Sunday, June 17, 2012

Health Care Unions In California Split Over Nurse-To-Patient Ratios

One labor union?s position on nurse-to-patient ratios in California hospitals has outraged other unions that represent registered nurses in the state.

In California, hospitals are required by law to maintain certain nurse-to-patient ratios at all times -- a hard-won legal stipulation that went into effect in 2004 and has wide support among nurses as well as patient advocates in the state.

Although labor groups also strongly back the ratio law, the Service Employees International Union-United Healthcare Workers West (SEIU-UHW), which represents hospital workers of all kinds, signaled this week that in the face of state budget cuts to hospitals it might be willing to partially sacrifice mandated ratios.

During a call with other labor leaders on Thursday, SEIU-UHW President Dave Regan suggested that the California Labor Federation, an alliance of the state?s unions, should not stand in the way of any new legislation that would temporarily suspend ratios while nurses are on meals and breaks, according to RoseAnn DeMoro, executive director of National Nurses United, who was on the call.

DeMoro said that eliminating the ratios during breaks would undermine or even gut the ratio law entirely, since breaks in large hospitals occur all the time. Calling the ratio law a "holy grail" for nurses, she said that she considered the recommendation an affront to her own union. The union leaders on the call voted overwhelmingly against the recommendation, she said.

"This is just historically unprecedented," DeMoro said. "These are bedrock labor issues -- workplace safety, public safety ... This is a fundamental issue to these nurses. He was attempting to undo a fundamental reform."

Steve Trossman, a spokesman for SEIU-UHW, said that the union supports ratios and believes they should remain in place, and that Regan expressed his support for nurses ratios on the call. He said the union voted that the federation stand "neutral" on ratios during breaks only because of California?s budget situation. A large portion of the union?s members are in lower wage hospital jobs, and Trossman said many of them, such as maintenance and food-service workers, could end up losing their positions.

"The reality is that front-line hospital workers are going to bear the brunt of [cuts] -- we think there will be hundreds if not thousands of layoffs," he said. "When you?re in a budget situation like this, everything is worth taking a look at. That?s what we did."

The president of the National Union of Healthcare Workers (NUHW), which is not part of the state labor federation, said he was also angered by the suggestion that unions not fully support the ratios during breaks.

"It?s outrageous,? said Sal Rosselli, whose union was formed after a split from SEIU-UHW. "In the private-sector hospital industry, profits are unprecedented. Suspending these ratios that we all fought for for years ... the industry has been trying to do this."

Trossman said the significance of the SEIU-UHW?s vote on the matter has been blown out of proportion. ?It was quickly rejected," he noted. ?We move on." And despite the drama surrounding the call, there is no imminent danger of nurses losing their ratios during breaks or otherwise, as no such legislation has been introduced.

Yet DeMoro, who said her union has been "inundated" with emails from nurses due to Thursday?s call, doesn?t seem likely to forget the incident. She said that rather than show solidarity among labor groups, the vote "pit nurses against low-wage workers."

"It might signal some of the trouble that the labor movement is in," she said.

CORRECTION: A previous version of this story incorrectly listed RoseAnn Demoro's first name as Roseanne.

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Ron Paul backers seek influence at GOP convention (Star Tribune)

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Suicide bomber hits Somali military camp: official

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Friday, June 15, 2012

More evacuated as wildfires spread in New Mexico, Colorado

Ed Andrieski / AP

Firefighters watch as flames leap hundreds of feet in the air as the High Park wildfire fire explodes on the south side of Poudre Canyon west of Fort Collins, Colo., on Thursday. The wildfire started Saturday and has burned over 50,000 acres.

By msnbc.com news services

Wildfires continued to spread in New Mexico and Colorado as a new evacuation order was issued for approximately 80 homes in northern Colorado, NBC affiliate 9News.com reported.

Meanwhile, Reuters reported that some of the 2,500 people forced to evacuate their central New Mexico houses by wildfires raging near the resort village of Ruidoso began returning home on Thursday with the help of National Guard troops, officials said.

Evacuees from five communities have started heading home, but residents of four other neighborhoods around Ruidoso and the Lincoln National Forest, including those who lived in 230 burned homes, have yet to be allowed.


"There are still hot spots and active fire burning," said fire information officer Jimmye Turner. "We won't let people in until those areas are safe."

The Little Bear Fire, sparked by lightning on June 4, has consumed 37,912 acres of the Lincoln National Forest.

Firefighters say the fire may continue burning into the fall, feeding on hundreds of acres of trees killed by pine beetles. NBC's Miguel Almaguer reports.

Read the story at 9news.com

More than 1,300 firefighters and others have be working to cope with the disaster, including 400 National Guardsmen ordered to protect property and assist evacuations and returns.

Firefighters have been able to contain 40 percent of the blaze, helped by low winds and higher humidity. However, higher winds and temperatures on Thursday were igniting previously unburned islands within containment lines, Turner said.

In southeastern New Mexico, firefighters continued to battle what is known as the Whitewater-Baldy Complex fire, the largest in the state's history. The 289,478-acre fire is now 56 percent contained, officials said.

However, in neighboring Colorado, a blaze known as the High Park Fire, which has scorched 52,000 acres of timber and dried brush, is only 15-20 percent under control, despite the efforts of 1,200 firefighters, fire managers said.

The Colorado fire has destroyed more than 100 structures - including more than 30 homes - in the rugged mountain canyons 15 miles west of Fort Collins. It is blamed for one death.

Hundreds of people remain under evacuation orders, but some residents on the south side of the fire have been allowed home.

The western edge of the fire has moved into the Roosevelt National Forest, where there are fewer homes and denser concentrations of trees. The fire made a run into the stands of dead trees on Wednesday, sending a mushroom cloud of smoke some 30,000 feet into the air that was visible for hundreds of miles.

Officials have warned residents of a 1,000-home subdivision at the mouth of Poudre Canyon to "move out quickly" should flames jump the Poudre River and move into the canyon.?

Reuters contributed to this report.

More content from msnbc.com and NBC News:

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You may carry cells from siblings, aunts and uncles

YOUR siblings may be closer to you than you thought. Male cells have been found in the umbilical cord blood of baby girls with older brothers, suggesting that the transfer of cells between mother and baby may be more extensive than previously imagined. Indeed, all of us may be walking chimeras.

Previous studies have shown that cells from both mother and fetus can cross the placenta during pregnancy, and survive for decades in the skin, liver, brain and spleen - a phenomenon called fetal microchimerism. There is even evidence that fetal cells may repair damage to the mother's heart during pregnancy.

Other studies have hinted that fetal cells might contribute to autoimmune disease, prompting speculation that fetal cells disperse more widely, possibly passing between siblings and even across generations.

To investigate this, Miranda Dierselhuis of Leiden University Medical Center in the Netherlands and her colleagues analysed umbilical cord blood from 23 newborn girls, 17 of whom had older brothers. In a subset of the samples, they looked for immune cells directed against the male Y chromosome.

Of the 12 girls in the subset with elder brothers, 11 had cord blood containing immune cells against the Y chromosome, suggesting that male cells had somehow crossed the placenta from the mother - presumably entering her body from a male fetus during an earlier pregnancy. In some of the girls, DNA testing revealed direct evidence of male cells in the cord blood (Blood, DOI: 10.1182/blood-2012-02-410571).

"We may be more microchimeric than we imagined," says Dierselhuis, although she cautions that they haven't yet confirmed the source of the male cells.

Curiously, small numbers of male cells were also detected in one of the girls with no older brother, raising the possibility that these cells were from her uncle, passing to her mother during her grandmother's pregnancy. Another possibility is that they originated from an earlier miscarriage of which the mother was unaware.

"It shows just how ubiquitous the exchange of these cells is," says Hilary Gammill of the Fred Hutchinson Cancer Research Center in Seattle. "We used to think of the placenta as a complete barrier."

Last year, Gammill detected cells in the blood of pregnant women that came from their mothers - the grandmother of their fetus. The number of the cells increased as the pregnancies progressed (PLoS One, DOI: 10.1371/journal.pone.0024101).

"We think the mother's cells shape the ability of the developing immune system to learn tolerance," Gammill says. "We wonder if the grandmother's cells are continuing that education process in some way."

The discovery of even wider transfer of cells between siblings and across generations raises the possibility that these cells may influence the course of health or disease in all of us. Several diseases including asthma, type 1 diabetes and certain cancers are less common in younger siblings. "Even in small numbers, some of these cells have stem-like properties, so I think they could influence health," says Gammill.

Meanwhile, an autoimmune disease called scleroderma - which causes hardening of the skin and blood vessels - has also been linked to the presence of fetal cells in the blood, and seems to be more common in younger siblings. "The further you are down the line in birth order, the greater the risk," says Maureen Mayes at the University of Texas in Houston, who has studied the phenomenon (Arthritis Care and Research, DOI: 10.1002/acr.20096). "Multi-fetal microchimerism is one possible explanation," she says.

And Christoph Bucher of the University of Minnesota in Minneapolis reported in 2007 that stem-cell transplants from cord blood between siblings for various types of blood disease appeared to be more successful if the cells came from younger siblings. This hints that a level of tolerance had already developed between donor's and receiver's cells (Blood, DOI: 10.1182/blood-2007-02-076257). Previously it was assumed that cord blood was immunologically naive, but Dierselhuis's study may help to explain this phenomenon.

However, Bucher is cautious about whether the new study will have any immediate clinical impact. "It's a fascinating idea but it's not something that could be exploited clinically at this stage," he says. "More detailed studies are needed to show conclusively that sibling A is in the cord blood of sibling B."

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