Rudd Sound Bites, the weblog of the Yale Rudd Center for Food Policy and Obesity, aims to encourage global discussion of the most critical issues regarding food policy and obesity. The Rudd Center is a research and public policy organization at Yale University that strives to improve the world’s diet, prevent obesity, and reduce weight stigma.
Rudd Sound Bites has eleven regular contributors who are faculty members and affiliates of the Rudd Center. If you would like to join us as a Guest Blogger, please contact us via email.
The NNRT is designed to deploy nurses "to assist in chemoprophylaxis, a mass vaccination program, or a scenario that overwhelms the nation’s supply of nurses in responding to a weapon of mass destruction event" as part of the National Disaster Medical System.
If you're interested in joining NNRT, you start by e-mailing your qualifications through the DHHS website. Yes, you do have to work under DHHS, but what do you want from a bill co-sponsored by Ted Kennedy? I'm going to e-mail them as a student and see what they say. Stay tuned for details...
considers the reserves. My general feeling is that you should only do the reserves if you really believe in doing it right now. If, like BecomingJon and myself, you are still working on career creds, I think it's foolish to take the chance on getting deployed just to pad a resume or get some extra cash. I'm going to look into the military after I find out whether I get into an MSN program.
Nurses do it with aseptic technique.
Nurses do it with fluid restriction.
Nurses are prepared to resuscitate.
Not very good, but still funnier, I think. And, of course...
Nurses do it as the doctor ordered.
Nurses do it to patients.
That's all for me, folks. Thanks, you've been great. Goodnight.
'It was Bassett’s genius for dissection that attracted the attention of William Gruber, the photographer who invented the View-Master, a stereoscopic viewing device familiar to most children. A 17-year collaboration between the two resulted in the production of the Stereoscopic Atlas of Human Anatomy begun in 1948 and not completed until 1962. It consisted of 221 View-Master reels with 1,554 color stereo views of dissections of every body region. Each stereo view was accompanied by a black-and-white, labeled drawing and explanatory text.via BoingBoing and also see BoingBoing
'“It was very popular nationally,” (curator Dr. Robert) Chase said. “When Bassett first showed the images, lines formed around the block to see them.”
'“Although they’re 50 years old, the pictures were taken with high-resolution Kodak film,” said (anatomy professor Paul) Brown, explaining why the images have held up over the decades. “This is what they looked like before we got them,” he said holding up the original View-Master reels. “One can see how the nerve enters the jaw. It is possible to see inside of the sinus cavity. Look at the quality. It’s just fabulous.”'
I wonder if the release of these photos was met with any of the denunciation that accompanied the BodyWorld exhibition. I doubt it. The 1950s-1960s were a time of much greater faith and generalized interest in science--it wasn't nauseatingly ubiquitous the way it is now. Also, there is something about the BodyWorld exhibition that fails to satisfy inquisitiveness yet does not rise to the level of art. BodyWorld doesn't actually invite us to investigate closely, nor does it impress aesthetically. It seems to be an interest born out of interest in death. The point of the exhibition seems not to be to generalize from the plasticized corpses, but to constantly have in the back of one's mind this is an actual dead person. I can understand the criticisms.
The current issue has a free review of Tina Cassidy's Birth: The Surprising History of How We Are Born.
The most personally significant event was one visit with a mother who was, well... a babe, in modern bachelor parlance. This cinched my belief not only that I am completely wrong for maternity nursing but also that men are in general. In pediatrics last semester, I took care of one 17-year-11-month-old patient who was pretty but it was my first clinical rotation, and I think I was keyed into wondering about this issue. I haven't had a younger patient in med-surg, but with older med-surg patients I am able to turn off that switch in my brain. Not so in obstetrics. With all the femininity, babies-talk, vaginas, etc, everything about the situation says "reproduce!" so that on meeting attractive women it is not so easy to turn off that switch. Even if there are some guys who could function in this environment, I don't think it's fair to women to have to wonder.
I was supposed to go home at noon, but I went back to the office after lunch so I could meet a C.N.M. I was able to take in two visits with her, both with patients who had complicating medical problems and one of whom I knew, so I felt this was a good use of time. Plus, it turns out the C.N.M. ran the Lamaze class my mother took when I was born! She seemed like a highly competent person, but I was really hoping to see the midwife who ran the delivery I saw last week. They share an office, and I note that her bookshelf had a few too many books of too old a vintage for there not to be some sort of antiquarian-scholarly-nerdy-collector interest there (id est cool and intriguing to me).
The office (which is shared with a third midwife as well) also has a print hanging on the wall above aforementioned bookcase with the inscription "And the midwives feared God and did not as the king commanded them, but saved the children alive." In case you don't recognize it, this is derived from a passage from the first chapter of Exodus--
ותיראן המילדת את־האלהים ולא עשו כאשר דבר אליהן מלך מצרים ותחיין את־הילדים׃
I find this a very odd print to have in the office since, as I discovered using the UPIN registry, cool midwife also seems to be registered at Planned Parenthood. The print differs from the usual translation of the Exodus text on two important points: it removes "of Egypt" from the mention of the king and the modifier "male" from from before "children." These changes de-contextualize and universalize the text. I think that they're supposed to be liberalizing--midwives fight the power ("the king") on behalf of the women (not those boys!)--and that this is the spirit in which the print was hung. However, the changes really serve to highlight the point of this passage--"...the midwives feared God and... saved the children alive." The meaning still cannot be changed if universalized to a secular context--the midwives' emotional and ethical response led them to save the children. In a pediatric office, this print could have a different meaning, but in an obstetric office, there can be only one. How could someone miss it?
And the king of Egypt spake to the Hebrew midwives... And he said, When ye do the office of a midwife to the Hebrew women, and see them upon the stools; if it be a son, then ye shall kill him: but if it be a daughter, then she shall live. But the midwives feared God, and did not as the king of Egypt commanded them, but saved the men children alive. And the king of Egypt called for the midwives, and said unto them, Why have ye done this thing, and have saved the men children alive? And the midwives said unto Pharaoh, Because the Hebrew women are not as the Egyptian women; for they are lively, and are delivered ere the midwives come in unto them. Therefore God dealt well with the midwives: and the people multiplied, and waxed very mighty. And it came to pass, because the midwives feared God, that he made them houses.
A small focus of hemorrhagic fever (HF) cases occurred near Cochabamba, Bolivia, in December 2003 and January 2004. Specimens were available from only one fatal case, which had a clinical course that included fever, headache, arthralgia, myalgia, and vomiting with subsequent deterioration and multiple hemorrhagic signs. A non-cytopathic virus was isolated from two of the patient serum samples, and identified as an arenavirus by IFA staining with a rabbit polyvalent antiserum raised against South American arenaviruses known to be associated with HF (Guanarito, Machupo, and Sabiá). RT-PCR analysis and subsequent analysis of the complete virus S and L RNA segment sequences identified the virus as a member of the New World Clade B arenaviruses, which includes all the pathogenic South American arenaviruses. The virus was shown to be most closely related to Sabiá virus, but with 26% and 30% nucleotide difference in the S and L segments, and 26%, 28%, 15% and 22% amino acid differences for the L, Z, N, and GP proteins, respectively, indicating the virus represents a newly discovered arenavirus, for which we propose the name Chapare virus. In conclusion, two different arenaviruses, Machupo and Chapare, can be associated with severe HF cases in Bolivia.
Now, of course, you are going to say that it was so very important for me to know about child sexual abuse in a peds rotation. And I agree with you, but this is just the point: the conceptual content of the video could have been communicated adequately in about 5 minutes. Being forced to sit through 40 minutes of emotional turmoil was just value added abuse. People who propagate this video and this type of instruction are, I contend, themselves part of a victim chain in which fear and paranoia is spread as surely as sexual abuse is spread in that victim chain. Attempts to stop child sexual abuse by forcing students to watch videos like this are really attempts to inoculate by giving everyone a little seed of emotional hell to carry around. The implication is that I'm such a bad person that I would ignore abuse if I weren't exposed to it myself.
Well, Oprah, you may have had a tough life, but I reject you and your self-indulgent and useless video. And, clinical instructor, you should know that although I am friendly to your face, every time I see you I feel resentment at having been forced to watch Oprah's trash.
Sent: Sunday, April 20, 2008 6:00 PM
Subject: "Father Molestation on TV" Secret
I read a book when I was very young that dealt with father molestation. From that point on, I was so terrified of the idea that my dad could do that. It ended up controlling my relationship with him.
He died 8 years ago and the guilt still haunts me to this day. I wish I could have been closer to him.
I cried for the first time in years when I saw this postcard. I want to thank the person who sent it...it is my secret, too. I have never been strong enough to tell anyone about it.
Thursday, Day 1:
Arrived 0800 and changed into green-colored, provided, clean, OR-CWC-ICU scrubs. Then received tour of maternity unit. Then did scavenger hunt. Then watched NYS mandated shaken baby video. Short day.
Friday, Day 2:
Arrived 0630, ate breakfast, changed into green scrubs, and in L&D by 0700 with fellow nursing student Glen to receive report. As it turned out, there were only two labors going on today--one was a very fast labor, which resulted in a delivery I got to see, and the other was an induced labor that was going on when I got there and still going on when I left.
What can I say? I saw a delivery. Babies are wonderful. Seeing them pass through the vagina is humiliating.
Actually, come to think of it, my main impression of the day is of the midwife who managed the delivery. She was great. Anecdote: When inserting the foley catheter post-delivery, she saved the unused specimen container so her daughter could collect insects in it. Visual impression: A little more aggressive and modern looking than this photo from the CVPH website would suggest. Did I get a little crush? And so what?
Anyhow, I'll post here my academic journal entry for the day, hopefully sans HIPAA-violating info:
I woke up early Friday morning to trim my hair before clinicals only to discover what appeared to be the first gray hairs I've noticed. In clinicals, I was treated with complete indifference by the primary nurse to the extent that Glenn and I were addressed as "Glenn" throughout, as in "Glenn, come in here," or the following dialogue:
Glenn: "So I guess we're taking off. Thanks, Nurse#1."
Chris: "Bye, Nurse#1. Nice to meet you."
Nurse#1: "Bye, Glenn."
I've never been so invisible before... And I learned later in the day that Nurse#1 is carrying on with a doctor who lives with his wife and small children... Considering these blows to my ego and sense of community, I'm just glad to have finished the week without precipitating a mid-life crisis. But what about the learning?
Unfortunately, no Cesarean sections were performed this Friday, although a vaginal delivery was observed about 0800 ... This was my first exposure to labor and birthing, and, all dark humor aside, the situation with the nurse was not helpful as I was very unsure how to approach the mother and family… and was trying to follow the nurse's lead. As a result, I did not get involved in vital sign collecting beyond putting a BP cuff on the patient…. I was also not involved in analyzing the fetal monitoring strip, although it was reviewed after the birth.
Perhaps if we had been present during the latent or active stages of labor, there would have been more time to get used to the newness of the situation and develop rapport with the patient and family. Then, I might have been able to provide more comfort and support to the patient and father. These might have included assisting SM into a comfortable position, getting her ice chips and fluids, and encouraging her to focus, breath, and relax. As it was, Glenn and I mostly assisted by holding the patient's legs up and back during the birthing at the instruction of the midwife…
In the immediate post-delivery period, the situation was much the same. I did get… some water, and helped to change her soiled linens to the extent possible. However, most of the post-delivery period was devoted to.... After the midwife determined that she required the assistance of the doctor, the patient was covered with a sheet and left to relax. Any progress towards the post-partum unit was "put on hold," and… The primary nurse also hung a fluid bag in the post-delivery period with Pitocin, the exogenous oxytocin analogue used to promote uterine contractions that decrease the risk of post-partum hemorrhage. Carboprost might be ordered for this same purpose.
The whole business is very frustrating. I had a 4.0 in all my pre-nursing coursework and received so far a lowest grade of B+, and that was due to work being handed in late. This is so backwards that I can't get any of this maternity to stick in my memory!!
We think of our brains as the ultimate private sanctuary, a zone where other people can't intrude without our knowledge or permission. But its boundaries are gradually eroding. Hypersonic sound is just a portent of what's coming, one of a host of emerging technologies aimed at tapping into our heads. These tools raise a fascinating, and queasy, new ethical question: Do we have a right to "mental privacy"?
"We're going to be facing this question more and more, and nobody is really ready for it," says Paul Root Wolpe, a bioethicist and board member of the nonprofit Center for Cognitive Liberty and Ethics. "If the skull is not an absolute domain of privacy, there are no privacy domains left." He argues that the big personal liberty issues of the 21st century will all be in our heads — the "civil rights of the mind," he calls it.But this isn't just about reading minds; it's also about bombarding them with messages or tweaking their chemistry. Transcranial magnetic stimulation — now used to treat epilepsy — has shown that it can artificially generate states of empathy and euphoria. And you've probably heard of propranolol, a drug that can help erase traumatic memories.
Let's say you've been assaulted and you want to take propranolol to delete the memory. The state needs that memory to prosecute the assailant. Can it prevent you from taking the drug? "To a certain extent, memories are societal properties," says Adam Kolber, a visiting professor at Princeton. "Society has always made claims on your memory, such as subpoenaing you." Or what if you use transcranial stimulation to increase your empathy. Would you be required to disclose that? Could a judge throw you off a jury? Could the Army turn you away?
Myth No. 1: Drink Eight Glasses Each Day
Myth No. 2: Drinking Lots of Water Helps Clear Out Toxins
Myth No. 3: Lots of Water Equals Healthier Skin
Myth No. 4: Drinking Extra Water Leads to Weight Loss
Myth No. 5: It's Easy to Get Dehydrated During a Workout