially violent crimes.
The effect is so strong that it may account for a large percentage of crimes in inner-city areas, where old houses are far more likely to have lead paint, said Kim Dietrich of the University of Cincinnati in Ohio, who led one of the studies in the Public Library of Science journal PLoS Medicine.... http://www.reuters.com/article/healthNews/idUSN2740549020080528?feedType=nl&feedName=ushealth1100
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LONDON (Reuters 5/27) - People given cholesterol-fighting statin drugs before heart surgery are far less likely to die or suffer complications afterwards, German researchers said on Wednesday.
The analysis of more than 31,000 patients provides some of the strongest evidence yet of the benefits of statins before heart surgery but it also found that too few doctors are prescribing them, they said in the European Heart Journal.
"This is the first big summary of all the existing studies about people undergoing cardiac surgery," said Oliver Liakopoulos, a researcher at the University of Cologne, who led the study.... http://www.reuters.com/article/healthNews/idUSL2753138520080528?feedType=nl&feedName=ushealth1100
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HUMOR SECTION
HOW TO CALL THE POLICE WHEN YOU'RE OLD AND DON'T MOVE FAST ANYMORE.
George Phillips of Meridian, Mississippi was going up to bed when his wife told him that he'd left the light on in the garden shed, which she could see from the bedroom window.George opened the back door to go turn off the light but saw that there were people in the shed stealingthings. He phoned the police, who asked 'Is someone in your house?' and he said 'no'. Then they said that all patrols were busy, and that he should simply lock his door and an officer would be along when available.George said, 'Okay,' hung up, counted to 30, and phoned the police again. 'Hello, I just called you a few seconds ago because there were people stealing things from my shed. Well, you don't have to worry about them now because I just shot them.' Then he hung up.Within five minutes six police cars, a SWAT Team, a helicopter, two fire trucks, a paramedic and an ambulance showed up at the Phillips' residence and caught the burglars red handed !!!One of the Policemen said to George: 'I thought you said that you'd shot them!' George said, 'I thought you said there was nobody available !!!!
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Automated drug-dispensing improves care at nursing homes Dallas Morning News - Dallas,TX,USA "We hope the result will be a revolution in how nursing homes dispense drugs." OnSiteRx caught the attention of hundreds of nursing home administrators at ... http://www.dallasnews.com/sharedcontent/dws/bus/stories/DN-drugs_08bus.ART0.State.Edition1.4620e4c.html
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ATLANTA, Georgia --Quote: " Imagine my surprise when, in the course of doing research for this story, I stumbled upon my own personal health information online. There it was in black, white, and hypertext blue. My annual mammograms; the visits to the podiatrist for the splinter in my foot; the kind of birth control I use -- it was all on my health insurance company's Web site. And that's not all: The prescriptions drugs I use were listed on the Web site where I get my prescription drug insurance. I had no idea this was all on the World Wide Web. Welcome to the 21st century", says Dr. Steven Schwaitzberg, associate professor of surgery at Harvard Medical School and a medical informatics expert. "There's more information out there about people than could ever possibly be realized," he says.... http://www.cnn.com/2008/HEALTH/06/05/ep.online.records/index.html
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Check this out....really good suggestions. Rozalfaro@AOL.com (Roz) sent in the following: She wrote: "This person is my nursing school classmate--- and fellow basketball team member in 1969 --- Dr Marie Savard (they never say she was a nurse before (becoming) a doc). She's the new medical correspondent and did a great job on this topic today".
Conventional wisdom assumed losing your mental edge was just part of aging, but that may be incorrect. Scientists believe working out your brain -- just like you would your body to keep in shape -- could ward off the dulling of mental faculties and strengthen connections between newly-generated brain cells, which people make throughout life.
Use it or lose it. Neurobics may help maintain your mental reserves and ensure you'll keep your mental edge clear into your elderly years. It's like cross training, and researchers have found it's never too late to start, even in people who have some degree of dementia.
"Good Morning America" medical contributor Dr. Marie Savard breaks down the things you can do to keep your mind in tip-top shape, and what bad habits may harm you.... http://abcnews.go.com/GMA/OnCall/story?id=5023860&page=1
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NEW YORK (Reuters 6/09) - Microsoft Corp and Kaiser Permanente, the biggest U.S. health maintenance organization (HMO), are working on a patient information exchange pilot program to help give patients more control over their health records, The Wall Street Journal said on Monday.
Similar efforts are underway at companies such as Revolution Health Group LLC and Google Inc, which launched its online healthcare service, Google Health, in February.
Data kept in Kaiser's personal health records, which includes patients' test results, prescriptions and immunizations, will be shifted to Microsoft's HealthVault, a Web-based service that allows patients to store and manage medical data from a variety of websites and selectively share information with them, the paper reported.... http://www.reuters.com/article/healthNews/idUSN0939925320080609?feedType=nl&feedName=ushealth1100
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Low vitamin D common with rheumatic diseases... PARIS (Reuters 6/12) - Nearly three quarters of patients seen at a rheumatology clinic, which focuses on diseases affecting the joints, muscles, bones, and tendons, have a vitamin D deficiency, researchers based in Ireland found.
Dr. Muhammad Haroon and associates at South Infirmary-Victoria University Hospital, Cork, assessed the occurrence of vitamin D deficiency in all new patients seen at their rheumatology clinic between January and June 2007. The research team's findings were reported at the European Union League Against Rheumatism 2008 meeting here in Paris.
Of 264 patients seen during this time period, 231 agreed to have their levels of vitamin D measured and other related tests performed. Overall, 162 patients (70 percent) had low vitamin D levels and 26 percent had a severe deficiency. Little difference was seen in the percentage of younger and older patients who were deficient....
http://news.yahoo.com/s/nm/20080612/hl_nm/low_vitamin_d_dc;
_ylt=AjbRql72CiHBZ9Kp5RgPQ6LVJRIF
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Scientist say garlic can beat "superbug" MRSA The killer superbug MRSA can be beaten with garlic, scientists have claimed.
Trials showed that allicin, a natural compound which gives garlic its distinctive smell, can cure patients suffering from the antibiotic-resistant infection.
In a trial, all 52 patients who took allicin capsules or sprayed a liquid on to their wounds recovered fully within four to 12 weeks. Leader Dr Ron Cutler, of the University of East London, said: "This is a breakthrough in the fight against MRSA."
The infection officially kills almost 2,000 hospital patients a year, although experts believe the true toll is closer to 5,000.... http://www.mirror.co.uk/news/topstories/2008/06/10/scientists-say-garlic-can-beat-superbug-mrsa-89520-20601849/
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Overactive bladder affects many aspects of life NEW YORK (Reuters 6/12) - An overactive bladder has a considerable effect on the quality of life, work productivity, sexuality and the emotional well-being of men and women, U.S. and European researchers report in the journal BJU International.
Dr. Karin S. Coyne of United BioSource Corporation, Bethesda, Maryland and colleagues conducted a secondary analysis of data from a telephone survey involving participants from five countries.
The researchers matched 1,434 subjects who had an overactive bladder, with or without other lower urinary tract symptoms, to another 1,434 participants without overactive bladder or stress urinary incontinence who acted as a comparison group, or the "controls. "
The overactive bladder patients subjects reported significantly greater rates of chronic constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. There were also significant differences between the patients and controls in all reported lower urinary tract symptoms.... http://www.reuters.com/article/healthNews/idUSTON27713720080612
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The next three articles were submitted by MJSolon@AOL.com (Melva) Thanks
Antibiotics Reduce Risk for Postpartum Perineal Wound Complications June 11, 2008 — Women who received antibiotic prophylaxis vs placebo had reduced rates of perineal wound complications by 2 weeks postpartum, according to the results of a prospective, randomized controlled trial reported in the June issue of Obstetrics & Gynecology.
"The anal sphincter is susceptible to trauma during a vaginal delivery," write Neena Duggal, MD, from Santa Clara Valley Medical Center in San Jose, California, and colleagues. "The use of operative vaginal delivery, especially in combination with midline episiotomy, has been associated with a significantly increased risk of anal sphincter trauma in both nulliparous and multiparous women."
The goal of this study was to determine whether prophylactic antibiotics at the time of repair of third-degree or fourth-degree perineal tears after vaginal delivery would reduce the risk for wound infection and breakdown.... http://www.medscape.com/viewarticle/575875
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Hospitals peer into patients' credit reports Financially squeezed by shrinking reimbursements and expanding uninsured patient rolls, some Atlanta hospitals are using tools to peek into patient credit reports to gauge their ability, and willingness, to pay medical bills.
Hospitals say the information helps quickly identify broke patients who qualify for charity, or free, care. Figuring out who they are early saves the hospital millions of dollars in collection costs -- processing billing statements and making follow-up calls, hospitals say. Armed with the additional information, hospitals also have better leverage in negotiating payment plans with those patients who do have the ability to pay.
But critics say access to patient financial information can lead to abuse. Hospitals might deny non-emergency care to patients with a poor credit history. Overzealous billing personnel might nudge patients to tap into available lines-of-credit to pay for care... http://www.msnbc.msn.com/id/25087914/
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WEDNESDAY, June 11 (HealthDay News) -- Children with bigger necks are more likely to develop a sleep-related breathing disorder, says a University of Virginia study.
Researchers looked at 215 children, aged 18 months to 18 years, who were referred to a pediatric sleep center. Of these children, 37.3 percent were obese and had an increased frequency of snoring.
The children's neck size, in the sitting and neutral head position, was measured and apena-hypopnea index (AHI) and mean oxygen saturation values were used as indicators of the severity of the sleep-related breathing disorder.
Age-adjusted neck size correlated with body-mass index (BMI) and weight and showed a higher correlation with AHI than did BMI, weight or tonsil size. Neck size also showed a strong inverse correlation with mean oxygen saturation and was a better predictor of mean oxygen saturation than BMI, weight or tonsil size, the study found.
http://news.yahoo.com/s/hsn/20080612/hl_hsn/childrensnecksizeassociatedwithsleepdisorders;_
ylt=ApBTU11h15iRTbObJbaTVjHVJRIF
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Promising drug fights Alzheimer's in three ways WASHINGTON (Reuters 6/11) - A type of drug that may offer promise in treating Alzheimer's disease works in three ways to fight the formation of "plaques" in the brain that are a hallmark of the ailment, scientists said on Wednesday.
The researchers looked at a kind of drug called a gamma-secretase modulator, or GSM, now being tested to see if it slows Alzheimer's disease progression. One GSM drug now being tested in people with Alzheimer's is Myriad Genetics's Flurizan, also called tarenflurbil. A series of lab experiments showed these drugs inhibit production of long pieces of amyloid beta protein in the brain, block them from forming clumps, and boost production of shorter pieces that can make the longer ones less likely to stick together, the researchers said.... http://www.reuters.com/article/healthNews/idUSN1146894920080611?feedType=nl&feedName=ushealth1100
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Diet, exercise can delay diabetes for years: study LONDON (Reuters 5/22) - Drinking less alcohol, eating more vegetables and exercising can prevent or delay the onset of diabetes, researchers said on Friday in a study showing that lifestyle changes can make a big difference.
Diet and exercise reduced the incidence of diabetes by about 43 percent over 20 years among 577 high-risk Chinese adults, the researchers reported in the journal Lancet.
At the end of the 20 years, 80 percent of those who changed what they ate and exercised more had diabetes, compared with 93 percent who made no changes, said Guangwei Li of the China-Japan Friendship Hospital in Beijing and Ping Zhang at the U.S. Centers for Disease Control and Prevention.... http://www.reuters.com/article/healthNews/idUSL2293949320080522?feedType=nl&feedName=ushealth1100
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Wounds Prof. Michelle Pascone, MD; Giovanni Papa, MD; Alessandro Ranieri, MD Abstract: Debridement is a fundamental step in the management of all chronic and acute cutaneous wounds. Versajet™ Hydrosurgery System (Smith & Nephew, Hull, UK) is a novel waterjet dissection device designed to surgically debride difficult wounds. The authors used this new system on a variety of difficult chronic and acute lesions of different etiology (eg, necrotic infected traumatic and chronic wounds, burns, and post-surgical wounds), which were then managed with adequate dressings or different wound closure techniques such as skin grafting, use of dermal substitutes, negative pressure wound therapy (V.A.C.®, KCI, San Antonio, Tex), or treatment by secondary intention. Debridement can be safely accomplished in a brief operating time with sufficient tissue selectivity and eclecticism. Satisfactory results often were obtained with a single operating session. After debridement, the quality of the wound bed was ideal for accelerating endogenous wound healing or maximizing the effectiveness of other therapeutic measures. The authors believe this hydrosurgery device (Versajet) is a selective, safe, and innovative tool for debridement that allows for better control, can reduce collateral damage, and subsequently achieve overall better outcomes than conventional debridement techniques.... http://www.woundsresearch.com/article/8709
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From IV placement to blood draws to injection of medication, millions of needlesticks are performed on children each year - and for the child, parents and healthcare providers alike, the experience frequently is an unpleasant one.
Although techniques and interventions are available to make the process easier, they often are not employed because of barriers such as lack of awareness, time limitations or availability of supplies.
Recognizing the importance of improving needle pain management in pediatrics, RN VOICE (Registered Nurses for Venipuncture Optimization through Increased Comfort and Education) was established to facilitate solutions.
"There's plenty of information available about the impact of needle pain on children, but there's a huge gap between knowledge and practice," explained Sarah Leahy, BA, RN, RSCN, manager of the Center for Pain Relief at Children's Healthcare of Atlanta and member of the RN VOICE steering committee. "You can give people the knowledge but they still don't actually change their practice; the change has to become institutionalized to really be successful."
To bridge the gap from information to implementation, RN VOICE assembled a community of practitioners - nurses, child life specialists, pharmacists and physicians - from across the nation to promote improved needle pain management strategies. The result is a network of experts and a new resource - ManageIVpain.com - through which healthcare providers can access the tools they need to systemize needle pain management measures in their workplaces.... http://nursing.advanceweb.com/editorial/content/editorial.aspx?cc=114285
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WASHINGTON (Reuters 5/20) - The U.S. Medicare program may expand reimbursement for bariatric surgery for the obese, in light of a study that found the treatment can help reverse diabetes, the agency said on Monday. Recent research found the surgery can completely reverse type 2 diabetes, a metabolic condition spurred by weight gain and suffered by millions of Americans.
Medicare, the government health plan for the nation's 44 million elderly, "will assess the nature of the scientific evidence supporting surgery for the treatment of diabetes," the agency said on its Web site.... http://www.reuters.com/article/healthNews/idUSN1914912220080520?feedType=nl&feedName=ushealth1100
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You really can fight wrinkles from the inside out. And there's a fruit that can lead the charge. It's papaya. What makes papaya so perfect? Easy. Vitamin C. Papaya has loads of it, and getting lots of vitamin C may mean more youthful skin -- fewer wrinkles and less thinning and dryness. A recent study in women over 40 confirmed it. The Mysteries of C Vitamin C is a natural friend to skin. The nutrient is essential for making collagen, the protein fibers that give skin its strength and resiliency. And being a powerful antioxidant, C also disarms free radicals that would otherwise chip away and weaken collagen. (Did you know? Vitamin C helps protect skin from this sun scourge, too.)
More Food for Your Face A little extra vitamin C isn't all it takes to plump your complexion. Here are a few more food tips that can help keep your face fresh:
Munch on walnuts. In the vitamin C study, researchers also noted that diets rich in linoleic acid -- an essential fatty acid in walnuts -- meant moister, plumper skin. (Bonus: Walnuts will make this happy, too.)
Ease up on fats and refined carbs. Scientists found both were linked to aging skin. Discover the dark side of processed foods with this article.
Think whole grains. The magnesium and B vitamins you get from them help with the regeneration of skin cells. Find out what foods are mostly whole grains.
Keep the fruits and veggies coming. To stay smooth and healthy, your skin needs a whole slew of antioxidant-rich produce. Like this root vegetable.
Read this article for a complete chart of healthy food choices for your skin. Yes! Eat some papaya today! Beyond its lode of vitamin C, papaya has enzymes that help with digestion and immune function. For recipes and more, pore through Papaya.
Reference: Dietary nutrient intakes and skin-aging appearance among middle-aged American women. Cosgrove, M. C., Franco, O. H., Granger, S. P., Murray, P. G., Mayes, A. E., American Journal of Clinical Nutrition 2007 Oct;86(4):1225-1231.
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Whatever their color, bell peppers are brimming with age-fighting antioxidants. But which bell has the most -- red, orange, yellow, or green? If you're going to pick just one, you might be better off red. A study recently showed that reds were the bell of the ball when it came to disease-fighting phenol content. Phenol Defenders, and MorePhenols aren't the only feather in a red bell pepper's cap. According to another study, red bells are also highest in vitamin C -- that mighty antioxidant that helps keep your skin and blood vessels young. (Discover how the vitamin C in red and yellow peppers may help save lives.) Color Me HealthyBut don't chuck your green, yellow, or orange bell peppers. For maximum RealAge benefits, you want a colorful and diverse diet -- so you get the broadest antioxidant protection. To keep yourself colorful, follow the simple rules of this diversity diet. Go green . . . grow red . . . in your own organic garden. Whether it takes up an acre or sits in a window box, a garden can provide super nutritious foods fairly cheaply. Add these heirloom red pepper plants, a little sun, a little water, and -- presto! You’ve got big beautiful bells. Roast, grill, skewer, slice, and chop . . . Perfecto.Reference: Characterization and quantitation of antioxidant constituents of sweet pepper (Capsicum annuum L.). Marin, A., Ferreres, F., Tomas-Barberan, F. A., Gil, M. I., Journal of Agricultural and Food Chemistry 2004 Jun 16;52(12):3861-3869.
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"We have a 'perfect storm' of a healthcare crisis in this country, and we all have to get ready and act now," warned Terry Fulmer, PhD, RN, FAAN, the Erline Perkins McGriff Professor and Dean of the College of Nursing at New York University, New York City.
"What I mean by the 'perfect storm' is we have the first baby boomers turning 65 in 2011, and that situation will create not only a larger number of older people experiencing chronic disease, but a significant exodus from the workforce at the time of our greatest need. That creates a gap behind those retirements in terms of people prepared to care for the projected 78 million people over the age of 65."
As one of 14 committee members who wrote the Institute of Medicine (IOM) report, Retooling for an Aging America: Building the Health Care Workforce, Fulmer described one of the most pressing questions in healthcare today: "What can we do to adequately care for those older adults?"... http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?cc=117141
(this is my opinion....as I have expressed many times before.... nurses are leaving even those who are in their 60's (who could work longer) ...because of the patient to nurse ratios, the total lack of support, and the indifference paid to the nurses' working situation).
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Electronic health record standards agreed WASHINGTON (Reuters 6/26) - A major consumer group, insurers together with Google Inc and Microsoft Corp said on Wednesday they have agreed to standards intended to speed adoption of personal electronic health records.
The electronic medical record field remains in its infancy. While U.S. privacy laws govern actions by medical providers such as doctors, there is little in the way of other established privacy, security and data usage standards despite decades of industry efforts.
Backers, which also include some doctors and employer groups, said they hope to break a stalemate in moving medical records online, sparked by consumer fears that their personal information will be abused, or held against them.... http://www.reuters.com/article/healthNews/idUSN2520650720080626?feedType=nl&feedName=ushealth1100
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NEW YORK (Reuters 6/26) - A sudden loss of hearing can be an early warning of impending stroke, according to results of a study released Thursday.
Dr. Herng-Ching Lin and colleagues at Taipei Medical University identified 1423 adult patients hospitalized in 1998 with a first episode of sudden hearing loss and matched each "case" patient to four "control" patients.
Patients in the hearing loss group were significantly more likely to have hypertension (high blood pressure), diabetes, and elevated cholesterol levels, the investigators note.
Over the next 5 years, 180 hearing-loss patients (13 percent) and 441 control patients (8 percent) suffered a stroke. After adjusting for gender, income, level of urbanization, and comorbid illnesses, the risk of stroke was 1.64 times greater in the hearing-loss patients.... http://www.reuters.com/article/healthNews/idUSTON67358320080626?feedType=nl&feedName=ushealth1100
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This is for patient teaching : CDC Recommends Shingles Vaccine for MillionsShot Usually Prevents Condition That Can Be Unbearable Important health news for you or a loved one: The U.S. Centers for Disease Control and Prevention is now recommending that people age 60 or older get vaccinated against shingles. The shot is effective about two-thirds of the time. A common skin disease caused by the chickenpox virus, shingles ranges from mild to severe and debilitating. It sometimes damages vision and hearing and can lead to an excruciatingly painful chronic nerve condition called post-herpetic neuralgia. More:
Is the shingles virus related to genital herpes? How shingles affects other infections
Why did a healthy woman get shingles? How your family affects your risk
Surprising number of shingles patients report severe pain
Three medications that may ease the pain This enjoyable exercise could help prevent shingles
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A best place to walk A walk on a treadmill or a walk in the park? Either one will get you fit, but the walk in the park may make you feel a whole lot better! Research confirms it: Exercising in a green environment puts you in a better frame of mind than working out in a sterile gym. Go figure! The Green SceneIn a study, people walked on a treadmill and viewed pictures of urban areas or images of rural scenes with lots of green spaces. The result? Besides bringing down blood pressure, viewing the green scenery improved energy and activity levels, raised self-esteem, and boosted mood. Double the pleasure of walking outside: Catch up on a good book, too. Playaway Digital's tiny audiobooks (they're smaller than an Altoids tin) come complete with headphones, battery, and book pod. Listen to the #1 best-seller, and then return for a new title. The miles will fly by.
Reference: The mental and physical health outcomes of green exercise. Pretty, J., Peacock, J., Sellens, M., Griffin, M., International Journal of Environmental Health Research 2005 Oct;15(5):319-337.
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Looks like there may be yet another reason to kick sugar and white flour out of your diet: eye health. Cutting back on processed carbs could lower your risk of advanced age-related macular degeneration (AMD), a leading cause of blindness in people 60 and older. The Carb ConnectionWhat makes refined carbs so bad for your peepers? Seems their high glycemic index may be partly to blame. High-glycemic-index foods boost a whole bunch of bad things linked to AMD -- like increases in oxidative stress, inflammation, and blood-fat levels. See the FutureAlong with replacing the "bad" carbs in your diet with high-fiber whole grains, try these other sight-saving steps:
Make sure your diet includes these four super eye nutrients.
Figure out if changes in your vision are normal. (This article can tell you what's normal when your eyes age -- and what's not.)
See if it's time for a checkup. Answer the questions in this Disease Prevention Checklist.
Reference: Association between dietary glycemic index and age-related macular degeneration in nondiabetic participants in the Age-Related Eye Disease Study. Chiu, C. J., Milton, R. C., Gensler, G., Taylor, A., American Journal of Clinical Nutrition 2007 Jul;86(1):180-188.
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Scientists test brain pacemakers for depression; Experiments with so-called deep brain stimulation are in their infancy WASHINGTON - It's a new frontier for psychiatric illness: Brain pacemakers that promise to act as antidepressants by changing how patients' nerve circuitry fires. Scientists already know the power of these devices to block the tremors of Parkinson's disease and related illnesses; more than 40,000 such patients worldwide have the implants.... http://www.msnbc.msn.com/id/24829527/
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Whole Milk is Effective, Cost-Effective as an Oral Contrast Agent An item commonly found in many homes - whole milk - is just as effective, costs less and is easier on the patient than a diluted (0.1 percent) barium suspension that is also commonly used as an oral contrast agent in conjunction with CT to examine the gastrointestinal tract, a new study finds.
The study included 215 patients undergoing abdominal and pelvic CT, said Chi Wan Koo, MD, lead author of the study. All patients were given an IV contrast media; 115 were also given whole milk as an oral contrast agent; 100 received a 0.1 percent barium suspension. Two radiologists reviewed all the images and scored them based on degree of bowel distension and bowel wall visibility. Adequate bowel distension is necessary to optimize resolution of the bowel wall and contents, said Dr. Koo.
The study found that the images taken of patients who were given whole milk were just as useful as the images that were taken of patients given the diluted barium, she said. ...
http://nursing.advanceweb.com/editorial/content/editorial.aspx?cc=117266
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TODAY'S RANDOM FACT... Broccoli is the only vegetable that is also a flower.
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Studies link lead to adult crime, brain damage WASHINGTON (Reuters 5/27) - Exposure to lead in early childhood or in the womb can cause permanent brain damage that may even cause criminal behavior, researchers reported on Tuesday.
Two studies showed that people with high levels of lead in childhood grew up with blocks of missing brain cells -- and they also were far more likely to be arrested for crimes, especially violent crimes.
The effect is so strong that it may account for a large percentage of crimes in inner-city areas, where old houses are far more likely to have lead paint, said Kim Dietrich of the University of Cincinnati in Ohio, who led one of the studies in the Public Library of Science journal PLoS Medicine.... http://www.reuters.com/article/healthNews/idUSN2740549020080528?feedType=nl&feedName=ushealth1100
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LONDON (Reuters 5/27) - People given cholesterol-fighting statin drugs before heart surgery are far less likely to die or suffer complications afterwards, German researchers said on Wednesday.
The analysis of more than 31,000 patients provides some of the strongest evidence yet of the benefits of statins before heart surgery but it also found that too few doctors are prescribing them, they said in the European Heart Journal.
"This is the first big summary of all the existing studies about people undergoing cardiac surgery," said Oliver Liakopoulos, a researcher at the University of Cologne, who led the study.... http://www.reuters.com/article/healthNews/idUSL2753138520080528?feedType=nl&feedName=ushealth1100
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HUMOR SECTION
HOW TO CALL THE POLICE WHEN YOU'RE OLD AND DON'T MOVE FAST ANYMORE.
George Phillips of Meridian, Mississippi was going up to bed when his wife told him that he'd left the light on in the garden shed, which she could see from the bedroom window.George opened the back door to go turn off the light but saw that there were people in the shed stealingthings. He phoned the police, who asked 'Is someone in your house?' and he said 'no'. Then they said that all patrols were busy, and that he should simply lock his door and an officer would be along when available.George said, 'Okay,' hung up, counted to 30, and phoned the police again. 'Hello, I just called you a few seconds ago because there were people stealing things from my shed. Well, you don't have to worry about them now because I just shot them.' Then he hung up.Within five minutes six police cars, a SWAT Team, a helicopter, two fire trucks, a paramedic and an ambulance showed up at the Phillips' residence and caught the burglars red handed !!!One of the Policemen said to George: 'I thought you said that you'd shot them!' George said, 'I thought you said there was nobody available !!!!
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
www.nurse.com Pay Only $34.99 for a full year of CONTACT HOURS
MyFreeCE offers a membership-based web site where you can earn CE contact hours for your license or credential renewal. By purchasing a MyFreeCE membership for $29.95 you can take over 150 courses and earn hundreds of CE contact hours during your 12-month membership period. Your $29.95 membership fee includes your testing, re-testing (if necessary), completion certificates, and all course materials. There are no hidden costs or fees. http://www.myfreece.com/welcome.asp
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I ran across this while bumming around the internet: The Meniscus Educational Institute is accredited as a provider of continuing education for nurses by the American Nurses Credentialing Center’s Commission on Accreditation. The Meniscus Educational Institute is approved by the California Board of Registered Nursing (California BRN Provider No. 13164).
Colorectal Cancer: Pathway to Survival A CE activity for generalist nurses and pharmacists, oncology nurse specialists including advanced practice nurses, physician assistants, and oncology pharmacists who provide care to patients with colorectal cancer (CRC) across a variety of practice settings.
Critical Decision Making in Health Care-Associated Infections: Managing Serious Pediatric Infections A CE activity for physicians, nurses, and pharmacists in which Web-based patient cases evolve based on the therapeutic options you choose. Throughout the cases, refer to the patient’s medical chart, applicable literature, and clinical guidelines to help with your decision making. Compare your peers’ selections with your own, and your rationale with that of our expert faculty.
Critical Decision Making in Health Care–Associated Infections: Managing Serious Skin and Soft Tissue Infections A CE activity for physicians, nurses, and pharmacists in which Web-based patient cases evolve based on the therapeutic options you choose. Throughout the cases, refer to the patient’s medical chart, applicable literature, and clinical guidelines to help with your decision making. Compare your peers’ selections with your own, and your rationale with that of our expert faculty.
Critical Decision Making in Health Care–Associated Infections: Serious Cases in the Intensive Care Unit A CE activity for physicians, nurses, and pharmacists in which Web-based patient cases evolve based on the therapeutic options you choose. Throughout the cases, refer to the patient’s medical chart, applicable literature, and clinical guidelines to help with your decision making. Compare your peers’ selections with your own, and your rationale with that of our expert faculty.
Hot Topics in Colorectal Cancer for the Oncology APN A CE activity for advanced practice oncology nurses who care for patients with colorectal cancer (CRC) as well as their families or nurses who are interested in the topic and may care for this population in the future. http://www.meniscus.com/web/frames/fsnurses.htm
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The Power of Clinical Nursing Research: Engage Clinicians, Improve Patients' Lives, and Forge a Professional Legacy http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2313935/?user_id=157159&email=rnfrankie@aol.com&news_id=399&subspec_id=44American Journal of Critical Care CME
Intensive Care Nurses' Knowledge of Pressure Ulcers: Development of an Assessment Tool and Effect of an Educational Program http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2313937/?user_id=157159&email=rnfrankie@aol.com&news_id=399&subspec_id=44American Journal of Critical Care CME
Quality Improvement Program to Reduce the Prevalence of Pressure Ulcers in an Intensive Care Unit http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2313940/?user_id=157159&email=rnfrankie@aol.com&news_id=399&subspec_id=44
American Journal of Critical Care CME
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Order today and receive 15% off any of the titles in the CE program! This offer is good through July 31 so order your books today and start earning your Free CE credits.
SAGE has partnered with PsychoEducational Resources (PER) to provide Free CE credits to mental health professionals. Mental health professionals can now choose from a wide range of SAGE books, and receive CE credits free of charge after completing a CE Quiz online (80% correct for a pass). Thirty-One (31) new titles have just been added to the program to allow even more opportunity for CE credits. The SAGE CE program now has a total of 63 titles for you to chose from which can be viewed at www.sagepub.com/ceprogram.
CE certification can be achieved in three easy steps:
Step 1: Purchase and read a SAGE Book in the Program
Step 2: Go to the CE Quiz site, enter the pass code (included on the insert of the book) and take the interactive quiz
Step 3: Obtain 80% correct and print or download certification
CE credits can be used:
For license renewal
To meet managed care mandates
To obtain discounts on professional liability premiums (check with your insurance carrier)
To demonstrate commitment to ongoing professional development
For a complete list of SAGE titles in the CE Program, please visit www.sagepub.com/ceprogram. To view the complete CE statement for details of CE coverage, please call PER at 1-800-892-9249 or visit their website at http://per-ce.net/ce.php.
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise..........
www.nurse.com Pay Only $34.99 for a full year of CONTACT HOURS
MyFreeCE offers a membership-based web site where you can earn CE contact hours for your license or credential renewal. By purchasing a MyFreeCE membership for $29.95 you can take over 150 courses and earn hundreds of CE contact hours during your 12-month membership period. Your $29.95 membership fee includes your testing, re-testing (if necessary), completion certificates, and all course materials. There are no hidden costs or fees. http://www.myfreece.com/welcome.asp
******************
I ran across this while bumming around the internet: The Meniscus Educational Institute is accredited as a provider of continuing education for nurses by the American Nurses Credentialing Center’s Commission on Accreditation. The Meniscus Educational Institute is approved by the California Board of Registered Nursing (California BRN Provider No. 13164).
Colorectal Cancer: Pathway to Survival A CE activity for generalist nurses and pharmacists, oncology nurse specialists including advanced practice nurses, physician assistants, and oncology pharmacists who provide care to patients with colorectal cancer (CRC) across a variety of practice settings.
Critical Decision Making in Health Care-Associated Infections: Managing Serious Pediatric Infections A CE activity for physicians, nurses, and pharmacists in which Web-based patient cases evolve based on the therapeutic options you choose. Throughout the cases, refer to the patient’s medical chart, applicable literature, and clinical guidelines to help with your decision making. Compare your peers’ selections with your own, and your rationale with that of our expert faculty.
Critical Decision Making in Health Care–Associated Infections: Managing Serious Skin and Soft Tissue Infections A CE activity for physicians, nurses, and pharmacists in which Web-based patient cases evolve based on the therapeutic options you choose. Throughout the cases, refer to the patient’s medical chart, applicable literature, and clinical guidelines to help with your decision making. Compare your peers’ selections with your own, and your rationale with that of our expert faculty.
Critical Decision Making in Health Care–Associated Infections: Serious Cases in the Intensive Care Unit A CE activity for physicians, nurses, and pharmacists in which Web-based patient cases evolve based on the therapeutic options you choose. Throughout the cases, refer to the patient’s medical chart, applicable literature, and clinical guidelines to help with your decision making. Compare your peers’ selections with your own, and your rationale with that of our expert faculty.
Hot Topics in Colorectal Cancer for the Oncology APN A CE activity for advanced practice oncology nurses who care for patients with colorectal cancer (CRC) as well as their families or nurses who are interested in the topic and may care for this population in the future. http://www.meniscus.com/web/frames/fsnurses.htm
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The Power of Clinical Nursing Research: Engage Clinicians, Improve Patients' Lives, and Forge a Professional Legacy http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2313935/?user_id=157159&email=rnfrankie@aol.com&news_id=399&subspec_id=44American Journal of Critical Care CME
Intensive Care Nurses' Knowledge of Pressure Ulcers: Development of an Assessment Tool and Effect of an Educational Program http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2313937/?user_id=157159&email=rnfrankie@aol.com&news_id=399&subspec_id=44American Journal of Critical Care CME
Quality Improvement Program to Reduce the Prevalence of Pressure Ulcers in an Intensive Care Unit http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2313940/?user_id=157159&email=rnfrankie@aol.com&news_id=399&subspec_id=44
American Journal of Critical Care CME
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Order today and receive 15% off any of the titles in the CE program! This offer is good through July 31 so order your books today and start earning your Free CE credits.
SAGE has partnered with PsychoEducational Resources (PER) to provide Free CE credits to mental health professionals. Mental health professionals can now choose from a wide range of SAGE books, and receive CE credits free of charge after completing a CE Quiz online (80% correct for a pass). Thirty-One (31) new titles have just been added to the program to allow even more opportunity for CE credits. The SAGE CE program now has a total of 63 titles for you to chose from which can be viewed at www.sagepub.com/ceprogram.
CE certification can be achieved in three easy steps:
Step 1: Purchase and read a SAGE Book in the Program
Step 2: Go to the CE Quiz site, enter the pass code (included on the insert of the book) and take the interactive quiz
Step 3: Obtain 80% correct and print or download certification
CE credits can be used:
For license renewal
To meet managed care mandates
To obtain discounts on professional liability premiums (check with your insurance carrier)
To demonstrate commitment to ongoing professional development
For a complete list of SAGE titles in the CE Program, please visit www.sagepub.com/ceprogram. To view the complete CE statement for details of CE coverage, please call PER at 1-800-892-9249 or visit their website at http://per-ce.net/ce.php.
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WEBSITES/ LINKS
WEBSITES/ LINKS
Always on the lookout for interesting websites / links.
Please send them to: RNFrankie@AOL.com.
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.snopes.com/
the National Nurse's new website: http://nationalnurse.org/
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.snopes.com/
the National Nurse's new website: http://nationalnurse.org/
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MEDICAL RECALLS
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MEDICAL RECALLS
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FDA informed healthcare professionals of reports of life-threatening complications associated with recombinant human Bone Morphogenetic Protein (rhBMP) when used in the cervical spine. The safety and effectiveness of rhBMP in the cervical spine have not been demonstrated and these products are not approved by FDA for this use. There have been at least 38 reports of complications during the last 4 years with the use of rhBMP in cervical spine fusion. These complications were associated with swelling of neck and throat tissue, which resulted in compression of the airway and/or neurological structures in the neck. Some reports describe difficulty swallowing, breathing or speaking. FDA recommends that practitioners either use approved alternative treatments or consider enrolling as investigators in approved clinical studies. FDA requires hospitals and other user facilities to report deaths and serious injuries associated with the use of medical devices. If you suspect that a reportable adverse event was related to the use of rhBMP, you should follow the reporting procedure established by your facility. Reporting adverse events is everyone’s responsibility, even if the event involves off-label use of medical devices. ... http://www.fda.gov/medwatch/safety/2008/safety08.htm#Protein
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Jack Distribution, LLC issued a voluntary nationwide recall of selected lots of Rize 2 The Occasion Capsules and Rose 4 Her Capsules, marketed as dietary supplements. The products were recalled because certain lots contained thiomethisosildenafil, an undeclared ingredient that is an analog of sildenafil, a FDA-approved drug used for Erectile Dysfunction. This undeclared chemical poses a potential threat to consumers because it may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may lower blood pressure to dangerous levels. Consumers who have one of the above products should stop using them immediately and contact their physician if they have experienced any problems that may be related to taking the products. See the manufacturer's press release for the specific lot numbers of the recalled products. Read the entire 2008 MedWatch Safety Summary, including a link to the manufacturer's press release regarding this recall at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Rize
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Sage Products informed healthcare professionals of the voluntary recall of limited lots of 2% Chlorhexidine Gluconate Cloth Patient Preoperative Skin Preparation product. The product was recalled because certain lots were found positive for Burkholderia cepacia (B. cepacia). B. cepacia poses little medical risk to healthy people. However, people who have certain health problems such as a weakened immune system or chronic lung diseases, particularly cystic fibrosis (CF) may be more susceptible to infections with B. cepacia. This organism is a known cause of infections in hospitalized patients and its effects range from no symptoms to serious respiratory infections, especially in patients with CF. The product was distributed to U.S. hospitals and medical centers nationwide and was shipped between 4/28/08 and 6/19/08. Healthcare professionals should stop using the product and coordinate the return of the product with the manufacturer.
Read the complete MedWatch 2008 Safety Summary, including a link to the firm press release, at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Chlorhexidine
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UPDATE 6/26/08] Roche Laboratories informed healthcare professionals of changes to the WARNINGS and ADVERSE REACTIONS sections of the CellCept prescribing information. The changes are based on postmarketing data regarding cases of Progressive Multifocal Leukoencephalopathy (PML) in patients treated with CellCept.
[Posted 04/10/2008] FDA informed healthcare professionals that the Agency is investigating a potential association between the use of CellCept and Myfortic, medicines used to prevent organ rejection, and the development of progressive multifocal leukoencephalopathy (PML), a life-threatening disease. PML is a rare disorder that affects the central nervous system usually occurring in patients with immune systems suppressed by disease or medicines. FDA is reviewing data submitted by Roche, including postmarketing reports it has received of PML in patients who took CellCept or Myfortic, and the proposed revisions to the CellCept prescribing information. FDA has asked Novartis, the maker of Myfortic, for data on PML cases and to revise the Myfortic prescribing information to include the same information about PML included in the CellCept prescribing information. FDA anticipates it may take about 2 months to complete its review of the postmarketing reports and the proposed revisions to the prescribing information. As soon as the review is completed, FDA will communicate the conclusions and recommendations to the public. Until further information is available, patients and healthcare professionals should be aware of the possibility of PML, such as localized neurologic signs and symptoms in the setting of a suppressed immune system, including during therapy with CellCept and Myfortic. http://www.fda.gov/medwatch/safety/2008/safety08.htm#mycophenolate
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NURSING HINTS CORNER
Apron Catchall A full-length vinyl chef's apron works well for a stroke patient who is learning to feed him/her self again. It catches spills, and it is more dignified than a geriatric bib. These inexpensive aprons come in a variety of colors and styles. Terrilynn M. Quillen, RN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 41 Springhouse Corporation/www.springnetcom.
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Jack Distribution, LLC issued a voluntary nationwide recall of selected lots of Rize 2 The Occasion Capsules and Rose 4 Her Capsules, marketed as dietary supplements. The products were recalled because certain lots contained thiomethisosildenafil, an undeclared ingredient that is an analog of sildenafil, a FDA-approved drug used for Erectile Dysfunction. This undeclared chemical poses a potential threat to consumers because it may interact with nitrates found in some prescription drugs (such as nitroglycerin) and may lower blood pressure to dangerous levels. Consumers who have one of the above products should stop using them immediately and contact their physician if they have experienced any problems that may be related to taking the products. See the manufacturer's press release for the specific lot numbers of the recalled products. Read the entire 2008 MedWatch Safety Summary, including a link to the manufacturer's press release regarding this recall at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Rize
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Sage Products informed healthcare professionals of the voluntary recall of limited lots of 2% Chlorhexidine Gluconate Cloth Patient Preoperative Skin Preparation product. The product was recalled because certain lots were found positive for Burkholderia cepacia (B. cepacia). B. cepacia poses little medical risk to healthy people. However, people who have certain health problems such as a weakened immune system or chronic lung diseases, particularly cystic fibrosis (CF) may be more susceptible to infections with B. cepacia. This organism is a known cause of infections in hospitalized patients and its effects range from no symptoms to serious respiratory infections, especially in patients with CF. The product was distributed to U.S. hospitals and medical centers nationwide and was shipped between 4/28/08 and 6/19/08. Healthcare professionals should stop using the product and coordinate the return of the product with the manufacturer.
Read the complete MedWatch 2008 Safety Summary, including a link to the firm press release, at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Chlorhexidine
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UPDATE 6/26/08] Roche Laboratories informed healthcare professionals of changes to the WARNINGS and ADVERSE REACTIONS sections of the CellCept prescribing information. The changes are based on postmarketing data regarding cases of Progressive Multifocal Leukoencephalopathy (PML) in patients treated with CellCept.
[Posted 04/10/2008] FDA informed healthcare professionals that the Agency is investigating a potential association between the use of CellCept and Myfortic, medicines used to prevent organ rejection, and the development of progressive multifocal leukoencephalopathy (PML), a life-threatening disease. PML is a rare disorder that affects the central nervous system usually occurring in patients with immune systems suppressed by disease or medicines. FDA is reviewing data submitted by Roche, including postmarketing reports it has received of PML in patients who took CellCept or Myfortic, and the proposed revisions to the CellCept prescribing information. FDA has asked Novartis, the maker of Myfortic, for data on PML cases and to revise the Myfortic prescribing information to include the same information about PML included in the CellCept prescribing information. FDA anticipates it may take about 2 months to complete its review of the postmarketing reports and the proposed revisions to the prescribing information. As soon as the review is completed, FDA will communicate the conclusions and recommendations to the public. Until further information is available, patients and healthcare professionals should be aware of the possibility of PML, such as localized neurologic signs and symptoms in the setting of a suppressed immune system, including during therapy with CellCept and Myfortic. http://www.fda.gov/medwatch/safety/2008/safety08.htm#mycophenolate
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NURSING HINTS CORNER
Apron Catchall A full-length vinyl chef's apron works well for a stroke patient who is learning to feed him/her self again. It catches spills, and it is more dignified than a geriatric bib. These inexpensive aprons come in a variety of colors and styles. Terrilynn M. Quillen, RN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 41 Springhouse Corporation/www.springnetcom.
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ADVERTISEMENTS
from the members
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This ad is from Wendie (The Inservice guru)
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This ad is from: GShort @AOL.com (Gwen) These are great little cakes ! http://www.delightfulgreetingcakes.com/worldsgreatest.php
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This ad is from Wendie (The Inservice guru)
The eLifeCard can save your life when seconds count! Carry this life-saving card in your wallet in case of emergency at home, at work, at school, traveling, or on vacation! NEW online estate planning system membership makes it possible for you to buy, upload, change and securely store your health care directive, allergies and medication lists, emergency contacts, and more. Exceptional package of other benefits. Give yourself and your family the gift of peace of mind. For FREE information, email name & phone number. All responses kept confidential and answered promptly.
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508-564-9556 (office) 915-990-1367 (fax)
whowland1@mac.com www.thefoundationnetwork.com
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NEW MEMBERS
Welcome To:
gadsdengirlie14@AOL.com (Annie) 6/2/08
cks081@yahoo.com (Kay) 6/2/08
Please send the prospective members' screen names and first names to me: RNFrankie@AOL.com
Welcome To:
gadsdengirlie14@AOL.com (Annie) 6/2/08
cks081@yahoo.com (Kay) 6/2/08
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 current 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; I have no way to reach you without a correct email address....You could always send me your Home number.......lol
NOTICE:
I attempt to send newsletters to your current 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; I have no way to reach you without a correct email address....You could always send me your Home number.......lol
So please send me your new name/address, ok? RNFrankie@AOL.com
OLD ADDRESS: mharris555@cs.com
NEW ADDRESS: mharris555@comcast.net .
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EDITORIAL STAFF:
GALLO RN @AOL.com (Sue), GingerMyst @AOL.com (Anne), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
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OLD ADDRESS: mharris555@cs.com
NEW ADDRESS: mharris555@comcast.net .
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EDITORIAL STAFF:
GALLO RN @AOL.com (Sue), GingerMyst @AOL.com (Anne), 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)
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.~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY
The high office of the President has been used to foment a plot to destroy the American's freedom and before I leave office, I must inform the citizen of this plight. --President John Fitzgerald Kennedy -
In a speech made to Columbia University on Nov. 12, 1963, ten days before his assassination.
Hope to see you online..... Frankie
(RNFrankie@AOL.com)
The high office of the President has been used to foment a plot to destroy the American's freedom and before I leave office, I must inform the citizen of this plight. --President John Fitzgerald Kennedy -
In a speech made to Columbia University on Nov. 12, 1963, ten days before his assassination.
Hope to see you online..... Frankie
(RNFrankie@AOL.com)
