Obesity and Cancer

A group of us met yesterday to discuss a research project designed to reduce the risk factors associated with type 2 diabetes. We plan to use the Centers for Medicare and Medicaid (CMS) guidelines for Intensive Behavioral Therapy for Obesity.  As I visited students completing their practicums over the last few weeks, it was clear that obesity is a significant problem associated with health issues. 

The tragic issue associated with obesity is that the problem interferes with the ability to exercise.  Obesity often take a toll destroying knees and hips.  It reminds me of one of my favorite cardiologists who had a serious weight problem.  He was an avid and competitive tennis player in spite of his obesity.  In his last days (still in his early 60's) he was unable to walk because of joint problems and eventually died of a stroke.  He was an excellent example of a brilliant person "knowing" but unable to "do"  - control his weight.  I have such fond memories of his warm smile and twinkling (a bit mischievous) eyes.

Today Martha sent me an article about obesity and cancer. The March issue of Cancer has an article entitled -

"Annual Report to the Nation on the status of cancer, 1975-2008, featuring cancers associated with excess weight and lack of sufficient physical activity" written by Eheman et. al.  The article notes that while cancer rates are falling - obesity is a factor in types of cancers that are growing in incidence.

The journal article has spurred  a flurry of news articles, such as:

• Cancer deaths continue to fall: Obesity, inactivity contribute to cancer incidence, deaths
• Cancer rates fall: Lifestyle toll mounts

The message to me personally is that I need to blog and check email less and work in the yard more (exercise) getting flower beds ready to put out pine straw :-).

Word Processing, APA 6th edition, Reference Management Software

Linda has updated the textbook website for chapter 6 at http://dlthede.net/Informatics/Chap06WordProcessing/chap6.html

I completed a couple of journal article peer reviews, in addition to edits of student papers over the last couple of weeks. While I empathize with the time it takes to learn a citation style, it is relatively painless to use reference management software, such as Endnote, Zotero, as well as a host of others.  Wikipedia has a fantastic page that compares reference management software at http://en.wikipedia.org/wiki/Comparison_of_reference_management_software.

The reference section is a common area for errors.  Wrong author names, titles, journal names, volume & issue numbers, page numbers, and missing doi's, are the top problems I see.  Commercial software, for example - Endnote, allows the user to search databases such as PubMed.  Endnote also allow the user to search for full-text articles, and to import files and folders with PDF documents.  If the PDF article includes metadata - Endnote uses it to create an associated citation and files the PDF in a PDF folder.The imports require little or no edits and citation and the creation of a reference list is done with mouse clicks.  Commercial software may also come with word processing templates for the various citation styles.

I created an APA template for Chapter 6 on word processing.  The template uses the latest (revised) APA 6th style and can be downloaded from the website noted above.

ePublishing Faculty Development Workshop Progress

Too many things to blog about and not enough time!!!  The weather has been wonderful the past few days, so I have been working in the yard :-).

Our ePublishing Faculty Development Workshop (FDW) is still in the forming stage.  The New iPads are being ordered.  We decided to wait on ordering Macs until next month because we anticipate some new offerings. We are planning two meeting over the next couple of weeks.  The first one will be virtual so that we can all feel comfortable using Collaborate webinar software.  The second one will be face-to-face.  Our main goal is to build community.  We have a ePublishing course in GaView where the outline for the FDW and ePublishing resources we have accumulated are posted.

I decided to go with Verizon on the New iPad.  I really did not like the idea of paying an additional $5/month when I rarely use the 250 MB provided by AT&T, but I did like the ability to create a hotspot with the iPad with the Verizon data plan.  

New iPad 4G Data Plans Comparison

The ePublishing faculty development workshop participants met last week.  One of the agenda items related to hardware configurations for the New iPad.  The New iPad was not released until yesterday, so we were guessing about the comparisons for pricing of 4G connections.  Not surprising, the plans are competitive.  I frequently use the AT&T $14.99 data plan on the iPad2.  For example, I used it the past two days at the NLNAC self-study forum in Atlanta because WiFi was not available at the conference (apparently WiFi was a problem everywhere at the hotel).  The table below shows a comparison of the monthly access fee pricing (assuming that the iPad has the capability of 4G). Of course, the choice is personal - and for me - a difficult one to make because for just an additional $5, I could get 1Gb. 

Verizon 1Gb - $20 2Gb - $30 5Gb- $50 10Gb - $80

AT&T 250Mb - $14.99 3Gb - $30 5Gb- $50

One other interesting difference is that if you order the New iPad WITH 4G activated, the package allows global connectivity.  The AT&T package is only for nationwide coverage.
Sources: http://www.verizonwireless.com/b2c/splash/ipad.jsp  and http://www.att.com/ipad/?fbid=W7ZoQBpj9j-

NurseAdviseERR - March Edition

The Institute of Safe Medicine Practices (ISMP) publishes a fantastic newsletter, NurseAdviseERR every month.  The March newsletter (need Adobe Reader)focuses on several topics. I have copied/pasted the bullet points highlighting the features of the issue below. 

• Smart pump custom concentrations without hard "low concentration" alerts - A perfect storm for patient harm
• What's wrong with "ketofol"? In a word, plenty!
• All is not as it seems... Caution: drug names that end with the letter "L."
• OR nurses: "Stop using multidose vials."
• Medical equipment, not a toy.
• New Resource: Tubing Misconnections Self Assessment for Healthcare Facilities (www.ismp.org/selfassessments/tubingMisconnections)

For previous issues of the newsletter, go to http://www.ismp.org/Newsletters/nursing/archive.asp

To sign up to receive email alerts of new issues, go to http://www.ismp.org/Newsletters/nursing/default.asp

Nursing Informatics Certification Update

I took a few moments today to review the upcoming changes in the ANCC Informatics Nurse Certification exam. The test content outlines are online at the ANCC website. Notice that three of the categories were collapsed in the new test blueprint. Information Management and Knowledge Generation will comprise a little over 1/3 of the exam questions.  Professional Practice will be almost 27% of the questions, as compared with 10%. When comparing the two, the newer outline includes much more on accreditation guidelines, regulation, system design/development, nursing taxonomy, and education/staff development. The 4th edition of the Informatics and Nursing textbook will be an excellent resource for nurses who site for the newest informatics certification exam.  The 4th edition of the textbook contains all of the essential components for the current certification exam, as well. The table below shows a comparison of the two test blueprints (outlines).

Old ANCC Informatics Test Blueprint (Before 5/1/2012)  Category Domains of Practice No. of Questions Percent I System Life Cycle 41 27.00% II Human Factors 10 7.00% III Information Technology 30 20.00% IV Information Management and Knowledge Generation 27 18.00% V Professional Practice, Trends, and Issues 15 10.00% VI Models and Theories 12 8.00% VII Management and Leadership 15 10.00%

New ANCC Informatics Test Blueprint (Effective 5/7/2012)  Category Domains of Practice No. of Questions Percent I Information Management and Knowledge Generation 56 37.33% II Professional Practice 40 26.67% III System Life Cycle 33 22.00% IV Information Technology 21 14.00%

AONE Position Paper on the Nursing Informatics Executive Leader

Christel Anderson of HIMSS announced that AONE (American Organization of Nurse Executives) has issued a position statement on the Nursing Informatics Executive Leader that is available at: http://www.aone.org/resources/leadership%20tools/PDFs/AONE_Technology_Committee_CNIO_Position_Paper.pdf. 

The AONE position paper utilizes the HIMSS Position Statement on Transforming Nursing Practice through Technology & Informatics.

• “Technology will continue to be a fundamental enabler to the future care delivery models and nursing informatics leaders will be essential to transforming practice through technology (HIMSS Position Statement, 2011).”

• An essential ingredient is the inclusion at the leadership table providing budgeting, oversight and strategic guidance to support not only nursing practice, “but the entire care delivery team in anticipating and adapting to changes in the health care environment bridging new care delivery models into clinical practice with the right technology solution” (HIMSS Position Statement, 2011).

As Christel noted, "this position statement, our [HIMSS] position statement, the IOM Report of the Future of Nursing Report and many other notable documents are demonstrating the role and power of nursing and nursing informatics professionals that together, nurses and nursing informatics must lead, and be visible, vocal and present at the table to achieve healthcare delivery transformation'."

New iPad, New Apple App Updates

Work was too busy for me to learn about the Apple announcements yesterday, so I had to wait until early this morning. The CNET article, iPad vs. iPad 2 vs. the new iPad, provides a succinct overview of the changes in the new iPad. The video (long) at the Apple iPad site provides a comprehensive overview of the new releases. 

Several of the newest software updates require the new iOS 5.1.  The problem is that the servers are not able to keep up with the volume of attempts to update the software.  I have attempted to get the updates for the past two hours, but am getting timed out on the Mac laptop, the iPad, and the iPhone.  Once I can obtain the iOS update, I can report some feedback on the changes. 

New Additions to Informatics and Nursing Website

Linda added two additions to Chapter 17 on the textbook website we maintain:

2011 HIMSS Nursing Informatics Workforce Survey
www.himss.org/ASP/ContentRedirector.asp?ContentID=76364

AONE's (American Organization of Nurse Executives) position paper on the Nursing Informatics Executive Leader.
http://www.aone.org/resources/leadership%20tools/PDFs/AONE_Technology_
Committee_CNIO_Position_Paper.pdf

The AONE position paper has some very important language and is recommended for reading!  The opening paragraph is quoted below:

"Technology is revolutionizing the manner in which health care is delivered. Clinicians and consumers are incorporating high-speed data networks, wireless solutions, handheld devices, automated exchanges between organizations/clinicians and patients and various forms of social media into their daily interactions. Adapting to these new environments requires a shift in expectations for how care is delivered and communicated. This shift necessitates a greater understanding of the constant evolution of new solutions into practice. Nurses are at the core of these changes and are the care providers with the greatest amount of direct patient contact; therefore the nursing informatics leadership roles provide a significant backdrop towards achieving organizational informatics goals and priorities."

DocuCare Electronic Health Record for Nursing Students

Our nursing faculty had a demonstration on DocuCare electronic health record (EHR) for nursing students.  Until now, we have been using a home-grown spreadsheet simulation.  We looked at some of the free EMRs that are available, but they offered more that we needed to teach effectively and not enough nursing student support.  If you have followed my blogs, you will note that I have reviewed some of the other EHR solutions for students. Cost has been the main problem - especially when the product involved a huge annual maintenance feel.  The main pluses I saw with the DocuCare product are:

• It allows simulation documentation
• It allows a way for instructors to provide feedback on student documentation
• Student documentation can be tracked
• It includes a pre-populated case library
• It in integrated with the Lippincott Nursing Advisor and Procedures and skills
• It includes documentation for the Laerdal Simulations 

It is yet another interesting EHR simlulation product that our faculty will explore.

Request for FNP Input for DNP Reseach Project

Below is a copy of a memo from Kim Taylor.  She is requesting your input for her transformation research study.  If you are a FNP, please consider helping her and also forwarding the email to other FNPs.  Thanks

MEMORANDUM

Greetings. My name is Kim Taylor.  I am a Doctor of Nursing Practice student at the University of Tennessee at Chattanooga.  As part of my studies, I am developing a program to help advanced nurse practitioners (APN’s) use the Homeostasis Model Assessment (HOMA) as a tool to identify insulin resistance in at risk patients.

Please go to the web address below, and read the information.  The Home Page supplies general information about the project.  The Biography page introduces the author of the project.  The Pre-Survey page includes a form for gathering demographic information.  The HOMA page will direct the participant to evidence-based information about the use of the HOMA model.  The Post Survey page includes a form for gathering data after the tutorial has been read.

There is no risk involved with your participation.  No incentives will be provided.  However, your responses may benefit other APN’s and the patients who are identified by this method.

Please complete both the pre-and post-survey and submit the answers.  This should take about 10-15 minutes.  Thank you for your cooperation.

kimtaylorfnp.com

Kitabur eReader for the Mac

Kitabur is a eReader for the Mac OS.  How many eReaders can you have?  Although it is much easier to read an eBook on the iPad, it does make sense to have at least one or two on the laptop.  Clearly the answer is several. Each eReader has its own distinctions.  Kitabur features are:
- Apple Sandbox support.
- Drag and drop.
- Context popup menus.
- E-books library in two views.
- Table of contents.
- Book pane selection. Book can be displayed in one, two or three panes.
- Font and background selection.
- Plays audio & video.

Microsoft Windows 8 vs Apple Mountain Lion Operating Systems

CNET has a good article that gives a preview comparison of upcoming Microsoft Window 8 OS vs Apple Mountain Lion.  Those of us who use Windows 7 and are also Mac users can see where Windows is becoming more like a Mac OS.  It will be interesting to see the final versions of the two operating systems.