To your good health…A la buena salud!

address-book-new-3Hispanics or Latinos are the largest racial/ethnic minority population in the US. Heart disease and cancer in Hispanics are the two leading causes of death, accounting for about 2 of 5 deaths, which is about the same for whites. Hispanics have lower deaths than whites from most of the 10 leading causes of death with three exceptions—more deaths from diabetes and chronic liver disease, and similar numbers of deaths from kidney diseases. Health risk can vary by Hispanic subgroup—for example, 66% more Puerto Ricans smoke than Mexicans.
Health risk also depends partly on whether you were born in the US or another country. Hispanics are almost 3 times as likely to be uninsured as whites. Hispanics in the US are on average nearly 15 years younger than whites, so steps Hispanics take now to prevent disease can go a long way.
Doctors and other healthcare professionals can:
Work with interpreters to eliminate language barriers, when patient prefers to speak Spanish.
Counsel patients on weight control and diet if they have or are at high risk for high blood pressure, diabetes, or cancer.
Ask patients if they smoke and if they do, help them quit.
Engage community health workers (promotores de salud) to educate and link people to free or low-cost services…. >>>for more info

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Infografia in Espanol

A new kind of Physician Assistant…a dog?

dogA study, led by Arny Ferrando, Ph.D., a professor and researcher in the UAMS Donald W. Reynolds Institute on Aging, and Andrew Hinson, M.D., a postdoctoral fellow at UAMS, took dogs already trained for scent detection and imprinted them with fresh tissue taken from patients diagnosed with papillary thyroid carcinoma, the most common type of thyroid cancer. Fellow researcher Brendan Stack Jr., M.D., a head and neck surgeon in the UAMS College of Medicine Department of Otolaryngology-Head and Neck Surgery, assisted with the study.

The dogs were then presented with urine samples from patients — some with thyroid cancer and some with benign nodules — and asked to indicate whether each sample had thyroid cancer or not. Their results were compared to a surgical pathology diagnosis and matched in 30 of 34 cases, or 88.2 percent accuracy.

The results so far lead the researchers to believe the answer is “yes.”

 

Let Nonverbal Patients Communicate – Part 1

A hospital stay is seldom pleasant. Besides having pain and being sick, patients have to endure needle punctures a dozen times a day, beeps from medical equipment every ten minutes and moans from other patients. When a patient is nonverbal, a hospital stay can become much worse.

Since I am nonverbal because of cerebral palsy, I know the experience all too well. Last year I was hospitalized twice for pneumonia. The communication barrier played a major role in both hospital stays being dreadful. Although my mother and friends told doctors and nurses that I am intelligent, that I graduated from Cleveland State University and that I work as an accessibility analyst, many of them talked to me as if I could not understand. A sign that a friend posted above my bed saying I could comprehend and the way I could communicate did not help very much.

Their presumption possibly prevented them from interpreting my gestures and vocal cues. For example, when I could not reach the call button, I would yell for someone to come. Many times my calls would go unanswered. When someone did come and asked me what I wanted, I would look at my pillow and point to it, indicating that I wanted it raised or I wanted to be lifted up. Some nurses and aides did not understand, even if my head was five inches off the pillow. Sometimes they could not even understand my “yes” and “no” responses.
Communication Techniques and Tools
In general, effective interpersonal communication means the exchange of information between two or more persons in which it is understood. Technically speaking, one individual encodes information verbally while another decodes it.

Encoder: “I’m pregnant”
Decoder: Faints (He got the message clearly.)

Effective communication between a non-verbal patient and a medical professional involves more, According to the U.S. Joint Commission (formerly the Joint Commission on Accreditations of Health Organizations) it entails:

“the successful joint establishment of meaning wherein patients and healthcare providers exchange information, enabling patients to participate actively in their care from admission through discharge, and ensuring that the responsibilities of both patients and providers are understood”

In January 2011, the Joint Commission mandated The Patient-Centered Communication Standards for Hospitals. They will become effective in July 2012. Some of these standards that relate specifically to patients with communication disorders are as follows:

• Identify a patient’s communication needs
• Inform the patient’s assigned medical staff about these needs
• Include the patient’s communication needs in his medical records

Patients who cannot talk due to a disability, such as cerebral palsy or a stroke, try to exchange information through augmentative and alternative communication (AAC) methods. They include picture/word boards, hand gestures facial expressions, and eye movements.

Learning to communicate with nonverbal patients who cannot use their hands to write is as much the medical staff’s responsibility as it is that of the patient. As mentioned above, a note or booklet that includes basic information about the individual and his AAC techniques should be placed in clear view near his hospital bed. The information also should be placed in his medical records for future reference. Additionally, a relative or friend of the nonverbal patient should consult with the medical team to reiterate his communication techniques.

As shown with my hospital experiences, however, informing a nonverbal patient’s medical team about his AAC does not always serve its purpose. While nurses in the morning shift know that the patient raises his eyes for affirmative responses, for instance, the night shift may be oblivious of this detail. Patient-nurse ratio is another factor that can undermine receiving communication cues from non-verbal patients. When a nurse or aide has 10 or more patients to attend to, taking the time to decipher a patient’s gesture can be difficult unless an interpreter or speech pathologist is there to assist.

Successful interaction between nurses and nonverbal patients also is based on the nurses’ desire to communicate with them. Despite being in a profession where they are likely to work with persons with disabilities, some nurses still may have misconceptions about them. When a patient who is nonverbal already is admitted, an assumption may be that he is deaf or cannot understand. Therefore, any attempt from the patient to communicate may be overlooked or ignored. According to a study done by Patak L, Gawlinski A, Fung NI, Doering L, Berg J. (2004), patients on mechanical ventilation have more difficulty communicating with nurses who were robotic, inattentive, and absent from the bedside. Conversely, communication becomes less frustrating for patients when nurses are kind, physically present, and informative.

Training nurses and nursing aides to understand non-verbal patients has been based on the level of pain they are in. For instance, a course is offered at Suburban Hospital in Bethesda, Maryland, where nurses learn to recognize if nonverbal patients are in pain based on facial expression, restlessness, vocal sounds, muscle tone and the ability to console. Therefore, if a non-verbal patient were in extreme pain, he would express it in one or more of the following ways:
• Frown
• Moan
• Rigid limbs
• Cannot stay still
• Cannot accept verbal or tactical consolation

While training to recognize communication cues of nonverbal patients regarding pain is essential, the training should expand to include nonverbal cues under other circumstances (i.e. the patient wants his position adjusted in bed). One of the few classes in this area is offered at University Hospital in San Antonio, Texas. After nurses and other hospital staff participated in the class, they became more aware of the need to communicate with nonverbal patients. They also tried to find communication tools for nonverbal patients to use.

Speech language pathologists at a community hospital in Boulder, Colorado developed the “On The Spot Communication” toolkit. Acting like a First Aid kit for patient communication, it contains such tools as:
• Word and picture boards in different languages
• Adapted call bell for patients who cannot reach or press standard call bells
• Writing boards for patients who cannot talk but who can write
• Items to help patients who are hearing implied (i.e. pocket talker amplifier)

The toolkit is available nationwide through the AAC Connect Store with the hopes that as many hospitals as possible will purchase it. Once nurses and other medical professionals have the toolkit, they should store it where they have easy access to it so using it will become habitual.

 

Let Nonverbal Patients Communicate – Part 2

Non verbal communication

Let Nonverbal Patients Communicate
Introduction
A hospital stay is seldom pleasant. Besides having pain and being sick, patients have to endure needle punctures a dozen times a day, beeps from medical equipment every ten minutes and moans from other patients. When a patient is nonverbal, a hospital stay can become much worse.

Since I am nonverbal because of cerebral palsy, I know the experience all too well. Last year I was hospitalized twice for pneumonia. The communication barrier played a major role in both hospital stays being dreadful. Although my mother and friends told doctors and nurses that I am intelligent, that I graduated from Cleveland State University and that I work as an accessibility analyst, many of them talked to me as if I could not understand. A sign that a friend posted above my bed saying I could comprehend and the way I could communicate did not help very much.

Their presumption possibly prevented them from interpreting my gestures and vocal cues. For example, when I could not reach the call button, I would yell for someone to come. Many times my calls would go unanswered. When someone did come and asked me what I wanted, I would look at my pillow and point to it, indicating that I wanted it raised or I wanted to be lifted up. Some nurses and aides did not understand, even if my head was five inches off the pillow. Sometimes they could not even understand my “yes” and “no” responses.
Communication Techniques and Tools
In general, effective interpersonal communication means the exchange of information between two or more persons in which it is understood. Technically speaking, one individual encodes information verbally while another decodes it.

Encoder: “I’m pregnant”
Decoder: Faints (He got the message clearly.)

Effective communication between a non-verbal patient and a medical professional involves more, According to the U.S. Joint Commission (formerly the Joint Commission on Accreditations of Health Organizations) it entails:

“the successful joint establishment of meaning wherein patients and healthcare providers exchange information, enabling patients to participate actively in their care from admission through discharge, and ensuring that the responsibilities of both patients and providers are understood”

In January 2011, the Joint Commission mandated The Patient-Centered Communication Standards for Hospitals. They will become effective in July 2012. Some of these standards that relate specifically to patients with communication disorders are as follows:

• Identify a patient’s communication needs
• Inform the patient’s assigned medical staff about these needs
• Include the patient’s communication needs in his medical records

Patients who cannot talk due to a disability, such as cerebral palsy or a stroke, try to exchange information through augmentative and alternative communication (AAC) methods. They include picture/word boards, hand gestures facial expressions, and eye movements.

Learning to communicate with nonverbal patients who cannot use their hands to write is as much the medical staff’s responsibility as it is that of the patient. As mentioned above, a note or booklet that includes basic information about the individual and his AAC techniques should be placed in clear view near his hospital bed. The information also should be placed in his medical records for future reference. Additionally, a relative or friend of the nonverbal patient should consult with the medical team to reiterate his communication techniques.

As shown with my hospital experiences, however, informing a nonverbal patient’s medical team about his AAC does not always serve its purpose. While nurses in the morning shift know that the patient raises his eyes for affirmative responses, for instance, the night shift may be oblivious of this detail. Patient-nurse ratio is another factor that can undermine receiving communication cues from non-verbal patients. When a nurse or aide has 10 or more patients to attend to, taking the time to decipher a patient’s gesture can be difficult unless an interpreter or speech pathologist is there to assist.

Successful interaction between nurses and nonverbal patients also is based on the nurses’ desire to communicate with them. Despite being in a profession where they are likely to work with persons with disabilities, some nurses still may have misconceptions about them. When a patient who is nonverbal already is admitted, an assumption may be that he is deaf or cannot understand. Therefore, any attempt from the patient to communicate may be overlooked or ignored. According to a study done by Patak L, Gawlinski A, Fung NI, Doering L, Berg J. (2004), patients on mechanical ventilation have more difficulty communicating with nurses who were robotic, inattentive, and absent from the bedside. Conversely, communication becomes less frustrating for patients when nurses are kind, physically present, and informative.

Training nurses and nursing aides to understand non-verbal patients has been based on the level of pain they are in. For instance, a course is offered at Suburban Hospital in Bethesda, Maryland, where nurses learn to recognize if nonverbal patients are in pain based on facial expression, restlessness, vocal sounds, muscle tone and the ability to console. Therefore, if a non-verbal patient were in extreme pain, he would express it in one or more of the following ways:
• Frown
• Moan
• Rigid limbs
• Cannot stay still
• Cannot accept verbal or tactical consolation

While training to recognize communication cues of nonverbal patients regarding pain is essential, the training should expand to include nonverbal cues under other circumstances (i.e. the patient wants his position adjusted in bed). One of the few classes in this area is offered at University Hospital in San Antonio, Texas. After nurses and other hospital staff participated in the class, they became more aware of the need to communicate with nonverbal patients. They also tried to find communication tools for nonverbal patients to use.

Speech language pathologists at a community hospital in Boulder, Colorado developed the “On The Spot Communication” toolkit. Acting like a First Aid kit for patient communication, it contains such tools as:
• Word and picture boards in different languages
• Adapted call bell for patients who cannot reach or press standard call bells
• Writing boards for patients who cannot talk but who can write
• Items to help patients who are hearing implied (i.e. pocket talker amplifier)

The toolkit is available nationwide through the AAC Connect Store with the hopes that as many hospitals as possible will purchase it. Once nurses and other medical professionals have the toolkit, they should store it where they have easy access to it so using it will become habitual.

If nonverbal patients do not already have their own methods of communication, nurses could make simple word or picture boards. Pre-made boards also are available, such as EZ Board by Vidatak, Inc., which happens to be in the “On The Spot Communication” toolkit. The EZ Board has several versions, including ICU and EMS, with specific words and phases for each hospital setting. For instance, the ICU boards include words describing a patient’s state (i.e. cold, scared) and desires (i.e. to sit up). ICU boards also include a Pain Chart that includes words for pain levels, discomfort types, and personal hygiene. Each board also has the alphabet so patients can spell words. Since these boards are inexpensive, hospitals can purchase them to have for each floor unit.

Although many nonverbal individuals use voice synthesizers, they usually cannot use these devices in hospital settings for several reasons. The device may be mounted on a motorized wheelchair, which can be bulky to enter in a hospital room. Because of its custom position on the chair, the exact position possibly cannot be duplicated in the hospital bed.

Thanks to the tremendous popularity of iPads and other types of tablets, however, non-verbal patients can have access to electronic word boards and voice synthesizers. Because these devices are compact and adjustable, patients can use them in bed. Dozens of augmentative communication apps are available for specific age groups, disability types, and linguistic ability. For instance, Phrase Board is an iPad app is like the EZ Board with scrollable options and a chart of the human body. The app also lets patients draw with their fingers if they cannot find specific words. Medical professionals and speech pathologists also can develop apps to meet a patient’s specific needs.

To help non-verbal patients use manual or electronic boards more effectively, nurses can guess what the non-verbal patient wants to say while she spells it out. For example, if a patient points to “bed” on a word board, the nurse can guess if he wants his bed raised before he spells “raise” on the board. Additionally, practitioners can position the patient differently if he cannot reach the board or cannot gesture effectively. When patients with neurological disorders sit up, they usually have better motor control.

Nurses can facilitate communications with non-verbal patients by learning to ask them close-ended questions such as “Does your stomach hurt?”, rather than “What do you feel?” Medical staff also can help patients communicate by guessing what they are trying to say. If nurses or other medical staff cannot decipher or develop communication methods, they could ask the residential speech pathologist for assistance.

Effects of Nonverbal Patients who Use AAC
Studies have shown that effective communication by nonverbal patients can make them recover faster. For instance, according to Lindgren & Ames (2005), Henneman, Dracup, Ganz, Molayeme & Cooper (2001) & (2002), patients spend two to three days less in ICU when they can express themselves more effectively. Patients become less frustrated, which lowers blood pressure and stabilizes respiration. Their comfort level also increases since they can communicate if they are not positioned correctly in their hospital beds, for example.

Effective communications between hospital staff and non-verbal patients also diminishes the risk of medical errors. When nurses are aware of a non-verbal patient’s AAC cues, they can identify alert gestures such as repetitive eye gazes at an I.V. to indicate the wrong medication is being administered.

Persons with communication disabilities may face similar barriers in any medical environment, not just hospital rooms. Communication techniques and strategies that have been discussed in this paper can apply also at the doctor’s office, dentist’s office, radiology, physical therapy, and laboratory.

Overall, when patients who cannot speak communicate effectively with medical professionals, it makes them feel better physiologically. They feel like humans rather than medical subjects. Even if it cannot be heard, they have a voice that should not be ignored.

The ultimate silencer…

You need to make sure you put it into the right place. Don’t do like that guy who complained the suppositories weren’t working. “Are you taking them as prescribed?” the Doctor asked. ” Yes, I take them twice a day with a cup of coffee”.
It goes right there..the new gadget:” the Ultimate Fart Silencer” and it helps to alleviate and decrease odors and sounds. One extremity of the silencer is open for venting while the other has a number of pinholes which attenuate and diffuse the gas and odor spray. It’s works like a silencer of trumpet player or the one of a gun man.
For the sophisticated and refined one the silencer can be filled with tiny cotton balls impregnated with perfumes and this would transform the experience into one of fragrance and pleasure.

This type of creative biological and quality of life improvement is naturally the product of a Chinese designer committed to improve the quality of life of his fellowman and goes under the name of “Big Chicken Mushroom“. He called the invention The Ultimate Fart Silencer.

The product is presented in several colors and lengths and marketed in small basket in lavatories and near preservative machines. Some companies, furthermore, are investigating the possibility of embedding the item in underwear while others are bedding their money more into a “Transformer” rather than into a “Silencer” and incorporating microchips and using the gas for the production of cellphones ringtones such that a phone call is being simulated.
Instructions accompanying the Fart Silencer recommend to insert the device as soon as one’s feel the need even if this may sometime be a bit embarrassing.

Not clear are the collateral effect of the Silencer and the possible damages which could be caused by the sudden expulsion of the object which, as a bullet, can create some serious damage.
Remember now, if you happen to smell some lavender scent while you’re having a conversation you know now what is actually taking place.

II you need more on this subject here is an holistic approach

Pregnancy Test – Blood


This is a blood test that detects the presence of the pregnancy hormone, human chorionic gonadotropin (HCG), in the bloodstream.
HCG is a hormone that is produced by the placenta. It is detectable in the blood and urine within 10 days of fertilization, or conception. After the fertilized egg implants, or attaches, to the inside of the uterus or other structure inside the mother, the levels of HCG rise rapidly. The levels continue to increase throughout the first trimester of pregnancy and reach a peak 60 to 80 days after the fertilized egg implants. Continue reading “Pregnancy Test – Blood”

Prostate Health

The Prostate Health test (Prostate-Specific Antigen  Tota (PSA)  is a blood test that is used to screen for the presence of prostate cancer. Because PSA is produced by the body and can be used to detect disease, it is sometimes called a biological marker or tumor marker. Prostate specific antigen is a protein found in the fluid portion of blood, called serum. PSA is specific to the prostate.

No other human tissue or body part can make it. PSA levels can be measured in an individual’s serum.
It is normal for men to have low levels of PSA in their blood; however, prostate cancer or benign (not cancerous) conditions can increase PSA levels. As men age, both benign prostate conditions and prostate cancer become more frequent. The most common benign prostate conditions are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH = enlargement of the prostate).
There is no evidence that prostatitis or BPH cause cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.

 

Prostate Specific Antigen         $48.00

PSA is only present in men. PSA is present in all normal prostate tissue. The normal prostate cell holds onto most of the PSA. Very little leaks into the bloodstream. The small amount that leaks out is what is measured by the blood test. Prostate cancer cells actually have less PSA in each cell. However, the cancer cell tends to leak more PSA into the bloodstream. Knowing this fact, experts developed a range of expected values in patients with a normal prostate gland. The PSA value should be less than 4.0. This number reflects the belief that most men, roughly 95%, with normal prostate glands have a PSA value of 4.0 or less. (See below for age-specific normal values.) Almost any condition that affects the prostate can make the PSA rise.