Margot Quan Knight photography

Margot Quan Knight is a surrealistic photographer who has done a few anatomical and medically-related photos:



Aftermath Two

Sweater (veins series)

Cancer

cuil

There is a new search engine out there called cuil, created by engineers who left Google. It claims to search more webpages than Google and analyze the pages to create results (instead of basing search results on web user link preferences, like Google). It also has a different layout and design and a quirky "you might be interested in these searchs, too" box. And it advertises that it won't record any personal information about you (which Google does every time you search).

I tried searching for the term "cardiac arrhythmia" and then the term "critical care nursing" on both. In general, I would say that Google performed better. cuil's layout makes it easier to see every entry at a glance, but it isn't that big an advantage over scrolling since you have to read each entry anyhow. cuil's quirky box was useless. It also returned more business- and organization- related websites. For example, Wild Iris Medical Education came up on cuil's first page of "critical care nursing" results, whereas it was on the third page in Google. And there's a reason it's on the third page in Google, which is that "who cares" factor. cuil also returned a place where I can buy software for a PDA on the first page. When I search for critical care nursing, I want information about critical care nursing, not just places where I can spend more money.

The only interesting/useful advantage to cuil was that it returned information on British and European critical care nursing organizations that didn't show up on Google even after 5 pages of results. That makes me wonder if part of what's meant by (1) searching more pages and (2) analyzing page content instead of user links is that cuil tries to "level the playing field" with regard to the US dominance of world Internet usage.

The privacy issue is an advantage for cuil, too, but I don't see that it has much relevance to nursing--at least until your Google search for "how to cover up Heparin overdose" starts being admissible in civil actions.

For the time being, I'm going to stick with Google for most of my searching but I'll keep returning to cuil to see how it's doing, 'cause gosh don't they have a nice color scheme?

Richard Brookhiser on nursing

The last issue of National Review (LX 15) contained an essay on nurses in Richard Brookhiser's column "City Desk." Venturing out of his New York City apartment, he passes an outpatient KDU and takes a moment to reflect on the young people working there. Having suffered through testicular cancer, he is familiar with their work, and writes in conservative hagiography:
We are all good these days (haven't you heard?). Starlets cruise the plague and combat zones of the world for orphans of color. We are commanded to worry about polar bears and the ice-cap shortage. Habeas corpus will be extended to al-Qaeda and apes. But in the daily churn of ordinary life, these young men and women are committing more than their share of goodness.
He does well by male nurses, avoiding cliches about female nursing, although he does essentially refer to nurses as people who have just escaped welfare. This is a class matter. Nurses today are very touchy on this point, but there is no escaping that nursing still bears the marks of little white caps and skirts. Paul Fussell, in Class, A Guide Through the American Status System, calls nursing a job for female proles. Essentially any job, he says, in which you wear a uniform to work marks you as a prole. I find it hard to disagree with him. The years intervening 1983 and 2008 have served more to drag down medicine than to elevate nursing. The youngest doctors I work with seem almost wholly uneducated outside medicine and have poor command of language. As hospitalists, many of them are working for the man just as much as nurses and can be seen wearing around scrubs. Nurse practitioners often pointedly leave behind their scrubs for clothes sometimes dressier than the doctors, but still few are educated outside nursing and medicine. To my mind, among the youngest set in the hospital, the Physician Assistants tend to have the widest-ranging minds.

I'm sure most nurses today would take great offense at the suggestion that they are "working class," as we are all professionals now, as even Richard Brookhiser insists. But I'm afraid that's a sign that nursing still has a big inferiority complex.

Ian Fleming, RIP & heart disease

If you follow with any attention at all the James Bond movies, you are probably aware that they are based on books, which were written by the late Ian Fleming, a British journalist who served in naval intelligence during WWII. He was born in 1908, so this year marks the centenary of his birth. As part of the centenary activities, the British Heart Foundation is trying to raise awareness (and money) to combat heart disease. The rationale is that Fleming died of a heart attack. Although he was athletic as a youth, never obese, and kept active throughout his life with activities like snorkeling at his villa in Oracabessa, Jamaica, he was an avid smoker and drinker. His first biographer John Pearson records in Alias James Bond-The Life of Ian Fleming this medical assessment by a "New York heart specialist whom Fleming, unbeknownst to his friends, visited in the autumn of 1946":
The patient admits to smoking seventy cigarettes a day and drinking at least a quarter bottle of gin. He is not seriously ill but during the last two months has complained of a pain in the heart. He has slightly low blood pressure, the cardiograph shows an inverted T wave, but there are no important clinical symptoms of heart weakness. The above symptoms could all be the result of nicotine poisoning. I instructed the patient that the situation could not be improved by medication--only by will power.
This write-up was 18 years(!) before his death by heart attack on today's date, August 12, 1964. At 56 years old, Fleming was quite young, even for a time when people had shorter life expectancies. He left behind a wife who divorced her husband to be with him and a 12-year-old son.

R-3: why I haven't moved

Although I'm not sure the PostSecret website is all authentic, they occasionally have pieces that strike home anyhow. I've had several opportunities to move to better jobs in my hospital--in particular, an EMT position that I really should have taken, from a career, and possibly even ethical, perspective--but I've stayed put, apropos of this recent PostSecret...

Drug preferences by medical specialty

When I took an EMT-B class a while back, I noticed that there were a fair number of people in the class who were most worked up over the possibility of seeing car accidents and most engaged by the instructors' stories of having to hold in the intestines of an eviscerated patient. "This is what people want who go into emergency medicine," I thought. So, it comes as no surprise when Mindhacks reports that drug use is most high among doctors in nurses in emergency and critical care and lowest in surgery. Psychiatry also ranks highly, although with different classes of drugs. In nursing, but not in medicine, oncology also ranks highly. It doesn't surprise me to learn that oncology nurses use drugs, but I was surprised to learn that oncology nursing ranks with emergency and critical care nursing for binge drinking...

OVER!MY!MED!BODY! over

Graham was featured in some news mag article on medical bloggers a while back and became, I suppose, one of the most famous bloggers on the Internet. He's finished blogging for now as he graduated from med school.

Project N fail

I think one of the best nursing blogs out there is impactEDnurse (note: not ImpactedNurse). I don't follow it regularly, but recently Ian wrote that Project N, his and his readers' attempt to get textbooks to a Nigerian nursing school, seemed to have not come off well.

Of course, when I read this, my first thought was, don't they have the Internet? The obvious solution to continuously outdated textbooks is to create a digital, collaborative, open access textbook and try to get as many laptops to third world nursing schools as possible. In the short term, that takes a much larger capital investment, but I suspect it would save in the long term. Of course, the biggest problem is that the OLPC laptop is so constricted in its target audience. I don't understand why MIT didn't just create a laptop for third world nations in general instead of targeting children. Do the advantages of their ideas cease once you get beyond childhood or get out from total poverty into significant poverty?

There are other possibilities like the Koolu Works Everywhere Appliance, although at $299 + monitor, it is not really a substitute. Again, why there isn't something like a cross between OLPC and the WEA is beyond me, since the advantages of both are so great, but !!

Anyhow, a second thought I had was for nursing schools in first-world nations to adopt those in third-world nations. It could actually be made into a nice international relations/networking program. Say one nursing school each in Germany, UK, Australia, Japan, and the US collaborated on a school in Africa. You couldn't help very many schools this way, but you could help a few and it might be fun!

Geum japonicum for muscle recovery

I was cleaning today and came across two abstracts I pulled off MDConsult last year. Both deal with the effects of Geum japonicum, an herbal, on muscle recovery. In the first, an extract from the plant was found to promote muscle regeneration following "severe injury." In the second, an extract was found to be effective in promoting recovery from heart attack. Results of the study found a 35-45% reduction in size of infarct. That seems like a pretty big improvement to me. I think it's a shame that there isn't a little more leeway for using these things in the medical community. As far as I can tell, Geum japonicum is used in some bodybuilding products but isn't available as an herbal supplement by itself.

  1. Cheng L, Gu X, Sanderson JE, Wang X, Lee K, Yao X, Liu H, Cheung WL, Li M. (2006). A new function of a previously isolated compound that stimulates activation and differentiation of myogenic precursor cells leading to efficient myofiber regeneration and muscle repair. International Journal of Biochemistry and Cell Biology, 38(7), 1123-1133.
  2. Li M, Yu CM, Cheng L, Wang M, Gu X, Lee KH, Wang T, Sung YT, Sanderson JE. (2006). Repair of infarcted myocardium by an extract of Geum japonicum with dual effects on angiogenesis and myogenesis. Clinical Chemistry, 52(8), 1460-1468.

RN radio

If there were a radio station that nurses were going to listen to, wouldn't it make sense for it to be called "RN"? Does such a radio station exist? Actually, yes.

Australian Broadcasting Corporation (Autralia's BBC, I guess) provides Radio National (RN) for Australian listeners. Although not all the programs are related to nursing, a surprising number could be interesting/educational for student nurses or registered nurses. Of particular interest are shows called All in the Mind about psychology/psychiatry and Health Report. Also Ockham's Razor, about science, and Philosopher's Zone, about miscellaneous topics, have quite a few shows that touch on nursing themes. Right now, a sampling of ABC RN radio podcasts available for download includes:

The stomachs of champion eaters

Neurocritic writes about research on the physiology of being a champion eater. One paper in the American Journal of Roentgenology describes the physical differences between a champion eater and a normal person:
The regular guy went first, and stopped after seven dogs... Using fluoroscopy, an x-ray that gives a real-time view of what’s going on inside the body, the doctors saw what you’d expect: His stomach was indeed full of hot dogs and hadn’t stretched much from its original size.

Then they looked at the competitive eater. First, they noticed that his empty stomach showed virtually no peristalsis, the normal squeezing motion that helps the stomach break down food. He started eating hot dogs and his stomach got bigger and bigger. Ten minutes in, he’d eaten 36 dogs. He said he didn’t feel full, but the researchers told him they’d seen enough.

“His stomach now appeared as a massively distended, foodfilled sac occupying most of the upper abdomen, with little or no gastric peristalsis,” they wrote in their paper. Levine said the stomach was like no healthy stomach he’d seen in his 30-year career. He compared it to a “giant balloon that looks like it has no limit.” The eater’s previously flat belly swelled out as if he were pregnant.

Japanese drug pictograms

This seems like a very sensible nurse- and patient-friendly idea. I wonder if it will come to the U.S. Via Pink Tentacle:
The Risk/Benefit Assessment of Drugs-Analysis and Response (RAD-AR) Council of Japan has released a new batch of pictograms for use on pharmaceutical packaging. No more deciphering complicated dosage directions and warnings — a glance is all it takes now.



Although these pictograms are in Japanese, you can apparently download the entire set in English if you want to register:
https://www.rad-ar.or.jp/02/08_pict/08_pict_dl_eng.html

Monkey cells for bird flu vaccine

A former co-worker on R-3 with slightly paranoid inclinations used to talk about a fanciful doomsday scenario in which Avian Influenza would kill all the birds, and people wouldn't have anything to grow flu vaccine in (since flu vaccine is currently produced in eggs). Well, now some researchers report success using monkey cells for vaccine.
“Cell culture technology could represent the future of influenza vaccine production,” said virologist John Oxford of The Queen Mary School of Medicine in London.

Scientists had previously been using chicken eggs but they found it difficult to obtain the right type and observed that the virus, H5N1, kills chickens rapidly.

...

Cell-based vaccines would require less advance planning and could be made year-round, it was reported.

Baxter also has created a seasonal flu vaccine made in cells instead of eggs.

The vaccine, called Celvapan, is made in the Czech Republic.

Because it is not possible to test whether the vaccine actually prevents infection, the researchers measured antibodies in their volunteers in Austria and Singapore. They said it induced an immune response similar to the body's defence against a natural virus infection.

3rd annual R-3 barbeque

A few days ago, co-worker Liz held her 3rd annual R-3 barbeque/swim party/Trudy's birthday. Much fun was had amongst R-3 staff. Photos by Liz, here...













It's a dangerous neighborhood!!





HIV/AIDS update - revisions and solutions

If you've been following the news lately, you or may not have heard that the World Health Organization has declared that the threat of an AIDS epidemic in the general population of developed countries never existed. This news tidbit has been pretty much ignored as far as I can tell. I found the June 8th article in the Independent (#1 Google ranking) on this topic by accident almost as soon as it was published, and I made Google searches several times since then. At the current time, searching GoogleNews for WHO heterosexual AIDS pandemic returns 11 results, most of which aren't actually topical. You would think for such rather important news, there would be at least a little coverage at NBC, CBS, etc, but no. The thrust of the matter is that the epidemiologists were incorrect about the way HIV spreads, using the situations in developing nations to predict what would happen in the west:
In the first official admission that the universal prevention strategy promoted by the major Aids organisations may have been misdirected, Kevin de Cock, the head of the WHO's department of HIV/Aids said there will be no generalised epidemic of Aids in the heterosexual population outside Africa.

Dr De Cock, an epidemiologist who has spent much of his career leading the battle against the disease, said understanding of the threat posed by the virus had changed. Whereas once it was seen as a risk to populations everywhere, it was now recognised that, outside sub-Saharan Africa, it was confined to high-risk groups including men who have sex with men, injecting drug users, and sex workers and their clients.
Other news that seems largely to have been ignored is the announcement by University of Texas researchers that they have found an "Achilles' heel" to HIV. This is especially interesting to me since our local infection control specialist, Dr. Stephen G. Hausrath, was an HIV researcher at UT before going to medical school. I firmly believe every hospital should have their own Dr. Hausrath. He is from central casting, no joke--infectious disease bowtie and all. I mean that in a loving way, though. Two nurses I respect and who are working on their NP degrees both asked to have a rotation with him.
Anyhow, I digress:
Paul's group has engineered antibodies with enzymatic activity, also known as abzymes, which can attack the Achilles heel of the virus in a precise way. "The abzymes recognize essentially all of the diverse HIV forms found across the world. This solves the problem of HIV changeability. The next step is to confirm our theory in human clinical trials," Paul said.

Unlike regular antibodies, abzymes degrade the virus permanently. A single abzyme molecule inactivates thousands of virus particles. Regular antibodies inactivate only one virus particle, and their anti-viral HIV effect is weaker.

"This is an entirely new finding. It is a novel antibody that appears to be very effective in killing the HIV virus. The main question now is if this can be applied to developing vaccine and possibly used as a microbicide to prevent sexual transmission," said David C. Montefiori, Ph.D., director of the Laboratory for AIDS Vaccine Research & Development at Duke University Medical Center. The abzymes are now under development for HIV immunotherapy by infusion into blood. They could also be used to guard against sexual HIV transmission as topical vaginal or rectal formulations.

SciAm on misuses of fMRI

Scientific American reports on neuroscientists who are trying to educate people about the pitfalls of relying on fMRI to draw conclusions about brain activity. Frankly, while I understand the point that brain function is more diffuse and activities are not really "located" in certain brain areas, the whole thing is rather confusing since in nursing we don't delve much deeper than "Broca's area" and "Wernicke's area," which are modules in specific brain locations. Just something to keep in mind if reading news/journals, I guess.

Women better at learning nursing courses?

BPS reports on research that shows that women retain more verbal material in their memories (even though they don't talk more, as previously thought). I think this is interesting news for male nursing students. I have completely aghast at the low usage of visual cues in my nursing courses. Have I seen even one chart or graph in a PowerPoint or drawn on a chalk board since I started in nursing? No, I don't think so. It's incredible to me.

Michelangelo's David returns from America

After A Short Stay In the US, Michelangelo's David Returns To Florence

Really, it's not funny, though. The Health Care Blog links to this graphic of obesity trends:
http://www.scribd.com/doc/2465772/CDC-trends-in-obesity-1985-2001
Since 1985, we've gone from most states having less than 10% obesity to all states more than 10% and over half the states more than 20%. I think this is the real health care crisis, not the lack of insurance.

David, previously...

this is Niculina

This is Niculina. Niculina is sick. Isn't this just the image of sickness? I found this after getting sucked into looking at photos on Flickr. I warn you that you will be wasting a lot of time if you let yourself get sucked into that trap!

speedy studies

Over at language log, Mark Lieberman has an interesting post on research that shows that amphetamines may increase learning in addition to helping you stay up later studying. As one commenter noted, the research shows a 50% reduction in error rate!

parasite fun for little ones


You can buy on Amazon a card game for kids called Parasites Unleashed. Fun!

reason for studying nursing in upstate NY: romance!


I just came across the website Mr. and Mrs. Smith, which reviews boutique hotels for romantic get-aways. Of course, it's pricey, but there's no mistake that they include Montreal (within driving distance of upstate NY) amongst their review locations. Montreal is a great city for day and weekend visits with an old-town section that's like being in an European city. If you came to nursing school in upstate NY, you could adopt Montreal. Of course, does anyone in nursing school have time to visit Montreal?

new painless needle

Indian and Japanese researchers have created a new needle based on a mosquito that is supposed to be painless:
The new needle has an inner diameter of around 25 microns and an external diameter of 60 microns, which is about the same size as a mosquito's mouthpart. Its size and the fact that it works by suction, makes it painless. To compare, a conventional syringe needle has an outer diameter of around 900 microns.
...
Its size compared to earlier models also means that surface tension effects are exploited further, and the same capillary flow that draws water up into trees helps draw blood into the microneedle.
Unfortunately, it seems it is not designed for taking blood for CBC, BMP, PTT, etc:
The researchers have calculated that their needle can extract 5 microlitres of blood per second. This volume is sufficient for measuring blood-sugar levels in diabetics using a glucose sensor that can be attached to the needle in a "wristwatch" design.
via BoingBoing

anatomy t-shirts from Etsy

The website Etsy.com, which sells handmade products, has a lot of t-shirts. Quite a few people sell t-shirts (as well as other decorated items) with anatomical themes. There are over 800 pages of t-shirts, so I couldn't search them all, but here is a sampling...





















Oregan State Mental Hospital being torn down

The mental hospital that was used to film One Flew Over the Cuckoo's Nest is being torn down:
Although mean Nurse Ratched was pure fiction, the Oregon State Hospital has struggled with some very real troubles over the years, including overcrowding, crumbling floors and ceilings, outbreaks of scabies and stomach flu, sexual abuse of children by staff members, and patient-on-patient assaults.

Politicians had been talking for years about the need to replace the hospital, but didn't get serious about it until a group of legislators made a grim discovery during a 2004 tour: the cremated remains of 3,600 mental patients in corroding copper canisters in a storage room. The lawmakers were stunned.

"Nobody said anything to anybody," said Oregon Senate President Peter Courtney, who dubbed the chamber "the room of lost souls."

The remains belonged to patients who died at the hospital from the late 1880s to the mid-1970s, when mental illness was considered so shameful that many patients were all but abandoned by their families in institutions.

French causes cardiac dysrhythmia?

We have a zoo nearby called Parc Safari. As our local paper reported, they are now the proud owners of white lions. In order to promote this event, the Parc, with the sponsorship of the province of Quebec, sent out the following fliers stuffed in local newspapers...



Now, the province of Quebec was founded in 1534, and they would like everyone to know that they have been "providing emotions" since then. However, these are apparently extremely strong emotions...



Perhaps you would like to see that a little larger?



Yes, it appears that Quebec may cause a stress cardiomyopathy also known as stage 1 Tako-Tsubo Syndrome! If anyone can identify this rhythm for certain and its cause, please let me know!

life expectancy of Orthodox Jews


I recently saw the movie Ushpizin, which I understand has already passed its peak popularity. However, in looking up more information about the film on the internet, I came across this news release on the life expectancy of Orthodox Jews in B'nei Brak, Israel:
Bnei Brak, Israel's most religious city, also has the highest average life expectancy: 81.1 years for women and 77.4 years for men.

What makes that finding even more curious is that Bnei Brak also happens to be Israel's poorest city, confounding the expected correlation between increased wealth and health. Moreover, smoking among males remains entirely too popular, and even a casual glance around the streets of Bnei Brak will serve to establish that news of the benefits of exercise and a low-fat diet has not yet reached many of its inhabitants.

A growing body of scientific evidence suggests the key to the longevity of Bnei Brak residents may well be their religiosity. Fully three-quarters of the 300 studies to date of the relationship between religious belief and health have shown a positive correlation.

A commentor goes on to say:
Does the author mean current "average age" in Bnei Brak? Add up the ages of all people living in Bnei Brak and divide by population? That would just show that Bnei Brak has a lot of old people living there. Or does he mean "life expectancy?" Life expectancy means that a child born in Bnei Brak today would have a "life expectancy" of 81/77 as you said, assuming he lived his entire life in Bnei Brak. A tough statistic to gather. Either way, I have read much on this thesis in medical literature lately. In fact, even Grossmont Hospital, San Diego, CA had a recent grand rounds on the evidence for the positive health effect of prayer and religious observance. Good stuff. Thanks.

summer 2008, half-way

My two summer courses for the nursing program are over, and last night we had the midsummer night festival's meal from Andreas Viestad's Kitchen of Light (poached salmon with horseradish sour cream, cucumber salad, and boiled potatoes), so I guess my summer is on the downswing. What have I been up to?

As you probably guessed, I seem to have passed all my spring 2008 courses (which included Nur360 Maternity, Nur363 Care of the Adult II, and Nur356 Professional Concepts). I don't know absolutely, because I haven't bothered to look at my grades yet, but I didn't get any calls or e-mails along the lines of "We are sorry to inform you..." At the start of the semester, I was quite sure I would get at least A-'s in these courses, but I am quite sure I did not, and I think I just squeaked by in at least Maternity.

Following the end of the semester, I had a couple weeks off in which I went back to the gym and performed on the stair-climber for a couple hours a day. Very boring, but necessary, as my body was not liking 8 hour clinical shifts this past semester.



Then, back into classes. I took Psy101 Intro to Psychology and Soc101 Intro to Sociology this summer. You might be wondering how I got into the nursing courses I've been taking without these, but there is a good reason. Anyhow, I was hoping that, as I had taken upper level psychology courses already as well as upper level nursing courses, the Nursing Department would let me out of at least Psy101, but no luck.

But all's well that ends well. The professor for Psy101 took it pretty easy on us, and part of the final (pictured below) was watching One Flew Over the Cuckoo's Nest and answering some questions about how it relates to actual psychology practices. I had over 100% going into the final, pictured here...



The Soc101 course was an online course, which involved writing a number of papers and taking part in discussions on the college's ANGEL system. So most of my time so far this summer has been spent staring at a screen that looks like this...



I have to say I really disliked Soc101. Although the first lesson was about how sociology is a positivist science, our textbook, Kendall's Sociology in Our Times, makes it quite clear that the academic practice of sociology is part science and part political activism. In terms of major problems, the textbook (and I guess sociology in general) still use Marx and Freud pretty much uncritically, although in their own fields (economics and psychology), these two are not taken seriously any more.

Similarly, Theodor Adorno's Authortarian Personality is taught uncritically in the textbook, although it has pretty much been totally discredited and Adorno's F-scale has been replaced by other tools amongst personality researchers. If you have trouble going along with my scandalization, just check out the F-scale for yourself. I scored a 2.6, which makes me a liberal airhead, but as you can see if you take it yourself, it really doesn't measure anything except how you conform to Adorno's idea of what makes a Nazi.

The most fun I had was making up the Ivory Triangle of Power encompassing universities-executive/judicial-bureaucracy to parallel the Iron Triangle of Power. All things considered, academia has much more influence on the budget than military contractors...



I could go on about how, for example, Kendall gives a false example of the concept of culture lag in order to make a political point, or how she uses the term "family" in her definition of the term "family," a major logical and scholarly faux pas. But you would be bored by too much of this type of thing, so let me just say:

Dear Nurses and Nursing Students,
I know you don't really care about social sciences, and just want to put them behind you to get onto "real nursing." I respect and understand that. Therefore, just take my warning to heart: Marx and Freud are dead ideas, and when you see them referenced in your nursing textbooks, just ignore them. Take with a large grain of salt anything you read in nursing literature that is not solidly based in biology or life sciences research.
Yours,
Someone educated outside nursing


There, that's said. Finally, I recently updated the photos in my Flickr photostreams. Now, what's for the rest of the summer?

Well, I joined AACN and the local AACN chapter as a student member, and I intend to start attending education opportunities for the ICU staff at my local hospital. I also need to start reviewing for the NCLEX exam, which is in less than a year. However, I'm going to take it a little easy as well. This specifically involves sitting on my deck, which has great shade and great views of flowers.



The sitting can be done with or without gin, but always preferably with something good to read. I recently came into possession of bottles of both Hendrick's and Bombay Sapphire and will enjoy comparing them. To read, I have the newest volume of the journal Arion, I have to finish The Birth of the Clinic, and I intend to read all the Ian Fleming novels this year (as it's his centennary). And of course there's swimming, and pork ribs and...