Torrance Memorial Medical Center has hired Tracy Weintraub as vice president of nursing services. Weintraub was associate chief nurse of medical-surgical nursing at the VA Greater Los Angeles Healthcare System.

The University of Pittsburgh Medical Center (UPMC) has launched an Internet-based program for diabetes patients that allows them to communicate more effectively with their doctors from any location and to better manage their health care by using an Internet portal. The Web-based initiative, known as UPMC HealthTrak, is being offered in its first phase to people with diabetes to gauge its usefulness in managing chronic diseases. This phase is funded in part by a federal appropriation to the UPMC/ University of Pittsburgh Diabetes Institute.

Through a secure Internet portal, patients can view portions of their UPMC medical record, including lab results, medications, immunizations and current health problems. The portal includes online tools to help patients track their progress on various health indices such as weight, blood glucose levels and stress. Each participant in the pilot project also receives a pedometer so that he or she can check the number of steps walked each day.

“UPMC HealthTrak is a secure communication tool through which patients can communicate with their physicians in a more timely and effective fashion,” says Dr. Gary Fischer, assistant professor of medicine at the University of Pittsburgh School of Medicine, and one of the physicians participating in the pilot project. “It allows physicians to communicate to patients appropriate medical information, in context, and increase the medical knowledge of patients through evidence-based medical information,” he notes.
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The UPMC HealthTrak evolved from a program launched in 2003 by an UPMC physician group within the University of Pittsburgh Physicians Division of General Internal Medicine, in which more than 200 patients volunteered to enroll regardless of their health status. Plans call for three other UPMC physician groups to offer UPMC HealthTrak to patients with diabetes within the next several months.

“Diabetes is at an epidemic level in the United States. Improving awareness, educating people about self-care and providing excellent primary care for people with diabetes can have a real impact by reducing the incidence and severity of the disease,” says Dr. Linda Siminerio, the executive director of the University of Pittsburgh Diabetes Institute and assistant professor of medicine, division of endocrinology and metabolism, at the University of Pittsburgh School of Medicine.

BUSH: Thank you. Please be seated.

Thank you all for joining me. Every time I come to Walter Reed my spirits are lifted.

They’re first lifted by the soldiers and Marines who are recovering from some very tough wounds.

I had the honor of pinning the Purple Heart on quite a few people today, and I am always impressed by their resolve and their commitment to the country.

Every time I come to Walter Reed I’m also impressed by the caregivers: the docs, the nurses, the people who spend many hours trying to heal those who have been wounded in service to our country.

The soldiers and Marines stay here only for a few months, but the compassion they receive here stays with them for a lifetime.

BUSH: And so, on behalf of a grateful nation, I do want to thank our docs and our nurses and caregivers for providing extraordinary health care to the people who wear the uniform.

I know full well that the work you do is behind the scenes. In other words, you don’t get a lot of glory for what you do. But you certainly do from the family members who first come here and they see their loved one on a bed, wondering whether or not that person will ever walk again, and then, six months later, the body is returning and the spirit is strong, the person’s up and moving around.
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The family and the soldier is impressed by that care.

Americans must understand that the problems recently uncovered at Walter Reed were not the problems of medical care. The quality of care at this fantastic facility is great, and it needs to remain that way.

BUSH: Independent analysts have given extremely high marks for the quality of care here.

In other words, this isn’t my assessment; nor is it the assessment of people I have talked to, the families, although that’s what they believe.

It is also the assessment of a joint commission which accredits thousands of American hospitals. And this commission has given Walter Reed the highest possible rating, a gold seal of approval.

Recently, the commission performed a surprise inspection. You know, they didn’t give a bunch of notice. They showed up and verified the high quality of care here.

I want to congratulate you for what you’re doing.

(APPLAUSE)

The problems at Walter Reed were caused by bureaucratic and administrative failures.

BUSH: The system failed you and it failed our troops, and we’re going to fix it.

I met some of the soldiers who had been housed in Building 18. I was disturbed by their accounts of what went wrong. It is not right to have someone voluntary to wear our uniform and not get the best possible care.

I apologize for what they went through, and we’re going to fix the problem. That’s exactly what this government is going to do.

BUSH: We’re not going to be satisfied until everybody gets the kind of care that their folks and families expect. And that’s what I expect.

And we’ve taken important steps to achieve the objective. First, Secretary Gates has insisted on accountability in the military command. He made changes in leadership. He made tough decisions because he, like me, demands results.

I welcome General Schoomaker. But I also welcome General Tucker. Tucker’s not a doc. As General Schoomaker informed me, he is a bureaucracy-buster. His job is to make sure that the bureaucracy does not get in the way of making sure every soldier, Marine and their families get the best possible care.

BUSH: And I welcome you to the command. And thank you.

Secretary Gates, as I said, has approved a nonmedical deputy commander. That’s Tucker.

Building 18 has been closed. We’re fixing that which needs to be fixed, including — interestingly enough — putting a new roof on it.

The patients from Building 18 have been transferring to Abrams Hall, and the police report that living conditions there are of high quality.

We have formed three working groups to help address problems that may exist and may arise.

I want to share some — some of what the strategy behind the working groups is. And that is, first, Gates established — Secretary Gates established an independent review group. And that was primarily to examine the conditions at Walter Reed and Bethesda.

The group will recommend ways to ensure you have what you need to improve medical care. I heard one recommendation. One of the care providers said: Make sure we always have the best possible equipment. We want to be on the leading edge of technology, not the trailing edge.

BUSH: I agree completely. It’s the kinds of things that Secretary Gates’ commission is going to be looking into.

Veterans Affairs Secretary Nicholson is leading a task force of Cabinet officers to identify potential gaps in the services our wounded troops receive as they return from the battlefield.

In other words, we want all hands on deck here at the federal level to make sure that health care is as good as it possibly can be.

I’m not talking about the health care in the operating room, I’m talking about the bureaucracies that may prevent good health care from being delivered.

Hospital rankings and report cards are growing in number and importance, but a new University of Michigan study suggests these measures may be inaccurate if they don’t take into account the high number of very sick patients that large hospitals receive as transfers from other hospitals.

This study, which focused on medical intensive care unit (MICU) patients, was as much about benchmarking as it was about the MICU, says Andrew L. Rosenberg, MD, assistant professor of anesthesiology and internal medicine at the University of Michigan Health System (UMHS) in Ann Arbor, and lead author of the study.

“The idea of this study was to try to quantify something that most physicians intuitively know: Transfer patients are sicker,” says Rosenberg. “However, this is difficult to quantify because the type of precise data needed are often lacking; they are expensive and hard to get at. In fact, much of [the quality rating] benchmarking deals with administrative databases, not clinical databases.”

The UMHS study results were published in the June 3, 2003, issue of the Annals of Internal Medicine, in an article titled, “Accepting critically ill transfer patients: Adverse effect on a referral center’s outcome and benchmark measures.”

“We used a very detailed clinical database [APACHE III for Acute Physiology and Chronic Health Evaluation],” Rosenberg notes.

The study examined 4,579 consecutive admissions for 4,208 patients from Jan. 1, 1994, to April 1, 1998. A full 25% were transfer patients. Its measurements were MICU length of stay, hospital length of stay, MICU readmission, and hospital mortality rates. “We reasoned, why not study the place [MICU] where the most valid benchmarking tools are used?” says Rosenberg. “If we still can’t adjust for the ICU, how can we possibly do it at another level?”

After many years as a provider to primarily uninsured and underinsured patients, Truman Medical Centers in Kansas City, Mo., was confronting critical financial issues. With federal, state, and local sources of revenue drying up, the organization underwent physical and operational changes aimed at advancing its position in the marketplace and capturing the elusive healthcare dollar.

Truman placed a strong emphasis on managed care in the areas of contracting, operations, revenue, and most importantly, revenue recovery. The health system’s efforts were aimed at supporting its mission to provide health care to the city’s uninsured and underinsured while pursuing an evolving role as a viable partner with commercial payers in the Kansas City community.

Truman more than tripled the number of its managed care contracts over two years and soon realized that a monitoring function was needed to manage its growth effectively. To this end, Truman conceived its managed care revenue recovery program. In the early stages, Truman estimated that by improving processes and adding revenue recovery to its efforts, 10 percent of its gross managed care revenue could be returned to the organization’s bottom line.

Truman dedicated staff from its managed care division to recovering revenue owed because of underpayments from payers. The organization added a revenue recovery specialist to the division and hired a former insurance company staff member who had worked in provider relations to oversee the revenue recovery program.

Initially, the revenue recovery process was performed manually, using reports from the hospital’s information systems. Accounts were examined individually to identify errors in payments. Although this initial revenue recovery process was time-consuming and narrow in focus, Truman achieved its first success shortly after the start of the recovery program with a $500,000 recovery from a single payer.

Broadening the Scope

As additional significant recoveries were realized, Truman evaluated automated products that would enable the organization to broaden its reach by having the ability to monitor all contracts and payments simultaneously rather than conducting audits manually for one payer at a time. This integrated approach allowed

Truman to compare, track, and trend underpayments that are identified. After a careful selection process, Truman found its answer in contract management software.

An extensive survey reported in JAMA (July 6, 2005) showed that drinking coffee reduces risk for developing type II diabetes. However, two recent studies suggest that once you have diabetes, drinking coffee may be unwise.

Canadian researchers writing in Diabetes Care (March 2005) showed that caffeine significantly reduced insulin sensitivity. In the July 2005 issue of the same journal, scientists from Duke University Medical Center reported that drinking coffee could upset a diabetic’s ability to metabolize sugar.

Blood sugar levels are supposed to rise after you eat. To keep your blood sugar levels from rising too high, your pancreas releases insulin. The researchers found that taking caffeine causes blood sugar and insulin levels to rise even higher after meals. If your blood sugar rises too high, sugar sticks to cells. Once sugar is stuck on a cell membrane, it cannot be released and is converted to a poison called sorbitol which destroys that cell.

High levels of insulin constrict arteries to cause heart attacks and act directly on the brain to make you hungry, on your liver to make more fat, and on the fat cells in your belly to pick up that fat. If these studies are confirmed, diabetics will be advised to restrict coffee as well as those foods that cause the highest rise in blood sugar after meals.

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Medical assistants are one of the high growth jobs in the healthcare industry. If you are thinking about embarking on a new career, you might want to consider being a medical assistant. The health care field is growing on a daily basis, mainly to due to advances in medicine. There is always a great need for medical assistants in hospitals, medical centers and clinics. The aging of America’s largest generation is also pushing the need for additional medical assistants over the next several years.

Medical Assistants are responsible for administrative and clinical tasks. These assistants are responsible for keeping health care offices running smoothly. The duties of medical assistants vary from office to office. Some of the administrative duties performed by medical assistants include answering phones and scheduling appointments, updating and filing patient medical records, filling out insurance forms, and billing. There are also clinical duties to be performed by medical assistants. These duties can vary according to differences in state law. Some of the tasks performed medical assistants include taking vital signs, preparing patients for examinations, or assisting doctors with examinations. Medical assistants also collect specimens, administer medication as authorized by a physician and telephone prescriptions to pharmacies. They are also responsible for taking blood, changing sutures and dressing, and keeping examination rooms clean and tidy.

Medical assistants can move up in their careers by specializing in particular healthcare areas. There are also advancement opportunities by moving up to office manager. With additional certification and education, medical assistants can advance to other health care jobs such as nursing. Medical assistants with further formal training and current job experience are great candidates for career advancement. The U.S. Bureau of Labor Statistics projects that medical assisting will be one of the fastest growing jobs on average through 2014. This is due to the increasing use of medical assistants across the healthcare industry. The earnings of medical assistants vary, depending on their experience, skill level, and location. Median annual earnings of medical assistants were $24,610 in May 2004.

Now is the time to get in on the ground floor of this fast growing occupation. Healthcare employers prefer graduates of formal programs in medical assisting. Such programs are offered in vocational-technical high schools, postsecondary vocational schools, and community and junior colleges. Postsecondary programs usually last 1-year, resulting in a certificate or diploma, or 2 years, resulting in an associate degree.

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Sheet Lead is one of the most malleable of common metals. It can be easily shaped, formed, bent and/or easily cut to suit all applications. Sheet lead is extremely resistant to corrosion from the atmosphere, salt water, and most industrial chemicals.

It is ideal for making corrosion resistant gaskets, lead lining tanks, reducing sound in rooms and replacing metal flashing in roofs. With its high density and flexibility it becomes superior in shielding rooms from radiation against x-rays and gamma radiation.

For radiation shielding you should be looking for Sheet Lead with a consistent and high density manufactured from pure lead conforming to ASTM B-29, B-749 and Federal QQ-L-201F, QQ-L-171E. Sheet Lead is built into a variety of structures, such as walls, doors, window frames and cabinetry to provide the necessary shielding protection.

In waterproofing applications the sheet membranes are installed on-site, then burned (welded) with same-composition lead burning bar to affect, a long-lasting, impermeable barrier.

With its high “limpness” (low stiffness) and high internal damping capacity it becomes excellent barrier material to block the transmission of sound, and for isolating equipment from mechanical vibration. Since Sheet Lead can easily be shaped with little effort at ambient temperatures without the need for periodic softening or annealing it does not work harden. It therefore can be readily manipulated with standard hand tools without the risk of fracture. As with most other commodities, sheet lead is usually sold by the pound and is available in rolled or sheet form.

Many of the more common uses of sheet lead are for radiation shielding in hospitals, labs, medical centers, veterinary clinics, and dental. Construction roofing, flashing and waterproofing, Sound barriers and sound proofing, Nuclear shielding, tank lining and vibration absorption

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In 1490, Ponce de Leon set out to find the fountain of youth. He didn’t find it, and now, more than 500 year later, the only mechanism ever found to prolong life and delay aging is exercise. There is no data whatever to show that antioxidants, vitamins, or anything else prolong life. All tests that are used to measure aging really measure physical fitness. A fit 70-year old will score younger on aging tests than an out-of-shape 20 year old.

Scientists measure aging with a test called VO2max, your maximal ability to take in and use oxygen. Studies from Ball State University, Courtland State, Washington University in St. Louis and Mt Sinai Medical Center in Milwaukee show that intense exercise maintains fitness. People who do not exercise lose 15 percent of their fitness per decade, those who exercise at low intensity lose nine percent, while those who exercise intensely barely lose any fitness at all.

In the 1930s, Fred Wilt was an Olympian distance runner. At age 50, he was able to run two miles in less than ten minutes. Those of you who run competitively know that this is a magnificent time and that there are very few high school runners who can run faster than that. He was able to run a 9:40 two mile on training of only five to seven a week, by alternating almost flat-out 200 meter runs with jogging until recovery.

Increasing intensity makes you fit. If you go out and jog the same two miles at the same pace every day, you will not improve and you will not be very fit. However, if you run faster on one day, feel sore on the next day, and then run slowly until the soreness disappears, and then run fast again, you will be able to run faster, become more fit on every measure of fitness, and also test better on the tests that measure aging.

However, with increased intensity comes increased risk of injury. So, before you start an intense exercise program, and before you start lifting heavier weights, running faster, jumping, higher, throwing further, hitting a tennis ball harder, or doing anything that requires increased intensity, check with your doctor. The only problem with this recommendation is that the odds are overwhelming that your doctor won’t know very much about sports, training, or improving physical fitness. But you should at least check with him or her to see if you have a condition that can be aggravated by hard exercise. Also remember that older people can’t train intensely very often. You may have to wait two to ten days between hard workouts.

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Do you have your nursing degree and are ready to take the medical industry by storm? Are you an experienced nurse looking for an exciting new challenge? Regardless of the level of your nursing experience, looking for a new job can be a time-consuming and frequently frustrating process. A big part of the job search process is knowing where to look for nursing positions.

The following tips and tricks are designed to take some of the headache out of your search, by giving you some guidelines on steps you can take to land your ideal nursing position.

1. Visit the recruiting departments of local hospitals, medical centers, and doctor’s offices to inquire about available positions. If there are no current vacancies, ask if you can submit your resume to remain on file should future openings match what you are seeking.

2. Contact recruitment and contract employment agencies. Aligning yourself with a recruiter can give you access to jobs that are often not advertised to the public. The great thing about recruiting agencies is that allow you to “apply” for positions at multiple companies simultaneously with a single resume submittal, since most recruiters will shop your resume around to all of the available openings.

3. Use the internet to your advantage. Searching for “nurse” or “nursing” on major job boards such as Monster.com and Hotjobs.com will unearth hundreds of available openings – just be aware that competition for these positions is stiff since hundreds of other nurses are looking at and applying for the exact same jobs.

4. Don’t be adverse to accepting a contract or “training” position. This are often a great way to get you foot in the door in the medical profession. It also gives you a chance to evaluate an organization and department to ensure it is a match before fully committing yourself to a long-term full-time position.

5. Colleges and universities that offer nursing degrees often have a database of available positions in the school’s Career Center. Career Center advisors are also excellent sources of information on how to network in the industry and get your foot in the door. Many schools limit Career Center resource access to current students or alumni, though, so you may be limited to your Alma Matar.

6. Network, network, network! Let friends, family, and casual acquaintances know that you are on the market for a new position. Since most companies are much more willing to interview (and potentially hire) candidates who have already been vouched for, it’s important to get the word out that you are available and seeking a new opportunity.

7. Don’t forgot to investigate often-overlooked nursing avenues such as:

o School nurses (contact the local School Board for openings)

o Health Department Openings (both local/county and state offices)

o Health insurance companies

o Assisted living facilities and retirement homes

o Universities and colleges seeking teachers for nursing school programs

o Mentorship programs

o Traveling nurse programs that place you on short assignments at different locations around the country

8. Searching nursing-specific job boards for available opportunities is a great way to target only those jobs that require your degree and background.  There are many other excellent on-line resources for nursing job information.

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