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FALL 2008

BUSINESS GUIDE | GREAT ARTICLES | BENEFITS CHART | WHERE’S THE DOC?

GREAT NEW JOBS INSIDESPECIAL EDITION

THE PLAZA(806) 740-0800

ABILENE REGIONAL(325) 428-1065abileneregional.com

REGENCY HOSPITALregencyhospital.com

GOLDEN PLAINS(806) 273-1200

ODESSA REGIONAL(432) 582-8705odessaregionalmedicalcenter.com

TEXAS SPECIALTYHOSPITAL OF LUBBOCK(806) 723-8707

HOSPITALS

HUB CITY HOME MEDICAL(806) 745-2551

HEALTHY OPPORTUNITIESAuthorized Salad Master Dealer(806) 773-5816

MOBILE HOUSECALLS(806) 744-6873 (74-HOUSE)

HEALTH / MEDICAL SERVICES

SOLUTIONS FORLISTENING AND LEARNING(806) 685-1559switchonlearning.com

A MAID 2 ORDER(806) 787-2681

SYPERT INSURANCE(806) 794-9330

FARMERS INSURANCE(806) 367-9881

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ASSISTED LIVING / HOME CARE

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BUSINESSGUIDEMY MEDICAL FUTURE

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Business Guide - Various

The Plaza at Lubbock

A Maid 2 Order

Plum Creek

Martin Co. Hospital

Golden Plains Comm. Hospital

McDougal Properties

SW Regional Med. Complex

KootieKiller

@Work Medical

Parkridge

Reliable Nursing

Providence Healthcare Network

City Bank

Jackson County Memorial

Hill Country Memorial

Pampa Regional Med. Center

Medical Center Hospital

Farmers Insurance

Black Forest Bed & Breakfast

Griswold Special Care

Interim Healthcare

Lubbock Heart Hospital

Steve Sypert Insurance

Texas Tech HSC

Caring Senior Service

Polygen Cream

Physicians Network Assoc.

The Arbors / Park Central

255666810101011121212141515151617171819191920212222

FALL 2008

AD INDEXCONTENTSJim Hill

Executive Presidentand Internal Operations

Kai HillExecutive VPand Publisher

Melissa RobertsTreasurer and

Client Relations Coordinator

Debbie WalkerSecretary and

Professional Client Services

Cheryl FindeisenExecutive Director

Matt RoemischDesign & Layout

Kent BrooksEducation

Former WaylandBaptist Univ. Dean

Stephanie Holland, LVNPediatrics Nursing

Paul McKinneyHospital

Administrator

Shayne WebberHome HealthPresident,

Griswold Special Care

Rita JonesStaffing

West TexasInterim Director

Norval PollardContent Advisor

Former NewspaperMarketing Director

Steve SypertHealthcare Insurance

Sypert Insurance

Donna McMillan, RNNursing Hospice

Things to ConsiderWhen your Looking for

the Perfect Employer18

Feature Articles

Cover Letter & Interview Tips

Quotables - Stephanie Holland

Quotables - Amy Reed

Quotables - Edmond Balko

451221

Your Career

Eating Good

Extenguish Job Burnout921

Life Focus

A Helping Hand for Surgery

DNA Based Dating

The Artificial Pancreas

131416

Medical Technology

Business Guide

Benefits Chart

Calendar of Events

Puzzle Answers

2232323

Reference

Where’s the Doc?

Medical Quiz

Sudoku Puzzle

777

Break Time

Toxic Chemicalsin Baby Products

Laser Focus

11

20

Health News

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On The CoverLEFT TO RIGHT

Hilda Ramirez, RNMichael Franco, RN

Imelda Burnette, RNMedical Center Hospital

Odessa, Texas

MyMedicalFuture.com -


How to write a brief, concise, andconvincing cover letter that is well-organized and can accompany your resume... Addressing Always address the letter to a specific person. Call the employer to get the correct name and spelling, the title, and address, email, or fax number. Write each cover letter specifically for the company and/or position you are seeking.

IntroductionBegin with the purpose of your letter, stating the specific position or type of work you seek.

If you were referred to the addressee, indicate by whom, using the name of a contact or mutual acquain-tance.

Second ParagraphTie your qualifications to what you know about the position or organization. Refer the reader to the resume for more details.

Tell them why you are interested in this field or company.

Make the reader aware that you have done your homework and know something about the organiza-tion and how it fits with your skills, strengths, objec-tives, and interests.

Closing Paragraph Request the next step in the employment process:an interview.

If possible, indicate that you will contact the addressee at a specific date or time to arrange a mutually conve-nient appointment time.

You may request a written response, especially if the organization is not local.

Be positive in your attitude; expect an appointment or a response.

Format Use business letter format, block style, with every-thing beginning at the left margin.

If mailing, use the same good quality paper as your resume.

Keep it brief and concise.

Interview Follow-Up: Do's and Don'tsRemember that your work is not done once you finish the interview. You can't sit back and wait for the job offer, so consider these key rules and strategies for following-up your job interviews.

• Do ask at the end of the interview when the employer expects to make the hiring decision.

• Do be proactive and consider follow-up a strategic part of your job search process. Follow-up can give you just the edge you need to get the job offer over others who interviewed for the position.

• Do use these follow-up techniques to continue to show your enthusiasm and desire for the position, but don't make it seem as though you are desperate.

• Do obtain the correct titles and names of all the people who interviewed you. (Ideally, do get each person's business card.)

• Do write individual thank you notes or letters to each person who interviewed you -- within two business days. Each letter can be essentially the same, but try to vary each a bit in case recipients compare notes. Don't ever fail to send a thank you -- even if you are sure the job is not for you. Do write thank you notes after every interview.

• Don't worry so much about hand-written versus typed thank you letters, but don't make a mistake by sending it through the wrong medium; make sure you know the best method of reaching the employer, whether by regular mail, email, or fax.

• In your thank you letter, do show appreciation for the employer's interest in you and do remind the employer about why you are the perfect person for the position.

• Don't ever have any errors (misspellings or typos) in your thank you letters.

• Do alert your references - if you have not done so already - that they may be getting a phone call from the employer.

• Don't stop job-hunting, even if you feel confident that you will get a job offer. Do continue to interview and attempt to find other opportunities.

• Do follow-up with a telephone call to the employer within a week to ten days (or sooner, if the employer had a shorter timetable) to ask about the position. Do continue to build rapport and sell your strengths during the phone call.

• Do be patient. The hiring process often takes longer than the employer expects.

• Do continue following-up, especially if the employer asks you to. Remember the adage about the squeaky wheel getting the oil, just don't go overboard and annoy or bother the employer.

• Don't place too much importance on one job or one interview; there will be other opportunities for you.

• Do use other job offers as leverage in your follow-up to get the offer you really want.

• Don't burn any bridges if you do not get a job offer. Do try and turn the situation into a positive by bringing the interviewer(s) into your network, possi-bly even asking them for referrals to other contacts.

Article by:Randall S. Hansen, Ph.D.


What do you like leastabout your career?

At first I was going to men-tion that I like the paper-

work the least about Pedi but there is something that hits me much deeper. The thing that I like the least is watch-ing young patients suffer with a fatal disease and finally lose the battle. I don't think we as nurses ever get use to that nor should we. With adults it is a little more expected but with children it is always a hard thing to accept. Without a doubt that is the hardest thing to me about being a nurse in pediatrics.

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My Medical Future “Quotables”is a new feature that will give yousome insight into the world ofmedical professionals. Learnabout different medical fields,experiences and stories from thepeople you work side by sidewith everyday.

Share your story -email: [email protected]


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1. What is the second largestorgan in the body?

a) Lungsb) Liverc) Braind) Heart 2. What is the longest bonein the human body?

a) Tibiab) Fibulac) Humerusd) Femur

3. The average span of astomach cell is?a) 1 dayb) 3 daysc) 7 hoursd) 2 days

4. What is the loudest naturalsound made by an organism?

a) yelling humanb) call of humpback whalec) roar of a tigerd) trumpet of elephant

5. The average span of a brain cell is?

a) 7 daysb) 10 daysc) 1 yeard) Lifetime 6. Where would you find a radial pulse?

a) Wristb) Neckc) Armpitd) Groin 7. Who discovered the X-ray?

a) Paul Dannonb) Wilhelm Roengenc) Steve Conradd) Dr John Wooden 8. What year was the X-rays discovered?

a) 1901b) 1895c) 1898d) 1925

See Page 23 for the answers to the quiz.

STUDY BREAKPUZZLES

MEDICAL QUIZPROVIDED BY: DISCOVERY HEALTH

Find Dr. Spot hidden on one of these pages.The first 3 emails to list the page and location

correctly will WIN a $25 Visa Gift Card!email your answer to:

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COMPLETED PUZZLEON PAGE 23

VEGETABLES AND FRUITSVITAMIN, ANTIOXIDANT AND FIBER POWERHOUSES

Choose: Go for the brights: the deeper the color, the greater the concentration of vitamins, minerals and antioxidants - broccoli, kale, mustard greens, butternut squash and sweet potatoes are several excellent choices. For fruits, choose fresh or frozen, and focus on variety. Berries are cancer-fighting, apples provide fiber, oranges and mangos offer vitamin C, and so on.

Avoid: Fruit juices can contain up to 10 teaspoons of sugar per cup; avoid or dilute with water. Canned fruit often contains sugary syrup, and dried fruit, while an excellent source of fiber, can be high in calories. Avoid fried veggies or ones smothered in dressings or sauces – you may still get the vitamins, but you’ll be getting a lot of unhealthy fat and extra calories as well.

WHOLE GRAINSFOR LONG-LASTING, HEALTHY CARBOHYDRATE ENERGY

The words stone-ground, multi-grain, 100% wheat, or bran, don’t necessarily mean that a product is whole grain. Look for the words “whole grain” or “100% whole wheat,” and check the ingredients to make sure each grain listed is specified as whole grain.

Choose: Dark breads, whole wheat, brown rice, oatmeal, barley, millet, toasted wheat cereals.

Avoid: Refined grains (breads, pastas, and breakfast cereals that are not specified as whole grain), “whole grain” cereals foods that also contain a lot of sugar (example: whole grain Cookie Crisp cereal).

HEALTHY FATS AND OILSTO SUPPORT BRAIN AND BODY FUNCTIONS

Choose: Vegetable oils (olive, canola, peanut), avocados, fatty fish (salmon), nuts, and seeds.

Avoid: “Damaging” good fats by exposing them to heat, light or air – for example, keep your bottles of canola or olive oil in the refrigerator. Avoid trans fats and saturated fats.

NUTS, SEEDS, BEANS, AND TOFUHEALTHY PROTEIN ALTERNATIVES

These plant foods are excellent sources of protein, fiber, vitamins, and minerals.

Choose: Good choices include black beans, navy beans, garbanzos, and lentils; and nuts like almonds, walnuts, and pecans. Soy products like tofu are great for protein.

Avoid: Salted or sugary nuts; refried beans.

FISH, POULTRY, AND EGGSTHE BEST ANIMAL PROTEIN SOURCES

Eating omega-3 fatty acid-rich fish can reduce the risk of heart disease. Good choices also include chicken, turkey, and eggs. (Vegetarians and vegans can substitute vegetable protein for these sources, but may want to consider an omega-3 supplement.)

Choose: Lean, white meat; egg whites; fatty fish like mack-erel, lake trout, herring, sardines, canned light tuna, catfish and wild salmon.

Avoid: fish that’s high in mercury such as shark, swordfish, king mackerel, tilefish and albacore tuna.

MILK AND OTHER DAIRY PRODUCTSFOR CALCIUM AND VITAMIN D

Dairy products provide a rich source of calcium, neces-sary for bone health. Most are fortified with vitamin D, which helps the small intestine absorb calcium.

Take a vitamin D and calcium supplement if you are unable to get enough of these nutrients from your diet, or if you follow a vegan diet.

Choose: 1-2 servings per day of low-fat dairy products that do not contain rBST (bovine growth hormone). If you're lactose-intolerant, choose lactose-free and lower-lactose products, such as hard cheeses and yogurt.

Avoid: Full-fat dairy products, or products from cows treated with rBST.

WATERHOW MUCH SHOULD I DRINK?

Most experts suggest drinking at least eight 8-oz. glasses of water a day. However, you may need to drink more water if you are very active, pregnant or breastfeeding, live in a warmer climate, or have certain health problems. Heavy people may also need more water.

EatingGoodBALANCING THEBASIC FOOD GROUPS

To ensure that you get a well-balanced diet that provides

the daily nutrients you need, the Harvard School of Public Health recommends

you focus your diet on the following six basic food groups.



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California lawmakers are considering a measure that would phase out harmful chemical toxins used to manufacture baby products such as pacifiers, plastic bottles and toddler cups designed for children under three years of age.National health organizations and state authorities are seeking restrictions on the potentially harmful chemi-cal bisphenol A, used in hard plastic containers.

The recent study conducted by the National Toxicology Program, part of the U.S. National Institutes of Health, revealed that the toxic chemical bisphenol A—a synthetic hormone similar to estrogen, leaches from popular baby bottles and food containers when heated. A similar study on mice given bisphenol A on a regular basis resulted in precancerous tumors and early puberty when the animals were given low doses of the chemical.

“However, because these effects in animals occur at bisphenol A exposure levels similar to those experienced by humans, the possibility that bisphenol A may alter human development cannot be dismissed,” the study concludes, although the authors of the study admit that the report only provides limited evidence for adverse effects on human health.

The study also showed that when new bottles are heated, those manufactured by Avent, Evenflo, Dr. Brown's and Disney/First Years discharged between 4.7 and 8.3 parts per billion of bisphenol A into the baby food.

The harmful toxin which can disrupt develop-ment in babies was found in bottles purchased at popular retail stores across the country in nine states including Babies "R" Us, CVS, Target, Toys "R" Us, Walgreens, and Wal-Mart. Several of these retailers discontinued baby products that contain bisphenol A.

Ninety-five percent of all baby bottles on the market are made with bisphenol A, according to the study.

The report has been opposed by chemical industry representatives who say that if used in small amounts, bisphenol A is not harmful and has been safely used for decades. An official of the U.S. Food and Drug Adminis-tration (FDA) said to Congress that the chemical is safe in its current application and that there is no reason for consumers to stop using products that contain the chemical.

Based on the results of the study, several state and national health organizations in the U.S. and Canada have called local authorities for an immediate ban on the use of bisphenol A used in hard polycarbonate plastics used to manufacture baby food and beverage containers.

The study results have been confirmed over time by other reports, however, making consumers anxious over the harmful effect of the bisphenol A products.

In response to the escalating reports of toxins in children’s products, California State Senator Carole Migden introduced a bill to “clean up” poisonous products sold in the State.

“I think manufacturers who make money should do all they can to make their products safe,” Migden said.

If the legislation proposed by Migden passes, California would become the first state that restricts the use of the chemical. Eleven other states in the U.S. have also toyed with the idea of forbidding bisphenol A.

Canada has made public its intention to ban the use of bisphenol A in baby bottles, and Canadian lawmakers are considering legislation to ban it in goods designed for children.

Article by: Ivan Velinov


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A tiny handlike gripper that can grasp tissue or cell samples could make it easier for doctors to perform minimally invasive surgery, such as biopsies. The tiny device curls its "fingers" around an object when triggered chemically, and it can be moved around remotely with a magnet.

Minimally invasive, or "keyhole," surgery currently involves making several centimeter-size incisions and inserting surgical tools through hollow tubes placed in these incisions. Wires connect the tools to external controls that a surgeon uses to oper-ate inside the body. This is less damag-ing than conventional surgery, but it limits a surgeon's ability to maneuver the instruments.

The new technology is a step toward surgical tools that move more freely inside the human body. "We want to make mobile surgical tools," says David Gracias, a biomolecular- and chemical-engineering professor at Johns Hopkins University, who led the development of the new gripper. "The ultimate goal is to have a machine that you can swallow, or [to] inject small structures that move and can do things [on their own]."

A gripper based on the current design could respond autonomously to chemical cues in the body. For example, it might react to the biochemicals released by infected tissue by closing around the tissue, so that pieces can be removed for analysis.

Gracias and his colleagues presented the microgripper at the American Chemical Society meeting earlier this month. To demonstrate the device, they used it to grasp and maneuver tiny beads and clumps of cells in a petri dish. They have also used the device in the laboratory to perform an in vitro biopsy on a cow's bladder. "This is the first mobile micromachine that has been shown convincingly to do very useful things," Gracias says. "And it does not require electric power for operation."

The open gripper is 500 micrometers (0.05 centime-ters) in diameter, and it is made of a film of copper and chromium covered with polymer. As long as the

polymer stays rigid, the gripper remains open. But introducing a chemical trigger or lowering the temperature causes the polymer to soften, actuating the gripper's fingers so that they curl inward to form a ball that is 190 micrometers wide. Another chemical

signal can be used to reopen the gripper. All of the chemicals used as triggers in experiments are harmless to the body.

Since the new technology does not need to be connected to controls outside the body, it could mean more dexterous microsurgery, says Chang-Jin Kim, a mechanical-engineering professor at the University of Califor-nia, Los Angeles. "You don't have to have a physical connection, and that is pretty attractive," he says.

Microgrippers could also be important for lab-on-a-chip applications--for example, moving samples around a chip or cleaning away debris. But Kim says that using chemical triggers from the environment makes the Johns Hopkins device tricky to control. "If the environment changes, your perfor-mance changes," he adds.

Kim and his colleagues previously developed a four-fingered "microhand"

that opens and closes when gas pressure is changed inside tiny polymer balloons at the finger joints. The microhand offers more precise control but must be tethered to a control unit. Nonetheless, Kim says that his device could have a wider range of uses--as a tool for remotely removing detonators from explosives, for example.

The new technology, meanwhile, is designed exclu-sively for surgery. Gracias hopes to shrink the gripper further--to about 10 micrometers wide--and to enable it to move in response to different chemical concen-trations, like a bacteria moving toward higher concen-trations of sugars.

Article Provided by:TechnologyReview.com

A Helping Handfor SurgeryBy Prachi Patel-Predd

Get a grip: The fingers of this metal-and-polymer gripping gadget curl around a tiny bead when the device senses a certain triggering chemical. The gripper could someday help doctors perform minimally invasive surgeries. Photo Credit: Timothy Leong/JHU

By Emily Singer

No luck with Match.com or EHarmony?Online daters now have a new way to screen potential dates. Two companies offer genetic analysis that purports to find your perfect love match based in part on the smell of his or her sweat.

The genetic tests for both companies--ScientificMatch, based in Naples, FL, and GenePartner, based in Zurich, Switzerland--are based on the same study, performed more than a decade ago in Switzerland. Women were asked to rate the odor of men's sweaty T-shirts, and then both sexes were tested for the genotype of several genes within the major histocompatibility complex (MHC), a family of genes that is crucial for immune function. Women were more likely to prefer the sweaty smells of men whose MHC genes were most different from their own.

While it sounds bizarre, the finding does have a potential evolutionary explanation. According to an article from the Economist:

“The children of couples with a wide range of MHC genes, and thus of immune responses, will be better protected from disease. . . . That could be particularly important in a collaborative, group-living species such as humanity. Moreover, comparing MHCs could be a proxy for comparing kinship, and thus help to prevent inbreeding.”

Does it really work for finding a date? Probably not. Subcon-scious feelings about a person's smell likely make only a minor contribution to each person's attractiveness equation.

DNA Based DatingSexy Smells: Online dating gets weirder.

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Today, people with diabetes have a range of technologies to help keep their blood sugar in check, including continuous monitors that can keep tabs on glucose levels throughout the day and insulin pumps that can deliver the drug. But the diabetic is still responsible for making executive decisions--when to test his blood or give himself a shot--and the system has plenty of room for human error. Now, however, researchers say that the first genera-tions of an artificial pancreas, which would be able to make most dosing decisions without the wearer's intervention, could be available within the next few years.

Type 1 diabetes develops when the islet cells of the human pancreas stop producing adequate amounts of insulin, leaving the body unable to regulate blood-sugar levels on its own. Left unchecked, glucose fluctuations over the long term can lead to nerve damage, blindness, stroke and heart attacks. Even among the most vigilant diabetics, large dips and surges in glucose levels are still common occurrences. "We have data on hand today that suggests that you could get much better diabetes outcomes with the computer taking the lead instead of the person with diabetes doing it all themselves," says Aaron Kowalski, research director of the Juvenile Diabetes Research Foundation's Artificial Pancreas Project.

At its most basic level, an artificial pancreas consists of three components: a continuous sensor to detect glucose levels in real time, a miniature computer that can take those readings and use an algorithm to predict what will happen next and determine how much insulin is necessary to keep the levels steady, and an insulin pump driven by the computer that doses out the appropriate amount of the drug.

Two of the components--insulin pumps and continuous glucose monitors--are already on the commercial market (the latter received marketing approval by the U.S. Food and Drug Administration just a few years ago). "In the near term, you could probably create a pretty robust system with today's technologies," says Kowalski, whose group has spearheaded a coalition aimed at bringing an artificial pancreas to market as soon as possible.

Members of the consortium are experimenting with variations of this closed-loop system, so named because the computer algorithm connects the insulin pump and the glucose monitor, closing the loop. Perhaps the person closest to developing a commercial system is Roman Hovorka, a principal research associate at the University of Cambridge, in the U.K.,

By Lauren Gravitz

where he leads the Diabetes Modelling Group. His first closed-loop study examined the effectiveness of the system when used overnight, during the hours when blood-sugar levels are likely to drop precipi-tously and complications can occur. "I want to move to an approach that could be commercialized, and the simplest is just to close the loop overnight, at a time when one cannot do too much about insulin anyway."

Hovorka used two devices, both commercially available. The first, a continuous glucose monitor, consists of a subcutaneous sensor that measures glucose levels in tissue beneath the skin and a device that communicates wirelessly with the sensor to download its data. The second is the pump itself, a pager-size device with an insulin reservoir that delivers the drug through a thin tube to a subcutane-ous needle. Hovorka and his collaborators added an algorithm that not only put the pump and sensor in communication with each other, but also took the (sleeping) user out of the picture by determining precisely how much insulin to mete out every 15 minutes.

When tested in 12 children with type 1 diabetes, the closed-loop system brought the kids' blood-glucose levels into the target range 61 percent of the time, up from 23 percent for those who followed their normal routine. "With the closed loop, we are able to avoid the extremes--the extreme bad low and the extreme bad high," Hovorka says. He's currently working with device makers in the industry to create a marketable commercial product.

Technologically, the remaining obstacles for research-ers are those of refinement--for example, construct-ing algorithms that are exquisitely honed to predict in which direction glucose levels are moving and at what rate. Other researchers are working on sensors that can monitor blood glucose over an extended period of time (currently, sensors must be replaced every three to eight days) and with improved accuracy.

Despite the fact that much of the technology is on the market, researchers must still prove to the FDA that their system is safe when combined with the algorithms, and that if anything goes wrong--if a sensor goes wonky or the insulin pump clogs up--the computer can sense it and either set off an alarm or turn the whole system off.

"You don't have to get the perfect system to make a tremendous advance and make it considerably easier to live with diabetes," says William Tamborlane, chief of pediatric endocrinology at Yale School of Medicine, who invented insulin-pump therapy in the late 1970s. As a clinician, he's more interested in seeing these incremental advances make their way to the patients than in waiting for a perfect system to be created. "We now have sensors that can say what the blood sugar's doing every minute," Tamborlane says. "And we have insulin pumps that can change how much insulin it gives on a minute-to-minute basis. We have the technology right now to come pretty close to what might be considered the ultimate solution."

Article Provided by: TechnologyReview.com


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Today, people with diabetes have a range of technologies to help keep their blood sugar in check, including continuous monitors that can keep tabs on glucose levels throughout the day and insulin pumps that can deliver the drug. But the diabetic is still responsible for making executive decisions--when to test his blood or give himself a shot--and the system has plenty of room for human error. Now, however, researchers say that the first genera-tions of an artificial pancreas, which would be able to make most dosing decisions without the wearer's intervention, could be available within the next few years.

Type 1 diabetes develops when the islet cells of the human pancreas stop producing adequate amounts of insulin, leaving the body unable to regulate blood-sugar levels on its own. Left unchecked, glucose fluctuations over the long term can lead to nerve damage, blindness, stroke and heart attacks. Even among the most vigilant diabetics, large dips and surges in glucose levels are still common occurrences. "We have data on hand today that suggests that you could get much better diabetes outcomes with the computer taking the lead instead of the person with diabetes doing it all themselves," says Aaron Kowalski, research director of the Juvenile Diabetes Research Foundation's Artificial Pancreas Project.

At its most basic level, an artificial pancreas consists of three components: a continuous sensor to detect glucose levels in real time, a miniature computer that can take those readings and use an algorithm to predict what will happen next and determine how much insulin is necessary to keep the levels steady, and an insulin pump driven by the computer that doses out the appropriate amount of the drug.

Two of the components--insulin pumps and continuous glucose monitors--are already on the commercial market (the latter received marketing approval by the U.S. Food and Drug Administration just a few years ago). "In the near term, you could probably create a pretty robust system with today's technologies," says Kowalski, whose group has spearheaded a coalition aimed at bringing an artificial pancreas to market as soon as possible.

Members of the consortium are experimenting with variations of this closed-loop system, so named because the computer algorithm connects the insulin pump and the glucose monitor, closing the loop. Perhaps the person closest to developing a commercial system is Roman Hovorka, a principal research associate at the University of Cambridge, in the U.K.,

By Lauren Gravitz

where he leads the Diabetes Modelling Group. His first closed-loop study examined the effectiveness of the system when used overnight, during the hours when blood-sugar levels are likely to drop precipi-tously and complications can occur. "I want to move to an approach that could be commercialized, and the simplest is just to close the loop overnight, at a time when one cannot do too much about insulin anyway."

Hovorka used two devices, both commercially available. The first, a continuous glucose monitor, consists of a subcutaneous sensor that measures glucose levels in tissue beneath the skin and a device that communicates wirelessly with the sensor to download its data. The second is the pump itself, a pager-size device with an insulin reservoir that delivers the drug through a thin tube to a subcutane-ous needle. Hovorka and his collaborators added an algorithm that not only put the pump and sensor in communication with each other, but also took the (sleeping) user out of the picture by determining precisely how much insulin to mete out every 15 minutes.

When tested in 12 children with type 1 diabetes, the closed-loop system brought the kids' blood-glucose levels into the target range 61 percent of the time, up from 23 percent for those who followed their normal routine. "With the closed loop, we are able to avoid the extremes--the extreme bad low and the extreme bad high," Hovorka says. He's currently working with device makers in the industry to create a marketable commercial product.

Technologically, the remaining obstacles for research-ers are those of refinement--for example, construct-ing algorithms that are exquisitely honed to predict in which direction glucose levels are moving and at what rate. Other researchers are working on sensors that can monitor blood glucose over an extended period of time (currently, sensors must be replaced every three to eight days) and with improved accuracy.

Despite the fact that much of the technology is on the market, researchers must still prove to the FDA that their system is safe when combined with the algorithms, and that if anything goes wrong--if a sensor goes wonky or the insulin pump clogs up--the computer can sense it and either set off an alarm or turn the whole system off.

"You don't have to get the perfect system to make a tremendous advance and make it considerably easier to live with diabetes," says William Tamborlane, chief of pediatric endocrinology at Yale School of Medicine, who invented insulin-pump therapy in the late 1970s. As a clinician, he's more interested in seeing these incremental advances make their way to the patients than in waiting for a perfect system to be created. "We now have sensors that can say what the blood sugar's doing every minute," Tamborlane says. "And we have insulin pumps that can change how much insulin it gives on a minute-to-minute basis. We have the technology right now to come pretty close to what might be considered the ultimate solution."

Article Provided by: TechnologyReview.com


The security of a permanent position with opportunities to change: A question many students ask themselves is, “What if I choose one area in which to work just to find that it isn’t the right fit?” No one wants to “job-hop”. The longer an employee works for an employer, the better vacation and sick pay you have, the better employer match in the retire-ment plan, not to mention the better salary.

When looking for the right employer for you, check out the ones that can offer diverse career opportuni-ties under the same employer. Home health and medical staffing employers can do just that. There are even some employers that offer opportunities to work in different cities and facilities while still working for the same employer with uninterrupted benefits and retirement plans. Talk about the best of all worlds! Some employers offer traveling nursing opportunities. As an employee you can experience different cities and different work environments and still be a long-term employee with one employer. This can be especially important to those whose spouse is in a profession that requires moving around such as the military and ministry.

Ongoing education and careeradvancement: Look for the employer that embraces continuing education and promotes career advancement. Employers that provide flexible sched-ules and tuition reimbursement for education, training, certification, etc., that will advance your career and increase your salary are employers to take a look at. You may be about to graduate soon from

your current school, but look around. Is there an opportunity to move to the next level? Can you earn more and have more choices if you further your education? If so, check out what the employer you are considering working for is offering. Look for the “earn while you learn” type of employer.

The Employee Benefits: Where you work makes a difference when it comes to the “second paycheck” of employee benefits.

Typically the larger the employer the better the benefits offered. There are so many more benefits besides health, dental and retirement. Employers are now offering vision, Section 125 medical reimbursement plans, supplemental policies, and all sorts of special types of benefits. Make sure you look closely into the complete benefits package.

Where you work does make a difference. There are so many different medical employers: home health, hospitals, doctors’ offices and clinics, medical staffing, assisted care, nursing home and many more. If you want the right fit for you, make sure to familiarize yourself with the many different work environments available.

We at Interim Home Health want you to be educated and aware of the choices you have when choosing where to work. We know that happy employees stay and unhappy employees leave. We want you to be a happy employee.

THINGS TO CONSIDER...InterimLocations

Interim HealthCareLubbock5224 75th StLubbock, Texas 79424806.791.0042806.797.6694 (F)

Interim HospiceLubbock5224 75th StLubbock, TX 79424806.791.0043806.687.5958(F)

Interim HealthCareCrosbyton218 W. AspenCrosbyton, TX 79322806.675.1516806.675.1519(F)

Interim HealthCareLevelland707 College Ave. Ste. 106Levelland, TX 79336806.897.1485806.897.1487(F)

Interim HealthCarePlainview3320 Olton RoadPlainview, Texas 79072806.288.0220806.288.0224(F)

Where you work makes a difference. That “differ-ence” can tremendously affect the quality of your life. The truth is, we work to live, not live to work. So when choosing who to work for, it is very wise to consider just how “employee friendly” the employer is. That is why so many health care professionals seek to work for employers that offer schedule flexibility, career advancement, internal transfer opportunities as well and the usual employee benefits.

If you are currently a student, here are some things for you to consider when you begin your search for the best employer fit for you.

Flexible Schedules: Many employers are begin-ning to offer choices in health care staffing. They understand that happy employees tend to stay and unhappy employees tend to leave. Employees with young children at home have different scheduling needs from employees with high school age or college age children. Employees with no children at home have different scheduling desires from those with children.

Many employers are offering per diem, blocked and multi-week schedules. Many offer specialty staffing in different areas within the organization.

when you are looking forthe perfect employer.

Melissa Roberts

By Melissa Roberts



*Based on 2008 Analysis Ratings published by HealthGrades, a leading provider of outcome ratings and services within healthcare. Read more about our rankings at www.HealthGrades.com. EQUAL OPPORTUNITY EMPLOYER

Like most treatments, laser therapy can benefit from image guidance. A Houston-based com-pany has developed an MRI-guided system that has been tested and is now FDA-approved.

The laser light is channeled through an optical fiber that can be inserted practically anywhere in the body. One of the biggest challenges in LITT is that the target cannot get too hot, otherwise it will char - thus preventing further laser light from penetrating into the tissue.

To avoid this, physicians have traditionally mea-sured the temperature at some point near the target using a thermometer-like probe. But real-time imaging could provide a non-invasive means to monitor the temperature throughout the target region. In particular, MRI provides a sensi-tive temperature probe. The frequency of the MRI signal, which depends on the magnetic prop-erties of water molecules, shifts as the tempera-ture of the corresponding tissue changes.

Using this effect, Visualase, Inc., has developed a closed-loop MRI guided LITT system that provides the user with a temperature map of the target region and calculates the corresponding dose (i.e. the likelihood that cells in some region will die from the applied heat). If nearby healthy tissue is receiving too much heat, or if the temperature is approaching the charring temperature, the user can respond by changing the laser power or shutting it off, which helps to increase both the safety and efficacy of the procedure.

Trials of the system were independently performed on canines by R. Jason Stafford from the University of Texas M.D. Anderson Cancer Center, and his collaborators. Several LITT lesions were made in the brain, spine and pros-tate with MRI guidance. The results showed that the machine's calculated dose matched up well with a post-operation assessment. Initial safety studies have also been performed in human patients and the device has recently received FDA approval. Stafford thinks MRI-guided LITT will provide a less invasive alternative to conven-tional surgery. He is currently working to improve the real-time targeting and heat delivery.

The research was described in the talk, "Closed-Loop Guidance of Laser Induced Thermal Therapy Using MRI," presented July 2008 at the 50th meeting of the American Association of Physicists in Medicine.

Article Provided by:ScienceDaily

Laser Focus

Laser induced thermal therapy (LITT) destroys unhealthy tissue, like cancer, with the intense heat supplied from a laser.



Nowhere is stress more likely than in the workplace. Twenty-five percent of people say that their job is the primary stressor in their lives. And the vast majority of workers believe that on-the-job stress is worse today than it was just 10 years ago.

Job stress can affect your professional and personal relationships, your livelihood, and your health.

Here are strategies you canuse to extinguish job burnout :

• Identify the source of the problem. Whether it's an unrealistic workload, job insecurity, inadequate compensation, office politics or a hostile work environment, you need to figure out what's making you miserable at work and then take steps to deal with it.

• Develop friendships at work and outside the office. Sharing unsettling feelings with people you trust is the first step toward resolving them. Minimize activities with "negative" people who only reinforce bad feelings.

• Take time off. Take a vacation or a long week-end. During the workday, take short breaks.

• Set limits. When necessary, learn to say no in a friendly but firm manner.

• Choose battles wisely. Don't rush to argue every time someone disagrees with you. Keep a cool head, and save your argument for things that really matter.

• Have an outlet. Read, enjoy a hobby, exercise or get involved in some other activity that is relaxing and gets your mind off work.

• Seek help. If none of these things relieves your feelings of stress or burnout, ask a health care professional for advice.

Article Provided by:The MayoClinic

EXTINGUISHJOBBURNOUT

What is rewardingto you as a nurse?

What I find rewarding is the opportunity to speak

into the lives of people (patients and staff) everyday. When you learn to listen you have a greater ability to encourage and offer healing.

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September 11-12, 2008Nurse Leadership Conference Austin, Tx

September 18-19, 2008Emergency NursePediatric CourseDallas, Texas

Visit MyMedicalFuture.com/event for the full calendar!

Contact My Medical Future to have yourevent included in the online calendar.

ANSWER KEYMedical Quiz1. b) Liver2. d) Femur3. d) 2 days4. b) call of humpback whale5. d) lifetime6. a) Wrist7. b) Wilhelm Roentgen8. b) 1895

September 22, 2008The Art and Science ofMassage of Aging AdultSan Juan CollegeFarmington, NM

November 6-7, 2008Advanced Fetal MonitoringTexas Tech HSCLubbock, Tx

VacationSick Days

Education Reim.Holidays

HealthDentalVision

Life Insurance401-K

Housing AllowanceFuel Allowance

Workout FacilityRetirement PlanMaternity Leave

Flexible ScheduleSign-On Bonus

Retention Bonus

Golden Plains

Comm. Hospital

Borger, TX

Plum Creek

Specialty Hospital

Amarillo, TX

The Plaza

at Lubbock

Lubbock, TX

Interim Staffing

Various Locations

Lubbock HeartHospital

Lubbock, TX

Garrison Center

Lubbock, TX

@ Work

Medical Services

Odessa, TX

Medical CenterHospital

Odessa, TX

Texas Tech HSC

Various Locations

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Note: This benefits chart is NOT comprehensive - many of these companies may offer additional benefits that are not listed.Please contact the individual companies for complete details about what they offer employees and to verify any benefits that are listed.My Medical Future compiled this list from info given by each company and is not responsible for omissions or misinformation.

BENEFITSCHARTMY MEDICAL FUTURE

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