Travel Registered Nurse: July 2010

Thursday, July 29, 2010

Top Of The List For Dropping Out Of High School - ADHD, Conduct Disorder And Smoking

Top Of The List For Dropping Out Of High School - ADHD, Conduct Disorder And SmokingOriginally from: http://www.nursinglink.monster.com/news/articles/15647-top-of-the-list-for-dropping-out-of-high-school---adhd-conduct-disorder-and-smoking

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A Man's Desperate Quest for a Kidney Hits Cyberspace

July 29 - A South Tamaqua man in desperate need of a kidney donor continues to network his plea through newspapers, television and just recently the Internet.

John Nakata, 37, says he is too young to die and he wants to be around to raise his five-year-old son. But as each hour and day passes, he feels the likelihood of that happening decreases.

Nakata and his family appeared on YouTube in a video dated July 8 of this year.

The three-and-a-half-minute video shows John, his wife, Sherry, and his sister, Tina Nakata, pleading to anyone who is between the ages of 21 and 60 and in good health with type "O" blood to agree to be tested by doctors at the University of Pennsylvania Hospital in Philadelphia as a potential donor.

John has diabetes, coronary heart disease and failing kidneys. He receives hemodialysis three times a week and he has been on the donor list for years. But he feels time is running out and he believes he may have only two years to live.

Doctors at the hospital suggested that he get the word out for a stranger to step forward and donate a kidney.

"Each day about 19 people die waiting for a kidney donor. There are 80,000 people who need kidneys," Sherry said. She and her husband want to make people aware of the need for kidney and other organ donors.

Nakata's rare blood type presents another problem for donors but he and his family have been encouraged by the fact that they've heard from people in California, Cincinnati and other sections of the country.

"Four people have been tested and more are responding," Sherry said. "We're getting a lot of feedback and it's just amazing how strangers will offer to donate their kidney, but so far we haven't found a match."

The family has used just about every form of the media to get their message out for a kidney donor.

A man who identified himself as Jeremy White e-mailed the Standard-Speaker on July 22 asking for an area code number from a story published in the Standard-Speaker in June.

White said in the e-mail that he is a healthy, 37-year-old man with type "O" blood and stated he is willing to donate his kidney.

White sent a follow-up e-mail explaining his plans to contact a nephrologist to find out what else he needs to do to help Nakata. A nephrologist is a physician specializing in kidneys.

The newspaper forwarded White's e-mail to the Nakata family so they might contact him.

White wrote that he can't save everybody but it would be great to save one person.

John Nakata is hoping along with his family for just such a stranger to get tested at the University of Pennsylvania and to have a matching kidney that can be transplanted in time to save his life.

In addition to receiving hemodialysis, Nakata must take insulin and 46 pills daily.

He hopes that a donor will be found soon so he can celebrate his 15th wedding anniversary and continue to be able to spend time with his son.

To contact the Nakatas, call 570-436-5114 or e-mail them at donate2john@gmail.com.

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[widget:related_reads_flywheel_1]A Man's Desperate Quest for a Kidney Hits CyberspaceOriginally from: http://www.nursinglink.monster.com/news/articles/15600-a-mans-desperate-quest-for-a-kidney-hits-cyberspace

View this post on my blog: http://travelnursesuccess.com/a-mans-desperate-quest-for-a-kidney-hits-cyberspace

States Continue Push For Extension Of Extra Medicaid Funds

States Continue Push For Extension Of Extra Medicaid FundsOriginally from: http://mnt.to/f/3GKh

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Restless Legs Syndrome Appears To Occur Within Families

Restless Legs Syndrome Appears To Occur Within FamiliesOriginally from: http://www.nursinglink.monster.com/news/articles/15556-restless-legs-syndrome-appears-to-occur-within-families

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Wednesday, July 28, 2010

CDC Confirms Dengue-Fever in Florida

July 28 - The chief researcher of dengue fever at the Centers for Disease Control and Prevention says the federal agency stands by its statement that upward of 1,000 Key Westers could be infected with the disease.

However, Dr. Harold Margolis, based at the CDC's dengue lab in Puerto Rico, says that doesn't mean that 1,000 people are clinically ill with it.

"When you talk about a dengue case, you talk about someone who is clinically ill. For every case, you may have three or four people who are infected but not ill," he said Tuesday.

He likened it to HIV and AIDS. One can carry the HIV virus yet not have full-blown AIDS.

Symptoms of dengue fever include high fever, aching bones, headaches, pain behind the eyes and a rash. More than 100 million people worldwide have contracted the disease, which is endemic in some tropical areas including Puerto Rico, where Margolis is based, and Central America.

On July 13, in preparation for an Atlanta conference on infectious diseases, the CDC put out a report that said 5 percent of Key Westers could have dengue.

That was an extrapolation of 240 blood samples taken from Old Town residents after an initial outbreak of the mosquito-borne disease last June. Five percent of that group tested positive for dengue or related antibodies.

Five percent of a Key West population estimated at 20,000 people is 1,000 people.

And that has caused all kinds of headaches for tourism officials, since those numbers were reported worldwide.

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"This idea that there's an epidemic here, or that we're on the verge of an epidemic, is just false," said Andy Newman, chief marketing guru for the Monroe County Tourist Development Council.

But it's not, Margolis said.

Since 2009, 43 Key Westers have been diagnosed with having the actual dengue disease, according to the Monroe County Health Department.

"We've never said there are 1,000 people walking around with dengue," Margolis said. But he also said the 43 cases of those with the actual disease are "by definition ... an epidemic."

"I think we've been very clear from a technical standpoint," he said. "Yes, it has gotten to the public that you've got this large number of people who are ill, which is not the case."

He added, "I understand the message has gotten mixed, but we never said don't travel to this area. We're saying take precautions."

Florida Keys Mosquito Control District Director Ed Fussell is trying to sell his board on raising the agency's annual budget from $9.48 million to $12.16 million; that includes $931,000 to fight the spread of dengue.

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[widget:related_reads_flywheel_1]CDC Confirms Dengue-Fever in FloridaOriginally from: http://www.nursinglink.monster.com/news/articles/15565-cdc-confirms-dengue-fever-in-florida

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Stimulus Money Funding Medical Training Courses for the Unemployed

Passaic County Community College in New Jersey is offering health care training courses beginning Aug. 2 for the unemployed and entry-level health care workers in an attempt to fill needed positions.

In February, the college received a $4.5 million grant from the American Recovery and Reinvestment Act to fund the Healthcare Training Initiative at no cost to participants. The first session is a phlebotomy course - training in drawing blood.

Project Director Donna Stankiewicz, assistant dean of health science and nurse education, has built a faculty and staff to develop and run the three-year program.

Six courses will be offered in electronic medical records, medical coding, supervisory/front line management, pharmacy technician, customer service training and phlebotomy.

Stankiewicz said PCCC plans to train 1,150 people, 300 unemployed and the remainder from PCCC's grant partners, including St. Mary's Hospital in Passaic, St. Joseph's Regional Medical Center in Paterson and Chilton Memorial Hospital in Pequannock.

"The goal is to get participants trained now ... so they can get employed," she said. Passaic County's unemployment rate is 11.4 percent.

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A placement coordinator will help participants find jobs after they complete the programs.

Cathy Lynch-Kilic, St. Mary's Hospital vice president of human resources, said PCCC will conduct three training programs at the hospital.

"They're offering courses for cross-cultural understanding, dealing with difficult people and communication listening," she said.

"We always want to maintain a high level of skill, and it's going to bring the hospital to the next level."

Stankiewicz said about 10 people are registered for the Aug. 2 class.

PCCC President Steve Rose said the program will pay dividends by providing opportunities for those with no or low-paying jobs in a field lacking qualified people.

"I think this is what the stimulus money was meant to do," he said.

"We all know in health care the unemployment rate is much lower than anything else."

According to the Bureau of Labor Statistics, the health care industry has added about 217,000 jobs since last year.

However, Trisha McTigue, director of education at Chilton Memorial Hospital, said she has not noticed a need for health- related workers.

"In the tri-state area we've had so many hospital closures, I don't know if we see the impact of the shortage," she said.

While the hospital may not have an employee shortage, Mctigue said Chilton is looking to enroll its employees in the customer service training and leadership certificate programs.

"Customer service you can't learn enough about," she said. "It's a 24-hour certificate program.

"People are looking for ways to market themselves today. This is an actual certificate program so it also looks nice on a resume."

Fast facts

Who is eligible? Unemployed or entry-level workers at a partner organization. Applicants must have a high school diploma or GED and take the college's placement test. Passaic County residents receive first priority.

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[widget:related_reads_flywheel_1]Stimulus Money Funding Medical Training Courses for the UnemployedOriginally from: http://www.nursinglink.monster.com/news/articles/15567-stimulus-money-funding-medical-training-courses-for-the-unemployed

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Average ED Wait Times Increase; Some Facilities Make Improvements

Average ED Wait Times Increase; Some Facilities Make ImprovementsOriginally from: http://feedproxy.google.com/~r/NursezonecomNursingNews/~3/8TBOCqflpmc/Average-ED-Wait-Times-Increase-Some-Facilities-Make-Improvements_34716.aspx

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Alzheimer's Foundation Of America And Second Wind Dreams Forge Strategic Partnership

Alzheimer's Foundation Of America And Second Wind Dreams Forge Strategic PartnershipOriginally from: http://mnt.to/f/3GH3

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Also In Global Health News: NIH And Rare Diseases; Cold Emergency In Peru; U.S.-Russia Emergency Cooperation Pact

Also In Global Health News: NIH And Rare Diseases; Cold Emergency In Peru; U.S.-Russia Emergency Cooperation PactOriginally from: http://www.nursinglink.monster.com/news/articles/15551-also-in-global-health-news-nih-and-rare-diseases-cold-emergency-in-peru-us-russia-emergency-cooperation-pact

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HHS Awards $9 Million To Train Preventive Medicine Physicians

HHS Awards $9 Million To Train Preventive Medicine PhysiciansOriginally from: http://www.nursinglink.monster.com/news/articles/15552-hhs-awards-9-million-to-train-preventive-medicine-physicians

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Tuesday, July 27, 2010

Improving Studies Of Cardiac Muscle With New Mathematical Model

Improving Studies Of Cardiac Muscle With New Mathematical ModelOriginally from: http://www.nursinglink.monster.com/news/articles/15553-improving-studies-of-cardiac-muscle-with-new-mathematical-model

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New Study Shows That U.S. Nurses Believe They Considerably Influence Patient Health Decisions and Behavior

New Study Shows That U.S. Nurses Believe They Considerably Influence Patient Health Decisions and BehaviorOriginally from: http://feedproxy.google.com/~r/NursezonecomNursingNews/~3/jvJdH9ZkDyo/New-Study-Shows-That-US-Nurses-Believe-They-Considerably-Influence-Patient-Health-Decisions-and-Behavior_34714.aspx

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Cancer On the Run But Not Conquered

The American Cancer Society recently reported some good news: Cancer is still on the run.

Although men and women continue to get the disease in large numbers, the big change is found in cancer deaths. For men, death rates from cancer fell 21 percent between 1990 and 2006. Death rates for women fell 12.3 percent during that time. In all, some 767,000 deaths from cancer were avoided.

Now the sobering news: An estimated 569,490 people in the U.S. will die from cancer this year.

It's easy to get swept up in conflicting advice on how to avoid cancer. Some of the recommendations you hear are absolutely sound. Some ideas are tomfoolery.

There's at least one cause-and-effect that's plain as day and completely controlled by the individual. As smoking in the U.S. has plunged, so has the rate of lung cancer. Not smoking substantially reduces the chances that you will succumb to one of the greatest threats to public health. The national campaign against smoking has been a resounding success. Thousands of people walking around are living proof.

There are troubling signs, though, that we've hit a roadblock on this. About one in every five U.S. high school students smoke cigarettes, and that number has been stubbornly consistent, according to the Centers for Disease Control and Prevention.

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Youths aren't getting the message that smoking can kill you. Anyone who has visited an outdoor mall recently can't help but notice how many teens light up. It's painful to watch. Less obvious, but on the rise, is the use of other tobacco products such as snuff, roll-your-own tobacco, small cigars and even hookahs. They're aggressively marketed.

The vast majority of adult smokers got hooked before they reached age 21. Persuading teens not to start remains a critical public- health objective. Cost is a big deterrent for teens.

On Jan. 1, 2008, Illinois imposed a welcome ban on smoking in public places. We're glad to see a Wisconsin law went into effect earlier this month that helps level the competition for taverns and restaurants along the border with Illinois. Kansas adopted new rules on July 1. Michigan did two months before that.

Almost half the states, though, have yet to ban smoking in food and drink establishments, and a few states allow it in private workplaces and public spaces. Want to guess where cancer rates tend to be stubbornly high?

Lung cancer still accounts for more deaths than any other kind of cancer. The numbers are going in the right direction - cancer is indeed on the run. But let's make sure the kids know the story.

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Cancer On the Run But Not ConqueredOriginally from: http://www.nursinglink.monster.com/news/articles/15499-cancer-on-the-run-but-not-conquered

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Health Care Industry And Professionals Respond To Seniors' Growing Health Needs

Health Care Industry And Professionals Respond To Seniors' Growing Health NeedsOriginally from: http://mnt.to/f/3GCJ

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Face transplant recipient makes first public appearance

Face transplant recipient makes first public appearanceOriginally from: http://www.nursinglink.monster.com/news/articles/15487-face-transplant-recipient-makes-first-public-appearance

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Monday, July 26, 2010

Lean Thinking and Healthcare

Lean Thinking and HealthcareOriginally from: http://feedproxy.google.com/~r/NursingAndCareer/~3/b9lnCHuLyuQ/BlogPostDetail.aspx

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The Binky Fairy and Other Lies Parents Tell Kids

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Jean Twenge knew her daughter was too old for a pacifier but liked the comfort it provided — not only for her three-year-old, but also for mom and dad. Twenge, a psychology professor at San Diego University and co-author of The Narcissism Epidemic — Living in the Age of Entitlement, knew it wouldn't be easy to part ways with the pacifier. So she did what many other modern parents have done and enlisted the Binky Fairy to take her child's pacifiers and (wink, wink) give them to babies who need them.
Pacifiers aren't all bad. Sucking calms and soothes babies. Plus, studies show a link between pacifier use during sleep and a reduced risk of sudden infant death syndrome (SIDS). But when toddlers can give a full report of their day with a pacifier clenched between their teeth, it's time to rethink the binky. In Twenge's case, a few months after her daughter's third birthday, the Fairy came late at night and left a few gifts and a note thanking her for helping the babies. "The look on her face when I read the note was a mixture of pride and fear," says Twenge. Blessedly absent was any anger toward Mommy.
Many parents today are looking for a buffer in the binky battle. And they could fill a bookshelf with pacifier-purging aids: The Binky Fairy, The Paci Fairy, The Binky Ba-ba Fairy, Goodbye Binky — the Binky Fairy Story.
In earlier generations, the Binky Fairy idea might not have flown. Parents likely just took the plug away, and that was that. "Kids wanted to make their parents happy, but today's parents want to make the children happy," says Twenge. Parents who let their kids hang on to pacifiers as long as they want tend to follow the permissive parenting style, which is linked to children growing up to be more narcissistic than their peers, according to Twenge.
There are other reasons to break the binky habit sooner rather than later. Pacifier use in the toddler and preschool years can lead to dental issues, speech problems, and middle ear infections, not to mention becoming the dreaded binky addict. Children should not be walking around with a pacifier at age 2, says Jonathan D. Shenkin, a pediatric dentist in Augusta, Maine.
According to Claire B. Kopp, a developmental psychologist in Los Angeles, prolonged use of pacifiers into the third or fourth year may indicate a child is experiencing heightened stress levels, not unlike an anxious adult who reaches for food, coffee or a smoke. "It's best to figure out the cause of stress, such as insufficient mom or dad time, erratic sleep or boredom."
To break the habit, many parents are fine with turning to a fairy even if it means telling fibs, and these parents have plenty of company. Two recent studies published in the Journal of Moral Education found that parents regularly lie to their children. The practice has been dubbed "parenting by lying" by Gail Heyman, professor of psychology at University of California, San Diego, and her study co-author, Kang Lee, a professor at the University of Toronto. Heyman says more than 80% of parents lie to their children to try to influence their emotions or behavior. "We were surprised about the extent to which parents lied to children," says Heyman. "They seemed to justify it in terms of a goal they wanted to accomplish."
Melissa Burnett published The Paci Fairy in 2008, after her pediatrician in Encino, Calif., instructed her to banish her daughter's binky. Burnett sought a positive, tear-free way of doing so. "It's obvious that children have an addiction, but what's not obvious is that parents share in this addiction," she says.
The Binky Fairy might seem like an easy way out for parents, but so is going cold turkey. "Simply stating, 'We don't use pacifiers anymore' works pretty well," says Dr. Jennifer Shu, co-author of Heading? Home with Your Newborn: From Birth to Reality. "Parents are often afraid there will be a lot of crying, but if they're consistent, the child will probably adapt and not even miss the pacifier after a day or two."
?The Binky Fairy and Other Lies Parents Tell KidsOriginally from: http://www.nursinglink.monster.com/news/articles/15423-the-binky-fairy-and-other-lies-parents-tell-kids

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AHRQ State Snapshots Expanded to Include New Data on Health Insurance Coverage

AHRQ State Snapshots Expanded to Include New Data on Health Insurance CoverageOriginally from: http://feedproxy.google.com/~r/NursezonecomNursingNews/~3/QuLo8TtyHq8/AHRQ-State-Snapshots-Expanded-to-Include-New-Data-on-Health-Insurance-Coverage_34710.aspx

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The Obesity Crisis Continues

If nurses and the public are not yet convinced it is time to take action to combat obesity, the latest report posted online by the Trust for America's Health and Robert Wood Johnson Foundation is another sobering wake up call. The timely report "F as in Fat: How Obesity Threatens America's Future 2010" reflects data for both adults and children, includes color maps to indicate obesity rates in each state, and provides links to more specific data for each state. Included are statistics that highlight the ethnic, racial, regional and income disparities in this growing epidemic. The article provides more excellent data to support the premise of HR 4601 - creation of a National Nurse to raise awareness and prompt nurses in every community to take action to combat obesity and other costly preventable diseases. Although some progress is reported, the disparities continue according to Jeffrey Levi, PhD, executive director of Trust for America's Health. Levi states "This report shows that the country has taken bold steps to address the obesity crisis in recent years, but the nation's response has yet to fully match the magnitude of the problem." More can and must be done to raise awareness and motivate behavioral changes. The report acknowledges that more than 12 million children are obese, and sites survey data indicating 84% of parents believe their children are at a healthy weight, even when research shows nearly one-third of children and teens are obese or overweight. "Obesity rates among the current generation of young people are unacceptably high and a very serious problem," said Risa Lavizzo-Mourey, M.D., M.B.A., RWJF president and CEO. "To reverse this national epidemic, we have to make every community a healthy community. Americans are increasingly ready and willing to make that investment." This readiness and willingness are obvious to supporters of HR 4601, and serve to drive the campaign for a National Nurse to help spearhead community action. This report also discusses ways some of the new Patient Protection and Affordable Care Act of 2010 sets policy and provides a number of prevention and wellness provisions to help address the issue. Community Transformation grants and the National Diabetes Prevention program are mentioned as having potential to help leverage the success of existing evidence based programs in more communities. Such funding will be a key resource, as the National Nurse role is developed to mobilize nurses, students and retirees to become active supporters and participants in their community's efforts. The NNNO Board encourages all supporters to review this key report online. Be prepared to reference this pertinent report whenever you encourage support for a National Nurse and/or visit your legislators to request they become co-sponsors of HR 4601 The National Nurse Act of 2010.The Obesity Crisis Continues

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Survey Shows Need For Horse Safety Campaign

Survey Shows Need For Horse Safety CampaignOriginally from: http://www.nursinglink.monster.com/news/articles/15401-survey-shows-need-for-horse-safety-campaign

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HHS Awards States $88M For Home Visits Programs

HHS Awards States $88M For Home Visits ProgramsOriginally from: http://mnt.to/f/3GyB

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NPS Pharmaceuticals Announces Completion Of Patient Randomization In Phase 3 STEPS Study Of GATTEX(R) In Short Bowel Syndrome

NPS Pharmaceuticals Announces Completion Of Patient Randomization In Phase 3 STEPS Study Of GATTEX(R) In Short Bowel SyndromeOriginally from: http://www.nursinglink.monster.com/news/articles/15405-nps-pharmaceuticals-announces-completion-of-patient-randomization-in-phase-3-steps-study-of-gattexr-in-short-bowel-syndrome

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Sunday, July 25, 2010

Repros Therapeutics Receives Investigational Review Board Approval To Commence Low Dose For Proellex(R) Study At ICON Site

Repros Therapeutics Receives Investigational Review Board Approval To Commence Low Dose For Proellex(R) Study At ICON SiteOriginally from: http://www.nursinglink.monster.com/news/articles/15407-repros-therapeutics-receives-investigational-review-board-approval-to-commence-low-dose-for-proellexr-study-at-icon-site

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Hospital School Program Helps Demystify Cancer For Classmates Of Young Patients

Hospital School Program Helps Demystify Cancer For Classmates Of Young PatientsOriginally from: http://www.nursinglink.monster.com/news/articles/15383-hospital-school-program-helps-demystify-cancer-for-classmates-of-young-patients

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California's Whooping Cough Outbreak Worst in Half-Century

July 23- SAN ANDREAS - Calaveras County health officials Thursday announced they have now documented three cases of pertussis -- known as whooping cough - so far this year. The announcement comes as California is in the grip of its worst whooping cough outbreak in 50 years, according to state officials.

Calaveras County Health Officer Dr. Dean Kelaita urged adults and youths who have infants or expectant mothers in their households to get immunized against the disease. So far this year, at least six people have died of whooping cough in California, all of them infants.

"The Health Department is also investigating several other cases which are likely to also be confirmed as cases of pertussis," Kelaita said.

Kelaita declined to identify the age, sex or town of residence of those infected, saying that in the county's small communities it would be easy for such information to violate the privacy of patients. But he said that both adults and children have been affected, and that no one in Calaveras County has died or been hospitalized because of the disease.

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Kelaita said that anyone in the county should assume they are at risk for exposure.

Meanwhile, San Joaquin County as of Tuesday this week had received 28 reports of pertussis cases so far this year, said County Health Officer Dr. Karen Furst. Not all of those cases have yet been formally investigated and reported to the state government, she said.

Furst said it is important for people to be vaccinated well before a pregnant relative is expected to give birth. That way they will develop immunity before a new baby comes into the household and will be less likely to pass the disease on to the infant.

Before the current epidemic, in the first six months of 2009, Calaveras County had the highest rate of pertussis in California - a rate of 14.83 cases per 100,000 population. According to the California Department of Public Health, that figure came from seven actual cases divided by the county population of less than 50,000.

Kelaita said there may be two explanations for the high rate last year: 1. the current epidemic began earlier in the Mother Lode and 2. the county has a relatively low rate of vaccination against the disease compared with the state as a whole.

The Tdap (Tetanus, diphtheria and pertussis) vaccine gives immunity to the disease but that immunity does not last forever. Middle-school age children, for example, need a booster if they have not received the Tdap since they were in kindergarten, Kelaita said.

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[widget:related_reads_flywheel_2]California's Whooping Cough Outbreak Worst in Half-CenturyOriginally from: http://www.nursinglink.monster.com/news/articles/15353-californias-whooping-cough-outbreak-worst-in-half-century

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Back pain? Alternative therapies may help

Back pain? Alternative therapies may helpOriginally from: http://www.nursinglink.monster.com/news/articles/15368-back-pain-alternative-therapies-may-help

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New therapies slow vision loss in diabetics

New therapies slow vision loss in diabeticsOriginally from: http://www.nursinglink.monster.com/news/articles/15369-new-therapies-slow-vision-loss-in-diabetics

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Saturday, July 24, 2010

Contextual Errors Often Complicate Medical Care

?July 21, 2010 — Physicians' lack of attention to patient's contextual information, such as transportation needs, finances, literacy, or caregiving, can lead to contextual errors complicating medical care, according to the results of an incomplete randomized block design study published in the July 19 issue of?Annals of Internal Medicine.
"A contextual error occurs when a physician overlooks elements of a patient's environment or behavior that are essential to planning appropriate care," write Saul J. Weiner, MD, from Veterans Affairs Center for the Management of Complex Chronic Care, University of Illinois at Chicago, and colleagues. "In contrast to biomedical errors, which are not patient-specific, contextual errors represent a failure to individualize care."
The study goal was to evaluate how often and under what circumstances physicians examine contextual and biomedical red flags and how well they use what they learn to avoid medical errors. Of 14 practices included in the study, 2 were academic clinics, 1 was a core safety net provider, and 3 were US Department of Veterans Affairs facilities, and the remaining sites came from 2 community-based primary care networks.
Between April 2007 and April 2009, unannounced, standardized patients (actors following scripts) visited 111 attending physicians in internal medicine and presented variants of 4 scenarios. Each variant of the case scenarios was either uncomplicated or included a contextual red flag, a biomedical red flag, or both providing hints to complicating factors. When physicians asked about these red flags, responses of the standardized patients varied in whether they revealed an underlying complicating biomedical and/or contextual factor that could cause management errors.
The main study endpoints were the proportion of visits in which physicians asked about contextual and biomedical factors in response to hints or red flags, and the proportion of visits in which physicians designed error-free treatment plans.
Ninety-six (86.5%) of the physicians completed the study. Some physicians moved or closed their practice following initiation of the study. The total number of patient encounters coded was 399. Coding was based predominately on audio recordings of the encounter, but also on actor checklists and physician notes.
Compared with biomedical red flags, physicians were less likely to ask about contextual red flags (63% vs 51%). For the treatment plan to be error-free, probing for contextual or biomedical information in response to red flags was generally necessary but was not sufficient. Error-free care was provided in 73% of the uncomplicated encounters, 38% of the biomedically complicated encounters, 22% of the contextually complicated encounters, and 9% of the combined biomedically and contextually complicated encounters. Of the 191 biomedically complicated encounters, physicians planned appropriate treatment 31% of the time when elicitation occurred but only 6% of the time when it did not. Of the 185 contextually complicated encounters, physicians planned appropriate treatment 20% of the time when elicitation occurred and only 3% of the time when it did not.
"Inattention to contextual information, such as a patient's transportation needs, economic situation, or caretaker responsibilities, can lead to contextual error, which is not currently measured in assessments of physician performance," the study authors write.
In addition, the authors describe earlier research in which evidence-based medicine has been defined as "conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." Therefore, the authors explain, "a conscientious and judicious approach requires that physicians investigate indicators of clinically important patient contextual factors and adapt their care plan accordingly."
Limitations of this study include that it used only 4 case scenarios, that there were some missing data, and that there was an inability to measure actual rates of contextual errors occurring in primary care settings or during return visits. In addition, the hints provided by the actors regarding underlying contextual issues may have been too subtle.
"Although tracking physician adherence to guidelines as a quality indicator is straightforward, determining whether physicians are appropriately individualizing care is not," the study authors conclude. "Broadening the assessment of physician performance to include this metric unmasks serious performance problems. Strategies that address the challenge of individualizing clinical decisions through both provider education and new measures of performance are urgently needed."
Contextual Errors Often Complicate Medical CareOriginally from: http://www.nursinglink.monster.com/news/articles/15358-contextual-errors-often-complicate-medical-care

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Study Links Zinc Nose Sprays, Loss of Smell

?July 20, 2010 — Just over a year ago, the FDA warned that zinc-containing intranasal cold remedies might cause loss of sense of smell.
Now a researcher who has long argued that the sprays were harmful says he has scientific evidence to back up the claim.
Last summer, the FDA warned consumers to stop using three zinc-containing Zicam products: Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Swabs, and Zicam Cold Remedy Swabs for kids. The federal regulators cited 130 reports of loss of sense of smell among users of the products.
Zicam manufacturer Matrixx Initiatives pulled the three products from the shelves, but the company maintains that there is no link between their use and loss of smell.
In the newly reported analysis, researchers applied a statistical method used to establish a cause-and-effect link between an environmental exposure and development of a disease in an effort to confirm that zinc-containing nasal products can cause loss of sense of smell, known medically as anosmia.
University of California, San Diego professor Terence M. Davidson, MD, says the analysis supports the hypothesis.
He adds that the effectiveness of zinc-containing products for preventing or shortening the duration of colds has never been proven.
“Given that they do absolutely no good for colds and given that there is potential for harm, I see no point in putting any zinc gluconate products in the nose,” Davidson tells WebMD.
Zinc Sprays and Smell Loss
The analysis included 25 patients treated at the University of California, San Diego Nasal Dysfunction Clinic, which Davidson directs, who experienced loss of smell after using zinc nasal sprays or swabs to prevent or treat colds.
Along with colleague Wendy M. Smith, MD, Davidson applied the nine-point Bradford Hill causation environmental exposure statistical measure to assess the probability that the cold-remedy use caused the loss of sense of smell.
In lawsuits brought by Zicam users, Matrixx has maintained that loss of smell resulted from colds or sinus conditions and not use of the zinc-based nasal products.
Upper respiratory infections and nasal and sinus disease are major causes of both temporary and permanent loss of smell and diminished sense of smell.
Davidson says many of his patients and others with suspected zinc-induced smell loss reported intensely painful burning in the nose when they used the products. This was followed by loss of smell within several hours.
“This is a pain that brings people to their knees,” he says. “And soon after they get over the pain, they realize they can’t smell their coffee. This is very different from viral-induced anosmia.”
Study Links Zinc Nose Sprays, Loss of SmellOriginally from: http://www.nursinglink.monster.com/news/articles/15359-study-links-zinc-nose-sprays-loss-of-smell

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New Method for Predicting IVF Success

?July 20, 2010 — A new method for predicting IVF success that takes 52 variables into account works better overall than the commonly used age model, according to a new report.
In IVF (in vitro fertilization), eggs and sperm are brought together in a lab dish to fertilize an egg.
''Our model is more than 1,000 times more predictive than the age-based model," researcher Mylene Yao, MD,? an assistant professor of obstetrics and gynecology at Stanford University School of Medicine, tells WebMD.
"We are pinpointing patients more specifically, using [more than] 50 variables rather than one, " she says.
The model estimates the likelihood of a live birth with future IVF cycles for women who have already gone through one cycle.
Eventually, Yao hopes the method will be available for commercial use. The report is published online in theProceedings of the National Academy of Sciences.
Predicting IVF Success: The Model
Nearly 75% of IVF treatments don't produce a live birth, Yao writes. When deciding whether to try another IVF cycle, patients are guided mostly by age considerations, with estimates based on that.
Yao and her colleagues wanted to develop a more personalized way to estimate future success. So they evaluated data from 1,676 first IVF cycles done at Stanford Hospital & Clinics between 2003 and 2006. They found 52 factors, including age but also hormone levels, quality of eggs, and embryo characteristics, that had an effect on the chances of having a live baby.
"It's basic information," Yao tells WebMD. "We stuck to information that is freely available in people's medical records."
Next, they put together a computer model that classified patients into subgroups based on their clinical characteristics, a method called ''deep phenotyping."
They validated the model by testing it on 634 first IVF cycles and 230 second IVF cycles done at the facility from 2007-2008.
The findings? The new model wasn't perfect, but was often more accurate than using age alone, Yao says. "For every patient for whom the age test was more predictive, there were more than 1,000 for whom our test was more predictive."
Yao and another co-author have founded a company, Univfy Inc., a start-up that will focus on refining the model and bringing it to market. Stanford holds the patent on the test.
Predicting IVF Success: Second Opinion
The new model is termed an improvement by Andrew R. La Barbera, PhD, scientific director of the American Society for Reproductive Medicine in Birmingham, Ala., who reviewed the report for WebMD.
''This model certainly improves the ability to inform patients of the likelihood of them conceiving after IVF," he says. Further research is needed, he says, to make the predictions more reliable.
And he has this caveat about the new model: "It does not provide an accurate prediction in all cases. This model correctly predicts outcome more frequently than the test based on age."
The new model, La Barbera says, takes variables and data that experts often discuss as playing a role in IVF success and plugs them into the prediction.
IVF in the U.S.
About 1% of newborns born in the U.S. annually are IVF babies, according to Yao.
If fertility problems exist, she writes, IVF treatment ''offers the highest live birth rate per treatment cycle."
Even so, she says, the decision to pursue more treatment after the initial attempt fails is a difficult one due to high costs and an ''uncertain prognosis."
Her model, she says, aims to provide a tool that can provide both an evidence-based and personalized prediction of the chances of a live birth from an IVF cycle.
New Method for Predicting IVF SuccessOriginally from: http://www.nursinglink.monster.com/news/articles/15360-new-method-for-predicting-ivf-success

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WHO Guidelines Call for Prompt HIV Testing and Treatment of Newborns

?July 22, 2010 (Vienna, Austria) — Infants born to mothers who are HIV-positive should have their HIV status determined at birth or soon after, with a diagnosis of HIV infection confirmed within 4 to 6 weeks of age, so that treatment can be initiated as early as possible, according to new guidelines issued by the World Health Organization (WHO). The guidelines are available at on the WHOWeb site.
As many as one third of HIV-infected infants die before their first birthday, WHO officials said here at AIDS 2010: XVIII International AIDS Conference, in announcing the new treatment guidelines. By age 2 years, mortality is roughly 50%. Prompt diagnosis and treatment improve survival dramatically. "Compelling data show unequivocally that early initiation of treatment reduces mortality 5-fold," Shaffiq Essajee, MD, medical officer, pediatrics and family care, in the HIV Department of WHO, told?Medscape Medical News.
WHO is trying to eliminate mother-to-child transmission of HIV completely, perhaps as early as 2015.

Dr. Shaffiq Essajee

"We are expanding significantly the recommendation to identify potentially infected children," Dr. Essajee said. "Previously, we advocated for testing sick children in hospital care settings and children known to be exposed through mother-to-child transmission. Now we're going one step further, saying that every child should have their exposure status ascertained as soon as possible. That's the only way we can then link that child to the appropriate care, testing, and treatment services that they need to prevent the morbidity and mortality that occurs in [HIV-positive] children."
Officials in regions with a high burden of HIV disease, defined as prevalence of more than 1% in the general population, are urged to adopt a strategy of ascertaining a neonate's HIV exposure status and beginning treatment as soon as possible. The very high mortality rates among infected children during their first 2 years of life "makes infants and children the most vulnerable of all people living with HIV," Dr. Essajee said.
WHO has done a good job of closing the treatment gap between children and adults, Dr. Essajee said. By the end of 2008, 276,000 children were receiving treatment; by the following year, that number was up to 355,000. However, until now, most of those efforts have been directed at older children, with distressing consequences. "By the time a child reaches 5 years of age, only 1 in 5 has survived," Dr. Essajee added.
"In the recommendations launched today, we're saying any child under the age of 2 should be treated, because mortality in this age group is so high," said Chewe Luo, MD, PhD, senior advisor for HIV-AIDS in the program division of the United Nations Children's Fund.
Many children are still going undiagnosed, Dr. Luo told?Medscape Medical News. "What's critical about these guidelines is that they call for screening these babies as early as 6 weeks, and once you've made the diagnosis, you refer them for treatment."
Infants in impoverished, high-risk regions can have their blood samples dried on filter paper and sent to laboratories for analysis. "This works very well in field conditions," Dr. Luo said. Treatment can begin as soon as the diagnosis is confirmed.
Treatment for HIV-infected children basically is the same as it is for adults — lifelong triple therapy using several different classes of drugs — Dr. Essajee said. Management becomes more complicated if the mother has been on the antiretroviral drug nevirapine during pregnancy, as children exposed to nevirapine in utero may develop resistance to it, so pediatric regimens ideally should include protease inhibitors, as well as triple therapy.
However, Dr. Essajee acknowledges that protease inhibitors can be pricey. "So we tell clinicians that if you don't have access to these expensive and hard-to-get protease inhibitors, treat anyway with the nevirapine you have available, because it's not inevitable that every child will develop a resistance mutation, and even if they do, it's not inevitable that the clinical impact of that resistance mutation will be treatment failure for the child."
WHO Guidelines Call for Prompt HIV Testing and Treatment of NewbornsOriginally from: http://www.nursinglink.monster.com/news/articles/15362-who-guidelines-call-for-prompt-hiv-testing-and-treatment-of-newborns

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Low Vitamin D Levels Associated With Increased Risk for Cognitive Impairment

?July 13, 2010 (Honolulu, Hawaii) — Results of a new analysis using data from the Third National Health and Nutrition Survey (NHANES III) show that vitamin D deficiency is associated with an increased risk for cognitive impairment in older Americans.
The findings echo those from a second report from the same group in a different cohort showing that low levels of vitamin D were associated with subsequent cognitive decline during 6 years of follow-up.
Taken together, it appears that, "low levels of vitamin D are just genuinely bad for the brain," lead author David J. Llewellyn, PhD, from the University of Exeter Peninsula Medical School in the United Kingdom, told?Medscape Medical News. "That's why we're so excited, because vitamin D supplements are such an obvious thing that we can do something about now."

Dr. David J. Llewellyn

The expected epidemic of dementia with the aging population is already starting to appear, he said, and although long-term strategies are needed, trials that may have a short- to medium-term payoff are urgently required immediately. In that setting, trials of vitamin D for prevention may be a promising strategy, he said.
The results from NHANES III were presented here at the Alzheimer's Association International Conference on Alzheimer's Disease 2010. The results from the Invecchiare in Chianti (InCHIANTI) study appear in the July 12 issue of the?Archives of Internal Medicine.
NHANES Findings
Vitamin D was once just of interest in bone health, but recent work has suggested low vitamin D levels may be a risk factor for a wide range of age-associated diseases, Dr. Llewellyn said, including cancer, hypertension, stroke, and more recently, cognitive decline.
It is known that vitamin D crosses the blood–brain barrier and that receptors for vitamin D are found across the brain, but its precise role is still not known, Dr. Llewellyn noted. It does seem to play a role in processes that may be important for dementia risk, including vascular health and amyloid clearance from the brain. Given these associations, he noted, it seems "biologically plausible" that there might be an association of low vitamin D levels with dementia risk and cognitive performance in the general population.
It is estimated that about a billion people worldwide have vitamin D levels considered insufficient (

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Drinking Alcohol Temporarily Heightens Stroke Risk

?July 22, 2010 — Drinking even small amounts of alcohol increases the risk for ischemic stroke, a controversial new study suggests. Results from the Stroke Onset Study show double the risk for stroke an hour after consuming as little as a single serving of wine, beer, or hard liquor.
Previous research has suggested that regular heavy drinking increases the risk for ischemic stroke, but other studies have linked light to moderate alcohol intake to a decreased risk.

Alcohol recommendations

"The evidence on heavy drinking is consistent," senior investigator Murray Mittleman, MD, from Harvard Medical School in Boston, Massachusetts, said in a news release. "Both in the long and short term it raises stroke risk, but we're finding it's more complicated with light to moderate drinking," he said.
The preliminary findings are published online July 15 in?Stroke.
In this multicenter study, investigators interviewed 390 stroke patients about 3 days after hospitalization. The researchers used a case-crossover approach to compare alcohol consumption in the hour before stroke symptoms with the frequency of use during the past year.
They found that 64% of patients drank alcohol the year before their stroke. Some of these patients (27%) drank within 24 hours of their symptoms, and some patients (3.6%) had had a drink within 1 hour of stroke.
The researchers, led by Elizabeth Mostofsky, MPH, also at Harvard, report that the relative risk for stroke in the hour after drinking was 2.3 (95% confidence interval, 1.4 - 4.0;?P?= .002). They report that the relative risks were similar for different types of alcoholic beverages.
Drinking Alcohol Temporarily Heightens Stroke RiskOriginally from: http://www.nursinglink.monster.com/news/articles/15367-drinking-alcohol-temporarily-heightens-stroke-risk

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Mental Disorders, Substance Abuse Linked to Increased Emergency Department Visits

?July 20, 2010 — Almost 12 million of the 95 million total emergency department (ED) visits (1 in 8) made by adults in the United States in 2007 were due to a mental health and/or substance abuse (MHSA) problem, according to a new report from the Agency for Healthcare Research and Quality (AHRQ).
The findings also found that the most common MHSA-related reason for these visits was a mood disorder (42.7%), followed by anxiety disorders (26.1%), alcohol-related problems (22.9%), and drug disorders (17.6%). Nearly 41% of the total MHSA visits led to hospitalization.
"The number of patients with [MHSA] conditions treated in EDs has been on the rise for more than a decade," write lead study author Pamela L. Owens, PhD, from the AHRQ in Rockville, Maryland, and colleagues.
"Not only is this of concern to members of the mental health community but also to the members of the emergency medicine community who are concerned that ED overcrowding results in decreased quality of care and increased likelihood of medical error," they add.
The findings were reported July 2010 in a Healthcare Cost and Utilization Project (HCUP) statistical brief from the AHRQ.
Increased MHSA-Related Visits
For this project, data were examined from the HCUP 2007 Nationwide ED Sample, an AHRQ database of community hospitals in the United States.
Results showed that 12.5% of all ED visits during that year were related to an MHSA condition. These visits were also "2? times more likely to result in hospital admission than ED visits related to non-MHSA conditions," write the study authors.
In addition, 63.7% of all MHSA-related visits were due to mental health conditions, 24.4% were for substance abuse conditions, and 11.9% were for co-occurring conditions.
Women had more of the overall MHSA visits (at 53.9%) and more of the visits due to mental health conditions (65.4%), whereas men had more of the visits related to substance abuse (29.3%) and co-occurring MHSA conditions (43%).
When looking at age range, adults between 18 and 44 years old had the largest percentage of overall MHSA-related ED visits (at 46.6%), followed by those between 45 and 64 years old (34.5%) and those older than 65 years (18.9%).
The patients 18 to 44 years of age were more likely to have visits due to co-occurring MHSA conditions (58.8% vs 42.7% and 50.7% for mental conditions only and substance abuse only, respectively), whereas those older than 65 years were more likely to have mental health conditions only (25.3% vs 9.1% for substance abuse and 5.2% for co-occurring conditions).
Finally, hospital admissions were most related to co-occurring MHSA conditions (57.1%), followed by mental health conditions only (39.3%) and substance abuse (36.6%). The group most likely to be admitted to the hospital was patients 65 years and older with co-occurring conditions, and those least likely to be admitted were between the ages of 18 and 44 years with mental health problems only.
Mental Disorders, Substance Abuse Linked to Increased Emergency Department VisitsOriginally from: http://www.nursinglink.monster.com/news/articles/15363-mental-disorders-substance-abuse-linked-to-increased-emergency-department-visits

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Friday, July 23, 2010

Six Key Tips For Caregivers Navigating The System On Behalf Of Their Parents, Grandparents And Others

Six Key Tips For Caregivers Navigating The System On Behalf Of Their Parents, Grandparents And OthersOriginally from: http://mnt.to/f/3GvD

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No Link Between Moderate Caffeine Consumption And Miscarriage

No Link Between Moderate Caffeine Consumption And MiscarriageOriginally from: http://www.nursinglink.monster.com/news/articles/15344-no-link-between-moderate-caffeine-consumption-and-miscarriage

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Thursday, July 22, 2010

Ob-Gyns Issue Less Restrictive VBAC Guidelines

Ob-Gyns Issue Less Restrictive VBAC GuidelinesOriginally from: http://www.nursinglink.monster.com/news/articles/15346-ob-gyns-issue-less-restrictive-vbac-guidelines

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Vaginal births after C-section usually OK, docs say

Vaginal births after C-section usually OK, docs sayOriginally from: http://www.nursinglink.monster.com/news/articles/15307-vaginal-births-after-c-section-usually-ok-docs-say

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La Jolla Institute Teams With Dana-Farber And Washington University On Sickle Cell Clinical Trial

La Jolla Institute Teams With Dana-Farber And Washington University On Sickle Cell Clinical TrialOriginally from: http://www.nursinglink.monster.com/news/articles/15292-la-jolla-institute-teams-with-dana-farber-and-washington-university-on-sickle-cell-clinical-trial

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La Jolla Institute Teams With Dana-Farber And Washington University On Sickle Cell Clinical Trial

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Black Parents Shocked to Give Birth to White Baby Girl

Black Parents Shocked to Give Birth to White Baby GirlOriginally from: http://www.nursinglink.monster.com/news/articles/15303-black-parents-shocked-to-give-birth-to-white-baby-girl

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Senate Panel To Focus On Problems At Continuing Care Retirement Communities With Large Fees

Senate Panel To Focus On Problems At Continuing Care Retirement Communities With Large FeesOriginally from: http://mnt.to/f/3Gsf

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Ear Mites: How To Get Rid Of Them

Right now we are planning to talk about soiled ears and ear mites. So here's this fantastic feline and he has quite a few dust in his ears. Anytime you turn the ear back you can see that there's some brownish, crumbly wax within. Therefore the best way to tidy this out and inspect it for ear mites, just simply put a small amount of cleaner on the cloth and more or less soak a small q tip inside and scoop a few of that nasty material out of there. You are able to see that his ears are extremely itchy. This is really assisting with the progression and that coarse wax. It's pretty indicative of ear mites.

This particular form of mite wax is often crumbly and heavy like that. The ear mites are actually microscopic so you are not able to look at them with no magnifying, yet they're tiny white bugs that spider around their ear. Thus make certain to grant this pussy-cat some cure for his ear mites to deal with that itching that he's suffering from disappears. If it turns out your pussy-cat goes out routinely or if it really is an enclosed out of doors pussy-cat, or in the event that you come across a run-a-way cat that you choose to make your own, you could notice that these pussies acquire conditions with their ears and their epidermis and generally ear mites are extremely frequent.

Fleas and ticks are additionally completely widespread and so is a ring worm which is really a fungus of the epidermis. These have triggered sizable harm on your dearest pussy or canine. The ear mites are the most typical reason behind ear illness in pet cats. An ear infection will arise in a couple of ways: one you certainly will see black particles within the kitten's ears and secondly, one could see the kitty really batting at his ears, shaking his head off and then one would see the dust after wards.

They may just be inflammed, yet in nearly all circumstances, those felines have ear mites. You can find over-the-counter products and solutions for ear mites that are little bottles of things that one can place in the pet's ears. The thing is, felines never enjoy it! Pussies loathe getting moist and they detest getting stuff in their ears and you commonly have to do it a couple weeks on, two weeks off, a couple weeks on so that you can get the eggs. This is primarily because it'll only stop the adults, it will likely not kill the eggs and you will have to wait until the eggs hatch out and you may have to do this for a couple of months. So managing them non-prescription is cheaper, yet can be extremely difficult.

Therefore bringing them to the animal medical practitioner, you may well find that you can get a great deal of things that are a lot less complicated: drops that go on their back, or perhaps drops that go inside the ears. This is specially a one time remedy and it really is just a great deal, the office call is well worth every penny in comparison with what you go through aiming to handle it in your house.

Wondercide has devoted themselves to discovering the key to quality natural pet products. At present, this company proudly delivers qualified strategies and help on how to remove biting, flying, and burrowing pests by making use of only the very best ear mites treatment.

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Nurses Are Important To The Health Care Industry

Nurses are a very important part of the health care industry. Doctors do not have the time to do everything for their patients and that is where the nurse comes in. When a doctor has something more pressing to attend to then the nurse can handle the problems that are not life threatening. Not all nurses have the same duties. The duties of the nurse will depend on where she or he works.

Nurses who work in the emergency room have to help doctors with their patients. When someone goes to the emergency room it is up to the nurse to get the medical information that the doctor needs. When the doctor looks at the medical information and speaks with the patient the nurse is the one that gives the medicine that the doctor orders to the patient.

There are a lot of people that come into the emergency room every day and the doctor may not have time to give the medication to each patient. Patients can get their medication and be on their way much faster with a doctor helping them. Without a nurse helping the doctor the patient could be at the emergency room for a long time. No one wants to sit for hours at an emergency room when they are not feeling well.

A nurse that works for a doctor in a private office usually has standard duties such as checking temperatures, and blood pressure along with weighing patients. Sometimes the nurse has to draw blood or collect a urine sample.

If you are planning to become a nurse then you will need to decide which type of work would fit you best. If you work for a doctor in his office then you will have a regular schedule usually from 9 to 5 with weekends off. If you work at a hospital your hours could change from one week to the next and you may be asked to work weekends and holidays.

There are upsides as well as downsides to any working environment. Working in an emergency room means that you will get the chance to save lives. Working in a doctors office means you will not see many emergencies but you will have the chance to help keep the patients healthy.

If you are working in an emergency room you may also have to see people die. This is something that some people just can not handle. Working in a private doctors office you are much less likely to see someone die than in the emergency room.

You know yourself better than anyone else does so you are the only person that can decide what working environment is best for you. If you think an emergency room is too much for you then you could try sending your resume out to all the local doctors offices. In the end it really wont matter where you work because you will still be helping others and doing a good thing.

Having trouble filling in nurse staffing shortage at your hospital? As one of the largest healthcare staffing companies in the country, they help connect highly qualified physicians and pharmacists with your hospital's physician job and pharmacist jobs.

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Dust Mites: Tips On How To Get Rid Of Them

They are the primary bug on earth and they might be living at your residence at the present time but you won't be able to see these. How's that for a thought? In case you have got major allergy or asthma, dust mites might be really terminal and serious. These types of dust mites can be the principal reason for precisely why allergic reaction and bronchial asthma attacks come about. A milestone investigation on dust mite treatment done wrapped up and the final results unraveled, which includes data to resolve your monstrous mite difficulty permanently.

On the outside, individuals residence seems to be perfectly nice and clean but what is under the surface is what is actually helping to make plenty of people sick. These very little nasties, incredibly small spider like bugs called dust mites roam around our properties, perhaps resting with us. Dust mites are microscopic animals that stay quite possibly in the cleanest of households. House dust mites are closely related to spiders. It's the waste materials applied by live mites and the body fragments of dead mites that contain the specific allergy substance liable for home dust hypersensitivity. These types of mites are photophobic, dwelling deep in cushions, beds, padded pieces of furniture, rugs and several other soft materials.

When the houses were closed up, men and women often say that they wake up with sinusitus strain and have lots of severe headaches. During the day, they frequently grumble about that "itchy feeling" on their nasal. Any time folks who experience these signs or symptoms had the possibility to drive away the critters on their rugs, they subsequently responded to distinct ads on the newspapers talking about participating in a research to research dangerous mites on some people's properties. A staff of scientists placed a solution of a dust mite solution product on the floor covering and after six months would come back to the home and examine to watch if the mites gone away or remain on. The results confirmed very effectively that this natural mite cure which is reliable to be applied inside your home and outside the house lessens the number of these mites fairly drastically in the household and the results lasts for around six months.

Persons then stated that the effects were impressive. They started to inhale so significantly better. They learned that in the beginning of their dust mite challenge, most people involved in the research had triple the quantity of mites. Finally, many if not all had Absolutely no sums in their households simply because of these natural mite treatments. Each week, individuals lose nearly 5 grams of skin, enough to fill a little spoon and that is what these tiny creatures really live on.

Virtually millions of termites might live in a single mattress. The alarming part about it is that there may be no way of totally eradicating these very perilous mites, but you can find very successful strategies and cures to manage them via the use of natural and organically produced dust mite treatments that people don't have an idea actually exist. People need to be advised and intelligent about what these mites are effective at doing and harming and how they can eliminate them well before its too delayed.

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Mites Control: How To Put Them Out

Sadly, people who suspect they have mites are normally brushed off by the medical related neighborhood as "insane". Organic pest control companies know that individuals expounding on the disappointment and horror of oozing lesions and sensations of parasites stinging and crawling beneath their epidermis is just not a delusion, rather the infiltration of a microscopic mite predator.

Considering they may be both outside and airborne, mites are an arduous pest to learn and deal with, above all when they strike people. An individual may or might certainly not know you can find a number of species of mites. Some humans are worried by all of them and quite a few thankfully are not. Many termites live on plant life and harm farming crops. Even while dust mites can cause terrible allergies for folks and impact their respiratory system. Other individuals have a problem with skin mites and bed mites, which in turn might all be the identical mites. These natural pest control companies never declare to be authorities on each variety of mite inhabiting planet Earth, but have progressively been exposed to many different problems constructed by mites. By way of laboratory, field tests, and consumer comments of personal experiences, it's recognized that many of these organic ear mite treatment will destroy and handle a lengthy number of mites with out using poisonous chemicals, which often have no results regardless. Every day applications of these to the body appear to be especially powerful and are 100% safe. The formulation is restricted to puncture of the epidermal layer of skin and will never move into the blood stream that will cause a sick stomach or other health and wellness troubles.

In addition, they will not make no explicit claims as to success of their mite control, but will bring up to any person that right after years of on-going field working experience and testing, it is found that there are quite a few Mite treatment products and solutions that will get rid of termites of many kinds with out harming you, your youngsters, domestic pets or home with dangerous neuro-toxic chemical substances.

Fogging with this ear mite remedy has brought help to hundreds of residences plagued by mite harmful attacks. A good number of industry professionals would suggest the same remedy would reward them. Though authorities don't possess all the solutions, they think that they may be getting closer to obtaining almost all of them. Because it is extremely hard to distinguish all of the distinct kinds of mites, it really is to some degree challenging to make promises of one hundred percent control. They nonetheless continue ongoing findings and compile comments from their buyers to pass the results on to absolutely everyone.

Regarding the all-inclusive lab tests performed by Iowa State for the USDA, the effects will never be released until finally the discourse and objection time period has been came to the conclusion. The understanding is that written and published information will be forth-coming by middle 2010, susceptible to the objections of the Chemical Businesses that regularly refer to lobbying in opposition to Chemical Free and Organic items. They could simply provide you the statistical consequences that they received verbally and those that are naturally validated by users of the product.

Wondercide has committed themselves to identifying the key to high quality ear mite treatment. Currently, this company proudly gives expert techniques and suggestions on how you can eradicate stinging, flying, and burrowing insects by utilizing only the most beneficial mites treatment.

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Tips For Nurses Who Care For Elderly In The Home

If you are a nurse who cares for an elderly person in their home you know how great your job can be. If you are one of the nurses that takes care of an elderly in their home, there are a few suggestions that will make you more able to administer the best possible care. If there is something you can do to make the experience better for you and the patient then you may want to consider trying it.

When caring for an elderly person you want to know as much information as possible about the patient. You need to meet with family members or anyone that is close with the person you will be taking care of. Any information you can get about their personality, likes, dislikes, will help you know how better to care for the patient.

It is important to know everything about your patient. You should know all the conditions your elderly patient has so that you can better treat your patient. You will also need to know who the condition can affect the patient. If you know everything your patient has to go through in a day then you can develop and proper car plan for them.

You should also know all the medications your patient will be taking everyday. You have to know the medications names, what time they should be given, and how you should administer them. It may be helpful to make a list of the medications as well as the times you have to give them and keep that list with you at all times.

You may want to do some research on all the medications you will be giving your patient. This will give you an idea of what to expect from the side effects from medicine. This will help you to be prepared in case of a medication reaction. It is best to have the information and not need it than to need it and then not have it.

The next thing you want to do is build a personal relationship with the patient. This person is putting their care in your hands and they need to know that you can be trusted. Sit and talk with you patient. Make sure that the patient knows just as much about you as you know about them. If you have their trust you will have an easier time caring for them.

Patience is mandatory when dealing with the elderly. Some can be head strong and kind of testy at times. You need to check you patience level every time you walk into the house. There is no way that you can know what your patient is going through and you need to consider this when caring for an elderly person.

It can be a rewarding job to care for the elderly. It is also a very hard job to do. You have to be a special kind of person to take care of the sick and elderly. From speech pathologists to traveling nurses, there is a great deal of skill required to care for the elderly. You have to be able to show your patient the same kind of love that you would show your own parents. You would not want someone to mistreat your parents so be sure that you show lots of love to your elderly patient.

Career opportunities in the medical industry are constantly growing - from nurse staffing jobs all the way to travel nursing jobs, there is always something opening up!

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Doctors And Patients Both Victimized By Hmos?

One associate professor from a very prestigious university was shocked upon receiving a letter which stated that he will be removed from the provider network of a US health care firm. This huge HMO from the east coast did not give him any reason for making him leave, but this doctor knew well enough that it had something to do with his public denigration about HMOs. He had disputed that this particular HMO along with other for profit HMOs clearly put their clients? lives at risk by gratifying physicians for not granting their patients their desired care and even forcing these people to sign the fixed gag clauses in the standard contract of this HMO.

The contract is very particular in making sure that the doctor will not pursue any action or communication that will turn away any potential or current enrollees, their superiors, their company union groups or the extent of the coverage and that all these things must be kept in paramount confidentiality. In other words, a doctor can easily be terminated upon saying some things to his patient that an HMO won?t approve of.

In the current culture of health service, where their only concern is to maximize earnings, these HMOs tailor fit these policies to keep doctors from letting their patients know the truth on their treatment options, prognoses and diagnoses. Because they silence these doctors, the following horrendous scenarios could become real.

In the mammogram results of a 49-year-old woman, a mysterious shadow appears. the negative finding troubled the woman's doctor and so, he would want to order another test to make sure that the result was just because of a machine error, as to disregard the cancer- positive result. The problem is that the HMO won't pay for it. Advising the patient to pay for a second mammogram herself could be a sign of criticism against the quality of care her HMO provides. So the doctor minimizes the findings and advises his patient to come back in six months for another check up. Unfortunately, the six months could be very dangerous for the woman if she really has breast cancer.

An action should be made to a 60-year-old man to lessen an obstruction caused an enlarged prostate. His surgeon would like to consider using a new laser technique that produces less blood loss, pain and risk of infection or impotence. The truth is that the HMO of the patient will only be used for invasive operation that holds many more consequences. Spilling the new discovery in surgery and suggesting an appeal for the HMO usage of a surgeon to his patient could be the reason of his termination from work.

A woman who is 35 years old was reported to be suffering from extreme depression. Since the doctor wanted the best for the patient, he wanted to prescribe her something that has very little side effects and without risk of death from an overdose. However, an agreement entered by the HMO calls for the pushing of a medicine with high death rates due to overdose as well as tons of side effects. The doctor would prescribed his patient to buy the better brand by her own. But sadly, he signed a contract that won't allow him to say a word. If patients then are clearly informed about the health care, they could possibly build a better decisions on this.

Although the rapid advancements in medical knowledge is available, many consumers, even the smartest ones still depend on their doctors due to its complexity. Health care fates of the patients could fail if the physicians will not be honest with their patients. Patients in this situation would be considered foolish if they were to believe everything their doctors are telling them.

California's nurses association and consumer watchdogs team up for a ballot initiative that would end these unjust gag orders. With the help of public education, legislation and aid of professional organizations, many patients under HMO rule can now get the consultation from doctors they need. Other doctors must learn to be like this bold man who spoke against the unfair laws of HMOs even if it means getting sacked like him. After crossing out the gag clause in his contract, he sent it back to the health care company.

Gag stipulations found in HMO contracts cancel out what the Hippocratic Oath stands for, that physicians must never cause harm on another and that he must work to his capability and judgment to ensure the patient?s health. It is simply abhorrent how many doctors who swore to the Hippocratic Oath break it by getting into another one that jeopardizes their patients? well-being

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Genders Of Alcohol-Dependent Parents And Children Influence Psychopathology In The Children

Genders Of Alcohol-Dependent Parents And Children Influence Psychopathology In The ChildrenOriginally from: http://www.nursinglink.monster.com/news/articles/15299-genders-of-alcohol-dependent-parents-and-children-influence-psychopathology-in-the-children

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Genders Of Alcohol-Dependent Parents And Children Influence Psychopathology In The Children

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Nurses: Giving Excellent Care To Their Patients

From the moment you were born, there was a nurse there to help care for you. Since then, whenever you have been ill or hurt and needed to see a doctor, she has been there for you. Even as important as nurses are to our health, they seldom get the credit they deserve. Without quality professionals in this profession, we would all suffer.

They work very hard, and many must work on holidays and other special occasions when others are on holiday. Their salaries are starting to get a little better because the demand for them has become so great. Hospitals and doctors has started to realize just how valuable a good nurse is to their work.

The field of nursing has many levels. Probably the three best known are nursing assistant, licensed practical nurse, and registered nurse. As the levels progress, she needs more education and has more job responsibilities. At any level, a professional nurse gives her all for the benefit of the patients. There are many openings in this profession, as there is a shortage of qualified professionals.

They, like doctors, can choose to specialize. They may work exclusively in emergency rooms or for a private practice. Some work in specialties like neonatal care, cancer centers, or many other areas. Every area of medicine needs nursing professionals to be successful.

All persons in this profession strive to provide excellent patient care. If you go to see your primary doctor, a nurse is always there to find out about your visit and to get needed information. They get your vitals so that the process is expedited for the doctor. If a doctor has an excellent nurse, he knows his job will be much easier.

Unfortunately, at some point in our life we will probably have to visit a hospital emergency room. When that time comes, a nurse will be there getting your information and making you as comfortable as possible until the doctor arrives. Once the doctor asks for specific tests or x-rays, she will supervise to be certain the right tests are done.

Upon admission to a hospital, a nurse will be there to get your information and make sure you are comfortable. You will see your doctor only a few minutes per day, but she will be there at all times. If you have a need, she will quickly be there to help you. She will help no matter how large or small your need. If you need surgery, she will be there when you wake up. She is there for you in case you have any medical needs.

Travel nurse jobs provide so many people with excellent medical care. We often forget just how valuable they are to our health. If you have one who gives you excellent care, let her know how grateful you are for the work she and so many others like her do. Although they do not do their jobs to get praise, it is the least we can do for these medical heroes.

Find freedom in your career aspirations by filling one of many travel nurse jobs available. Our website offers the tools and resources you need to find, occupational therapy jobs and nurse practitioner jobs.

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Doctors Feel Like Glorified Receptionists Between Patient To Specialist

In California, one doctor suddenly exchanged his shingle on a thriving group practice for a nameplate on the door of a corporation. Many report that the practice of private medicine has just become too boring and routine. He was tired of just listening to patients and then telling them which specialist to go to. His group practice was forced to abandon the very things he enjoyed about medicine, from complex medical problems to obstetrics and surgery, due to the high cost of malpractice insurance. The medical field is now dominated by the specialists and traditional general practitioners feel their position is largely redundant.

New positions such as those in companies that manufacture pharmaceuticals pay much more and don't carry the risk factors that push malpractice insurance through the roof. He is among the increasing ranks of doctors who have transitioned into the corporate realm. The corporate world offers medical research, support and development jobs that free the doctor from the complications of insurance and the worries over funding and research grants. There is even a city that wants to hire these doctors in hopes of improving employee health and safety. The majority are still employed in the medical realm, some in occupational health advisory roles, some in pharmaceutical research, though business has emerged has having more appeal for some than medicine does.

The financial rewards for those working for the city can equal what a doctor made in private practice. Physicians employed by corporate entities generally work 8-hour days, are provided with paid malpractice coverage, receive time off for educational purposes, and are compensated at levels that are comparable to those who remain in private practice.

The percentage of individuals practicing medicine full time in the United States corporate world is roughly 2 percent of the total population. In addition, thousands more physicians work in occupational medicine, meaning that they provide advice and guidance in the areas of employee wellness, industrial safety and product development. There are another 10,000 physicians who work part time in roles such as these. Certain doctors are employed in the pharmaceutical industry and thousands more are employed by insurance carriers as underwriters and claims consultants.

The chief medical director's career track for a large insurance agency is not rare amongst corporate physicians. One doctor seeking a change from his already established private practice, accepted an available part-time job with a restaurant chain; this position began his exit from private practice. Sometimes examining up to 60 food handlers in an hour, the doctor worked at an exhausting pace. Eventually he landed a job to be the medical director of a couple of movie studios and said goodbye to his private practice for good. This position offered him greater opportunities; the patient wasn't responsible for paying so he could treat them without limit and he could practice preventative medicine.

Many private physicians see themselves as automatons faced with ever-increasing obstacles in their quest for a viable business. The perception was that of a physician who handed out pills, wrapped bandages and provided care to those who were not really in need of medical attention. However, a shift in opinion and regulations regarding occupational and product safety have rendered corporate doctors newly powerful and worthy of admiration. A major New York telecommunications company's medical director says that it is rather refreshing to be actually "practicing" medicine again.

The younger generation of doctors are able to work just as well (or even better) than they would be able to anywhere else. Older doctors can usually afford to sacrifice gross and net income for the benefits of corporate medicine. Some corporate physicians are saying that in terms of quality of lifestyle and career earnings, the change from private practice is well worth it. Taking a job in occupational medicine was thought of as a silly choice by most every physician at one point in time. Now it seems that these people who thought this way are becoming envious.

The potential for bigger salaries and better benefits make these jobs popular. Possibly the most famous is a 78 year old doctor who made millions without ever practicing medicine. He made his first million while still in medical school by bringing new life to his father's failing drug company. After he graduated from medical school he bought and set up a surplus army field hospital in the famine stricken Ural Mountain region of the Soviet Union. Once there, he discovered that food was needed more than medicine, and so he imported grain, making trade contracts in the process which became stepping stones to a new career.

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