The Philippine Health Insurance Corporation (Philhealth) will be needing at least 600 Filipino nurses under its Customer Assistance, Relations and Empowerment Staff (CARES) Program.

The program aims to provide better, more personalized services to Philhealth members. It will also help lessen the problems encountered in benefits availment.

Aside from that, the nurses to be deployed under PhilHealth’s CARES project will also tasked to do the ff: (1) data- gathering (2) conduct surveys and other studies that PhilHealth might initiate.

According to PhilHealth president Dr. Eduardo Banzon, deployment is expected to start next month once the recruitment and training processes have been completed. Their engagement will run for six months but may be renewed until end of this year.

Initially, 334 nurses will be fielded to levels 3 and 4 government hospitals with 196 others to levels 1 and 2 health facilities.

“We value partnership. The main reason why we are innovating our ways is to be more responsive to the needs of our members and partners,” said Dr. Eduardo P. Banzon, PhilHealth president and chief executive officer.

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Calcium and vitamin D are important nutrients in keeping strong and healthy bones. Researchers suggested the importance of eating of the right kinds of food to give bone health a lift. This is the main why most of the start-your-day foods and beverages are now fortified with calcium. Individuals diagnosed with osteoporosis are advised to take about 1500 mg of calcium in a day. Although, there are some arguments about how much is required day for these people, Paul Mystkowski, MD, an endocrinologist from Virginia Mason Medical Center in Seattle, stated that an intake of 500 mg of calcium 3 times in a day is good for the health.

Daily Calcium Requirement for People with Osteopororsis

Separate doses are recommended since the body can only absorb this amount each time. Hence, to lift the health of the bones, calcium supplement should be distributed in the meals throughout the day. Adding a calcium supplement could make up the difference from a lack of calcium.

Health Benefits of Calcium

Calcium does more than what making the bones stronger. This nutrient can also boost up the efficacy of osteoporosis drugs taken to fight bone breakage and loss. In addition, calcium can also amplify the benefit of weight bearing exercises to build stronger bones. To experience these benefits, it is important to include Vitamin D in the diet. Calcium is not absorbed in the body without this fat-soluble vitamin.

The best way on getting the biggest bang for calcium stores, these calcium-rich foods should be added to the diet:

1. BREAKFAST

There is a wide range of selection for calcium-rich foods to start a day. However, when purchasing items in the grocery it is better to check out the label and evaluate the calcium content as the levels vary per brand. So it is wise to compare and choose brands wisely. To satisfy calcium needs before lunch, calcium fortified foods should be included in the meal such as the following:

• Cereal
• Soy milk
• Yogurt
• Orange juice

Individuals with lactose-intolerance problems, can still take in sufficient amount of calcium in breakfast. There are lots of dainty products which contains reduced lactose. Lactose-free products are even available now in the market.

2. LUNCH and DINNER

Most people skip breakfast. Especially those who works in the office and are only taking in coffee to start their day. If breakfast is not just your thing, then you should add in calcium during lunch and dinner. Adding in salmon, kale or turnip greens to a delish recipe can increase the calcium supply in the body. Fishes are good sources of calcium. As bones store calcium, fish bones do too. Canned fish contains tiny bones which are good sources of calcium. So better stack in sardines and salmon in your next grocery schedule. Listed below are bone health booster foods appropriate for lunch and dinner:

• Canned sardines
• Swiss cheese
• Cheddar cheese
• Raw Broccoli
• Cooked Kale

Vitamin D Essential for Bone Health

Calcium is absorbed when Vitamin D is present. Absence of this vitamin would make efforts of increasing calcium intake. The skin normally synthesizes Vitamin D faster when a person has exposed his or her skin to the sunlight early in the morning. However, as an individual gets older the skin undergoes Degenerative processes that makes the synthesis slower. This is the main reason why even though the recommended dietary allowance of Vitamin D for adults is 400 IU, when bone problems such as osteoporosis, bone thinning and insufficient sunlight exposure exist, 800-1200 IU is required daily.

People with a darker skin complexion are less likely to absorb sunlight. Hence, they should bump up their intake of Vitamin D for a better calcium absorption. Individuals living in big cities where the air is polluted should also do the same. There are also foods which contain both calcium and Vitamin D such as:

• Sardines
• Herring
• Salmon

The secret to having a healthier bone is eating the right kinds of food. Bump up calcium and Vitamin D in the diet. This is the only way to achieving optimum bone functioning.

 Image courtesy of palscience.com

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Urinary incontinence is the involuntary or uncontrolled loss of urine from the bladder sufficient to cause a social or hygienic problem. This may be caused by external urinary sphincter injury, obstetric injury, lesions of bladder neck, detrusor dysfunction, infection, neurogenic bladder, medications and neurologic abnormalities.

Risk Factors

1. Pregnancy related (vaginal delivery, episiotomy)
2. Menopause
3. Caregiver or toilet unavailability
4. Use of medications (diuretics, sedatives, opioids, hypnotics)
5. Dementia
6. Parkinson’s disease
7. Genitourinary surgery
8. Pelvic muscle weakness
9. Diabetes milletus
10. Immobility
11. High impact exercise
12. Stroke
13. Morbid obesity

Types of Urinary Incontinence

1. Stress incontinence – involuntary loss of urine from an intact urethra due to an increased intra- abdominal pressure (sneezing, coughing or position changes)
2. Urge incontinence- is the involuntary loss of urine associated with a strong urge to void that cannot be suppressed
3. Reflex incontinence- is the involuntary loss of urine as a result of hyperreflexia in the absence of normal sensations usually associated with voiding
4. Overflow incontinence- is the involuntary loss of urine associate with the over- distention of the bladder. The over- distention results from the bladders inability to empty normally, despite frequent urine loss.
5. Functional incontinence- refers to those instances when the lower urinary tract function is intact but the other factors such as severe cognitive impairment, makes it difficult for the patient to identify the need to void or physical impairments make it difficult or impossible to reach the loo in time.
6. Iatrogenic incontinence- refers to the involuntary loss of urine due to extrinsic medical factors, specifically medications.

Assessment and Diagnostic Findings

• Complete history taking is important. This includes a factual data regarding the problem medication use, the patient’s voiding history and fluid intake and output documentation.
• Residual urine test
• Stress maneuvers test
• Urodynamic test
• Urinalysis and urine culture (tests that identify hematuria, infection, cancer, kidney stoen, glycosuria, pyuria, bacteriuria)

Medical Management

1. Behavioural therapy- this type of therapy has always been performed to decrease incidence of urinary incontinence. By the use of behavioural therapy, adverse effects of pharmacologic interventions and surgical interventions are avoided.
2. Pharmacologic therapy- this management is a supplemental and adjunct regimen to behavioural therapy.
• Anti- cholinergic agents inhibit bladder contractions and are considered first line medications for urge incontinence.
• Tricyclic antidepressant decrease bladder contactions as well as increase bladder neck resistance.
• Pseudoepinephprine are used to treat stress incontinence.
• Estrogen decreases obstruction to urine flow by restoring the mucosal, vascular and muscular integrity of the urethra.

Surgical Management

1. Women with stress incontinence (repair or closure of the urethra)
• Anterior vaginal repair
• Retropubic suspension
• Needle suspension
• Periurethral bulking
• Collagen placement
• Modified artificial sphincter
• Electronic stimulation
2. Men with stress incontinence
• Transurethral resection
• Artificial sphincter
• Periurethral bulking

Nursing Management

• Provide support and encouragement to improve the patient’s level of incontinence.
• Patient education regarding bladder program is essential.
• Monitoring and documenting the input and output.
• Teaching patients to do Kegel’s exercises.

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Approximately 4 percent of adults are suffering from ADHD, attention deficit hyperactivity disorder. Sadly, most of these individuals are not diagnosed and they don’t have an idea that are actually suffering from it. Another interesting fact about ADHD, is the percentage of children who have this condition will still have it when they reach adulthood.

What is Adult ADHD?

ADHD is one of he most common childhood developmental conditions. The disorder is characterized by in attention, hyperactivity and impulsiveness. Recently, this condition has been known to affect about 60% of adults too. This means that about 4% of adults in the U.S. population or 8 million individuals as a whole. However, the number of individuals diagnosed and treated for adult ADHD.

Adults with this condition have difficulty following given directions. They also find it impossible to remember information and concentrate or organize tasks by themselves in a given time. When the condition is not managed, problems may arise in the following areas: behavioral, emotional, social, vocational and academic. Data reveals that the condition is more prevalent among males during childhood, but the digits even up during adulthood.

Early diagnosis of the problem is essential to mplementing timely interventions. Adults with ADHD usually have lower income rates. Furthermore, these individuals are more prone to experiencing accidents. They were also reported to have higher rates of planned pregnancies and substance abuse. This data is presented b an assistant professor of psychiatry at the University of Nebraska Medical Center in Omaha, Martin W. Wetzel, M.D.

How to know if you have Adult ADHD?

Here are common signs that are observed to people with adult ADHD:

• Restlessness. People with ADHD appear to be having troubles staying calm and relax.
• History of ADHD during childhood. Based on the data published by the Attention Deficit Hyperactivity Disorder Association, adults who have the same symptoms when they were children are more likely to develop the same problem when they become adults without even realizing it.
• Your child has ADHD. The condition appears to have genetic components too. When a member of the family is identified with the condition, it is more likely because someone in the blood line has it too.
• Relationship troubles. Adults with ADHD, finds it difficult to adjust to the difficulties of a relationship. Because of inattentiveness, existing relationships can easily be sabotaged as these adults tend to appear self-centered.
• Kings or Queens of Procrastination. Because of having a hard time focusing on something, these adults tend to be always in marathon with deadlines and schedules.
• Adventurous. These people are drawn to stimulating or attention-grabbing activities such as gambling, extramarital affairs and fast driving. This behavior of affected individuals can be directed to good activities such as parasailing and safe high-adventure outlets.
• Frequently misplace things. People with ADHD has an underpowered state of consciousness which results to not paying attention on a memory or event.
• Employment problems. Most adults with this condition have a difficult time surviving the boredom brought about by the routines of a job. Hence, some of them skips from one job to another.
• Quick anger. Another sign of ADHD is the intense expression of anger for a period of time but becomes completely over it after a few minutes. Their emotions are quite unstable.
• Impulsiveness
• Easily distracted
• Tardiness
• Low self-esteem
• Anxiety
• Disorganized
• Chronic boredom
• Depression
• Low tolerance to frustration
• Unstable moood
• Substance abuse a d cigarette smoking

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Every one of us went through teenager. One of the things this age group hates the most is having acne that distorts their body image. Most probably when you were a teenager you’d hear all sorts of advice about the cause of acne and what to do about it such as, ‘You’re eating too much chocolate!’ or ‘Too much junk causes that, you should cut them down on your diet!’

The fact is that most of the thing you are hearing about acne as teen may still what you believe right now. And unfortunately, not all of the things shared by our folks are true. To give you a run-down, here is the list of common myths on acne:

Myth 1: Only teens get acne. A number of adults are still getting acne between 30-50 years of age. They may not look the same with the younger group though. Adult acne are usually characterized with reddish nodules around the mouth and jaw.

Myth 2: Chocolates and sodas cause acne. A dermatologist in Great Barrington, III – Amy Derick, MD, FAAD debunked this misconception. According to her, there are data suggesting how products found on milk, caffeine and chocolate can cause acne but the clinical foundation of this theory is still subject for further study.

Myth 3: Stress causes acne. Students stressed out during their final exams develop acne. Thus, a lot of people have been linking acne to stress. But according to Derrick, stress may play a role but no scientific evidences are convincing enough to support the data.

Myth 4: Sunscreen makes acne worse. Sunscreens don’t make acne worst. However, one just needs to pick the right product. People prone to acne are advised to use sunscreens that contain zinc oxide.

Myth 5: Acne appears when you don’t wash your face enough. According to Derrick, washing more than twice a day causes the skin to dry out thus causing acne.

Myth 6: Wearing makeups during acne breakout is not advisable. An individual can still wear a makeup even with acne. But of course there are compromises that need to be implemented. Light and loose powder foundations should be used rather than thicker ones that can clog pores.

Myth 7: Just ignore your acne; it’s just a cosmetic problem. Acne is not just a cosmetic problem. When improperly managed, it can cause lasting consequences about one’s perception of self by the permanent marks on the face.

Myth 8: Scrub your pimple. Spending hours picking the skin just to get rid of acne is not a good habit. This is actually the major reason why pimple scars appear.

Image courtesy of demenvironequity.net

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The Department of Health (DOH) announced yesterday that 10,000 nurses and 3,000 midwives will be deployed next month to the various provinces in the Philippines to augment the inadequate nursing workforce in DOH hospitals and other health facilities of local government units.

According to the report, the government deployed the first batch of 10,000 nurses last year and another batch of 11,500 nurses and 1,000 midwives last November.

This year 2012, the recruitment of 10,000 nurses and 3,000 midwives is already ongoing and is expected to be completed by the end of the month.

“The recruitment and selection shall be done by the respective Center for Health Development (CMDs) to be completed by February,” the DOH said.

Under the RN Heals 3 program, newly hired nurses and midwives shall undergo general orientation scheduled on the first week of March before the actual deployment.

Those who were previously hired under the same program and rendered satisfactory services until the end of their contract next week can re-apply.

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No one might be exempted for experiencing fever. In the side of people who undergo chemotherapy, having a fever might signal something serious going on with the body’s defences. Fever can be defined as a state wherein the body’s core temperature is increased than 38ºC or 100.4ºF. The body reacts to the shift of the homeostasis in many forms and one is through fever. Fever is a compensatory response to infection. It tells the individual that he must do something in order to be more responsible in building up a stronger immune system.

Almost 50% of the patients who have cancer may have neutropenic fever at any point of time. When examined closely, the white blood count may come to its lowest point. This means that the normal combating parts of the blood are being defeated by viral or bacterial invasion. With this manifestation, neutropenic fever should be taken into consideration for proper medical management as well as reverse isolation to prevent further infection.

Since chemotherapy includes not only the cancerous cells as well as the healthy cells, it also means that it may weaken the immune system. During chemotherapy, drastic practices were done in order to minimize infection on its minimum. When a patient exhibits flu-like symptoms, it may mean to properly approach it with proper timing to control the culprit.

Diagnostic Evaluation:

1. Physical assessment must be done together with close monitoring of vital signs. Fever spikes may also mean a round the clock medication of antipyretics. During physical assessment signs of infection must be taken into consideration such as: redness, swelling, pain, fever. Mouth sore or various skin breakouts may also mean that the body is trying to let out the extra heat from it. Dry mouth may also mean dehydration also that accompanies with febrile episodes.
2. Chemotherapy sessions done as well as succeeding sessions must also be noted. A current chemotherapy may pose the patient to be neutropenic.
3. A complete blood count is taking in order to evaluate the neutrophils count. An individual must be hospitalized if the neutrophils count is below 500/mm3. Proper antibiotics are given in order to prevent a life-threatening condition called sepsis.
4. Other laboratory testing can be conducted in order to square down where is the source of the infection. These are blood culture, urinalysis, and throat swab, gram stain testing of blood and body fluids, fecalysis.

Signs and Symptoms:

1. Cancer pain
2. Tenderness on parts of the body
3. Fever
4. Blood result may come out with lower levels of neutrophils

Medical Management:

1. Monitor the fever episodes accurately.
2. Inform the physician when fever levels exceeds 38.5ºC or 100.5ºF.
3. Take note of the side effects of the chemotherapeutic drugs. Some of it may temporarily lower the white blood cell count.
4. Assist the individual in bathing using tepid water. Place ice packs on skin folds and pressure points alternating it with a dry cloth in order to prevent a rebound.
5. Keep hydrated as much as possible.
6. Comply with the antipyretic medications prescribed by the physician.
7. If the symptom persists, consult the physician for a direct-to-room admission to the hospital in order to introduce intravenous fluids.

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A very common knee injury is called anterior cruciate ligament tear or sprain. Athletes are very likely to experience this condition, especially those who are involved in football, soccer, and basketball.

If you or anyone you know have suffered anterior cruciate ligament injuries, you might have to undergo surgery in order to take back a fully functioning knee. This will also rely on a lot of different factors, including how severe the injury is and the level of your activity.

Anatomy

There are three bones that meet in order to make up your knee joint. These are femur or your thigh bone, tibia or your shinbone, and patella or your kneecap. The patella is located just in front of the joint to give it some protection.

There are also bones that are connected to other bones and these are possible with what we call ligaments. Four main ligaments are in your knee. They serve as very sturdy ropes that support the bones and help keep them together as well as help keep your knee steady.

Collateral Ligaments

These can be located just at your knee’s sides. Inside is the medial collateral ligament while outside is the lateral collateral ligament. They manage the sideways movement of your knee and support it from atypical movement.

Cruciate Ligaments

These are located within your knee joint. They intersect to make an “x” having the anterior cruciate ligament at the front with the posterior cruciate ligament on the back. The cruciate ligaments manage the back and forth movement of the knee.

The anterior cruciate ligament is in the middle of your knee and runs across it in a diagonal manner. It keeps the tibia from slipping out in front of the femur, and it also gives the knee rotational stability.

Types

Almost half of every injury to the anterior cruciate ligament happen in conjunction with injury to other knee structures, including the meniscus, articular cartilage, or some other ligaments.

Injured ligaments are also known as sprains and are rated using a severity scale.

Grade 1 Sprains. There is mild damage on the ligament. It has been stretched a bit, but still, it is capable of keeping the knee joint steady.

Grade 2 Sprains. The ligament has become loose. This is usually known as a partial or incomplete ligament tear.

Grade 3 Sprains. Usually known as complete or full ligament tear. The ligament has been divided and has become two pieces now, with the knee joint becoming unsteady.

Incomplete anterior cruciate ligament tears are not commonly occurring. A lot of ACL injuries are near complete or complete tears.

Cause

There are several causes for anterior cruciate ligament injuries. These include:

• Suddenly stopping
• Changing direction hastily
• Slowing down even while running
• Collision or direct contact (as in a football tackle)
• Landing wrongly from a jump

A lot of studies reveal that a more ACL injuries occur with female athletes as opposed to male athletes in some sports. Suggestions for these include physical conditioning differences, strength of the muscles, and neuromuscular control. Several other recommended causes include pelvis and lower leg alignment differences, higher ligament looseness, and estrogen effect on ligament attributes.

Symptoms

When anterior cruciate ligament injuries happen, usually there is a “popping” sound and then your knee feels like it buckles and might give out under you. Several other more common symptoms are:

• Pain and swelling. Your knee might swell within just 24 hours. If you don’t do something about it, the pain and swelling might go away on its own. But, if you try to go back to sports, your knee might be unsteady and there is risk of bringing about more damage to the meniscus or cushioning cartilage of your knee.
• Full range of motion loss
• Joint line tenderness
• Discomfort/unease while walking

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Are you sneezing a lot with cough and have that achy and feeling that you seem don’t want to move? If so, you might be having cold or flu? More often people use the terms interchangeably. So what’s the difference between a cold and flu? Let’s find out!

People should understand and able to identify the symptoms for cold and flu. A cold is a milder respiratory condition than flu. Having a cold makes someone feel weak and just want to cuddle up in bed for days. With flu, the symptoms experienced make a person ill for days to weeks. Flu is a result of underlying disease conditions such as pneumonia.

Symptoms of Common Cold

A person notices sore throat first if he or she has colds. Usually the throat discomforts goes away after a day or two. Physical symptoms such as nasal secretion and congestion and cough are experienced on the fourth and fifth day. In adults fever is uncommon, although a slight fever may possibly be felt. When children have cold, the symptoms are usually accompanied by fever.

For the first few days, the nose is teemed with nasal secretions. As the condition progresses it becomes thicker and darker in color. Darkening of the mucus is just part of natural process. It doesn’t mean anything, in contrast to what most people think that the condition developed to a bacterial or sinus infection.

Symptoms of Flu

The following are symptoms of flu:

• Sore throat
• Fever
• Headache
• Muscle aches
• Nasal congestion
• Cough

People who are experiencing swine flu also are seen to be having diarrheal and vomiting episodes.

Improvement in the condition is usually noticed by day two to five. But most people are experiencing body weakness for over a week, possibly more for some. Common flu complications include pneumonia. People with a heart disease are more prone to contracting the complication. When shortness of breath is experienced, a physician should be called in for evaluation. In addition to shortness of breath, pneumonia has most likely developed if the fever comes back after having a normal temperature for a day or more.

Duration of Illness

Symptoms of colds usually last for a week. Individuals with cold should know that during the first three days, they are contagious so staying home is critical at this point to avoid passing it on to others. However, if the condition seem to persist for a week then bacterial infection should be suspected and antibiotic therapy should be implemented.

 Image courtesy of thesitsgirls.com

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Nursing as a profession evolves as time goes by. There is a necessity for these professionals to upgrade their knowledge as well as specialize in a certain field. In order to get organized, the trending goes with the systems approach of intervention. People who have problems with the urinary system can be taken care of nurse who specialize in urology nursing. It is a special area wherein nurses study intensively the urinary system of males and females provide an approach that is suited for each patient as well as focus on the preventive care.

Activities of a urology nurse:

1. Obtain a physical assessment on patients with complaints on their urinary system
2. Order diagnostic examinations such as X-rays, urinalysis or gram-stain of urine
3. Perform diagnostic procedures
4. Interpret the results of diagnostic procedures
5. Provide proper referral for further medical treatment
6. Evaluates bladder dysfunction
7. Provide proper treatment for all urinary malfunctions
8. Prescribing medications intended for the urinary system problems
9. Provide health teaching regarding compliance on medications as well as treatment prescribed
10. Collaboration with physicians in terms of check-up and follow up of patients
11. Screening and evaluation of the response from the treatment
12. Care on the integrity of urinary catheter
13. Perform urinary catheterizations
14. Teaching about proper nutrition
15. Giving emphasis on Kegel’s exercise as an important exercise to strengthen the pelvic floor thereby reducing problems in the future such urinary incontinence

Some examples of the urinary problems that urology nurses solve:

1. Urinary tract infection
2. Renal problems (such as pyelonephritis, cystitis or urethritis
3. Urinary incontinence
4. Urinary dysfunction secondary to nerve damage or side effects
5. Prostatitis
6. Conn’s syndrome

The last two examples of problems were actually special since it has been focused on urology nursing. Prostatitis for instance happens when urine back flows into the prostate. The urine will infect the prostate causing acute or chronic states of prostatitis. Conn’s syndrome on the other hand involves a manifestation of hypertension among patients due to the increased levels of hormones called aldosterone. All of these urinary tract problems are being treated by urology nurses.

Possible workplace of urology nurses:

1. Renal clinics
2. Hospitals shouldering Urology department
3. Community setting

In order for a nurse to become an effective urology nurse, he or she must first be a bachelor’s degree holder in nursing. After finishing this degree, he or she must also be a registered nurse and expose to basic nursing care as part of the clinical experience. A Master’s degree in Nursing is also important in order to be able to apply principles of management and administration on the clinical setting.

A competent urology nurse is well equipped with skills in urinary catheterization, physical assessment, self-care education, counselling regarding coping with sexual dysfunction accompanies by problems with the urinary tract.

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