DiversityNursing Blog

Posted by Brooke Olson

healthecareers.com 

Nursing is one of the most prominent — and much needed — professions in the healthcare industry, with over three million registered nurses worldwide. This number is set to grow over the coming years, with the Bureau of Labor Statistics predicting that employment of RNs will grow 19 percent in the decade leading up to 2022, faster than the average for all occupations.

This growth will be fueled by demand for healthcare providers for the aging population, the federal health insurance reform, and the increase in chronic medical conditions such as diabetes and dementia that require care. While more nurses will be required to provide care for patients across the country, there will also be more competition for the top nursing jobs.

If you’re keen to maximize your chances for the role of your dreams, read on for some top tips for using social media sites to further your career in 2015.

Network on LinkedIn

One of the best sites for networking is LinkedIn. Millions of professionals and businesses around the world use the social media platform, and as a result it’s the perfect place to network with key people in your industry and further your career in the healthcare industry.

To start yourself off on the right foot on LinkedIn, make sure your profile is completely filled out. A comprehensive profile that will get you noticed on LinkedIn will include a business-suitable photo and your skills and achievements you have acquired during the course of your education and career.

LinkedIn makes it easy for you to ask for recommendations to go on your profile from people you’ve worked with over the years, whether co-workers, bosses or clients. In addition, don’t forget to optimize your profile and job title with relevant keywords, as this can make a big difference in search results.

Once you have your information up to date, it’s time to start working on adding connections. Apart from making requests to connect with people you already know, it’s also a good idea to join relevant LinkedIn groups and participate in discussions about any topics where you can contribute useful information or an unusual insight — this is a fantastic way to generate interest from potential new ones. In addition, regularly sharing interesting articles and information with all of your connections and update LinkedIn with your career successes and new skills is a great way to stay engaged with your current contacts.

Create a Personal Brand

Social media is a great avenue through which to promote your personal brand. Blogs, Twitter, and Instagram, for example, are all fantastic platforms to use to get your name out there and develop a brand for yourself. Although you might only associate the word “brand” with businesses, developing your own personal brand is a great way for many professionals, especially contractors, to promote themselves.

Build a consistent personal brand by ensuring that you always use the same font, image, language, and even logo, on any online profiles. Creating and maintaining a distinct voice will set you apart from others, helping you to stand out in a competitive industry.

Showcase Yourself as an Industry Expert

Blogs, LinkedIn and Twitter in particular are great platforms to demonstrate your ability to be an industry expert, and is used by many workers to foster relationships and build a profile in their industry.

Publish relevant and engaging content on your blog and distribute it on social media to showcase your experience, skills, and knowledge of healthcare to potential employers and contacts. In addition, share pictures, infographics, quotes, links to articles your connections might find helpful or informative. It’s important to stick to posting about your industry and/or specialty, and refrain from posting personal information in order to build a loyal following and give employers an idea of your passion and what you might offer their company.

By networking, building a personal brand, and showcasing yourself as an industry expert via social media, you will set yourself up to generate more interest when you apply for jobs, and can even bring employers directly to you.

Want a career in nursing? Search hundreds of nursing jobs across the U.S. today!

Here’s an interesting option for people with Parkinson’s Disease to cope with the motor skills challenges they face every day. It’s another example of technology improving people’s lives.

Parkinson's Disease is a nervous system disorder that affects a person's movement. The most common sign of this disease is hand tremors. Other signs like stiffness or slow movement can also be common. Parkinson's Disease has symptoms that will worsen with progression of the condition over time. This disease has no cure but, medications or physical therapy programs can help improve symptoms. 

Google Glass was a failure. At least, according to most people. But not for one specific group: people with Parkinson's. They've been experimenting with new software for Glass and say that it improves the quality of their lives.

People suffering from Parkinson's have challenges with their motor skills. Joy Esterberg, who was diagnosed with Parkinson's in 2003, compares the feeling to moving through mud. She was an early adopter of the Glass software, which has been in development for the last year. 

"It is very sci-fi," Esterberg said of Glass. "What I like about it is that I can wear it at home. You have the little screen, you see David dancing, and you can follow the moves." 

She's talking about David Leventhal, the director of the Mark Morris Dance Group's Dance for PD program, which has been offering free dance classes for people with Parkinson's since 2001.

When a user activates Glass, they can choose from a variety of different exercises, like "warm me up" or "balance me." Once selected, they see Leventhal or one of his co-teachers projected in front of them. 

This technology is especially important because when people with Parkinson's walk down the street, they sometimes freeze up. In order to get going again, they often need to watch someone else's movements or footsteps. This can be problematic, especially if there's no one around.

The software, called Moving Through Glass, is based off exercises done in Leventhal's weekly class. The movements have roots in ballet and modern dance, and include a lot of extension exercises, which are particularly helpful for people with Parkinson's. Some students are very mobile, while others are confined to wheelchairs and exercise with assistance. 

To get the Glass project going, Leventhal applied for a $25,000 Google (GOOG) grant. He got it, and then partnered with SS+K, a New-York based advertising agency with a strong focus on social responsibility. It developed the software for free through its innovation lab.

Though still in the pilot stage, it's hoped that the software will make people with Parkinson's more independent and confident when they go outside. 

"It's surprisingly un-weird," Esterberg said. "In New York, nobody is going to look at you if you have something on your face. You'd have to have orange feathers sticking out of it for people to notice." 

More and more of the students in her dance class will be using Glass as part of the program. There are about 50 people who attend each week in Brooklyn, and it's known as a place for camaraderie and acceptance. 

"Everyone comes to dance class for a reason," Leventhal said. "Some people come to escape Parkinson's. Some people come because they want to work on specific skills related to balance or coordination or musicality."

There isn't data on how successful the class has been, but Levanthal said he sees it in students' stories. One student, he said, had been able to dance at a family member's wedding thanks to the class. Esterberg said she dances better now than she did before Parkinson's because she practices every day. 

For now, the Glass software is still in the early stages, and the dance studio has 25 pairs available for students to borrow. However, the future is uncertain because Google stopped selling Glass earlier this year, saying it will focus on future incarnations. 

Whatever Glass 2.0 looks like, Leventhal said his students will have a lot of feedback and, no matter what, they'll still be dancing. Esterberg certainly will be, and said she hopes more people will see that a diagnosis doesn't have to mean giving up. 

"You can do new things," she said. "You don't have to just accept [that Parkinson's is] the end of everything. Because it really isn't."

Contributor: Jillian Eugenios and Erica Bettencourt

Story Source: CNN

By Carina Storrs

CNN 

Jenner's story, and others', is indeed bringing gender transitioning, which can involve surgery, hormonal therapy and behavioral changes, into the mainstream. "There's certainly a growing acceptance of gender diversity and understanding of how important [affirming internal gender] is," said Dr. Timothy Cavanaugh, medical director of the Transgender Health Program at Fenway Health.

It is estimated that one in 10,000 people who are born male feel their true identify is female or have a strong desire to be female. There are approximately 100 to 500 genital surgeries every year in the United States as part of gender transition, according to the Encyclopedia of Surgery. But that number could be growing. 

In the older generation, the demographic to which Jenner belongs, "I think many people thought their only option was to hide their internal gender or repress it [because] there wasn't a lot of social support or acceptance," Cavanaugh said. "With growing awareness, people in their 40s, 50s and up are coming to a place where they can do something about it," he added. 

But what does it mean to have gender transition procedures, particularly hormonal therapies and invasive genital and facial surgeries, for this older group, compared with transgender people in their 20s and 30s (which Cavanaugh says is the other common demographic)? Are there health concerns, or benefits, with undergoing physical changes later in life? 

Many transgender people take lifelong hormone therapy, and for transwomen (transitioning from male to female) hormones are estrogens and anti-androgens that block their body's testosterone. Jenner reported undergoing hormone therapy, along with a 10-hour facial feminization surgery and breast augmentation. The Olympic gold medalist and former husband of Kris Kardashian said she has not had genital surgery and it's unclear whether she will.

However, as people age, their bodies become less responsive to hormones, and estrogen's effects. Primarily, breast development and weight redistribution will probably be less dramatic in older transwomen compared with younger, Cavanaugh said. At the same time, doctors tend to prescribe a lower dose of estrogen in older women because of concerns of blood clots, and consequent heart attacks and strokes. 

"It may mean that it takes a little longer, that the feminization is not as vigorous, or the effects may not be as satisfactory in older transwomen," Cavanaugh said. However, physical changes do still occur, and they have clear psychological benefits for these women. (In transmen, or people transitioning from female to male, testosterone therapy is generally viewed as safer than estrogen and more effective, Cavanaugh added.)

Facial surgery can be part of gender transitioning for transwomen who have manly features, such as sagging brows that develop with age, said Dr. David Alessi, facial plastic surgeon and owner and director of the Alessi Institute in Beverly Hills, California. (He added that transwomen who have effeminate faces may not need surgery.)

It is possible to make the face look younger and more feminine at the same time, Alessi said. For example, lifting the brow makes it less saggy and removes wrinkles. But there are limits. "I can make a 60-year-old male look like a 50-year-old woman, but not like a 20-year-old girl," he said. 

The more difficult surgery, for all ages, is genital, and older transgender people have special challenges, Alessi said. In particular, surgeons create a vagina, typically using tissue from the penis. However, that tissue may die in its new location if it does not have good circulation, as is more common in older people, and the surgery would have to be repeated to graft tissue from the colon or mouth, Alessi said. "The goal is to do the genital surgery in one surgery, but more likely it takes two or three surgeries, and that is more likely in older patients," he said. 

There are also general problems with any surgery in people in their 60s and 70s. "Often they develop chronic medical conditions, such as high blood pressure and cardiovascular disease, that makes surgery a little bit more risky" because it could exacerbate these conditions, Cavanaugh said

Gender transitioning does not always involve hormone therapy and surgery, however. Among people in their 20s and 30s, who may have more access to information online and to support groups, "we see a number of younger patients who say, 'I just need my identity affirmed,'" Cavanaugh said. They can sometimes achieve this goal through dress and social behavior and finding groups of like-minded people. 

"[Yet] there are always going to be people who really feel a disconnect between internal gender and anatomy, especially when interacting with the world, that it makes more sense and is really beneficial for them to masculinize or feminize the body," Cavanaugh said.

We found this interesting article about the growth of smartphone use and apps available to Nurses while at work. These apps are being used to research drugs, gather information about home care as well as diseases and disorders. This is an area that will continue to grow and hopefully provide much needed assistance to our hard-working Nurses.

A new survey indicates nurses are relying more than ever on their smartphone for clinical care – to the detriment of the so-called "doctor on call."

Conducted by InCrowd, a Boston-based market intelligence firm, the survey found that 95 percent of the 241 responding nurses own a smartphone and 88 percent use smartphone apps at work. More intriguing, 52 percent said they use an app instead of asking a colleague, and 32 percent said they consult their smartphone instead of a physician.

"The hospital gets very busy and there isn't always someone available to bounce ideas off of," one respondent said. Said another: "It's often easier to get the information needed using my smartphone – I don't have to wait for a response from a coworker."

Nurses have long been seen as an under-appreciated market for mHealth technology, and one that differs significantly from doctors, but that seems to be changing. Companies like Voalte are marketing communications platforms targeted at nurses, and even IBM has come out with a line of nurse-specific apps.

"There's a lot of untapped potential in the use of mobile apps for nursing," Judy Murphy, IBM's chief nursing officer, told mHealth News.

Unlike physicians, who are looking for apps that can retrieve information, enter orders and push notifications, nurses need apps that assist their workflow, offer quick information and coordinate multiple activities.

"It's all about care coordination," Murphy said. "Nurses want apps that can help them organize their day."

The ideal app will be simple in nature, so that it can be used quickly, and will help nurses organize several functions, from taking care of multiple patients to addressing orders from doctors, according to Murphy. Some tasks, like entering complex data into the EMR, actually clutter the form factor of the smartphone and are best handled at a workstation.

According to the InCrowd survey, nurses are quick to point out that their smartphones "enhance but don't substitute" for the physician, but when they're running around and need a quick question answered about medications, illnesses or symptoms, sometimes the app does the job more effectively – such as "in patient homecare situations when I need quick answers without making a bunch of phone calls," or "so I can make an educated suggestion to the doctor."

According to the survey, 73 percent of the nurses surveyed use their smartphones to look up drug information at the bedside, while 72 percent use it to look up various diseases or disorders. And befitting the various roles of the smartphone in the healthcare setting, 69 percent of nurses said they use their smartphones to stay in touch with colleagues. Other uses include viewing images and setting timers for medication administration.

Finally, the survey found that nurses are using smartphones in the workplace no matter who's paying for them. Some 87 percent of those surveyed said their employer isn't covering any costs related to the smartphone, while 9 percent are reimbursed for the cost of the monthly bill, 1 percent receive some reimbursement for the cost of the smartphone, and 3 percent are reimbursed for both the phone and the phone bill. Less than 1 percent, meanwhile, said their institution bans the use of personal smartphones while on duty.

"We're hitting the tip of the iceberg here with apps that a nurse will want and will use," Murphy said.

www.mhealthnews.com

Contributor: Eric Wicklund

We wholeheartedly agree with this article that Nurse Practitioners across the country should be allowed to practice without a doctor’s consent in a variety of medical areas.

What are your thoughts about this important issue? Do you strongly agree or disagree?

In March, Nebraska became the 20th state to allow nurses with the most advanced degrees to practice without a doctor’s oversight in a variety of medical fields. Maryland recently followed suit and eight more states are considering similar legislation.

What does all this mean? Nurses in Nebraska with a master’s degree or better, known as nurse practitioners, no longer have to get a signed agreement from a doctor to be able to order and interpret diagnostic tests, prescribe medications and administer treatments.

These changes are long overdue.

The preponderance of empirical evidence indicates that, compared to physicians, nurse practitioners provide as good — if not better — quality of care. As I’ve written previously, patients are often more satisfied with nurse practitioner care — and sometimes even prefer it.

The Institute of Medicine is unambiguously clear about this: 

No studies suggest that APRNs [Advanced Practice Registered Nurse] are less able than physicians to deliver care that is safe, effective, and efficient or that care is better in states with more restrictive scope of practice regulations for APRNs.

In addition, see this review of the literature in Health Affairs.

In general, nurse practitioners have the skills to prescribe, treat and do most things a primary care physician can do. They generally must have completed a Registered Nurse and a Nurse Practitioner Program and have a Masters or PhD degree. In addition, there are physician assistants, registered nurses, licensed vocational nurses, emergency medical technicians, paramedics and army medics. In most states, each of these categories has its own set of restrictions and regulations, delineating what the practitioners can and can’t do.

What should each of these professionals be allowed to do? Whatever they’ve been trained to do.

The doctors counter that someone who hasn’t trained to be a doctor might miss important symptoms or clues that a physician might catch. This observation is true but trivial. Every professional might miss something that someone who is better trained might catch. A specialist might catch something a primary care physician might miss. A specialist in one field (say, oncology) might catch something a specialist in some other field (say ENT) might miss.

Perhaps more relevant to common experience, Emergency Medical Technicians riding in ambulances are treating victims of accidents and emergencies every day. Would the care be slightly less risky if we put doctors in all those ambulances? Maybe. Is anyone seriously suggesting that we do that? Of course not.

Think of health care as a large market in which everyone has to make decisions about whether the patient-provider nexus is the right fit. It’s not just the providers who have to decide whether the problem lies within their area of competence. Patients must make those decisions too. In Britain (under socialized medicine), patients make such decisions all the time. For routine problems, most Britons see a National Health Service physician. But “if it’s serious, go private” is a common bit of advice in that country.

How do professionals handle these decisions? From the most part quite well. Walk-in clinics (where nurses deliver care following computerized protocols) have been around for at least a decade. Studies show that the nurses follow best practices as well or better than traditional primary care physicians. And I am not aware of any serious, reported cases of nurses failing to distinguish between cases they are competent to handle and those they are not.

But even if a nurse did make a serious mistake, doctors make mistakes too. There is no such thing as a risk free world. We encounter tradeoffs between cost and risk every day. There is no reason for politicians (beholden to special interests) to make these decision for us.

In Texas, which has some of the most stringent regulations in the country, however, a nurse practitioner can’t do much of anything without being supervised by a doctor who must:

•Not oversee more than four nurses at one time.

•Not oversee nurses located outside of a 75 mile radius.

•Conduct a random review of 10 percent of the nurses’ patient charts every 10 days.

•Be on the premises 20 percent of the time.

These restrictions make it virtually impossible for Texas’ 8,600 nurse practitioners to practice outside the office of a primary care physician. The Texas requirement that a doctor supervising nurse practitioners be physically present and spend at least 20 percent of her time overseeing them creates an incentive for the physician to require nurses to be employees, rather than self-employed professionals. When practitioners are employed by a doctor, the physician meets state supervision requirements simply by showing up. This allows the doctor to see her own patients while generating additional revenue from patients seen by the practitioners.

These regulations have the greatest impact on the poor, especially the rural poor. The farther a nurse is located from a doctor’s office, the less likely the physician will be willing to make the drive to supervise the nurse. This means that people living in poverty-stricken Texas counties must drive long distances, miss work and take their kids out of school in order to get simple prescriptions and uncomplicated diagnoses. This problem might be alleviated if nurse practitioners were allowed to practice independently in rural areas. But, under Texas law, these practices must be located within 75 miles of a supervising physician. A physician with four nurses located in rural areas could drive hundreds of miles a week to review the nurses’ patient charts. The result is that doctors in Texas don’t receive a return on investment sufficient to induce them to supervise nurse practitioners.

If all this sounds like the reinvention of the Medieval Guild system, that’s exactly what it is. In Capitalism and Freedom, Milton Friedman argued that these labor market restrictions are no more justified today than they were several centuries ago. The proper role of government, said Friedman, is to certify the skills of various practitioners; then let consumers decide what services to buy from them.

Contributer: John C. Goodman

www.forbes.com

By ALEXANDRA ROBBINS

www.nytimes.com 

SEVERAL emergency-room nurses were crying in frustration after their shift ended at a large metropolitan hospital when Molly, who was new to the hospital, walked in. The nurses were scared because their department was so understaffed that they believed their patients — and their nursing licenses — were in danger, and because they knew that when tensions ran high and nurses were spread thin, patients could snap and turn violent.

The nurses were regularly assigned seven to nine patients at a time, when the safe maximum is generally considered four (and just two for patients bound for the intensive-care unit). Molly — whom I followed for a year for a book about nursing, on the condition that I use a pseudonym for her — was assigned 20 patients with non-life-threatening conditions.

“The nurse-patient ratio is insane, the hallways are full of patients, most patients aren’t seen by the attending until they’re ready to leave, and the policies are really unsafe,” Molly told the group.

That’s just how the hospital does things, one nurse said, resigned.

Unfortunately, that’s how many hospitals operate. Inadequate staffing is a nationwide problem, and with the exception of California, not a single state sets a minimum standard for hospital-wide nurse-to-patient ratios.

Dozens of studies have found that the more patients assigned to a nurse, the higher the patients’ risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital — and the longer their hospital stay. According to one study, for every 100 surgical patients who die in hospitals where nurses are assigned four patients, 131 would die if they were assigned eight.

In pediatrics, adding even one extra surgical patient to a nurse’s ratio increases a child’s likelihood of readmission to the hospital by nearly 50 percent. The Center for Health Outcomes and Policy Research found that if every hospital improved its nurses’ working conditions to the levels of the top quarter of hospitals, more than 40,000 lives would be saved nationwide every year.

Nurses are well aware of the problem. In a survey of nurses in Massachusetts released this month, 25 percent said that understaffing was directly responsible for patient deaths, 50 percent blamed understaffing for harm or injury to patients and 85 percent said that patient care is suffering because of the high numbers of patients assigned to each nurse. (The Massachusetts Nurses Association, a labor union, sponsored the study; it was conducted by an independent research firm and the majority of respondents were not members of the association.)

And yet too often, nurses are punished for speaking out. According to the New York State Nurses Association, this month Jack D. Weiler Hospital of the Albert Einstein College of Medicine in New York threatened nurses with arrest, and even escorted seven nurses out of the building, because, during a breakfast to celebrate National Nurses Week, the nurses discussed staffing shortages. (A spokesman for the hospital disputed this characterization of the events.)

It’s not unusual for hospitals to intimidate nurses who speak up about understaffing, said Deborah Burger, co-president of National Nurses United, a union. “It happens all the time, and nurses are harassed into taking what they know are not safe assignments,” she said. “The pressure has gotten even greater to keep your mouth shut. Nurses have gotten blackballed for speaking up.”

The landscape hasn’t always been so alarming. But as the push for hospital profits has increased, important matters like personnel count, most notably nurses, have suffered. “The biggest change in the last five to 10 years is the unrelenting emphasis on boosting their profit margins at the expense of patient safety,” said David Schildmeier, a spokesman for the Massachusetts Nurses Association. “Absolutely every decision is made on the basis of cost savings.”

Experts said that many hospital administrators assume the studies don’t apply to them and fault individuals, not the system, for negative outcomes. “They mistakenly believe their staffing is adequate,” said Judy Smetzer, the vice president of the Institute for Safe Medication Practices, a consumer group. “It’s a vicious cycle. When they’re understaffed, nurses are required to cut corners to get the work done the best they can. Then when there’s a bad outcome, hospitals fire the nurse for cutting corners.”

Nursing advocates continue to push for change. In April, National Nurses United filed a grievance against the James A. Haley Veterans’ Hospital in Tampa, which it said is 100 registered nurses short of the minimum staffing levels mandated by the Department of Veterans Affairs (the hospital said it intends to hire more nurses, but disputes the union’s reading of the mandate).

Nurses are the key to improving American health care; research has proved repeatedly that nurse staffing is directly tied to patient outcomes. Nurses are unsung and underestimated heroes who are needlessly overstretched and overdue for the kind of recognition befitting champions. For their sake and ours, we must insist that hospitals treat them right.

The Nursing profession is in dire need of an IT upgrade. The way the nursing profession currently handles information is costing time, money, patient health and more importantly, lives. Creating an integrated health IT system will address these costs, as well as reducing errors among hospital staff and mistakes with prescriptions both when they are written and when patients obtain them.

To learn more checkout the following infographic, created by the Adventist University of Health Sciences Online RN to BSN program, that illustrates the need, benefit and impact of Health IT in nursing.

By GILLIAN MOHNEY

http://abcnews.go.com 

A 15-year-old California softball player is reportedly fighting for her life days after a brain aneurysm led her to collapse on the field.

Dana Housley told her coach she “felt dizzy” before collapsing on the field, according to ABC's Los Angeles station KABC.

She was taken to Kaiser Permanente in Fontana, California, where she is on life support, according to KABC. Hospital officials did not comment further on the case, citing privacy laws.

As Housley’s teammates rally with messages of support with the hashtag #PrayforDana, experts said that the teen’s case can help put the spotlight on this mysterious condition that affects an estimated 6 million Americans.

Experts are quick to point out that Housley’s activity on the softball team likely had no bearing on her developing a brain aneurysm or having it rupture.

“The biggest mystery is why they form,” Christine Buckley, the executive director of the Brain Aneurysm Foundation told ABC News.

Just two days after Housley’s hospitalization, a teen baseball player reportedly died after being hit by a baseball. In that case, the cause of death was not yet released, though his grandfather told a local newspaper that one cause may have been an underlying condition, including possibly an aneurysm.

Teens rarely develop aneurysms, but those that do often do not understand their symptoms including headache, eye pain and sometimes earache, Buckley said.

“Early detection is the key,” she said, noting that people should seek treatment at a hospital if they experience signs and symptoms.

An aneurysm develops when a weak spot develops on the wall of a brain artery, leading to a bulge. Should the weak spot rupture, the blood loss can lead devastating results, including stroke, brain injury or death.

Aneurysms can run in families and ruptured aneurysms are more associated with smoking, but no specific activity is associated with developing an aneurysm or having it rupture, Buckley said.

Dr. Nicholas Bambakidis, director of Cerebrovascular and Skull Base Surgery at University Hospitals Case Medical Center in Cleveland, said brain aneurysms in teenagers and children are rare but they do occur.

“It’s a severe tremendous headache, almost always accompanied by loss of consciousness,” Bambakidis said of brain aneurysm symptoms. "Worst headache of my life. It’s not like a tension headache or a headache after a bad day."

Bambakidis said even an outside trauma like a baseball hitting the head may not lead to rupture and that they are mostly likely to be rupture due to severe trauma that actually pierces the brain.

The biggest predictor of survival is how a patient is doing when they arrive to get treatment, he said.

“How bad was the bleeding and how much damage was done to the brain when it’s bleeding?” Bambakidis said of figuring out the likelihood of a patient surviving.

Brain aneurysms are most prevalent for people between the ages of 35 to 60, according to the Brain Aneurysm Foundation. The condition can be deadly if ruptured and approximately 15 percent of patients with a specific type of aneurysm called an aneurysmal subarachnoid hemorrhage, die before reaching the hospital.

Approximately 30,000 Americans will have a brain aneurysm rupture annually and about 40 percent of these cases are fatal.

By Jethro Mullen

www.cnn.com 

But not for Annegret Raunigk.

The 65-year-old German grandmother recently gave birth to quadruplets, making her the oldest woman ever to do so.

The new arrivals increase her progeny to a total of 17 children. And let's not forget her seven grandchildren.

Raunigk, a single mother, gave birth last week to three boys and one girl after a pregnancy of just under 26 weeks, the German broadcaster RTL reported. 

The newborns -- whose names are Neeta, Dries, Bence and Fjonn -- were delivered by C-section and are being kept in incubators for premature babies, according to RTL.

Daughter wanted a younger sibling

Raunigk, a teacher from Berlin, made headlines 10 years ago when, at the age of 55, she gave birth to a daughter, Leila. And it was apparently Leila's plea for a younger sibling that encouraged her mother to try again.

"I myself find life with children great," Raunigk said earlier this year. "You constantly have to live up to new challenges. And that probably also keeps you young."

To become pregnant, she used in vitro fertilization (IVF) treatment with donated eggs that were fertilized.

One doctor tried to persuade her to abort one or two of the fetuses, but she refused to consider it.

Indian woman holds record

Raunigk, who had her first child at 21, is still not the oldest woman to give birth.

That record is held by Rajo Devi Lohan, an Indian woman who at 70 became the world's oldest known first time mother after three rounds of IVF.

Her daughter Naveen will turn 7 later this year.

What are your thoughts about this story?

www.npr.org 

A couple of extra minutes attached to the umbilical cord at birth may translate into a small boost in neurodevelopment several years later, a study suggests.

Children whose cords were cut more than three minutes after birth had slightly higher social skills and fine motor skills than those whose cords were cut within 10 seconds. The results showed no differences in IQ.

"There is growing evidence from a number of studies that all infants, those born at term and those born early, benefit from receiving extra blood from the placenta at birth," said Dr. Heike Rabe, a neonatologist at Brighton & Sussex Medical School in the United Kingdom. Rabe's editorial accompanied the study published Tuesday in the journal JAMA Pediatrics.

Delaying the clamping of the cord allows more blood to transfer from the placenta to the infant, sometimes increasing the infant's blood volume by up to a third. The iron in the blood increases infants' iron storage, and iron is essential for healthy brain development.

"The extra blood at birth helps the baby to cope better with the transition from life in the womb, where everything is provided for them by the placenta and the mother, to the outside world," Rabe said. "Their lungs get more blood so that the exchange of oxygen into the blood can take place smoothly."

Past studies have shown higher levels of iron and other positive effects later in infancy among babies whose cords were clamped after several minutes, but few studies have looked at results past infancy.

In this study, researchers randomly assigned half of 263 healthy Swedish full-term newborns to have their cords clamped more than three minutes after birth. The other half were clamped less than 10 seconds after birth.

Four years later, the children underwent a series of assessments for IQ, motor skills, social skills, problem-solving, communication skills and behavior. Those with delayed cord clamping showed modestly higher scores in social skills and fine motor skills. When separated by sex, only the boys showed statistically significant improvement.

"We don't know exactly why, but speculate that girls receive extra protection through higher estrogen levels whilst being in the womb," Rabe said. "The results in term infants are consistent with those of follow-up in preterm infants."

Delayed cord clamping has garnered more attention in the past few years for its potential benefits to the newborn. Until recently, clinicians believed early clamping reduced the risk of hemorrhaging in the mother, but research hasn't borne that out.

Much of the research has focused on preterm infants, who appear to benefit most from delayed cord clamping, Rabe said. Preemies who have delayed cord clamping tend to have better blood pressure in the days immediately after birth, need fewer drugs to support blood pressure, need fewer blood transfusions, have less bleeding into the brain and have a lower risk of necrotizing enterocolitis, a life-threatening bowel injury, she said.

This study is among the few looking at healthy, full-term infants in a country high in resources, as opposed to developing countries where iron deficiency may be more likely.

The American Congress of Obstetricians and Gynecologists has not yet endorsed the practice, citing insufficient evidence for full-term infants. The World Health Organization recommends delayed cord clamping of not less than one minute.

It is unclear whether the practice could harm infants' health. Some studies have found a higher risk of jaundice, a buildup of bilirubin in the blood from the breakdown of red blood cells. Jaundice is treated with blue light therapy and rarely has serious complications.

Another potential risk is a condition called polycythemia, a very high red blood cell count, said Dr. Scott Lorch, an associate professor of pediatrics at the University of Pennsylvania Perelman School of Medicine and director of the Center for Perinatal and Pediatric Health Disparities Research at Children's Hospital of Philadelphia.

"Polycythemia can have medical consequences for the infant, including blood clots, respiratory distress and even strokes in the worst-case scenario," Lorch said. Some studies have found higher levels of red blood cells in babies with delayed cord clamping, but there were no complications.

Lorch also pointed out that this study involved a mostly homogenous population in a country outside the U.S.

"We should see whether similar effects are seen in higher-risk populations, such as the low socioeconomic population, racial and ethnic minorities and those at higher risk for neurodevelopmental delay," Lorch said.

So far, studies on delayed cord clamping have excluded infants born in distress, such as those with breathing difficulties or other problems. But Rabe said these infants may actually benefit most from the practice.

These babies often need more blood volume to help with blood pressure, breathing and circulation problems, Rabe said. "Also, the placental blood is rich with stem cells, which could help to repair any brain damage the baby might have suffered during a difficult birth," she added. "Milking of the cord would be the easiest way to get the extra blood into the baby quickly in an emergency situation."