DiversityNursing Blog

By Joe Sutton and Holly Yan

A second American aid worker in Liberia has tested positive for Ebola, according to the Christian humanitarian group she works for.

Nancy Writebol is employed by Serving in Mission, or SIM, in Liberia and was helping the joint SIM/Samaritan's Purse team that is treating Ebola patients in Monrovia, according to a Samaritan's Purse statement.

Writebol, who serves as SIM's personnel coordinator, has been living in Monrovia with her husband, David, according to SIM's website. The Charlotte, North Carolina, residents have been in Liberia since August 2013, according to the blog Writebols2Liberia. They have two adult children.

On Saturday, Samaritan's Purse announced that American doctor Kent Brantly had become infected. The 33-year-old former Indianapolis resident had been treating Ebola patients in Monrovia and started feeling ill, spokeswoman Melissa Strickland said. Once he started noticing the symptoms last week, Brantly isolated himself.

Brantly, the medical director for Samaritan Purse's Ebola Consolidated Case Management Center in Monrovia, has been in the country since October, Strickland said.

"When the Ebola outbreak hit, he took on responsibilities with our Ebola direct clinical treatment response, but he was serving in a missionary hospital in Liberia prior to his work with Ebola patients," she said.

Deadliest Ebola outbreak

Health officials say the Ebola outbreak, centered in West Africa, is the deadliest ever.

As of July 20, some 1,093 people in Guinea, Sierra Leone and Liberia are thought to have been infected by Ebola since its symptoms were first observed four months ago, according to the World Health Organization.

Testing confirmed the Ebola virus in 786 of those cases; 442 of those people died.

Of the 1,093 confirmed, probable and suspected cases, 660 people have died.

There also are fears the virus could spread to Africa's most populous country, Nigeria.

Last week, a Liberian man hospitalized with Ebola in Lagos died, Nigerian Health Minister Onyebuchi Chukwu said.

Lagos, the largest city in Nigeria, has a population of more than 20 million.

The man arrived at Lagos airport on July 20 and was isolated in a local hospital after showing symptoms associated with the virus. He told officials he had no direct contact with anyone with the virus nor had he attended the burial of anyone who died of Ebola.

Another doctor infected

Confirmation of the death in Lagos came after news that a doctor who has played a key role in fighting the Ebola outbreak in Sierra Leone is infected with the disease, according to that country's Ministry of Health.

Dr. Sheik Humarr Khan is being treated by the French aid group Medecins Sans Frontieres -- also known as Doctors Without Borders -- in Kailahun, Sierra Leone, agency spokesman Tim Shenk said.

Before falling ill, Khan had been overseeing Ebola treatment and isolation units at Kenema Government Hospital, about 185 miles east of the capital, Freetown.

Ebola typically kills 90% of those infected, but the death rate in this outbreak has dropped to roughly 60% because of early treatment.

Spread by bodily fluids

Officials believe the Ebola outbreak has taken such a strong hold in West Africa because of the proximity of the jungle -- where the virus originated -- to Conakry, Guinea, which has a population of 2 million.

Because symptoms don't immediately appear, the virus can easily spread as people travel around the region. Once infected with the virus, many people die in an average of 10 days as the blood fails to clot and hemorrhaging occurs.

The disease isn't contagious until symptoms appear. Symptoms include fever, headache and fatigue. At that point, the Ebola virus is spread via bodily fluids.

Health workers are at especially high risk, because they are in close contact with infected people and their bodily fluids. Adding to the danger, doctors may mistake the initial stages of an Ebola infection for another, milder illness.

Source: www.cnn.com

By Kim Painter

Music has an unmatched power to bring back our pasts. But what if our memories have been lost to Alzheimer's or some other condition? Can music still work its magic?

A new film, Alive Inside, says yes. The film, opening Friday in New York, features the work of Dan Cohen, a New York social worker who started taking personalized iPods to people with dementia in nursing homes several years ago. Cohen's non-profit Music & Memory got a huge boost in 2012 when an early clip from the film, featuring a gentleman named Henry, became an online sensation. It has been viewed more than 10 million times at various websites, filmmaker Michael Rossato-Bennett says.

In the clip, Henry, then 94, is shown slumped and unresponsive in a wheelchair – until a nursing home worker places a set of headphones over his ears. Henry comes alive. He scats along with Cab Calloway and sings a soulful I'll Be Home for Christmas. The music "gives me the feeling of love, romance," he says.

Henry has since passed away, but that clip is one big reason that the Music & Memory program is in 640 nursing homes and assisted-living facilities, Cohen says. He says he won't be satisfied until personalized iPods – loaded with music especially chosen for each participant – are in all 16,000 U.S. nursing homes, available to all 1.6 million residents.

"Ninety-nine percent of these people are still sitting around and doing nothing all day when they could be rocking to their music," he says.

The reasons for Cohen's passion become clear in what Rossato-Bennett dubs "the only good-news film ever made about Alzheimer's." In segment after segment, people with Alzheimer's and other conditions don the headphones, hear the music of their youths and light up. A World War II veteran named John dances in his chair as the Andrews Sisters sing Oh Johnny, Oh Johnny, Oh! Another man holds his wife's hands and sings a duet of Can't Take My Eyes Off of You. An agitated woman becomes serene as she dances to strains of Schubert.

Such scenes are interspersed with comments from doctors, including the neurologist Oliver Sacks, who says, "Music has more ability to activate more parts of the brain than any other stimulus." Others talk about the need to reconnect with lonely, inactive and neglected elders, in and out of nursing homes.

Viewers might come away with the idea that a skillfully loaded iPod is a proven and universally effective cure for all that. In fact, the first big study of Music & Memory is just getting underway in Wisconsin, as part of a state-funded rollout in 200 nursing homes. Researchers will look at whether the approach improves social engagement and reduces agitation, anxiety and depression, say University of Wisconsin-Milwaukee researchers Jung Kwak and Michael Brondino. The study won't focus on memory but will look at overall effects on dementia, Brondino says. One thing they know, he says, is that staffs and patients "absolutely love this program."

The program, which relies on families and aides to work with patients, should not be confused with formal music therapy delivered by professionals trained in that discipline, says Alicia Clair, professor of music education and therapy at the University of Kansas.

Still, she says, "it's a wonderful thing" for many people. Caregivers need to know, she says, that not everyone will respond and that some people can even respond negatively. A song that stirs up sadness or anger might do more harm than good, she says.

Cohen says, "This is not a cure for Alzheimer's, and this does not work for everybody." But, he says, it is something just about anyone can try – something that might open up a whole lost world.

Cohen's tips for setting up an individualized music program and for donating used iPods to the program are at musicandmemory.org.

Alive Inside will open in theaters and be shown in film festivals around the country through mid-September.

Source: http://www.usatoday.com

By Robert Preidt

Surviving a life-threatening illness or injury may be more likely if you're treated at a busy emergency department instead of one that handles fewer patients, a new study finds.

Researchers analyzed data on 17.5 million emergency patients treated at nearly 3,000 hospitals across the United States. The overall risk of death in the hospital was 10 percent lower among those who initially went to the busiest emergency departments rather than to the least busy ones, the study found.

"It's too early to say that based on these results, patients and first responders should change their decision about which hospital to choose in an emergency," said the study's lead author, Dr. Keith Kocher, an assistant professor of emergency medicine at the University of Michigan Medical School.

"But the bottom line is that emergency departments and hospitals perform differently, there really are differences in care and they matter," he added.

The survival difference was even greater for patients with serious, time-sensitive conditions. Death rates were 26 percent lower for sepsis patients and 22 percent lower for lung failure patients who went to the busiest emergency departments, compared to those who went to the least busy ones.

Heart attack patients were also more likely to survive if they went to the busiest emergency departments, according to the study published July 17 in the journal Annals of Emergency Medicine.

If all emergency patients received the kind of care provided at the busiest emergency departments, 24,000 fewer patients would die each year, the researchers said.

The finding held even when the researchers accounted for differences in the patients' health, income level, hospital location and technology, they said.

But the study wasn't designed to look into the reasons for the finding; it only found an association between better survival rates and busier ERs.

"The take-home message for patients is that you should still call 911 or seek the closest emergency care, because you don't know exactly what you're experiencing. What makes one hospital better than another is still a black box, and emergency medicine is still in its infancy in terms of figuring that out," Kocher said in a university news release.

"For those who study and want to improve emergency care and post-emergency care, we hope these findings will inform the way we identify conditions in the pre-hospital setting, where we send patients, and what we do once they arrive at the emergency department and we admit them to an inpatient bed," he added.

Source: http://www.medicinenet.com

By Honor Whiteman

For women going through menopause, hot flashes can be one of the most uncomfortable symptoms. But a new study suggests that acupuncture may help to reduce the severity and frequency of hot flashes among menopausal women.

Hot flashes, also known as hot flushes, are a sudden feeling of heat over all or parts of the body. They may also cause redness on the face and neck, red blotches on the arms, back and chest, and heavy sweating or cold shivers. Many health conditions can cause hot flashes, but they are most common among women going through menopause.

The most effective treatment for hot flashes is hormone therapy - the use of medication that contains estrogen or progesterone. However, such treatment can increase the risk of other health conditions, including stroke, heart disease and cancer.

In this latest study, recently published in the journalMenopause, researchers wanted to see how acupuncture affected the regularity and severity of hot flashes a woman experienced while going through natural menopause.

Acupuncture is a form of alternative medicine that is more than 2,500 years old. It incorporates a number of procedures that stimulate anatomical points on the body as a form of healing. The most common form of acupuncture involves the use of thin, metallic needles that penetrate the skin.

The technique is most commonly used to help treat chronic pain, but past research has indicated it can help reduce inflammation and may even boost weight loss.

Acupuncture 'reduced severity and frequency of hot flashes for up to 3 months'

The research team analyzed 104 studies that assessed the effectiveness of acupuncture. The team included 12 of these studies in their research, involving 869 women between the ages of 40-60 who were going through natural menopause.

The women included in the study underwent various forms of acupuncture, including acupressure, electroacupuncture, laser acupuncture, ear acupuncture and traditional Chinese medicine acupuncture.

The investigators found that women who underwent acupuncture experienced a reduction in the severity and frequency of hot flashes for up to 3 months. Furthermore, the treatment appeared to have a beneficial effect on hot flashes regardless of the number of doses, sessions or duration of treatment received.

However, the researchers note that sham acupuncture reduced the frequency of hot flashes as much as true acupuncture.

The team is unable to explain why acupuncture appears to help alleviate hot flashes among menopausal women, but they hypothesize that acupuncture may trigger a reduction in the concentration of beta-endorphin - a neuropeptide found in the cells of the central and peripheral nervous system - in the hypothalamus of the brain. They say lower levels of beta-endorphin may activate the release of calcitonin gene-related peptide (CGRP), which regulates body temperature.

Commenting on the team's findings, Dr. Margery Gass, executive director of The North American Menopause Society (NAMS), says:

"More than anything, this review indicates that there is still much to be learned relative to the causes and treatments of menopausal hot flashes. The review suggests that acupuncture may be an effective alternative for reducing hot flashes, especially for those women seeking non-pharmacologic therapies."

A 2012 study, also published in the journal Menopause, suggested that hypnosis can also minimize the occurrence of hot flashes during menopause by around 75%.

Source: http://www.medicalnewstoday.com

By Serusha Govender and Sara Cheshire

(CNN) -- Do you tend to forget things when you're stressed? Like when you're late for a meeting and can't remember where you left your car keys? Or when you have to give a big presentation and suddenly forget all your talking points seconds before you start?

There's nothing like stress to make your memory go a little spotty. A 2010 study found that chronic stress reduces spatial memory: the memory that helps you recall locations and relate objects.

Hence, your missing car keys.

University of Iowa researchers recently found a connection between the stress hormone cortisol and short-term memory loss in older rats. Their findings, published in the Journal of Neuroscience this week, showed that cortisol reduced synapses -- connections between neurons -- in the animals' pre-frontal cortex, the area of the brain that houses short-term memory.

But there's a difference between how your brain processes long-term job stress, for example, and the stress of getting into a car accident. Research suggests low levels of anxiety can affect your ability to recall memories; acute or high-anxiety situations, on the other hand, can actually reinforce the learning process.

Acute stress increases your brain's ability to encode and recall traumatic events, according to studies. These memories get stored in the part of the brain responsible for survival, and serve as a warning and defense mechanism against future trauma.

If the stress you're experiencing is ongoing, however, there can be devastating effects.

Neuroscientists from the University of California, Berkeley,found that chronic stress can create long-term changes in the brain. Stress increases the development of white matter, which helps send messages across the brain, but decreases the number of neurons that assist with information processing.

The neuroscientists say the resulting imbalance can affect your brain's ability to communicate with itself, and make you more vulnerable to developing a mental illness.

Defects in white matter have been associated with schizophrenia, chronic depression, bipolar disorder, obsessive-compulsive disorder and post-traumatic stress disorder. Research on post-traumatic stress disorder further shows that it can reduce the amount of gray matter in the brain.

The Berkeley researchers believe their findings could explain why young people who are exposed to chronic stress early in life are prone to learning difficulties, anxiety and other mood disorders.

To reduce the effects of stress, the Mayo Clinic recommends identifying and reducing stress triggers. Eating a healthy diet, exercising, getting enough sleep and participating in a stress-reduction activity such as deep breathing, massage or yoga, can also help.

Stress may harm the brain, but it recovers.

Source: www.cnn.com

By Val Willingham and Miriam Falco

 (CNN) -- Chikungunya -- a tropical disease with a funny name that packs a wallop like having your bones crushed -- has finally taken up residence in the United States.

Ever since the first local transmission of chikungunya was reported in the Americas late last year, health officials have been bracing for the arrival of the debilitating, mosquito-borne virus in the United States. Just seven months after the first cases were found in the Caribbean, the Centers for Disease Control and Preventionreported the first locally acquired case of chikungunya in Florida.

Even though chikungunya is not on the National Notifiable Diseases Surveillance System list, 31 states and two U.S. territories have reported cases of the disease since the beginning of the year. But only Puerto Rico and the U.S. Virgin Islands reported locally acquired cases. All the other cases were travelers who were infected in countries where the virus was endemic and were diagnosed upon returning to the United States.

That ended Thursday, when the CDC reported a man in Florida, who had not recently traveled outside the country, came down with the illness.

As of right now, the Florida Department of Health confirmed there are at least two cases. One case is in Miami Dade County and the other is in Palm Beach County.

Its arrival did not surprise the chair of the Florida Keys Mosquito Control Board.

"It was just a matter of when. We are prepared in the Keys and have been prepared for some time to deal with chikungunya," Steve Smith said. "From what I am seeing, I'm sure there are more cases out there that we don't know about. It's really a matter of time."

The CDC is working closely with the Florida Department of Health to investigate how the patient came down with the virus. The CDC will also monitor for additional locally acquired U.S. cases in the coming weeks and months.

The virus, which can cause joint pain and arthritis-like symptoms, has been on the U.S. public health radar for some time.

Usually about 25 to 28 infected travelers bring it to the United States each year. But this new case represents the first time that mosquitoes themselves are thought to have transferred the disease within the continental United States

"The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens," said Roger Nasci, chief of CDC's Arboviral Diseases Branch. "This emphasizes the importance of CDC's health security initiatives designed to maintain effective surveillance networks, diagnostic laboratories and mosquito control programs both in the United States and around the world."

The virus is not deadly, but it can be extremely painful, with symptoms lasting for weeks. Those with weak immune systems, such as the elderly, are more likely to suffer from the virus' side effects than those who are healthier. About 60% to 90% of those infected will have symptoms, says Nasci. People infected with chikungunya will often have severe joint pain, particularly in their hands and feet, and can also quickly get very high fevers.

The good news, said Dr. William Schaffner, an infectious diseases expert with Vanderbilt University in Nashville, is that the United States is more sophisticated when it comes to controlling mosquitoes than many other nations and should be able to keep the problem under control.

"We live in a largely air-conditioned environment, and we have a lot of screening (window screens, porch screens)," Shaffner said. "So we can separate the humans from the mosquito population, but we cannot be completely be isolated."

Mosquito-borne virus worries CDC

Chikungunya was originally identified in East Africa in the 1950s. Then about 10 years ago, chikungunya spread to the Indian Ocean and India, and a few years later an outbreak in northern Italy sickened about 200 people. Now at least 74 countries plus the United States are reporting local transmission of the virus.

The ecological makeup of the United States supports the spread of an illness such as this, especially in the tropical areas of Florida and other Southern states, according to the CDC.

The other concern is the type of mosquito that carries the illness.

Unlike most mosquitoes that breed and prosper outside from dusk to dawn, the chikungunya virus is most often spread to people byAedes aegypti and Aedes albopictus mosquitoes, which are most active during the day, which makes it difficult to use the same chemical mosquito control measures.

These are the same mosquitoes that transmit the virus that causes dengue fever. The disease is transmitted from mosquito to human, human to mosquito and so forth. A female mosquito of this type lives three to four weeks and can bite someone every three to four days.

Shaffner and other health experts recommend people remember the mosquito-control basics:

-- Use bug spray if you are going out, especially in tropical or wooded areas near water.

-- Get rid of standing water in empty plastic pools, flower pots, pet dishes and gutters to eliminate mosquito breeding grounds.

-- Wear long sleeves and pants.

Source: www.cnn.com

By Reuters

Three more people in Colorado have been diagnosed with the plague after coming in contact with an infected dog whose owner contracted a life-threatening form of the disease, state health officials said on Friday.

In all, four people were infected with the disease from the same source, the Colorado Department of Public Health and Environment said in a statement.

Last week the department said a man in an eastern Colorado county whose dog died of the plague had been diagnosed with pneumonic plague, a rare and serious form of the disease.

The man remains hospitalized, but authorities have not released his condition.

The three people in the latest reported cases had "mild symptoms" and have fully recovered after being treated with antibiotics, the department said, adding that they are no longer contagious.

Two of the patients in the new cases contracted pneumonic plague, the department said.

Pneumonic plague is the only form of the disease that can be transmitted person-to-person, usually through infectious droplets from coughing.

The bacteria that causes plague occurs naturally in the western United States, primarily in California, New Mexico, Arizona and Colorado, according to the U.S. Centers for Disease Control and Prevention.

The infected canine in Colorado likely contracted the disease from prairie dogs or rabbits, which are the primary hosts for fleas that carry the bacteria.

When an infected animal dies, the fleas spread the disease when they find another host.

Colorado has seen a total of 12 cases of humans infected with the plague over the last decade, said Jennifer House, the department's public health veterinarian.

"We usually don't see an outbreak like this related to the same source," House said.

Colorado had not had a confirmed human case of pneumonic plague since 2004, she said.

Source: http://www.foxnews.com/health

Source: University of San Francisco Online

Source: http://onlinenursingdegrees.maryville.edu

By KATIE MOISSE

It’s been nine months since the government shutdown, and some D.C. area hospitals are reporting a surprising development: Babies. Lots of them.

Sibley Memorial Hospital in Washington, D.C., has seen an additional three births per day in July, according to spokesman Gary Stephenson.

“We’re at near-capacity right now,” said Stephenson, joking that some furloughed workers “apparently found ways to amuse themselves.”

Virginia Hospital Center in Arlington delivered 99 more babies in April, May and June than they did in the same stretch last year, according to spokeswoman Maryanne Boster.

Both hospitals stopped short of crediting the two-week shutdown in October 2013 for the spike in births, stressing that the apparent link was purely anecdotal. But it’s not the first time a local baby boom has been blamed –- albeit anecdotally –- on an event nine months prior.

“It’s just so appealing to think, ‘Oh, it’s a full moon,’ or ‘it’s nine months after a blackout or Hurricane Sandy,’” said Dr. Marjorie Greenfield, chief of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland. “But there’s a lot of natural fluctuation.”

Some days Greenfield has 20 women in labor, she said. Other days, there are four.

“There are so many things that play into whether someone gets pregnant,” she said, explaining that a small proportion of furloughed couples would be fertile –- not to mention eager to conceive -– during the two-week shutdown.

“It’s such a sexy topic,” she said of the big event-baby boom link. “It just doesn’t appear to be real.”

But other OBs say they not only see an uptick in births nine months after unusual events like blizzards and blackouts, their patients say those events are why they got pregnant.

“I can say that I've definitely seen spikes after things like hurricanes, blackouts and blizzards,” said Dr. Jennifer Ashton, ABC News’ senior medical contributor and a practicing OB/GYN. “I’m not aware of any hard data on this, but anecdotally, many obstetricians will ask their patients about the events nine months prior, and many women will say 'Yes, we conceived during the blackout.'"

Ashton said it’s definitely possible that the link is coincidental, and said there tend to be seasonal fluctuations in birth rates as well.

Boster of Virginia Hospital Center said they expect to see the baby boom continue through the summer months “after the long, snowy winter.”

Source: http://abcnews.go.com