CDC and The Joint Commission Present FREE Continuing Education Webinar Tomorrow - Your Lab and Ebola: click here

CDC and The Joint Commission Present FREE Continuing Education Webinar Tomorrow - Your Lab and Ebola: What you Need to Know

Anyone getting prepped for NCLEX RN? or any nurses want to get some review out of the way....click on the title link for more....

Pharmacokinetics Made Simple....

What is personal protective equipment?

Personal protective equipment, commonly referred to as "PPE", is equipment worn to minimize exposure to serious workplace injuries and illnesses. These injuries and illnesses may result from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards. Personal protective equipment may include items such as gloves, safety glasses and shoes, earplugs or muffs, hard hats, respirators, or coveralls, vests and full body suits.

What can be done to ensure proper use of personal protective equipment?

All personal protective equipment should be of safe design and construction, and should be maintained in a clean and reliable fashion. It should fit well and be comfortable to wear, encouraging worker use. If the personal protective equipment does not fit properly, it can make the difference between being safely covered or dangerously exposed. When engineering, work practice, and administrative controls are not feasible or do not provide sufficient protection, employers must provide personal protective equipment to their workers and ensure its proper use. Employers are also required to train each worker required to use personal protective equipment to know:

• When it is necessary
• What kind is necessary
• How to properly put it on, adjust, wear and take it off
• The limitations of the equipment
• Proper care, maintenance, useful life, and disposal of the equipment

If PPE is to be used, a PPE program should be implemented. This program should address the hazards present; the selection, maintenance, and use of PPE; the training of employees; and monitoring of the program to ensure its ongoing effectiveness.

Personal protective equipment is addressed in OSHA standards for Construction, General Industry, Shipyard Employment,Marine Terminals, and Longshoring. OSHA requires that many categories of personal protective equipment meet or be equivalent to standards developed by the American National Standards Institute (ANSI).

Blog News Updates....Check out our Virtual Book Store by clicking here.....

Celebrating Eva Noles......

The first African-American woman to train and graduate as a Registered Nurse in Buffalo, New York, who went on to become a Nursing Educator and the Director of Nursing at the world- renowned Roswell Park Cancer Institute.Eva M. Noles is a registered nurse, a nursing educator, and a former Director of Nursing at Buffalo, New York’s world-renowned Roswell Park Cancer Institute. The first African-American nurse to train in Buffalo, Eva actually retired twice only to come back to train many people how to provide various levels of healthcare. She was with Roswell Park Cancer Institute Park for over 30 years, serving in many capacities.Eva Malinda Noles was born Eva Bateman in Cleveland, Ohio on April 5, 1919. 

Her family settled in Buffalo, New York in1928. She graduated from Hutchinson Central High School in 1932. After high school, Eva began thinking about her future. For a young African-American woman in the 1900s, options were usually limited to such things as house cleaning, cooking or child-rearing.As part of a dare from a friend, Eva courageously applied and was accepted to the E. J. Meyer Memorial Hospital School of Nursing (now Erie County Medical Center) after high school. Although she was admitted into the nursing program, Eva was not fully accepted in the school and encountered many subtle forms of racial prejudice, even right up to graduation.In 1940, she finished at the top of her class and became the first African-American woman to be trained as a registered nurse in Buffalo. However, prejudice didn’t end with her diploma from the school of nursing. It followed her into her first years of working at her profession.

After establishing herself in the field, she went on to earn a Bachelor of Science degree in Nursing in 1962 and a Master of Arts degree in Education in 1967 from the University at Buffalo.After stints at EJ Meyer Memorial, Sisters and Columbus Hospitals, Eva was hired as a staff nurse at Roswell Park Cancer Institute in 1945. Eva credits Roswell Park in allowing her to realize her professional aspirations.Eva founded the New York State Nurses Week in 1970, which has been celebrated ever since from May 24th to the 30th.She climbed through the ranks, breaking race barriers at every step, until she became the director of nursing in 1971.

Over this time, Eva had opportunities to work with renowned Roswell Park doctors and researchers.Eva Noles dedicated her life to nursing, but also to community service and outreach. She served on many local and national committees, including the NYS Board of Nursing and the  American Nurses Association. She also served on the Buffalo General Hospital Board of Trustees and the Community Mental Health.She has received many awards for her dedicated community service, including the Uncrowned Queens Institute’s Culture Keepers award for outstanding contributions to African-American culture in Western New York, which she received in 2002.Eva is the author of several publications, including Buffalo’s Blacks: Talking Proud and Black History: A Different Approach. Eva credits the lack of real and truthful history collection and story-telling on the local African-American experience as her reasons of becoming an author several years ago. In 1974, Eva retired from Roswell Park.

Despite retirement, however, Eva continued working with the federal government that trained nurse practitioners, as well as joining Medical Personal Pool as a home care supervisor, where she was later appointed as a staff developer for the firmEva, who now resides in Williamsville, New York, continues to be an inspiration for many people. She continues to be referred to as the consummate example of inspiration and determination for many.Even after her retirement, Eva still spends much of her time helping others. Struggling against impressive odds and coming out on top has been a pattern for her, but she insists it has been more than a matter of luck.Many people throughout the Buffalo-community, in an effort to thank her for her years of service in the field of health and her commitment in making the city that she loves a better place to live for so many, have organized efforts to create a college scholarship in her name, that will be awarded annually to a deserving student aspiring for a career in health.

Roswell Park will also name a nursing training room at its campus in her honor

Vasculitis-Prevention, Diagnosis, and Management....

 

 

  Vasculitis is an inflammation and necrosis of the blood vessels, leading to hemorrhage, ischemia, and infarction.. Treatment of the condition is entirely dependent on the extent of the disease. In many instances, cutaneous vasculitis is a self-limited condition, relieved by leg elevation, avoidance of standing, and therapy with non-steroidal anti-inflammatory drugs (NSAIDs). However, more extensive or severe disease can prove more difficult to manage.

Treatment of vasculitis should begin with a confirmatory diagnosis to eliminate conditions with a similar appearance. A tissue biopsy may confirm diagnosis of cutaneous vasculitis, and can sometimes be used to identify the type of immunoglobin involved. Once a diagnosis is confirmed histologically, other organ systems should be evaluated to identify potential causative factors.

The first and preferred treatment for cutaneous vasculitis should always be avoidance of triggers known to exacerbate the condition, such as excessive standing, infection, or drugs.  For mild recurrent or persistent disease, colchicine and dapsone are first-choice agents.

Severe cutaneous disease requires treatment with systemic corticosteroids or more potent immunosuppression (azathioprine, methotrexate, or cyclophosphamide are typical treatments). A combination of corticosteroids and cyclophosphamide is required therapy for systemic vasculitis, which is associated with a high risk of permanent organ damage or death. Intravenous immunoglobin or plasmapheresis may be useful in the treatment of severe, refractory vasculitis, or in patients who have contraindications to traditional immunosuppression.

New biologic therapies that act via cytokine blockade or lymphocyte depletion, such as the tumor necrosis factor-α inhibitor infliximab and the anti-B-cell antibody rituximab, respectively, appear to offer some benefit in certain settings, such as connective tissue disease and anti-neutrophil cytoplasmic antibody-associated vasculitis.

This is article 3 in a series of four articles pertaining to vasculitis.  To read the additional articles click title link, or  click here.

.
Vasculitis is the inflammation of blood vessels. There are many types of vasculitis. Diseases in which vasculitis is a primary process are called primary systemic vasculitides. Vasculitis may also occur as a secondary feature in other rheumatic diseases and syndromes
WHAT YOU NEED TO KNOW ABOUT VASCULITIS What is vasculitis? Vasculitis is a general term that refers to the inflammation of blood vessels. When blood vessels become inflamed, they can only react in limited ways. They may become weakened, stretch and increase in size, or become narrow – even to the point of closing off entirely. What are the consequences of vasculitis? In an extreme situation, when a segment of a blood vessel becomes weakened, it may then stretch and bulge (called an “aneurysm”). The wall of the blood vessel can become so weak that it ruptures and bleeds. Fortunately, this is a very rare event. If a blood vessel becomes inflamed and narrowed, blood supply to that area may be partially or completely eliminated. If collateral blood vessels (thought of as alternate routes of blood supply) are not available in sufficient quantity to carry the blood to such sites, the tissue supplied by the affected blood vessels will die. This is called infarction. Because vasculitis can occur in any part of the body, any tissue or organ can be at risk. Who is affected by vasculitis? Vasculitis can affect people of all ages from childhood to adulthood. There are some types of vasculitis that occur in certain age groups more than others. What are the causes of vasculitis? Vasculitis may occur secondary to an identified underlying disease or trigger. Occasionally, an allergic reaction to a medicine may trigger vasculitis. Vasculitis can sometimes develop in conjunction with an infection. Usually in these cases, the infection causes an abnormal response in the person’s immune system, damaging the blood vessels. Viral hepatitis (a type of liver infection), is a specific infection that can be associated with vasculitis. Vasculitis may also be related to other diseases of the immune system that the patient had for months or years. For example, vasculitis could be a complication of rheumatoid arthritis, systemic lupus erythematosus, or Sjögren’s syndrome. In many cases though, the causes of vasculitis are not known. These diseases are collectively sometimes referred to under the broad heading of primary forms of vasculitis. In such settings, the appearance and location of the vasculitis often behaves in a distinct way allowing it to be diagnosed as a unique type of vasculitis and is given a specific name. What are the types of primary vasculitis? There are many types of primary vasculitis including disease entities such as Wegener’s granulomatosis, microscopic polyangiitis, Henoch-Schönlein purpura, polyarteritis nodosa, Kawasaki disease, giant cell arteritis, Takayasu’s arteritis, and Behçet’s disease. Some are named after doctors (Wegener, Takayasu, Kawasaki) who were among those to provide the best original descriptions of the illness or are named based on features seen on biopsies (giant cell arteritis, angiitis, arteritis nodosa) of affected tissues or blood vessels. Although most of these are systemic (or generalized) vasculitides where the vasculitis may affect many organ systems at the same time, they often differ a great deal among each other. Some of the primary systemic vasculitic diseases may be quite mild and require little or even no treatment. Other forms may be severe, affecting critical organs and, if left untreated, may lead to death within days or months. Some forms of primary vasculitis may be restricted in their location to certain organs (these are called isolated forms of vasculitis). Examples include vasculitis that only occurs either in the skin, eye, brain (isolated CNS vasculitis) or certain internal organs. What are the symptoms of vasculitis? Because any organ system may be involved, an enormous number of symptoms are possible. If the skin is involved, there may be a rash. If nerves suffer loss of blood supply, there may initially be an abnormal sensation followed by a loss of sensation. Vasculitis in the brain may cause a stroke, or in the heart may result in a heart attack. Kidney inflammation usually is not associated with symptoms and is detected by the doctor by examination of the urine. This is important to recognize as inflammation in the kidneys can lead to kidney failure unless promptly detected. Sometimes the symptoms are nonspecific. When inflammation is present in the body, we tend to respond in ways that tell us that we are not well, but those responses may not be unique to vasculitis at all. For example, along with the symptoms mentioned previously, a person with vasculitis may also have a fever or experience loss of appetite, weight loss and loss of energy. How is vasculitis treated? Treatment depends entirely upon the diagnosis, the organs that are affected, and the severity of the vasculitis. When vasculitis represents an allergic reaction, it may be “self limiting,” or will go away on its own and not require treatment. There are other instances also where minimal to no treatment is required and the person can be closely observed. In instances where critical organs such as the lungs, brain or kidneys are involved, the outlook is less positive and aggressive and timely treatment is necessary. For most forms of systemic vasculitis, treatment generally includes corticosteroid medications (prednisone is the most commonly prescribed). For some forms of vasculitis, treatment must also include another immunosuppressive medication used in combination with the prednisone. Some of these medications are chemotherapy agents like those used to treat cancer, but are given in doses considerably lower than people with cancer may receive. The goal of this type of chemotherapy is to suppress the abnormal immune response that has led to blood vessel damage. What is the outlook for people with vasculitis? The outlook for a person who has vasculitis will vary with the type of vasculitis that is present, what organs are being affected, how severe the vasculitis is, and how the person responds to treatment. Knowing the type of vasculitis allows the doctor to predict the likelihood of illness severity and outcome. Prior to the time of available treatment, people with severe vasculitis may have had anticipated survival of only weeks to months. However, today with proper treatment, normal life spans are possible. The success of therapy is related to prompt diagnosis, aggressive treatment and careful follow-up to be sure that side effects from medications do not develop. Once vasculitis is under control (often referred to as “remission”), medications may be cautiously withdrawn, with the hope that the patient will sustain a long remission, independent of treatment. Because some forms of vasculitis can recur (referred to as a “relapse”) after a period of remission, it is very important for patients with vasculitis to remain under the care of a knowledgeable physician.

FDA Issues Public Health Advisory on Certain Pain Meds....

 

January 9, 2012 — The US Food and Drug Administration (FDA) is advising patients and healthcare professionals of a potential problem with opiate products manufactured and packaged for Endo Pharmaceuticals by Novartis Consumer Health at its Lincoln, Nebraska, manufacturing site.

In a telebriefing today, Edward Cox, MD, from the FDA's Center for Drug Evaluation of Research, said: "Due to problems incurred when these products were packaged and labeled at the site, it's possible that tablets from 1 product may have been retained in the packaging machinery, and then may have carried over into packaging of another product."

"This could result in an incorrect pill of 1 medicine ending up in the bottle of another product," he said. "The likelihood of this occurring in medication dispensed to medication is low," he emphasized.
According to the public health advisory the FDA posted today, the following products may be affected:

• Opana ER (oxymorphone hydrochloride) extended-release tablets CII
• Opana (oxymorphone hydrochloride) CII
• oxymorphone hydrochloride tablets CII
• Percocet (oxycodone hydrochloride and acetaminophen USP) tablets CII
• Percodan (oxycodone hydrochloride and aspirin, USP) tablets CII
• Endocet (oxycodone hydrochloride and acetaminophen USP) tablets CII
• Endodan (oxycodone hydrochloride and aspirin, USP) tablets CII
• morphine sulfate extended-release tablets CII
• Zydone (hydrocodone bitartrate/acetaminophen tablets, USP) CIII
•  

"Endo Pharmaceuticals reports that they are aware of only 3 product mix-ups with respect to these products since 2009," Dr. Cox said. "Endo is not aware of any patient having experienced a confirmed product mix-up, nor any adverse events attributable to a product mix-up," he added.
He also noted that an FDA review of the Adverse Event Reporting System database from January 1, 2009, through January 6, 2012, for the Endo Pharmaceutical opioid products manufactured at the Lincoln, Nebraska, facility failed to turn up any reports of adverse events directly related to manufacturing problems.
The FDA advises patients and healthcare professionals to check any opiate medicines made by Endo in their possession and to ensure that all tablets are the same.

"We are asking patients to check their medicines to look for any tablet of a different size, shape, or color from their regular medicine," Dr. Cox said. "We are asking pharmacists to perform a visual inspection when dispensing the potential affected Endo opioid medications, according to the instructions provided by FDA."
For more information, patients and healthcare providers can also contact Endo Pharmaceuticals' call center at 1-800-462-3636.

In the advisory, the FDA says they expect there will be "periods of shortages for these products" in the coming weeks, and they are actively working with Endo Pharmaceuticals and Novartis to "minimize the degree of impact."
As a precautionary measure, Novartis Consumer Health has initiated a voluntary recall of the other nonopiate products made at their Lincoln, Nebraska, manufacturing facility.
These products include all lots of Excedrin and NoDoz products with expiration dates of December 20, 2014, or earlier, as well as Bufferin and Gas-X Prevention products with expiration dates of December 20, 2013, or earlier, in the United States.

Healthcare professionals and patients are encouraged to report adverse events related to the use of these products to MedWatch, the FDA's safety information and adverse event reporting program, by telephone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm, or by mail to MedWatch, FDA, 5600 Fishers Lane, Rockville, Maryland 20852-9787.

Diabetes Animation...Maintaining Blood Glucose Homeostasis.....

Adherence to Post MI Medications

Stroke Risk Associated With Diet Quality, Energy Intake Overall.....

 

Clinical Context...

Undernutrition before birth, as well as in infancy, childhood, and adulthood, is associated with an increased risk for stroke in later life. However, the mechanism of increased stroke risk is poorly understood.

In addition, overnutrition also increases stroke risk. The likely mechanism is by hastening the onset of obesity, hypertension, hyperlipidemia, and diabetes. The objective of this review by Hankey was to describe recent evidence regarding the effects of nutrition on stroke risk.

Study Synoposis and Perspective

The overall quality of a person’s diet and the balance between caloric intake and caloric expenditure appear to be more important determinants of stroke risk than the actual foods and nutrients consumed, according to a new review published in the January 2012 special issue of the Lancet Neurology.

In general, the 2 biggest threats to health and risk of stroke are overeating and excess salt, author Graeme J. Hankey, from Royal Perth Hospital, Perth, Western Australia, writes.

"These behaviors are a normal response by people to an abnormal environment," Dr. Hankey notes. "Our living environments have become more conducive to consumption of energy and less conducive to expenditure of energy in developed and increasingly in developing regions."

He writes that between 1970 and 2008, the incidence of stroke in high-income countries fell by 42%, probably as a result of increased public awareness about the dangers of high blood pressure, high cholesterol, and cigarette smoking.

But in poorer countries, the incidence of stroke increased by more than 100% during this period. This rise coincided with food and lifestyle changes associated with industrialization and urbanization.

Small Number of Trials

In his review, Dr. Hankey examines the evidence linking nutrition and diet to the risk of stroke. He searched PubMed articles published in English from 1970 to October 2011, using a variety of search terms.

The review included a small number of randomized trials and large observational and epidemiological studies.

He found that the findings from these studies were diverse, owing to the fact that most were epidemiological and therefore "prone to substantial methodological challenges of bias, confounding, and measurement error."

For example, one observational study found that a high intake of a healthy diet was associated with an increased risk of stroke, whereas another observational study found just the opposite.

Dr. Hankey's review also revealed the following effects of individual foods and beverages on the risk of stroke:

• Fish: 3 servings a day associated with a 6% lower risk of stroke
• Fruits and vegetables: >5 servings a day associated with a 26% lower risk of stroke
• Meat: Each daily serving associated with a 24% increased risk of stroke
• Reduced-fat milk: associated with a lower risk of stroke vs full-fat milk
• Chocolate: High consumption associated with a 29% lower risk of stroke
• Coffee: 3 to 4 cups per day associated with a 17% lower risk of stroke
• Tea: ≥3 cups per day associated with a 21% lower risk of stroke
• Sugar-sweetened beverages: high intake associated with increased obesity, diabetes, metabolic syndrome, and coronary heart disease
• Whole grains: high intake associated with a 21% lower incidence of cardiovascular events
• Rice: intake not associated with risk of stroke
•  

"Further research is needed to improve the quality of evidence relating to the association of many nutrients, foods, and dietary patterns with stroke risk," Dr. Hankey suggests.

This requires adequately powered, large randomized trials with carefully described patient populations and interventions. The outcomes of such trials should also distinguish first-ever and recurrent stroke, as well as ischemic and hemorrhagic stroke, and their different etiologies.

Dr. Hankey also suggests that population-wide salt reduction programs led by governments and with industry cooperation could be highly cost effective.

"In the USA, modest, population-wide reductions in dietary salt of up to 3 g per day…are projected to reduce the annual number of new cases of stroke by 32,000 to 66,000, similar to the benefits of population-wide reductions in tobacco use, obesity, and cholesterol levels," he writes.

Dr. Hankey told Medscape Medical News that he hopes his study will stimulate conclusive studies "by means of large, randomized controlled trials of the effect of dietary nutrients, foods, and patterns on stroke and its pathological and etiological subtypes."

The current evidence associating dietary nutrients, foods, and patterns with stroke is generally suboptimal for providing reliable conclusions about causality, he reiterated.

"The effect of only a few supplements on stroke risk have been studied by means of large, randomized controlled trials, and all of those have shown no benefit of antioxidant vitamins, B-vitamins, and calcium supplements in preventing stroke, despite large, more suboptimal, epidemiological studies claiming they should be beneficial," he said.

Best Diet Still Uncertain

Commenting on this study for Medscape Medical News, Eugene Storozynsky, MD, a cardiologist from the University of Rochester Medical Center, Rochester, New York, said that he agrees with Dr. Hankey's conclusions.

"This is a good review of the literature as to what role diets and their components would have on reducing stroke, and what it tells us is that there still is a lot of uncertainty about the best diet. One study suggests benefit of a certain food or strategy, the other may come to the opposite conclusion," Dr. Storozynsky said.

The take-home message here is as Dr. Hankey notes, Dr. Storozynsky continued. "We need rigorously done randomized controlled trials to really monitor the long-term effects of diets and nutrients, rather than observation studies that look at individual factors, to see whether or not there is any benefit to adopting certain strategies."

Dr. Storozynsky also noted what he considers to be an important omission from Dr. Hankey's review.

"This review did not look at the effect of exercise and how it affects nutrition or stroke results. Does routine daily exercise mitigate the effect of intermittent poor eating? Exercise definitely needs to be part of the equation," he said.

Helmi L. Lutsep, MD, from the Oregon Stroke Center at Oregon Health Science University in Portland, added, "My quick read of the article suggests that it is a very nicely written, comprehensive review of our current knowledge regarding nutrition and stroke."

Dr. Lutsep, who is also a spokesperson for the American Academy of Neurology, added, "While I haven't seen all of these pieces summarized in one place before, I don't think that the article provides novel observations."

Dr. Hankey reports that he was the principal investigator of the VITAmins TO Prevent Stroke (VITATOPS) trial and has financial relationships with Sanofi-Aventis, Johnson & Johnson, Bristol-Myers Squibb, Boehringer Ingelheim, Bayer, and Pfizer Australia. Dr. Storozynsky and Dr. Lutsep have disclosed no relevant financial relationships. 

 

Lancet Neurol. 2012;11:66-81. Abstract

The National Stroke Association provides a comprehensive discussion for patients about stroke prevention.

Study Highlights

• On the basis of a literature review, the reviewer noted the following findings:
  • Vitamin A supplementation increases all-cause mortality risk.
  • β-carotene supplementation increases cardiovascular and all-cause mortality risks and does not prevent stroke.
  • Vitamin C supplementation does not prevent stroke.
  • Vitamin E supplementation increases all-cause mortality risk and does not prevent stroke.
  • Although folic acid supplementation does not prevent stroke in populations with high folate intake, deficiency in regions of low folate intake may be a causal and treatable risk factor for stroke.
  • Vitamin D deficiency is associated with hypertension, cardiovascular disease, and stroke, but to date, supplementation has not been shown to prevent cardiovascular events. Randomized trials are underway.
  • Salt supplementation by 5 g per day is linked to a 23% increase in stroke risk (95% confidence interval [CI], 6 - 43).
  • Although decreasing salt intake has not been shown to reduce stroke risk, lowering consumption by 2 g per day is associated with a 20% decrease in cardiovascular events (95% CI, 1 - 36), and lower salt intake is also linked to blood pressure reduction.
  • Potassium supplementation by 1 g per day is associated with an 11% reduction in the risk for stroke (95% CI, 3 - 17), but supplementation is not proven to prevent stroke.
  • Potassium supplementation by 0.8 g per day is associated with a decrease in blood pressure by 5/3 mm Hg.
  • Calcium supplementation exceeding 0.5 g per day is linked to a 31% increase in the risk for myocardial infarction (95% CI, 2 - 67), does not prevent stroke, and may actually increase stroke risk.
  • High intake of total fat, trans fats, and saturated fats is not associated with an increased risk for stroke, and reduced total fat intake does not lower stroke risk.
  • High intake of plant n-3 polyunsaturated fats is associated with a reduced risk for stroke.
  • Marine n-3 polyunsaturated fat supplementation lowers cardiovascular events and death by 8% (95% CI, 1 - 15), but in a randomized trial, it did not reduce stroke risk.
  • High intake of carbohydrates with high glycemic index and glycemic load is associated with increased blood glucose levels, body weight, and stroke mortality.
  • High fiber intake is linked to lower blood pressure, blood glucose levels, and low-density lipoprotein cholesterol levels.
  • High protein intake is not associated with stroke risk.
  • High intake of a healthy diet was linked to an increased risk for stroke in one observational study and a reduced risk for stroke in another observational study.
  • High intake of an unhealthy diet was linked to an increased risk for stroke and a population-attributable risk for stroke of 19% (99% CI, 11 - 30).
  • In women, a prudent diet or Dietary Approaches to Stop Hypertension (DASH)–style diet is associated with a lower risk for stroke, and a Western diet is linked with a higher risk for stroke.
  • In women, the Mediterranean diet is associated with lower risks for stroke, cardiovascular disease, cardiovascular mortality, and all-cause mortality.
  • The effects of a vegetarian diet and a Japanese diet on stroke risk are unknown.
  •  
  •  

Clinical Implications

• Reliable evidence from randomized trials suggests that dietary supplementation with antioxidant vitamins, B vitamins, and calcium does not reduce the risk for stroke. However, methodologic limitations of studies to date preclude firm conclusions regarding the effect of many other nutrients on stroke risk.
• Less reliable evidence suggests that stroke can be prevented by prudent diets; Mediterranean or DASH-type diets; diets that are low in salt and added sugars and high in potassium; and diets that meet, but do not exceed, energy requirements. The overall quality of dietary pattern and the balance between energy intake and expenditure seem to affect stroke risk to a greater extent than individual nutrients and foods.

Borrowed from- Medscape Education Clinical Briefs

Study in monkeys raises hope for HIV .......vaccines

Study in monkeys raises hope for HIV vaccines

Click the Above link to read the Article....

Medical Information PodCasts....

Another way of learning is to listen to Podcasts that provide current and relevant information on medical / health topics. Podcasts also have the advantage of being downloadable to your IPod, MP3 player or other mobile device for listening at your convenience.
Below is a selected list of Podcasts from the US Centers for Disease Control and Prevention (CDCP) website. You can listen to each Podcast using the player on the CDCP site (click on the play icon on the player). Or, you can also download the audio file to your own computer or player. Each Podcast has a transcript that you can view and/or print out to follow along or for later reference.
To access the Podcast, click on its title. The length of each Podcast is indicated as well (minutes:seconds).

1.	Antibiotics Use	(5:58)
2.	Arthritis	(5:03)
3.	Arthritis II	(6:08)
4.	Asthma	(3:26)
5.	Asthma II	(4:47)
6.	Cerebral Palsy	(8:46)
7.	Cervical Cancer	(5:29)
8.	Chronic Obstructive Pulmonary Disease (COPD)	(4:03)
9.	Colorectal Cancer	(4:29)
10.	Colorectal Cancer: Screening Tests	(4:27)
11.	Concussions and Brain Injuries	(5:44)
12.	Cough and Cold Medications for Children	(2:29)
13.	Epilepsy	(5:07)
14.	Falls Among Older Adults	(3:42)
15.	Falls Among Older Adults: Prevention and Brain Injury	(2:37)
16.	Folic Acid for a Healthy Pregnancy	(4:37)
17.	Hand Hygiene	(5:29)
18.	Heart Attacks	(3:19)
19.	Heart Disease and Stroke	(4:20)
20.	High Blood Pressure	(4:55)
21.	Immunization: Flu and Pneumococcal	(5:44)
22.	Immunization: Meningitis for Adolescents	(5:04)
23.	Immunization: Shingles	(7:05)
24.	Infection Prevention during Pregnancy	(4:07)
25.	Lead Poisoning in Children	(5:10)
26.	Multidrug-Resistant Tuberculosis	(7:35)
27.	Oral Health and Older Adults	(7:14)
28.	Periodontal Disease and Diabetes	(5:33)
29.	Preventing Birth Defects	(6:10)
30.	RSV: Respiratory Virus in Young and Old	(4:37)
31.	Strokes	(3:16)
32.	Suicide in Young People	(6:51)
33.	Ticks	(5:25)
34.	Violence on the Job	(8:54)
35.	West Nile and Lyme Disease	(3:11)
36.	West Nile Virus	(4:53)
37.	Working in the Heat	(5:30)
38.	Working with Stress	(9:26)

Effective Study Tips for Online Nursing Students....

 

 

Having earned my MBA online, and being both a resident and online professor at Southwest Florida College, I am familiar with the study skills necessary to be successful in the online learning environment.  I hope the tips I outline below will help you as well!

If you follow the tips below, you WILL be successful in your online education:

 

 

1.    SYLLABUS = "A":  The syllabus in an online course IS the outline of the class expectations.  Everything you need to succeed is contained in this document.  Take the time to read and understand it.

 

2.    MAKE A CALENDAR:  Make a school calendar and mark due dates of EVERY assignment.  Also, take the time at the start of the course to schedule your study time.  This study time on your calendar is as important as any other appointment you have.  Don't deviate from your study schedule once you make it.

 

3.    READ AND WRITE EARLY AND OFTEN:  Most online classes require a great deal of reading and a weekly paper.  The papers involve research and well thought out answers.  You can't wait until the last minute to start the reading or writing assignments.

 

4.    KEEP UP:  One of the fallacies of online classes is, "I can wait until the weekend to start working on my class since most of the requirements are due by Sunday at midnight.”  ABSOLUTELY not true.  Most online classes have deadlines throughout each week for certain requirements.  If you miss those deadlines, you may get a zero for that assignment or a reduced grade.

 

5.    DON'T BE AFRAID TO ASK:  EVERY online class has a professor monitoring the class.  He/she is THERE FOR YOU - just as a resident professor is.  Your professor is an email or phone call away.  If you have questions along the way, don't hesitate to ask.  Many online classes also have weekly chat sessions where you can e-speak to your professor in real time.  Take advantage of the professor – he/she is there to help you learn. 

 

6.    STUDY FOR YOUR QUIZZES:  Many new online students think that since the quizzes are online, he/she can use the book while taking the quiz.  This is usually not the case.  Most online quizzes are timed and you do not have ample time to look up all the answers.  

 

7.    LEARN FROM YOUR PEERS:  One advantage of the online learning environment - believe it or not - is that you have more interaction with your peers.  Most online classes have a discussion question/interaction assignment each week.  These are the same types of questions that would be brought up in class.  However, in the online environment, EVERYONE has the opportunity (ok, requirement) to both "speak" about the topic and comment on his/her peers' discussion input.  You learn not only academic tidbits that may not be in the "book" or in your research, but you gain the knowledge of real life experiences from others.  You do not have this type of discussion opportunity in resident classrooms.

The Non-Compliant Patient 

 

“You’re such a non-compliant patient.”

Words I heard again at yet another medical appointment. I really should be fired sometimes.

The words were said with affection, from a nurse who has become a friend.

Nonetheless, though, she’s right. I am non-compliant. I comply when it suits me, and so often it doesn’t.

I recently saw my neurosurgeon for an annual re-check of a surgery he performed eight years ago. The symptoms that originally brought me to their office were similar to symptoms I once again found myself experiencing.

Numbness and weakness in my right hand were becoming all too constant.

Back then, the numbness was caused by a bone spur stealthily growing into my spinal cord. So the nasty little bugger was cut away and the numbness largely disappeared. Until this year.

I weighed my options: Do I bring this symptom to my medical team’s attention and potentially deal with another surgery? I’m really not in the mood for an operation at this time. My calendar is full of plans; surgery is not one of them.

Or do I act the responsible patient and mention this numbness, knowing I might not like the answer I hear?

It seems to be a no-brainer, but it’s not so clear cut when your brain is the one involved.

After some deliberation with myself, the ‘responsible patient’ won the battle.

I hesitantly brought up my symptoms to one of my favorite doc/nurse teams.

We did an in-office exam, we did EMG/NCS testing, we did a follow up appointment.

My nerves were shot, but not from physical causes.

My nurse, Vicki, made the appointments as quickly as she could. And because of her seniority, connections and reputation, when she made requests, things got done. I was humbled and grateful.

Finally, at the follow up, my neurosurgeon shared the great news. My nerves were fine!

The likely culprit is four decades of arthritis, causing musculoskeletal issues. Whew! Is that all? I can live with that, especially since my recently increased chiropractor appointments seemed to be lessening the symptoms.

I understand that hand surgery would probably make life easier, as my neurosurgeon suggested. But these old gnarled hands get me through normal daily activities just fine, thank you very much. If and when they no longer do, I’ll consider surgery.

At present, I have no desire to add to my eight-count and growing collection of surgeries. Some operations are non-negotiable: For example, spinal cord bone spurs and orthopedic surgeries needed for walking. Ones that are designed merely to make life easier? Pfft, they’ll have to take a number and wait.

Vicki asked if I planned to contact either of the referrals given to me. No, I’ve got my own calendar to get back to right now.

“You are so non-compliant, Kris. But it’s good. You know how all this works, and you think for yourself.”

Maybe so, maybe to my own detriment sometimes. But hey, as long as there are options to weigh, I will.

Click title link for the source page....

25 Google Tips and Tricks for Healthcare Professionals | Nurseblogger

25 Google Tips and Tricks for Healthcare Professionals | Nurseblogger

Nursing Skills: Charting

View more presentations from Bates2ndQuarterLPN

Provide excellent care through accurate nurse charting!

• Cost:

  $30

  CE Credit:

  5.4 contact hours

  Subscription Length:

  3 weeks

  Enroll Now:

  Go to NCSBN's Online Campus Now

  Audience:

  This program is for every nurse in every practice setting at every level of practice.
  

  Description:

  
  

  Improve your nursing documentation skills.

  Although documentation might seem less critical than other more client-centered tasks, it plays a significant role in everything from planning the best care to preventing a malpractice case!
  Through this self-paced course, you’ll learn skills that will demonstrate clear writing, critical thinking and the objective communication of key health care facts. By learning to implement these critical nursing documentation skills, you can:
  

  • Help prevent mistakes throughout the health care process.

  • Support health care providers by giving them accurate information.

  • Demonstrate a high level of patient care, as well as adherence to the nursing standard of care.

  For only $30, you will receive three weeks of unlimited, 24-hour access to the course and receive 5.4 contact hours.
  Sign up and start learning new nursing documentation systems today!
  

  Course Objectives:

  Analyze correct and incorrect nurse charting.

  Improve your charting skills and your confidence, as you master these course objectives:
  

  • Recognize documentation as a critical aspect of client care.
  • List the multiple purposes for medical record documentation.
  • Identify characteristics of effective documentation methods.
  • Describe the role of the nursing process in client care documentation.
  • Recognize common documentation errors related to patient injury.
  • Describe documentation errors associated with litigation.
  • Identify challenges and advantages of electronic documentation.
  • Identify documentation requirements noted in the Nurse Practice Act.

  Instructional Design:

  Study nursing documentation in a self-paced online classroom.

  Experience the fun and interactivity of e-learning as you:
  

  1. Learn by doing — Explore “Links to Knowledge,” visual and graphic aids, and key terms as you navigate the course contents.
     
  2. Solidify your knowledge — Complete fun and interactive exercises, including drag and drop, multiple-choice, true-false and matching assessments.
     
  3. Reflect on what you learn — Answer short-answer and essay questions in the downloadable workbook. Note: Completion of the workbook may be necessary to meet board of nursing requirements.
     
  4. Complete the course at your own pace — Guide yourself through the course and complete assignments at your convenience.
     

  
  At the end of the course, evaluate your understanding of key concepts by completing the posttest. A score of 75% or above is required to receive your contact hours!
  Take the first step to improving your nurse charting skills! Sign up now.
  

 

 

 

 

 

Developed by:

This course was developed by the National Council of State Boards of Nursing (NCSBN)

Author(s):

The course instructor and managing editor is Susan Richmond, MSN, RN, NCSBN Interactive Services Content Associate.

Background:

Learn more about Susan Richmond, MSN, RN and read Sue's blog.