Happy International Nurses Day!

For International Nurses' Day, let's highlight an area of nursing that is not often recognized--school nursing! Though not quite as flamboyant or dramatic as ER or ICU nursing (usually), it's not as simple as passing out Band-aids or comforting tummy aches, either. 

School nursing in fact provides a wide scope of direct service to school children and staff, which indirectly affects the health of the community and families of those schools. In some areas, for example, a school nurse may be the ONLY health professional a child has ever seen!

School nursing began in NYC in 1902 due to the keen observances of Lillian Wald, a prominent public health nurse and social reformer. She noticed that the practice of sending sick or infested children home from school to stop the spread of communicable diseases, especially tuberculosis, wasn't working. Too often these sick children never got treatment, and never returned to school, but just ran loose in the community, continuing to infect others. The health and education of these children were drastically affected by these tactics.

A nurse helps protect a family from TB, circa WWl.

Lillian Wald proposed a new model of practice to the NYC Board of Health--to treat sick children right there in school. The Board of Health reluctantly agreed to a one month trial. One nurse was assigned to four schools (this ratio of nurses to students is still common today, believe it or not) to treat students on-site and return them to class. After one month, the significant improvement in attendance and health of the students was undeniable. School nurses began to be hired for more schools across the country, and school nursing was born.

(click on the image to enlarge)

Since then, school nursing has continued to evolve with the needs of the moment. The mid-twentieth century saw a shift from treating contagious diseases to illness prevention and health education. In addition, in 1975, Public Law 94-142, the Education for all Handicapped Children Act, provided for the free and equal education for children with disabilities. Children with complex health needs entered the public school systems. School nurses are now managing g-tube and NG tube feedings, administering oxygen, suctioning, urinary catheterization, providing ostomy care, and monitoring shunt functioning along with their standard duties, enabling students with those needs to have the experience of going to school alongside their peers.

Today's school nurse is a licensed professional, usually with a bachelor's degree in nursing. Some states require a master's degree for this position, recognizing the multifaceted skill set that is needed. School nurses are certified with an extra year of college education, just as teachers are, to work in the school system as a specialty. They come from multiple and varied nursing backgrounds and are among the highest educated as a subgroup of nurses.

The role of the school nurse overall is one of a case manager. He/she is the liaison between the school, family, community, and health care providers. The school nurse is primary in developing the individualized health care plan for the student and participates directly in developing the educational plan and the Section 504 plan for students with health and educational needs.

Health promotion is the heart of school nursing. As Lillian Wald proved and subsequent studies have shown, health promotion and disease prevention are vastly more cost effective than treating disease once it occurs. Nurse theorist, Virginia Henderson, stated that "There is more to be gained by helping every man learn to be healthy than by preparing the most skilled therapists for service to those in crises." This single statement is an affirmation for the value of what school nurses do every day.

Thanks to Big Sister Marsha, RN, MSN, for all her help with this post.

Just Say No

Previously on this blog, we talked about the so-called DARK Act, a bill before Congress that would make it illegal to label products that contain GMOs. Just in case it fails, there's another plan in place, one even weirder than DARK.

To ensure that the public will never know what's really in their food, there's the proposed Trans-Pacific Partnership (TPP) trade deal. The TPP is a sweeping international trade deal, negotiated largely in secret, designed almost exclusively by the corporations it would most benefit. It would affect everything from banking to farming to intellectual property rights, so there's lots of reasons to be alarmed. 

From Vox.com: 

... this system for setting global rules has some serious defects. We expect the laws that govern our economic lives will be made in a transparent, representative, and accountable fashion. The TPP negotiation process is none of these — it's secretive, it's dominated by powerful insiders, and it provides little opportunity for public input.

Supporters of the deal say it will make the US more competitive in the global marketplace. I'm not sure turning the world into a court room where corporations can use legal muscle to trump native laws is what I would call "competition." This article is a great summary of the feeling:

Private corporations should not have the option of suing a nation whenever they feel like a rule or law has effected their profit rate. This is simply a part of doing business; an inherent aspect of capitalism. Investing is never risk-free; there are natural, social, and political changes that could always hurt an investment. More importantly, when a company’s product is hurting people or the environment, government has the right and obligation to stop it.

So what can any of us do to keep such a thing from happening? Well, there actually is something. There's a bill in Washington at the moment called the Bipartisan Congressional Trade Priorities and Accountability Act of 2015 (TPA-2015). It is “fast track” legislation to push through the proposed Trans-Pacific Partnership (TPP) trade deal. “Fast track” authority would eliminate Congress’s right to make any changes to the President’s trade deals before signing off. The administration needs Congress to pass TPA-2015 to bring the TPP negotiations to fruition.

That's where you come in.

Click here to let your Senators know you oppose the TPP, and urge them to vote "no" on TPA-2015. Corporations that profit from hiding GMOs shouldn’t be the ones writing the rules about GMO labeling – but that’s exactly what TPP and fast track would mean.

To learn more visit exposethetpp.org

Thanks to Big Sister Marsha, RN, MSN, for giving us the heads up on this important issue.

Stop the Pop! Part lll

Full disclosure: I used to drink a lot of Coca-Cola. A LOT. I didn't grow up drinking it; soft drinks were strictly off limits on our house. Not only was our mom a health fanatic, she was a thrifty health fanatic. Whenever one of us might hint that perhaps having pop around would be kind of awesome, she'd say: "I'm not paying good money for sugar water!" So, naturally, the first thing I did when I moved away was to start drinking Coke, which had grabbed my customer loyalty in my formative years. If there ever was a kid who wanted to be a hippie on a hillside, it was me.

This ad captured not just my imagination, but was an advertising smash; what in today's marketing parlance would be referred to as "Lifestyle Branding." That is, the ad wasn't about the product--fizzy brown sugar water--as much as it was about the experience that the customer could associate with it; it provided consumers with an emotional attachment to a particular lifestyle.

And that was me. Every time I had a Coke, I felt I became all the things the commercial had imprinted on me at a very young age: beautiful, peaceful, independent. Laterally, it also tapped into my always-appealing rebellion against my mom and her rules, and her generation's (in my view) missteps and misdeeds. Pretty silly, isn't it? That all those things could be contained in a bottle of fizzy brown sugar water, straight out of Atlanta, Georgia.

That's where they make it.

Mindfulness means thinking about why we do the things we do. What influences the decisions we make about what we eat and drink? Are they based on emotion? rebelliousness? conformity? economics? politics? Are our children learning to make their own choices, or are their choices being made for them by the bombardment of advertising they see every day?

Our house, where even the toys were vegetables.

Are You Afraid of the DARK?

GMO stands for Genetically Modified Organisms. The corporations that make them, such as Monsanto, constantly assure us that these scientifically altered foods and pesticides are perfectly safe. That must be why they are supporting a bill that would make it illegal to identify products that contain them.

The Statesman Journal (because CNN doesn't think you're interested) has reported that a bill was introduced in Congress last week that would overturn GMO labeling laws enacted in Vermont, Connecticut and Maine, prohibit other states from enacting food-labeling laws, and make it harder for the FDA to mandate labeling nationwide.

Among its supporters are the Grocery Manufacturers Association, PepsiCo, Monsanto and Koch Industries.

Opponents have dubbed it the Deny Americans the Right-to-Know, or DARK Act.

"The evidence is mounting that Monsanto's glyphosate and other chemicals used on genetically engineered crops may be harming our health," said Lisa Archer, a program director with Friends of the Earth. "Americans have more reason than ever to want to know whether they are eating GMOs."

Okay, Monsanto. If your Frankenfoods are safe, and you legitimately believe that the work you do is not just healthy, but a benefit to all mankind, why hide your light under a bushel? How can you not be excited to have your miraculous inventions labeled, helping the public to more easily find your products? Why not help a government mandate and design a label that shows how awesome you are? 

What are you afraid of?

Let's let Monsanto know that we trust them, and that we want to buy their products, in all their mysterious, probably cancer-causing glory, but that we can't do that unless they are CLEARLY LABELED.

Dial 1-877-796-1949. You’ll hear more information about the DARK Act, and then you’ll be automatically connected to your Representative’s office in Washington. Let him or her know that you OPPOSE the DARK Act (H.R. 1599) and SUPPORT the Genetically Engineered Food Right-to-Know Act (H.R. 913).

To learn more, visit this link.

Too late, Monsanto! The Interwebs have it covered.

Thanks to Big Sister Marsha, RN, MSN, for getting us this info .

WInds of Change, Part lll

For the past two Meatless Mondays, we've been looking at the problem of methane emissions from cattle, and why those emissions--farts, yes, but also burps and gases rising from their dung--have only become a problem in the last 50 years or so. We learned that when a cow eats what its insides were designed to eat--a variety of wild grasses--the emissions that result are harmless. But when you feed cows things they weren't designed by Nature to digest, well, it's apparently about as smart as feeding a baby chili. And you know how well THAT works out:

So, is there a solution to feeding cows the wrong things? The Union of Concerned Scientists thinks so. In 2011, they published a report on the environmental impacts of cattle methane, and offered these solutions for reducing methane emissions:

One way to reduce methane emissions is to increase the nutritional quality and digestibility of forage—the plants cattle eat while on pasture. [There are] several strategies to improve forage quality: increase the percentage of legumes in forage mixtures, avoid the use of low-quality, mature pasture crops for grazing, and breed better pasture species to improve nutritional quality.

(Despite the above link, may I recommend this summary, which I've discovered too late to keep me from actually having to read their report! My Ph.D. in Climate Studies and Ruminants, please!)

Interestingly, the report does not categorically condemn the nasty filthy godawful "finishing" technique of CAFOs--confined animal feeding operations--which account for the vast majority of beef farming in this country, if not the world:

The grain-based feeds used in CAFOs produce more rapid weight gain than pasture forage, with fewer calories lost to methane emissions. However, high-quality forage—especially when grown on high-quality land—can minimize the climate emissions advantage of grain. And pasture finishing has other climate advantages, including the ability to sequester more carbon than grain crops.

What they're saying is, CAFO cattle gain weight faster than pasture-feeders, therefore they will be slaughtered sooner, shorter life-spans equaling less time cows have to produce green-house gases. The rest of that paragraph is talking about utilizing manure in a more bio-friendly way, i.e., allowing it to be absorbed by soil in a field vs. piling up in a cattle pen.

In summary: to reduce the methane emissions of cows, cows should be allowed to live as their cousins the buffalo did, in open pastures, eating a variety of forage, pooping on the ground, as Nature intended.

A lot to think about at the next barbecue, huh? Anyway, the good news is, there are viable solutions to this problem, through sound science and agricultural education. For our part, as consumers, we should definitely eat less beef--Meatless Monday is a solid start in that direction. But we should also continue to encourage, through our buying habits, as well as other means, the most planet-friendly ways beef can be raised. Because a healthy, happy cow makes a better product for you and me, as well:

Beef from grass-fed animals has lower levels of unhealthy fats and higher levels of omega-3 fatty acids, which are better for cardiovascular health. Grass-fed beef also has lower levels of dietary cholesterol and offers more vitamins A and E as well as antioxidants. The study found that meat from animals raised entirely on grass also had about twice the levels of conjugated linoleic acid, or CLA, isomers, which may have cancer fighting properties and lower the risk of diabetes and other health problems.

That concludes our TMI "The Winds of Change" series! Tune in next Meatless Monday for a new topic. Thanks for reading!

SOURCES:

grass-fed beef

The Winds of Change, Part ll

Last Meatless Monday, we looked at the impact of cattle on global warming/climate change, and asked two questions: 1) if cattle do so much harm to the ozone layer through their methane-laced flatulence, why didn't the millions of buffalo that existed hundreds of years ago destroy the environment back then? and 2) why does the finger always get pointed at beef cattle, but not diary cows, when these lethal bovine farts are discussed?

No, because there just aren't enough of you compared to beef cattle. As a side note, there aren't just fewer dairy than beef cattle now, there's fewer dairy cows than there have ever been; 13 million fewer cows than than there were in 1950, to be exact. Between 1960 and 1990, the dairy industry increased annual milk production by ten million tons with 7.4 million fewer cows, reducing estimated methane emissions by almost one million metric tons of carbon. Go, dairy! But also, so many more cows, back in the day: whither methane?

So to the question of the buffalo. Presumably these animals farted just as much as today's cattle. We asked the question, why did global warming not start all that much sooner? More importantly, why am I not admiring a beachfront view (because rising sea levels) here in Western Pennsylvania at this very minute? After all:

Many individuals attribute global warming to the ozone layer eroding away or the burning of fossil fuels. Many people do not realize that methane gas in our atmosphere is a huge contributor to global warming. More surprising is that about 15% of the methane produced per year is from cattle.

So what's the story, science?

First, let's take a look at an important aspect that cattle and buffalo have in common: their stomachs.

In fact, all ruminants share this multi-chambered stomach. And what, you may ask, is a "ruminant"? Ruminants are named for the fore stomach, or rumen. 

[It's] any even-toed, hoofed mammal of the suborder Ruminantia, being comprised of cloven-hoofed, cud-chewing quadrupeds, and including, besides domestic cattle, bison, buffalo, deer, antelopes, giraffes, camels, and chevrotains ... Cattle, goats, and sheep produce more methane than other livestock because of the unique physiology of their digestive systems, [though] methane emissions from sheep and goats in the United States are relatively minor.

Methane, it turns out, is a natural consequence of their unique digestive process. Their stomachs use something called "enteric fermentation," to break down carbohydrates with microorganisms, known as methanogens, into simple molecules for absorption into the bloodstream. So if it's so "natural," then why haven't the cumulative ruminants through the ages--I'm looking at you now, giraffes--farted us into complete climate collapse before now?

Because it's not their fault. It's ours.

As you've probably figured out by now, there's a big difference in the lifestyles of the buffalo of yesteryear and today's cattle. There didn't used to be. Buffalo and cattle alike used to graze over huge territories, foraging from a variety of wild grasses.  Since the introduction of "industrial" farms in the 1930's, increasingly, beef cattle are "finished"--the industry term for "fattened for slaughter," in cramped feedlots, being fed things Nature never designed their stomachs for. Primarily corn, but also barley, hay, soy, and other grains and legumes. This diet gives American beef the tenderness and taste we've come to expect, but it's creating the unprecedented levels of methane that contribute to global warming.

Is this really the best we can do for these animals, ourselves, and our planet? Next time, we look into better ways of doing things.

Sources:

Dairy cows

Cattle feed pdf

Ruminants and climate change

Methanogens

The Winds of Change

As I'm sure everyone knows by now, the methane gas produced by cattle is acknowledged as a major contributor to  climate change:

Emissions of two important heat-trapping gases from agriculture account for about 6 percent of total global warming emissions in the United States, according to the U.S. Environmental Protection Agency. Beef production contributes about a third of those emissions, or roughly 2.2 percent of the total. 

"Emissions?" That would be farts. Cow farts, to be exact. Hilarious, yes, but also a very real threat to the environment. By contrast, pigs produce 6 kilograms of greenhouse gases and poultry releases only 4, (who measures this stuff and how...??) compared to cattle's 32 kilograms for the same amount of meat. Switching to poultry and pork reduces 80 to 90% of the emissions that you would eliminate by stopping your meat intake entirely. 

Like I said, this dangerous cow farting business is accepted wisdom in the scientific community, and has been for a while now. I'm not going to dispute that. However, I find I am not without questions about it, and I think a lot of other people have similar questions, too, so why not take time on this Meatless Monday to take a look at them?

Question 1: If cow farting is such a huge threat, why didn't the buffalo do us in long ago? After all:

In prehistoric times, millions of these animals roamed the North American Continent from the Great Slave Lake in northern Canada, south into Mexico and from coast to coast. No one knows how many bison there were, but the naturalist, Ernest Thompson Seton, estimated their numbers at sixty million when Columbus landed. They were part of the largest community of wild animals that the world has ever known. 

Lewis and Clark commented in 1806 that in what later became South Dakota "The moving multitude . . . darkened the whole plains." Others wrote that, when viewing a herd from a distance, it appeared the entire prairie was in motion. Army major Richard Dodge commented as late as 1871 that it took five days to pass one herd. 

Now that's a lot of buffalo. So how did we survive all that bison gas?

Question 2: Why does the blame, it seems, always get put on beef cattle? What about dairy cows? Do they not fart? Let's take a look at the graph:

McDonalds uses meat in their hamburgers? Who knew??

To review: even at their peak numbers, there weren't as many buffalo in North America in 1492 as there are cattle in the U.S. right now. And dairy cows? It's not that they aren't farting and contributing to greenhouse gases--they are. It's just that their numbers are so few in relation to beef cattle that focusing on them isn't worth doing. 

Another numerical fun fact: according to the latest census, the population of the U.S. in 2014 was 318.9 million people. If the 95 million total head of cattle were counted within that number as people, a little under 1 in 3 of us would be cows.

Back to the question of the buffalo. If, at sixty million, they were "part of the largest community of wild animals that the world has ever known", why didn't their farting jump-start climate change back when Columbus was sailing the ocean blue?

Tune in next Meatless Monday for the answer to that question, and more!

Thanks again to Big Sister Marsha, RN, MNS, for suggesting this topic!

SOURCES:

Cows and Climate Change PDF

Buffalo

Beef Industry Statistics

Wikipedia Dairy Cattle

Go Indie: McDonald's Statistics

The Shamrock Shakes

It's March, the month of extremely unpredictable weather, though with a strategically placed holiday: St. Patrick's Day. Here in America, this has become a day of celebrating the Irish, in the looniest ways possible, but it's only ostensibly about them. It's really about helping us to forget, at least for a day (and a night and a painful morning-after) that Spring, though right around the corner, is still at the end of a very long, cold, miserable street. 

So don't blame the Irish, or St. Patrick, for the abomination that is McDonald's Shamrock Shake.

Now it's rare that you'll indulge in a milkshake and expect it to be anything less than a calorie bomb, double that if you are eating at McDonalds. But there's something special about a dessert that has not just 820 calories in the large (22 ounce) size, but is also home to 54 mostly mysterious ingredients: 

click on the image to enlarge

The maraschino cherry alone has 11 ingredients. 11. Ingredients. In. The. Cherry.

This article from Bamboocorefitness.com goes even farther in-depth, listing every ingredient. and describing what it is and how bad it is for you. By their calculations, there are only 33 ingredients in this science nightmare. I'm not sure, but it may be because they only listed high fructose corn syrup once, whereas the HuffPost graphic lists it every time it occurs throughout the separate elements of the drink. Whatever. I think all reasonable people would agree that 33 or 54, that's still way too many freaking ingredients for a milkshake, especially when the vast majority of those ingredients are dangerous, health-threatening chemicals.

Look, McDonalds, you and I have never really had much of a relationship, so I know I'm not your target audience. What I wonder is, who IS your target audience? Not humans from Earth--I think that much is clear.

FYI: you can't pump us full of chemicals. We're really not made for it. It hurts us, makes us sick, and, over time, kills us. You know, makes us ex-customers. Maybe back on your home world, Carrageenan, things were different. Maybe there, the beings who came through your doors could tolerate the toxic concoctions you serve. Maybe they even thrived on it. But we humans don't; we really, really don't. So please, McDonalds, do the human race a favor: figure out how to put food in your food. Even the desserts. Even the special holiday desserts. Even the St. Patrick's Day desserts, when you think no one can tell the difference anyway. That would be really great, McDonalds.


Thanks to Big Sister Marsha, RN, MSN, for the Bamboocorefitness.com article.

Stop the Pop! Part ll

Previously, Big Sister Marsha, RN, MSN, talked about the health hazards of drinking sugary drinks, and not just soda pop, either. Juice, and sports drinks, as she noted, are also full of sugar. Too often, we assume that these are healthy alternatives to soft drinks. In a recent study, which I read about here, Harvard researchers found links between consumption of sugary drinks and various health issues for young girls. Like BSM, the study didn't differentiate between these beverage options, and its findings ranged from the obvious result of too much sugar consumption (obesity) and the not so obvious:

Among nearly 5,600 girls aged 9 to 14 who were followed between 1996 and 2001, the researchers found that those who drank more than 1.5 servings of sugary drinks a day had their first period 2.7 months earlier than those who drank two or fewer of these drinks a week.

Starting your period two to three months earlier than average doesn't sound like that big a deal, does it? However, study author Jenny Carwile, a postdoctoral associate at the Harvard School of Public Health, in Boston, goes on to say:

"Starting periods early is a risk factor for depression during adolescence and breast cancer during adulthood. Thus, our findings have implications beyond just starting menstruation early." 

I highly recommend reading the whole article, but in case you are pressed for time, it closes with excellent observations and solid advice (emphasis mine):

Samantha Heller, a senior clinical nutritionist at New York University Langone Medical Center in New York City, said, "Sugar-sweetened drinks, such as sodas, have no nutritional value. One may wonder what nutrients -- such as vitamins, minerals and protein -- are being replaced by these drinks that can lead to this metabolic problem," she added.

"Whatever the reasons for the earlier start of periods, there is no good reason for anyone to be drinking sugar-sweetened drinks or sodas regularly, at any age," Heller said.

Stop the Pop!

When not using her powers to keep me from death's door, my Big Sister Marsha, RN, MSN, works to improve the health of kids who are lucky enough to have her as their school nurse. One of the ways she does this is to write small articles for her school's newsletter, and I've asked her to share some of these with us. Below is her January article, and it features great advice for starting a new year off right.  I'll be adding my two cents as well (natch), but first, take it away, Marsha:

It's the New Year and we all make resolutions, many of which have to do with improving our health.  Even one change for the better can make a big difference.  For example, we can all benefit from reducing the sugar in our diets.  The easiest way to accomplish this is to remove sugared beverages from your house: soda, juice, sports drinks, all of it!  

BUT, I only drink diet pop, you say? Unfortunately, there's still a lot that is unknown regarding how the artificial sweeteners in diet soda affect the body and metabolism, and the safety of them is continuously debated. Something that isn't up for debate? That diet drinks are basically water with a whole lot of chemicals added.  What could be good for you in that? It's important to stay hydrated, so do it efficiently, by drinking only plain water and low-fat milk. Make 2015 your healthiest year yet! Stop the pop!

Thanks, Marsha! So much truth in there. Whether it's the sugar in regular pop or the questionable chemicals in diet versions, soft drinks aren't something your body derives any benefit from.