Prevention of contagious diseases medical information written by Gloria Poole,RN

Practical help for those traveling abroad and to help prevent disease anywhere:

In the news is the ebola outbreak in Africa that has the potential to become pandemic and that has killed about 800 people so far. I am including a link to the BBC article about that :
W.H.O. plan to curtail ebola, 31 July 2014:
http://www.bbc.com/news/world-africa-28593987.
I am updating this that I wrote yesterday [31 July] to add information that is available today on ebola, [virus]  from The New York Times: Quote: "The C.D.C. advised Americans to avoid all nonessential travel to the three countries hardest hit by the virus: Guinea, Sierra Leone and Liberia. The agency issued a Level 3 travel warning, reserved for grave situations. It was also used for the outbreak of the highly contagious respiratory disease SARS." And : "The virus causes high fever, vomiting, diarrhea and, in some cases, bleeding. In the current outbreak, about 60 percent of the cases have been fatal. It is transmitted by contact with bodily fluids from someone who is ill."  And :
 "There is no vaccine to prevent the illness, and no specific treatment for it, only care to try to nurse people through the worst of the fevers, bleeding and other symptoms. The only way to stop an outbreak is to isolate each infected patient, trace all their contacts, isolate the ones who get sick and repeat the process until, finally, there are no more cases." And :
"In New York, Dr. Jay Varma, the deputy commissioner for disease control at the city’s health department, said that someone at an area airport with symptoms that could be from Ebola would immediately be isolated and tested, briefly quarantined at the airport and quickly taken to a hospital where the department has standing arrangements for just such an event."
From http://www.nytimes.com/2014/08/01/world/africa/sierra-leone-declares-health-emergency-over-ebola.html?

 I logged back in this afternoon 1 August, at 3:24pm to add this info :
Very good article about ebola with visuals of how it affects humans:
http://www.businessinsider.com/how-the-ebola-virus-affects-the-body-2014-7

And also to remind all readers that hand washing is the NUMBER ONE thing they can and should do to prevent the spread of any disease. You should wash your hands with good soap for at least 5 minutes using a fingernail brush to get soap under nails and to remove debris when you come into contact with anybody's body fluids, excrement, sneezes, coughs, including your own because fingernails harbor bacteria and viruses under them. So, for any person working in any capacity with infected [with any disease ] persons handwashing is essential. Also, for diseases transmitted via droplets of moisture [such as tuberculosis] covering your nose and mouth is also essential [ the reason for wearing masks over those in the operating room and disinfecting centers]. Any time you sneeze or cough you should cover your nose and mouth with something that can either be disposed of, or washed thoroughly, to prevent the spread of "germs" from you to others.  Nurses and doctors are taught to wash their hands between patients and usually you do not see them do that because they wash up at nurse's station or restricted area.  But if you are in a situation where you do see a medical doctor, nurse, technician, technologist of any department go from one patient to another without washing hands, you should call them on it--insist they wash their hands to not spread the diseases around to others. They know to do that and get in hurry and forget. WE, who are trained in the health care disciplines, KNOW to do this and KNOW why to do it but we are all after only human.  This is critical when the diseases are infectious. Not all diseases are infectious but I have touched on some of the main points of the ones that are in the words below.  However, it is best practice to wash your hands after toileting, after putting on or off shoes, before eating or drinking, after touching another person because skin also harbors bacteria.  And it goes without saying do NOT share food or drink with infected persons. in other words, do not eat off their plate or drink from their cup. They get microscopic saliva on the rim of the cup and on their plate and it takes only a tiny amount of contaminant to infect you. So tiny in fact that you do not see it with the naked eye. That means that the virus or bacteria can only be seen under a microscope unless it has multiplied so much it is making colonies on an agar plate.

I know as Registered Nurse licensed in Missouri but whose main career was in state of Georgia, that contagious diseases have a set of practices that can help contain it, including quarantine of those infected. I am sure they need to do that in Africa and possibly burn the bodies of those who died from it to prevent contamination of mortuaries  and personnel handling them. I cannot add much to the BBC article as it shows the protective covering of health care workers to prevent contamination.

However, I am going to write here some practical advice using a medical  textbook as a reference that will help international travelers stay healthy. Three  to five million people travel from countries where they are not likely to be exposed to contagious disease, to countries where contagious diseases are common. And then they travel back, potentially exposing their family and friends and co-workers to anything they acquired that is infectious or contagious. Only a few contagious diseases have mandatory reporting of them to public health authorities. The diseases that must be reported are malaria, Lassa fever,  and African trypanosomiasis. The risk of contracting a contagious disease is not as great if a traveler is staying in a city hotel with clean drinking water. However, if staying in remote villages with spotty sanitation and non-potable drinking water, a traveler becomes a high risk of disease.

There are two recognized medical sources of information that are updated yearly to provide practical advice to international travelers:
1)  "Health Information for International Travel" published by the U.S. Public Health Service and available from the Center for Disease Control in Atlanta, GA, 30333; and
2) "Vaccination Requirements for International Travel and Advice to Travelers," published by the World Health Organization, available from WHO Publication Center, 49 Sheridan Ave, Albany, NY 12210, USA.
There are two other resources for international travelers:
1) International Association for Medical Assistance to Travelers [IAMAT] at 417 Center St. Lewistown, NY, 14092 which has info on tropical diseases & a list of English speaking medical doctors in other countries.
2) Center for Disease Control Traveler's information hotline  +1(404)3324559 and they will fax it to all regions of world.

As of the writing of the medical textbook I am using as reference, the only two legally required vaccinations to travel abroad are cholera and yellow fever. Yellow fever is endemic in Africa. And cholera is endemic in South and Central Americas. Typhoid fever is a danger for travelers since 60 percent of the cases of it occurred after international travel. The greatest risk of typhoid fever is in Peru, Chile, and the Indian sub-continent; although the risk is present in almost all developing countries. Typhoid vaccination is recommended for travelers who will stay in small villages and eat local food and drink local water. In developing countries, polio is still uncontrolled . For those who had the initial vaccinations against polio a booster vaccinate is recommended for those whose last vaccination was more than 10 years before. Also, tetanus is a worldwide problem especially in the tropics. A vaccination and or booster is recommended if traveling to those countries. Hepatitis A is an "important risk"  in many areas of the developing world. Immune globulin gives immediate resistance to Hepatitis A and is strongly recommended for travelers to the developing countries of the world. For travelers who will be in a country more than six months, in sub-Saharan Africa or Southeast Asia including China and Indonesia, North Africa, South Central Asia and Southern Europe  it is also recommended that they  be vaccinated for Hepatitis B.  Since rabies exists in many undeveloped countries, anyone who will be in presence of animals [ veterinarians, safari travelers, animal handlers, laboratory workers] should have the rabies prophylaxis which is three injections on days 0, 7, 21 and 28 before they travel. Tuberculosis is an airborne contagious disease caused by mycobacterium tuberculosis that are either inhaled or present in unpasteurized milk. The BCG vaccination is controversial and most U S experts do not recommend it but do recommend frequent skin testing for exposure to it for travelers in areas where it is known to be a problem [worldwide].

 Japanese encephalitis [abbrev JE] s a mosquito-borne encephalitis [inflammation of brain] that occurs in much of Asia including China and the tropical areas of Southeast Asia. There is a vaccination {JE-vax] manufactured by Research Foundation for Microbiological Diseases of Osaka University and distributed by Connaught Laboratories, that is a series of three injections.
Plague exists in certain rural parts of Africa, Asia, North  and South America. If any contact with rodents is a risk, then vaccination is recommended.
For travelers to New Delhi, Northern India, Sahel [sub-Sahara Africa], Saudi Arabia, Nepal, Tanzania and Burundi pre-travel vaccination for meningococcoal meningitis is recommended.

Malaria is a potentially fatal parasitic disease caused by infection of red blood cells with Plasmodium species and is usually transmitted by the anopheles mosquitoes but can be acquired from blood transfusions and intravenous drug use. Malaria is worldwide. The aim is to prevent it by sleeping in mosquito-netting during the anopheles feeding time of dusk to dawn. Travelers outside mosquito netting during those times should cover all body parts with clothing and use insect repellent. Mosquito repellent with N, N-diethylmetatoluamide [DEET] should be applied to expose skin including the face. Best to avoid night time activities in malaria prone countries. People die from malaria every year. In high risk areas, chemical prophylaxis is recommended to begin 1-2 weeks BEFORE traveling to the area and continue until four weeks after return from the area. There are six different medicines [chemicals ] used to prevent infection with malaria. 
Even with chemical prevention attempts, it is possible to contract malaria. The CDC maintains an up-to-date database on malaria and and it is available by calling +1(404) 639-1610. In seeking what chemical to use to prevent malaria, the traveler has to be assessed for risk of developing chloroquine-resistant Plasmodium falciparum [CRPF] malaria. The counties where CRPF have been reported are eastern Thailand and rural Cambodia. Travelers in those areas are advised to take with them Fansidar and to take it promptly if they develop a fever and can't get to medical care immediately. Some of the chemicals have serious side effects so a medical doctor prescribing those would need to know a complete history of any traveler.

The more minor infectious diseases international travelers can be exposed to abroad are : measles, mumps, rubella, influenza [flu] though some influenzas are deadly.

Food and water are the most common methods of introduction of infectious agents into the body.  It is best for international travelers to the developing or undeveloped world to consider all local food and drink as potentially contaminated and use extreme caution [boil water , cook food thoroughly] . Avoid eating raw fresh water fish and crustaceans. Avoid unrefrigerated creamy products and salads since leafy vegetables are hard to clean and often harbor parasites and eggs and bacteria. If purified water is not available, order beverages that require boiling water such as tea or coffee; drink bottled or canned beverages commercially available, soft drinks . Remember that ice may also be contaminated . The best thing to do is use bottled or canned drinking water and also for brushing teeth.  If you doubt the water, boil it vigorously for ten minutes and let it cool. If you see any sediment in it strain it somehow before you boil it. If you plan to be in an area where you cannot boil water, buy tincture of iodine or tetraglycine hydroperiodide tablets  before you travel and use them to disinfect water by putting 5 drops of Tincture of Iodine in a quart or liter of clean looking water and ten drops in cloudy looking water. If the water looks clean let is stand with the iodine for 30 minutes before drinking it. If the water looks cloudy let it stand several hours with the iodine before drinking it. The water purification tablets can be bought at a pharmacy or sporting goods store and you must follow the instructions with them. 
Infection with e.coli [escherichia coli bacteria] is the cause of 50 percent of diarrhea in travelers. For the general population, prophylaxis against e.coli is not recommended ; but in certain people it is recommended . Those people for whom even a mild case of dehydration would be serious [such as those taking diuretics , or with cardiovascular disease, or very young and very old] treatment to prevent infection with e.coli is recommended.

For travelers to Ethiopia and Kenya, the risk of Schistosomiasis is  a major problem. Three predominate species exist: Schistosoma mansoni; Schistosoma haematobium, and Schistosoma japonicum.
It is contracted by wading or swimming in fresh or estuary water that harbors the snail vector of the trematode parasite. It can penetrate the skin and get into the bloodstream without causing any problems at the time, then after about six months it can cause liver or urinary tract disease. To prevent this it is best to avoid rafting or swimming in fresh water in Ethiopia or Kenya.  It is treatable with the drug praziquantel [Biltricide] .

For people who have HIV+ blood there are risks of developing tuberculosis, malaria, and fungal infections and other infections are greater in international travel.

Other precautions is to avoid blood transfusions abroad since blood is not routinely screened for HIV or  Hepatitis B in many countries. And sterilization of equipment may not be adequate in undeveloped countries.

This is not an exhaustive report on the risks of contagious diseases nor on the methods to prevent them. It is only intended to provide some basic information to prompt any person planning to travel abroad to tell their doctor about it beforehand, and to educate people on some of the risks and some of the preventions and treatments that are known.

Copyright notice: since I put this in my own words I am copyrighting this . I, Gloria Poole, residing in Missouri but born in the state of Georgia, own all rights to this blog and to all content of it and it may not be transferred to anyone anywhere, nor have domains forwarded to it that do not belong to me, nor be re-published, nor printed at remote. It may be read as many times as you need too however. I do not track viewers in any way or require login or registration on any blog or site of mine. This is an effort to help improve the worlds' public health by teaching how to prevent contagious and or infectious diseases. Also, for the record: I am a white, single again, Southern Baptist Christian woman, and the natural mother of two grown daughters who are Jennifer and Leigh. I am also an artist in all mediums, a poet, author, republican, Registered Nurse licensed in Missouri, a writer, blogger, citizen journo, photographer, prolife activist and personhood amendment promoter. I have another site in this account at: https://sites.google.com/site/webmaamgloriapoole/ and it is quite different from this site. But all sites and blogs I own and create are moral and decent and intended to better the world.

Gloria Poole, RN [and artist in all mediums] licensed in Missouri, and using as reference but not quoting the medical textbook Principles of Ambulatory Surgery edited by L. Randol Barker, John R Burton and Philip Zieve;  ch 32. I am also known on the web as : gloriapoole; gloria0817 ; gpoole0817 ; gloriapoole.RN ; gloriapooleRN at yahoo where RN is standard abbreviation for Registered Nurse;  gloria-poole ;  gloria.poole ;  artist-gloriapoole ; Gloria.Poole ; and other variations of my real, born with, legal name of Gloria Poole; at my own, private apt in Missouri; 31, July 2014 at 8:01pm. Updated by me Gloria  twice on 1 August with info on ebola from NY Times and Business Insider .

Children are blessings according to Bible.

It is written,:

"blessed is every one who fears THE LORD, 

who walks in His ways, 

when you eat the labour of your hands,

you shall be happy,

and it shall be well with you.

Your wife shall be like a fruitful vine in 

the very heart of your house,

your children like olive plants

all about your table.

Behold, thus shall the man be blessed 

who fears THE LORD. " 

Psalms 128: 1-4, New KJV version

"Behold, children are a heritage from THE LORD;

the fruit of the womb is HIS reward.

Like arrows in the hand of a warrior,

so are the children of one's youth. 

Happy is the man who has his quiver full of them;

they shall not be ashamed,

but shall speak with their enemies in the gate."

Psalms 127:3-5, NKJV

"Children's children are the crown of old men,

and the glory of children is their father. " 

Proverbs 17:6, NKJV

I usually quote the King James Holy Bible and this version is from the New King James  Bible version which changes the thees and thous to you . 

I believe the word of GOD as written in the Bible to be true. I am a Southern Baptist Christian woman and I accepted JESUS as my Saviour at the age of seven.  I do what I can do to spread the gospel in all areas of life according to the commandment of JESUS in Matthew 28: 18-20. kjv. The purpose of this blog is to educate the public on the medical issues of the prolife and personhood movements in the U S and to spread those around the world. And to include the Bible scriptures that promote human life and childbirth from time to time. I also allow myself to add art I create to this blog occasionally to vary the content. 

For the record: I am white, Southern Baptist single again twice-divorced woman and the natural mother of two grown daughters who are Jennifer and Leigh; and a Registered Nurse licensed in Missouri;  an artist in all mediums, a republican, prolife activist, personhood promoter; author, poet, illustrator, cartoonist, citizen journo ,photographer and U S citizen born in the state of Georgia in the U S. you should also read my blog in my former married name of https://gloriapoolepappas.blogspot.com for the history of  my life and my missions goals.

Copyright notice: this blog and all content on it belongs exclusively to me Gloria Poole of Missouri [but I was born in state of Georgia] and it may not be transferred to anyone anywhere, nor have domains forwarded to it that do not belong to me, nor be downloaded, nor saved to disk, nor copied, nor printed at remote, nor re-published by anyone. I, Gloria Poole, RN, artist, own all rights to this blog and its content and it is covered as intellectual property under U S copyright law.

Today, I also updated my blog https://gloriapoole.blogspot.com  with 5 sketches of farm life that I created ; and over the weekend I updated my blogs  
http://gloriapoole.wordpress.com and also http://gloriapoole1749.wordpress.com with sketches I created.  Also, I wrote about States' rights on my official blog for Tapestry of LIFE ,  because of attempts by a RADICAL Senator to end States' rights. You should read about that at https://tapestry-of-life-llp.blogspot.com, if you are U S citizen.  I have other blogs also and you can see the list on that gloriapoole.blogspot blog in archives.

Gloria Poole / gloriapoole / Gloria / gloria0817 / gpoole817 / gloria-poole / gloria.poole / artist-gloriapoole / Gloria Poole, RN, artist / @gloriapoole / press.gloriapoole / gloriapoole.RN / Ms Gloria Poole / Poole.Gloria / gloria_poole /photo-by-gloriapoole / cartooning-by-gloriapoole  and other variations of my real born with legal name of Gloria Poole, at my own private apt in Missouri that is not shared with anyone, 28 July 2014 at 11:47 am.

Midwives saves lives, by Gloria Poole, RN, artist of Missouri

"Midwife " oil painting by Gloria Poole, RN, artist of Missouri in year 2009.

This post is about educating the public on the function of midwives and the need for them around the world. I am including some quotes on this topic and the source of the quotes.

Quote: "One important conclusion is that application of the evidence presented in this Series could avert more than 80% of maternal and newborn deaths, 1 including stillbirths. Midwifery therefore has a pivotal, yet widely neglected, part to play in accelerating progress to end preventable mortality of women and children. " From : http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960855-2/fulltext
And : "The authors also produce evidence of a trend towards the overmedicalisation of pregnancy, and the use of unnecessary interventions such as caesarean sections, in high-income and lower-income countries, with consequent hazards and costs." From : http://www.internationalmidwives.org/news/?nid=159

"Most neonatal deaths are preventable. The best possible
way of reducing neonatal mortality is through greater
investment in maternal care during the first 24 hours
after birth, particularly in labour and delivery care and
other high-impact interventions. Far too many births—
more than half in some countries—occur outside health
facilities, despite the increase in institutional deliveries globally" From : http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf

"In 2012, 40 million births in
developing regions were not
attended by skilled health
personnel, and over 32 million
of those births occurred in rural
area." From : http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf

"Most maternal deaths are preventable. There are
well-known health-care solutions for the prevention
and handling of complications. For instance, uterotonic
commodities and magnesium sulphate can prevent
and/or manage common complications such as bleeding
during childbirth and hypertensive disorders caused
by pregnancy. There must be a concerted effort to
ensure universal access to both skilled antenatal care
and effective interventions, enhanced to include access
to family planning, and information and services for
reproductive health, especially in vulnerable populations.
Monitoring efforts have to be strengthened to ensure
that effective action is taken." From : http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf

"One critical strategy for reducing maternal morbidity and
mortality is ensuring that every baby is delivered with the
assistance of a skilled health attendant (medical doctor,
nurse or midwife). A birth attendant with the necessary
training and medicines can administer interventions to
prevent or treat life-threatening complications such as
heavy bleeding, or refer a patient to a higher level of care. " From : http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf.

" Health care during pregnancy is essential to ensure
the normal, healthy evolution of the pregnancy and to
prevent, detect or predict potential complications during
the pregnancy or delivery. Good quality care must be
provided by skilled health personnel equipped to detect
potential complications and provide the necessary
attention or referral. The proportion of women in
developing regions who were attended at least once
during their pregnancy by skilled health-care personnel
increased from 65 per cent in 1990 to 83 per cent in
2012. In most developing regions, about 80 per cent of
pregnant women visited a skilled health-care provider at
least once, except in Southern Asia, where only 72 per
cent of women received this care.
The World Health Organization has recommended a
minimum of four antenatal care visits to ensure the
well-being of mothers and newborns. During these
visits, women should receive—at least—a minimum care
package, and be monitored for warning signs during
their pregnancy." From : http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf.

Resources for midwives: http://www.internationalmidwives.org/news/?nid=163

Midwives' youtube channel: http://www.youtube.com/user/WorldMidwives/feed

BBC's Fight for Life videos: http://www.who.int/maternal_child_adolescent/multimedia/videos/en/

World Health organization's :

Department of Maternal, Newborn, Child and Adolescent Health (MCA)

World Health Organization

20 Avenue Appia

1211 Geneva 27

Switzerland

Tel.: +41 22 791 3281

Fax: +41 22 791 4853

E-mail: mncah@who.int

 Youtube : "Midwives reaching out to women" at :http://www.youtube.com/watch?v=dx3zJmMy0Tg

Medical photos of how babies look in utero:
https://sites.google.com/site/newsforlife/humans-in-womb-photos

Article written by me Gloria Poole, RN using medical textbook as reference, entitled "From embryo to fetus"  is post on Feb 25, 2014 on another blog of mine at :
http://gloriapoole.livejournal.com

Article written by me as Registered Nurse for people who have no medical training in how to deliver a human baby in an emergency is the top post [for the time being but I update it intermittently so you might have to scroll archives to find it later] is on :
http://gloriapoole-UK.livejournal.com

Pencil drawing drawn by me to illustrate some of the stages of human development are on this site of mine:
https://sites.google.com/site/ArtistIllustrations.

Copyright Notice: this blog and all content on it belongs exclusively to me Gloria Poole, RN, artist residing in Missouri but born in the state of Georgia, and it may not be transferred to anyone anywhere, nor have domains forwarded to it that do not belong to me, nor be re-published, nor printed at remote, nor copied, nor photo-copied in its entirety. I, Gloria Poole, own all rights to this blog and its content. Also see https://gloriapoole.blogspot.com and also https://gloriapoolepappas.blogspot.com.
For the record: I am a white, single again twice divorced woman and a Southern Baptist Christian and the natural mother of two grown daughters who are Jennifer and Leigh, and an artist in all mediums, a poet, an author, a prolife activist, a blogger, a personhood amendment promoter, a Registered Nurse licensed in Missouri, a photographer, citizen journo, republican, writer.
Gloria Poole, RN, artist / Gloria / Gloria Poole / gloriapoole / gloria-poole / gloria.poole / @gloriapoole / gloriapoole.RN / gloria_poole / artist-gloriapoole / Ms Gloria Poole / Poole, Gloria /photo-by-gloriapoole / cartooning-by-gloriapoole, and other variations of my real, born with, legal name of Gloria Poole, at my own private apt in Missouri [meaning no one is authorized to login to any account of mine but me], on 19 July 2014 at 5:06pm. 

Genome sequencing of living babies & questionable medical orders

I, Gloria Poole, RN, artist of Missouri and Georgia, am adding two news snippets that directly affect the standards of medical care debates around the world. These were sent to my inbox to help publicize this news, so I am doing that numbered for reference.

Prolife 23 June 2014:
1) About genome sequencing [mapping DNA]  of living human babies developing in womb with quotes:
"Sequencing DNA has become so cheap and easy that its routine use in pregnancy, as a way to get a broad view of a fetus’s health, is starting to look inevitable. “In five years we will be offering [genome] sequencing for all routine pregnancies in the first trimester,” predicts Art Beaudet, chairman of molecular genetics at Baylor College of Medicine. He says Baylor is developing plans to begin offering so-called exome sequencing, or decoding of the key parts of the genome, during pregnancy for some couples.

What’s still not settled is the ethics of prenatal sequencing—or the question of who gets to control the data. In fact, that debate has barely begun. It’s such a new idea that the American College of Medical Genetics and Genomics, which sets guidelines for medical geneticists, still has no position on it, says Diana Bianchi, executive director of the Mother Infant Research Institute at Tufts University."

Read : http://www.technologyreview.com/news/527936/for-one-baby-life-begins-with-genome-revealed

2) Prolife of UK has taken case to court to stop hosptials from labeling humans as 'do not resuscitate" without patient requesting that or discusson with family members if patient is comatose. Quote: 
 "It is frighteningly easy for a doctor to decide unilaterally not simply that a treatment is non-beneficial but that a patient's life is not worth saving. When there is so much advertising of death by pro-euthanasia and pro-suicide activists, this is truly dangerous." - See more at: http://prolife.org.uk/2014/06/patient-labelled-resuscitate/...

Both of these cases are similar because both are examples of government run amok, and of "research" in the name of medicine that has huge potential to eradicate the human race. Think about it. If every pregnant woman around the world had the decision to analyze 6 billion cells in an unborn child to supposedly determine if that child would ever have any diseases in the lifetime, how much stress would that cause pregnant women AND how much pressure would be put on women to abort their babies? And in the second scenario, it is similar because a written "do not resuscitate " order by a medical doctor essentially means that NO life-saving measures wold be implemented, thus giving the doctor control over who lives and who dies. Should medical doctors anywhere have that power? NO! They should not.

Read the book, The Nazi Doctors written by Robert J Lifton, MD [who is still a medical doctor in the U S] about how medical doctors were used by Hitler to write the orders to gas to death the Jews .  And how the families were lied too and tricked by vague words as to what the "treatment" was [death was the result] ; and compare it to the present situation in  US where the federal government has totally taken over every facet of health care deliverey with thousands of pages of political rules about who gets care and who doesn't , and what level of "care" they get [death via with-holding of care which is called "passive euthanasia"  for some such handicapped, elderly which Obama defines as age 50 or older; and deliberate murder for some such as some in the womb via abortion paid for with taxpayer dollars] but limousine care for those in Congress .  

These are medical issues which every person should be aware of, and which every person should oppose in order to cultivate a climate conducive to human life.

I am not copyrighting this post so it may be quoted as long as sources including mine, are attributed. The art I created and posted to this blog and also my poem "Real women have babies" is copyrighted content however. Copyright notice: this blog and the art, photos, original poems and original words of mine [Gloria Poole, RN, artist of Missouri who was born in state of Georgia] are copyrighted and may not be transferred to anyone, anywhere, nor have domains forwarded to it that are not my domains, nor be saved to disk, nor be copied, nor photocopied, nor printed at remote. This blog and its content belongs exclusively to me Gloria Poole and I am a Registered Nurse licensed in Missouri and an artist in all mediums, and  a  white, Christian, woman, and mother of two grown daughters who are Jennifer and Leigh; and a republican, prolife blogger, photographer, citizen journo, and author, poet.  For the record I am also a single again [divorced twice] woman and I resumed my maiden name including my surname of Poole after both divorces. My 2 daughters [no sons] were born to me in my first marriage, and my second marriage lasted only 4 years, and final decree of divorce from male DBP was in Oct 2007 in Arapahoe County Colorado and is public record.

You may read more about me and see more of the art I create on these other blogs of mine
https://gloriapoole.blogspot.com
https://mini-exhibition.blogspot.com
https://artist-gloriapoole.blogspot.com
http://gloriapoole.wordpress.com
http://gloriapoole1749.wordpress.com
http;//gloriapoole.livejournal.com
http://gloriapoole-UK.livejournal.com
https://gloria0817.blogspot.com
https://gpoole817.blogspot.com
https://real-women-have-babies.blogspot.com
https://save-the-baby-humans.blogspot.com
https://tapestry-of-life-llp.blogspot.com
https://words-that-work-llp.blogspot.com
https://publishing-life.blogspot.com
https://news-for-life.blogspot.com
https://sites.google.com/site/ArtistIllustrations [human development sketches I drew in pencil]

You may follow me on twitter on any or all of these [if you are not trying to murder me]:
@gloriapoole; @ProlifeNurse; @gloria_poole; @Tartan_Bliss; @personhood1; @tweetie0817.

Gloria Poole, RN, artist / Gloria Poole / Gloria / gloriapoole / gloria-poole / gloria.poole / artist-gloriapoole / Ms Gloria Poole / Poole.Gloria / gloriapooleRN at yahoo, and other variations of my real, born with name of Gloria Poole, at my own private, not shared apt in Missouri, 23 June 2014 at 3:51pm

AMA recommends face-to-face physician-patient before telemedicine

I, Gloria Poole, RN, artist, am adding significant portions of the American Medical Associations' report and recommendations on telemedicine.  I am quoting it and since it had no copyright on it, I am believing it is as most health care policiies i.e. intended to be widely read and distributed so I am doing my part to educate the public on what telemedicine is and what the American Medical Association of medical doctors say it should be. I truly believe that no citizen of the U.S. should be ignorant on any subject concerning human life. This policy interestingly had code inserted into it that prohibited the two sections about face-to-face exams and or consultant with another medical doctor who knows the patient face-to-face , from copying. I had to hand-write those sections then re-type them in. If you read the info you will know automatically which baby-killing taxpayer-funded ngo opposes this policy.

From AMA telemedicine report at : http://mb.cision.com/Public/373/9600400/99c2f1db96d7fec3.pdf with title:
REPORT 7 OF THE COUNCIL ON MEDICAL SERVICE (A-14) Coverage of and Payment for Telemedicine (Reference Committee A)
Quote: "Since the release of the IOM report, the definition of telemedicine, as well as telehealth, has continued to evolve, and there is no consensus on the definition of either of the two terms. Today, there are three broad categories of telemedicine technologies: store-and-forward, remote monitoring, and (real-time) interactive services. Store-and-forward telemedicine involves the transmittal of medical data (such as medical images and bio signals) to a physician or medical specialist for assessment. It does not require the presence of both parties at the same time and has thus become popular with specialties such as dermatology, 34 radiology and pathology, which can be conducive to asynchronous telemedicine. " ..."
CMS Rep. 7-A-14 -- page 2 of 8
Remote monitoring, or self-monitoring or testing, enables medical professionals to monitor a patient remotely using various technological devices. This method is typically used to manage chronic diseases or specific conditions (e.g., heart disease, diabetes mellitus, or asthma), as devices that can be used by patients at home to capture such health indicators as blood pressure, glucose 5 levels, ECG and weight. 6 7 Interactive telemedicine services provide real-time, face-to-face interaction between patient and provider (e.g., online “portal” communications). Telemedicine, where the patient and provider are connected through real-time audio and video technology (generally a requirement for payment) has
been used as an alternative to the traditional method of care delivery, and in certain circumstances can be used to deliver such care as the diagnosis, consultation, treatment, education, care management and self-management of patients."...

"Arkansas ANGELS :
The Antenatal & Neonatal Guidelines, Education & Learning System (ANGELS) of the University of Arkansas for Medical Services (UAMS) provides patients with around-the-clock and telemedical support to address high-risk obstetrical care needs. With approximately thirty telemedicine sites, ANGELS delivers subspecialty care services to high-risk mothers and their infants. Notably, UAMS houses many of state’s only board-certified maternal-fetal medicine specialists and genetic counselors. ANGELS uses a variety of telemedicine technologies to deliver care, including specialized ultrasound equipment that digitally transfers a sonogram image to UAMS, as well as special devices to perform colposcopies via telemedicine to allow for remote cervical examination and biopsy. In 2012, there were 5,221 telemedicine visits as part of ANGELS, as well as 2,062"...

"CMS Rep. 7-A-14 -- page 5 of 8
telemedicine obstetric ultrasound visits and 130 fetal echocardiogram visits. Also in 2012, 1,629 2 colposcopy exams were provided, which identified 303 women with high-grade lesions requiring treatment and five diagnosed with cancer."...

"AMA policy states that physicians should uniformly be compensated for their professional services at a fair fee for established patients with whom the physician has had previous face-to-face professional contact, whether the current consultation service is rendered by telephone, fax, electronic mail or other forms of communication (Policy H-390.859). Policy H-390.859 also calls for CMS and other payers to separately recognize and adequately pay for non-face-to-face electronic visits. "...

Clinical standards
Policies H-480.974, H-480.968 and H-480.969 encourage national specialties to develop appropriate and comprehensive practice parameters, standards and guidelines to address the clinical and technological aspects of telemedicine. Policy H-480.968 urges national private accreditation organizations to require that medical care organizations that establish ongoing arrangements for medical care delivery from remote sites require practitioners at those sites to meet no less stringent credentialing standards and participate in quality review procedures that are at least equivalent to those at the site of care delivery."...

"CMS Rep. 7-A-14 -- page 6 of 8
1 Licensure 
Policy H-480.969 states that medical boards of states and territories should require a full and unrestricted license in that state for the practice of telemedicine, and outlines principles for any telemedicine license category. Policy D-480.999 opposes a single national federalized system of medical licensure. Policy H-160.937 outlines principles for the supervision of non-physician providers and technicians when telemedicine is used. "...

" Prior to delivering services via telemedicine, the Council believes a valid patient-physician relationship must be established, through at minimum a face-to-face examination, if a face-to-face encounter would otherwise be required in the provision of the same service not delivered via telemedicine. The face-to-face encounter could occur in person or virtually through real-time audio and video technology. Also, before a telemedicine service is provided, the physician or other health professional must notify the patient of cost-sharing responsibilities and limitations in drugs that can be prescribed via telemedicine. When a service is delivered using telemedicine, mechanisms to ensure continuity of care, follow-up care and referrals for emergency services must 36 be in place. "...

"The Council believes that key tenets in the delivery of in-person services hold true for the delivery of telemedicine services. Notably, physicians and other health practitioners delivering telemedicine services must abide by state licensure laws and requirements as well as state medical practice laws including, for example, laws concerning consent involving minors, prescribing, reproductive rights, end-of-life, and scope. In addition, prior to the delivery of any telemedicine service, physicians need to verify that their medical liability insurance policy covers telemedicine services, including telemedicine services provided across state lines if applicable. It is essential that patients have access to the licensure and board certification qualifications of the health care practitioners who are providing the care in advance of their visit. "...

To ensure quality of care, patient safety, and coordination of care in the provision of telemedicine services, the Council believes it is essential for national medical specialty societies to continue to develop appropriate and comprehensive practice parameters, standards and guidelines to address the clinical and technological aspects of telemedicine, as called for in Policies H-480.974,  H-480.968 and H-480.969. In addition, the Council notes that it is essential that specialty societies 10 leverage, to the extent practicable, the work of national telemedicine organizations, including the ATA, in the area of technical standards and take the lead in the development of clinical practice guidelines for telemedicine.
RECOMMENDATIONS
The Council on Medical Service recommends that the following be adopted and the remainder of the report be filed:
1. That American Medical Association (AMA) policy be that telemedicine services should be covered and paid for if they abide by the following principles:

a) A valid patient-physician relationship must be established before the provision of telemedicine services, through:
-a face to face examination if a face to face encounter would be otherwise required in the provision of the same service not delivered by telemedicine.
-a consultation with another physician who has an on-going patient-physician relationship with the patient. The physician who has established a valid physician-patient relationship must agree to supervise the care; or
-Meeting standards of establishing a patient-physician relationship included as part of evidence-based clinical practice guidelines on telemedicine developed by major medical specialty societies, such as those of radiology and pathology.
Exceptions to the foregoing include on-call, cross coverage situations; emergency medical treatment; and other exceptions that become recognized as meeting or improving the standard of care. If a medical home does not exist, telemedicine providers should facilitate the identification of medical homes and treating physicians where in-person services can be delivered in coordination with the telemedicine services.
b) Physicians and other health practitioners delivering telemedicine services must abide by state licensure laws and state medical practice laws and requirements in the state in which the patient receives services.
c) Physicians and other health practitioners delivering telemedicine services must be licensed in the state where the patient receives services, or be providing these services as otherwise authorized by that state’s medical board.
d) Patients seeking care delivered via telemedicine must have a choice of provider, as required for all medical services.
e) The delivery of telemedicine services must be consistent with state scope of practice laws.
f) Patients receiving telemedicine services must have access to the licensure and board certification qualifications of the health care practitioners who are providing the care in advance of their visit.

g)The standards and scope of telemedicine services should be consistent with related in- person services.
h)The delivery of telemedicine services must follow evidence-based practice guidelines, to the degree they are available, to ensure patient safety, quality of care and positive health outcomes.
i)The telemedicine service must be delivered in a transparent manner, to include but not be limited to, the identification of the patient and physician in advance of the delivery of the service, as well as patient cost-sharing responsibilities and any limitations in drugs that can be prescribed via telemedicine.
j)The patient’s medical history must be collected as part of the provision of any telemedicine service. The provision of telemedicine services must be properly documented and should include providing a visit summary to the patient.
k)The provision of telemedicine services must include care coordination with the patient’s medical home and/or existing treating physicians, which includes at a minimum identifying the patient’s existing medical home and treating physician(s) and providing to the latter a copy of the medical record.
m) Physicians, health professionals and entities that deliver telemedicine services must establish protocols for referrals for emergency services.
CMS Rep. 7-A-14 -- page 8 of 8
 2. That AMA policy be that delivery of telemedicine services must abide by laws addressing the privacy and security of patients’ medical information. (New HOD Policy)
3. That our AMA encourage additional research to develop a stronger evidence base for telemedicine. (New HOD Policy)
4. That our AMA support additional pilot programs in the Medicare program to enable coverage of telemedicine services, including, but not limited to store-and-forward telemedicine. (New HOD Policy)
5. That our AMA support demonstration projects under the auspices of the Center for Medicare and Medicaid Innovation to address how telemedicine can be integrated into new payment and delivery models. (New HOD Policy)
6. That our AMA encourage physicians to verify that their medical liability insurance policy covers telemedicine services, including telemedicine services provided across state lines if applicable, prior to the delivery of any telemedicine service. (New HOD Policy)
7. That our AMA encourage national medical specialty societies to leverage and potentially collaborate in the work of national telemedicine organizations, such as the American Telemedicine Association, in the area of telemedicine technical standards, to the extent practicable, and to take the lead in the development of telemedicine clinical practice guidelines. (New HOD Policy)
8. That our AMA reaffirm Policies H-480.974, H-480.968 and H-480.969, which encourage national medical specialty societies to develop appropriate and comprehensive practice parameters, standards and guidelines to address the clinical and technological aspects of telemedicine. (Reaffirm HOD Policy). "

This was not copyrighted by AMA, so therefore I am also not copyrighting it. It was sent to my inbox [another account that it known to be mine for long time] ; but I am adding in who I am, where I am, and the date and time for purposes of documenting this.
Also, I put the standards of care of admission for any real ambulatory surgery or major surgery in a hospital setting on another blog of mine at:
http://gloriapoole.livejournal.com. Compare that to how abortuaries routinely treat their patients like cattle going to slaughter on a conveyer belt; with no information, no true informed consent, and no standards of care for surgery, either as pre-op or post-op.

Gloria Poole, RN licensed in Missouri; artist in all mediums, at my own private apt in Missouril 12 June 2014 at 6:47pm. I am also known as merely Gloria on art I create and as gloriapoole on web and other variations of my real, legal, born with name of Gloria Poole including gloria-poole; gloria.poole; gloria0817 ; artist-gloriapoole ; gpoole817; @gloriapoole;gloriapoole.RN. 

How Genetic Modification is done by Gloria Poole, RN, artist of Missouri

Genetic modification and manipulation of cells 

written by Gloria Poole, RN, artist of Missouri and Georgia. 

I am quoting a medical textbook and will include info about it but here's the quotes: " DNA has become the easier [ to analyze]. It is now possible  o excise [cut out] specific regions of DNA to obtain them in virtually unlimited quantities, and to determine the sequence of their nucleotides at a rate of hundreds of nucleotides  a day. By variations of the same techniques, an isolated gene can be altered [engineered] at will and transferred back into cells in culture  or [with rather more difficulty ] into the germ line of animals where the modified gene becomes incorporated [ becomes a part of] as a permanent functional part of the genome. " page 181. And continuing further down the same page, this quote: " ..recombinant DNA technology has generated new experimental approaches that have revolutionized cell biology. " And skip to page 194 same textbook, for this quote: " although it is often not difficult to obtain mutants that are deficient in a particular process, such a DNA replication or eye development, it can take many years to trace the deficit to a particular altered protein. Recently, recombinant DNA technology has made possible  a different genetic approach in which one starts with a protein and creates a mutant cell or organism in which that protein [or its expression} is abnormal. Because the new approach reverses  the traditional gene-to-protein direction of genetic analysis, it is commonly referred to as reverse genetics.  Reverse genetics begins with a protein with interesting properties that has been isolated from a cell. By methods described [in a following chapter] the gene encoding the protein is cloned and its nucleotide sequence is determined. This sequence is then altered by biochemical  means, to create a mutant gene that codes for an altered version of the protein. The mutant gene is transferred into a cell, where it can integrate into a chromosome  by genetic recombination to become part of the cells' genome. If the gene is expressed, the cell and all of its descendants will now synthesize the an altered protein. if the original cell used for gene transfer is a fertilized egg, whole multi-cellular organisms can be obtained that contain the mutant gene, and some of these transgenic organisms will pass the [mutant] gene on to their progeny [offspring] as a permanent part of their germ line. Such genetic transformations are now routinely performed on such organisms as complex as fruit flies and mammals. And note that biotech is also doing these experiments on humans with cells obtained from aborted babies and their ovaries and gonads.]  Technically, even humans could now be transformed in this way..." 

I read some of the chapter explaining how the manipulation of the cells is done. It is very complex and difficult reading because it is geared to the education of medical doctors [but I, Gloria Poole, RN own this textbook that I got for medical education for my purposes.] I am only going to summarize a few key points in the how they do it section because I am writing this so lay people without any medical training or skills could understand it.  From pages 207-209 same textbook: The "scientists"  hydrolyze [tear apart} the amino acids [proteins] and then they manipulate  them using enzymes called aminoacyl-tRNA syntheses but there is a different enzyme for all 20 amino acids. They add "two methyl groups to G: n, N-dimethyl G; two hydrogens  to U: dihydro U; isopentenyl to A: N to the 6th power and [chemical sign of a triangle [not able to make on this keyboard] to the 2nd power isopentenyl] A; and sulphur to replace the oxygen in U : 4-thiouridine.  Then the amino acids recombine with a different tRNA molecule and is modified. The scientists can cause the cells to degenerate  by transforming it to more than one tRNA  or that a single tRNA can pair with more than one codon [ a triplet of three nucleotides in the mRNA molecule. I do not remember chemistry well enough to understand it all myself. The medical textbook I quoted is : Molecular Biology of The Cell' second edition"  written by Bruce Alperts, Dennis Bray, Julian Lewis, Martin Raff, Keith Roberts and James D Watson who are all PhD's except for one who is Martin Raff educated at McGill University who is a M.D.  it was published by Garland Publishing, Inc of New York and London.

I am writing this because I am OPPOSED to the manipulation of human cells for any reason. And I am OPPOSED to the manipulation / genetic modification of foods, seeds, animals also. 

I am not copyrighting this particular post because it contains quoted material from a medical textbook. But most of what I personally write is copyrighted content. See the about me page here: http://gloriapoole-rn-artist.blogspot.com/p/about-gloria-oole-rn-artist-of-missouri.html 
for more information. Also see my copyright notice on my official blog of Tapestry of LIFE at https://tapestry-of-life-llp.blogspot.com and on my name blog https://gloriapoole.blogspot.com.

Gloria Poole, RN, artist / Gloria Poole / Gloria / gloriapoole / gloria-poole / gloria.poole / artist-gloriapoole / gloriapoole_RN / gloriapoole.RN / at my own apt in Missouri 20 May 2014 at 10:27am. 

Study of words by Gloria Poole-RN- artist of Missouri and Georgia

This post is about the importance of words. There are many people who think that they can say anything and that it doesn't matter how much they deceive, lie, trick, scam others. But it matters. I looked up the truth from the Holy Bible and these are only some of the scriptures about words. And yes, of course, this pertains to the prolife cause and to the battle by Christians against the attempts by evil groups to turn the U S away from GOD.  In the prolife battle, the main instrument the wicked killers of the preborn use, is lies, lies and more lies to fool foolish women who don't know the scriptures.

 If you read each one of these, you will be transformed about your duty to control your words to not speak evil.

It is written, " Neither have I gone back from the commandment of His lips; I have esteemed the words of His [GOD's] mouth more than my necessary food." Job 23:12

"All the while my breath is in me, and The Spirit of GOD is in my nostrils, my lips shall not speak wickedness, nor my tongue utter deceit." Job 27:18

"Blessed is the man who walketh not in the counsel [advice, legal advice] of the ungodly, nor standeth in the seat of sinners, nor sitteth in the seat of the scornful.  But his delight is in the law of THE LORD; and in His law, doth he meditate day and night." Psalms 1:1-2

"The words of THE LORD are pure words, as silver tried in a furnace purified seven times. " Psalm 12: 6


"How sweet are thy words unto my taste! yea, sweeter than honey to my mouth. "Psalms 119:103

"Thy word is a lamp unto my feet and a light unto my path. " Psalms 119:105

"A wise man will hear and will increase learning; and a man of understanding shall attain unto wise counsels; to understand a proverb and the interpretation; the words of the wise and their dark sayings. The fear of THE LORD is the beginning of knowledge; but fools despise wisdom and instruction. " Proverbs 1: 5-7

"The words of the wicked are to lie in wait for blood; but the mouth of the upright shall deliver them. The wicked are overthrown and are not; but the house of the righteous shall stand. " Proverbs 12: 6-7

"The thoughts of the wicked are an abomination to THE LORD; but the words of the pure are pleasant words.". Proverbs 15: 26

"Pleasant words are as an honeycomb, sweet to the soul, and health to the bones. " Proverbs 16: 24

"That I might make thee know the certainty of the words of truth, that thou mightiest answer the words of truth to them that send unto thee." Proverbs 22:23

"The words of the wise are as goads, and as nails fastened by the masters of assemblies  which are given from one shepherd.  And further , by these..be admonished; of making many books there is no end; and of much study is a weariness of the flesh.  Let us hear the conclusion of the whole matter: fear GOD, and keep HIS commandments [words] ; for this is the whole duty of man. For GOD shall bring every work into judgement, with every secret thing, whether it be good or whether it be evil. "Eccelesiates 12:11-14

"The instruments also of the churl [defined as " a low-bred countryman; a surly person, a miser] are evil; he deviseth wicked devices to destroy the poor with lying words, even when the needy speaketh right. " Isaiah 32: 7

"Then THE LORD put forth HIS hand and touched my mouth, and THE LORD said unto me, "behold, I have put My words in thy mouth." Jeremiah 1:9

"Then THE LORD said unto me, " proclaim all these words in the cities of Judah, and in the streets of Jerusalem, saying, 'hear ye the words of this covenant, and do them'. " Jeremiah 11: 6

"The word which came to Jeremiah from THE LORD, saying, 'arise, and go down to the potter's house and there I will cause thee to hear My words. " Jeremiah 18:1-2

"And thou shalt say unto them, 'Thus saith THE LORD: if ye will not hearken to Me, to walk in My law, which I have set before you, to hearken to the words of My servants the  prophets whom I sent unto you, both rising up early and sending them, but ye have not hearkened, then will I make this house like Shi-loh, and will make this city a curse to all the nations of the earth. " Jeremiah 26: 4-6

JESUS said, "For by thy words thou shalt be justified and by thy words thou shalt be condemned. ". Matthew 12:37

JESUS said, "heaven and earth shall pass away but My words shall not pass away." Mark 13:31

All scripture from The King James Holy Bible.

Posted by me Gloria Poole, RN, artist of Missouri and Georgia; from my own private apt in Missouri, 9-May-2014 at 12:09pm.