The state Office of Regulatory Reinvention last month recommended deregulation of 18 occupations and the elimination of nine occupational boards in an effort to streamline government processes related to regulating occupations, increase competition in the professions, and encourage business growth and job creation.

"The Advisory Rules Committee was very serious in its considerations about whether certain occupational licensing regulation provides consumer protection," said committee member Rose Baran, assistant professor of pharmacy practice at Ferris State University in a press release. "We found a number of occupational regulations that simply did not provide enough benefit to justify devoting taxpayer dollars for administration of these programs."

But the loss of regulation, respiratory therapists in the state contend, would have a "devastating impact on practitioners and patients alike."

"To see the problems inherent in granting unlicensed personnel the authority to act as ‘respiratory providers,' one needs only look to Florida, where the most recent attempt to de-professionalize respiratory care providers resulted in situations as troublesome as ventilators being shut off by untrained personnel in order to quiet alarm conditions," Mike Hess, RRT, from Kalamazoo, Mich., wrote to ADVANCE. "Physicians could lose the benefit of consulting with pulmonary specialists, and nursing workloads would most likely increase in an area that is well outside the expertise of these already-overworked fellow providers."

Hess has started a Facebook group "Protect Michigan Respiratory Therapy Licenses!" and is asking respiratory therapists to sign a petition opposing deregulation of the profession. More than 1,000 signatures have been collected.

The state's respiratory care society also has sent a four-page letter to the governor outlining why state regulation is critical to public safety. They are asking RTs to send emails emphasizing licensure's importance in preventing risk or harm to customers, the specialized skills and training that RTs have, their autonomy, and the lack of alternatives to state regulation, among other reasons.

Other health care occupations recommended for deregulation are dieticians, nutritionists and speech language pathologists. Other occupations are acupuncturist, auctioneer, community planner, consumer finance services, forensic polygraph examiner, forester, immigration clerical assistant, insurance solicitor, interior designer, landscape architect, ocularist, professional employer organizations, proprietary school solicitor, security alarm contractor and vehicle protection product warrantor.

The other occupational boards recommended for elimination are the Osteopathic Medicine Advisory Board, the Ski Area Safety Board, and the boards of acupuncture, auctioneers, carnivals and amusement rides, dietetics and nutrition, occupational therapy and speech language pathology.

Editor's note:  Richard Krishner, editor of our sister magazine, ADVANCE for Nurses, wrote this blog after hearing about the "Cinnamon Challenge" from the American Association of Poison Control Centers. With the number of calls regarding intentional cinnamon misuse skyrocketing from 51 in 2011 to 139 so far in 2012 and the potential lung complications of swallowing a spoonful of cinnamon, we thought it important to share with you.

My two sons are 14 and 12. Wow, do they have different priorities and pastimes than I did at their age. I thought it was cool to have a telephone in my bedroom; they have mobile phones but use the "phone" function only if taking a call from their mom or me. I watched a lot of TV at their age; the Internet delivers their entertainment of choice.

Our family computer is in the den, and I marvel how long they can endlessly view random videos on YouTube or browse status updates on Facebook.

So when I heard about the "cinnamon challenge," I had to check with them. Sure, they heard of it a year ago. Where have I been?

According to the American Association of Poison Control Centers and a multitude of videos posted online, the challenge involves taking a dare to swallow a spoonful of powdered or ground cinnamon. "This results in the cinnamon coating and drying the mouth and throat, causing gagging, vomiting, coughing, choking and throat irritation," the association states. And hilarity for some, based on online comments.

One of the videos I found boasted more than 6.5 million views. Others had merely dozens. The activity seems to cut a wide swath across various youthful demographic groups. Many of the videos feature kids recording themselves, while others have friends and even their mom operating the camera.

I always ironically proclaim it a badge of honor to have been raised on '70s and '80s trash culture, but this stuff makes reruns of "The Love Boat," "Beverly Hillbillies" and "Star Trek" look like the classics.

But it's not just frivolous fun, say poison control centers officials.

"Although cinnamon is a common flavoring, swallowing a spoonful may result in unpleasant effects that can pose a health risk," said Alvin C. Bronstein, MD, FACEP, managing and medical director for the Rocky Mountain Poison and Drug Center. "The concern with the cinnamon challenge is that the cinnamon quickly dries out the mouth, making swallowing difficult. As a result, teens who engage in this activity often choke and vomit, injuring their mouths, throats and lungs. Teens who unintentionally breathe the cinnamon into their lungs also risk getting pneumonia as a result."

One of my kids related this scenario: Someone posts a status update on Facebook stating he'll take the cinnamon challenge if the status receives a certain number of "likes." Then it's off to gag on a spice.

He says the phenomenon has really taken off this year, and the numbers bear out his observation. Poison centers received 51 calls about teen exposure to cinnamon in all of 2011. But in the first 3 months of 2012, poison centers received 139 calls, with 122 classified as intentional misuse and 30 requiring medical evaluation.

Those figures don't amount to a public health emergency, but should be of some concern to parents. There are a lot of bored kids looking for attention via Internet stunts. The same judgment that leads to gulping cinnamon on a dare could lead to worse decisions and bigger problems in the future.

But it's a different game now. According to a New York Daily News report: "The surprising discovery of genetic fragments of a flu virus is the first well-documented report of it in the winged mammals. So far, scientists haven't been able to grow it, and it's not clear if - or how well - it spreads."

A CDC study underlying the discovery was published online Feb. 27 in Proceedings of the National Academy of Science.

"This is the first time an influenza virus has been identified in bats, but in its current form the virus is not a human health issue," study lead author Dr. Suxiang Tong, team leader of the Pathogen Discovery Program in the CDC's viral diseases division, said in a CDC news release. "The study is important because the research has identified a new animal species that may act as a source of flu viruses." In addition, the CDC study suggests that initial research reveals that the bat flu genes are compatible with human flu viruses.

However, study co-author Dr. Ruben Donis, chief of the Molecular Virology and Vaccines Branch in the CDC's influenza division, explains in the news release, "Fortunately, initial laboratory testing suggests the new virus would need to undergo significant changes to become capable of infecting and spreading easily among humans. A different animal -- such as a pig, horse or dog -- would need to be capable of being infected with both this new bat influenza virus and human influenza viruses for reassortment to occur."

Flu Trivia:
A new strain of influenza A virus has been discovered in bats. What does this mean to humans? Read about it here. And just for some flu fun (yes, I actually said that), can you name the top ten animals that carry flu?

They are:

1. Chicken

2. Pigs

3. Ducks

4. Geese

5. Turkeys

6. Horses

7. Dogs

8. Cats

9. Seals

10. Whales

Researchers surveyed close to 17,000 people about their daily consumption of Coke, lemonade, flavored mineral water, Powerade, and Gatorade, and all other types of soda. People who drank more than two cups a day were at higher risk of airway disease: 13.3 percent had asthma and 15.6 percent had COPD.

Researchers noted that cola drinkers are more likely to be obese and theorized that these pop-devotees might make other poor food choices that exacerbate the problem.

Read more about the study here.

And tell us: will you start counseling your patients about their soda consumption?

"If school isn't your thing, but you would love a big salary, consider a job that requires only a two-year degree. By training for a specialized healthcare, technology or trades job or heading for the police academy, you can be out of school and quickly working at a high-paying job...."

Respiratory therapists, Monster.com says,

 "may need only a two-year degree, but you'll have to take tough courses, like chemistry and anatomy to graduate with an associate's degree in respiratory therapy. Most respiratory therapists work in hospitals, which means evening or weekend shift work, testing and treating patients with breathing issues."

Do you think it's a fair write-up of the profession? Or does it call too much attention to the salary earned and not enough to the work put in?

Check out the full write up here. (By the way, nurses make the list too.)

Want to help us get a true read of the salaries earned by RTs? Complete our 2012 survey of respiratory therapists' and sleep professionals' salaries. We'll report back the results later this year.

Saverio (Sam) Giordano, executive director of the Association for Respiratory Care (AARC), will retire from his leadership position in June of this year, according to a news release from AARC.

"The AARC's executive committee ... has been working with Mr. Giordano since February of 2010 to prepare the association for its first change in the executive director position in over 30 years of inspiring and visionary leadership." AARC also noted that more detailed announcements and information will be provided later this month on search criteria for a new executive director and timelines for filling the position.

This may be a good time to weigh in with opinions. What direction would you like a new AARC leadership to reflect?

Get into the holiday spirit. It's time to sing!

On the first day of practice my true love gave to me, a VAP bundle under the tree.

On the second day of practice my true love gave to me two CEUs, and a VAP bundle under the tree.

On the third day of practice my true love gave to me three days off, two CEUs, and a VAP bundle under the tree.

On the fourth day of practice my true love gave to me four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the fifth day of practice my true love gave to me five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the sixth day of practice my true love gave to me six RTs venting, five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the seventh day of practice my true love gave to me seven techs a-testing, six RTs venting, five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the eighth day of practice my true love gave to me eight patients smiling, seven techs a-testing, six RTs venting, five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the ninth day of practice my true love gave to me nine docs prescribing, eight patients smiling, seven techs a-testing, six RTs venting, five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the tenth day of practice my true love gave to me ten dose inhalers, nine docs prescribing, eight patients smiling, seven techs a-testing, six RTs venting, five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the eleventh day of practice my true love gave to me eleven PAP titrations, ten dose inhalers, nine docs prescribing, eight patients smiling, seven techs a-testing, six RTs venting, five steth-o-scopes... four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

On the twelfth day of practice my true love gave to me twelve healthy outcomes, eleven PAP titrations, ten dose inhalers, nine docs prescribing, eight patients smiling, seven techs a-testing, six RTs venting, five steth-o-scopes...  four brand new scrubs, three days off, two CEUs, and a VAP bundle under the tree.

Respiratory care needs another rung on the career ladder, and there is no better time than now for respiratory care practitioners to start the climb, according Deniese S. LeBlanc, RRT, director of respiratory care at Stony Brook University Medical Center, N.Y.

LeBlanc gave a late afternoon lecture Monday at the AARC Congress 2011 in Tampa titled "An Advanced RCP With Prescriptive Rights ... The Journey Begins" that received an overwhelmingly enthusiastic response from attendees.

Few opportunities currently exist for vertical advancement in respiratory care, LeBlanc said, and the field is "losing its best and brightest to other disciplines." When talented RTs look five years down the road and can't see a clinical path to professional growth, they often detour toward other careers as nurse practitioners and physician assistants, or they leave direct patient care altogether for the sales and marketing arena.

But what if a new direction -  in fact a new profession - was available for RTs who want to elevate their skills and become a physician extender specifically trained in cardiopulmonary science?

In the hospital, let's say, this new physician extender position could allow RTs to optimize ventilation protocols, deliver conscious sedation with bronchoscopy, and perform central line insertions. In the outpatient setting, they could educate asthma and COPD patients, be authorized to write prescriptions and order pulmonary function tests, and perform necessary follow-ups. LeBlanc offered a long list of other responsibilities that could fall under an advanced RCP's scope of practice based on their extra education and experience.

The respiratory care program at Stony Brook University has taken the first steps toward creating this new profession. A rigorous master's of science degree curriculum with an emphasis on advanced clinical practice is in development. And plans are under way to present the concept of an advanced RCP with prescriptive rights for respiratory services to the New York State Department of Education's licensure board.

LeBlanc conducted a survey of 2,500 RTs in New York showed that out of 355 responders, 71 percent feel there are limited advancement opportunities in the respiratory care profession, and 56 percent expressed interest in attending an advanced clinical practice master's program.

She also identified other stakeholders within her hospital's community and gauged possible resistance from colleagues such as NPs and PAs. "The feeling out there is that we're all so busy, and so much work needs to be done in health care," LeBlanc said. "We can offer a niche market that doesn't step on others' toes ... There is room for all of us, and the time to move is now."

LeBlanc encouraged the audience to go back to their own programs and institutions and explore the feasibility of creating a new professional role of an advanced respiratory care practitioner with prescriptive rights.

The eagerness in the room was palpable. "This is the most exciting thing since NIV," said one audience member, who was followed by others who called it a, "brilliant idea," and "absolutely wonderful initiative."

For Grace Anne Dorney Koppel, the world changed on Sept. 25, 2001. That's the day her doctor advised her to make end-of-life preparations after diagnosing her with stage 4, very severe chronic obstructive pulmonary disease. 

The diagnosis was a complete shock. "In August 2001, I thought I was in very good health based on the results of my very incomplete physical," said Dorney Koppel, wife of famed newscaster Ted Koppel. Like many Americans, her annual physical exam did not include spirometry screening.

Today in the keynote address at the AARC's 57^th International Respiratory Convention and Exhibition in Tampa, Fl, she urged respiratory therapists to build evidence to support early COPD screenings. Because patients are not routinely screened for COPD until they start exhibiting the symptoms of cough, wheezing, and breathlessness, "too many of Americans are unaware of COPD," said Dorney Koppel. While spirometry is inexpensive and easy to perform, many clinicians are unaware of the disease's reversibility and treatment options. Research is needed to quantify and better explain it.

Studies also are needed to identify the underlying genetic components that lead 20 percent of smokers to develop COPD, while 80 percent remain disease-free. Finding that phenotype could unlock new treatments and new ways of measuring the disease progress and reversibility.

"From this impatient patient's perspective-and yes, my pulmonologist has called me that-we are not yet meeting the needs of the 12 million people who have COPD and the 12 million who have COPD and don't know it," said Dorney Koppel.

But respiratory therapists on the front lines of care can make more of a difference than any other medical professional out there, she said. "(You can) dispense courage to those who have lung disease that it is not yet curable, but is treatable."

Should tobacco in the ballpark count as a strike? "Smokeless tobacco" of the chewing variety is at the heart of a vile practice, giving way to the all-too-common distended cheeks, spit-spewing mouth, and discolored teeth found in many a major leaguer.

But more importantly, it's a health issue. "Not only is smokeless tobacco use hazardous, but young people who use smokeless tobacco are more likely to also start smoking cigarettes," said Douglas Luke, PhD, director of the Center for Tobacco Policy Research at the Brown School at Washington University in St. Louis, Mo., via a new release. 

"Baseball players continue to be huge role models, especially for kids and adolescents. Young people are very aware of and influenced by the tobacco use of their role models ... The World Series is one of the most viewed public venues in the world," he said, noting that minor-league baseball has had a ban on all forms of tobacco use since the mid-'90s.

 It is time for the major league to follow suit? Or must we wait until the habit dies -- literally?

Think of this next time you pick up your feather duster: Researchers at Ohio State University recently isolated 63 unique dust particles from their own lab. Forty of the particles (63 percent) contained organic material. The most common mineral was quartz, which was present in 34 (54 percent) of the particles, followed by carbonates (17 particles, or 27 percent), and gypsum (14 particles, or 22 percent).

The discovery of the diversity of particles was a matter of serendipity. The chemists were testing a new kind of sensor when the dust got stuck inside. Lo and behold, the scientists discovered they could measure the composition of a single particle. In a recent issue of The Journal of Physical Chemistry C, they describe how the discovery could aid the study of respiratory diseases caused by airborne particles.

 "A single dust particle is like a snapshot of mankind's impact on the environment," explained James Coe, professor of chemistry at Ohio State University.

Nowhere is dust composition more important than in public health, where some airborne particulates have been linked to diseases. Coe cited silica dust from mining operations, which causes a lung disease called silicosis.

The patented sensor that Coe's team was testing - a type of metal mesh that transmits infrared light through materials caught in the holes - is ideal for picking up minute details in the composition of single dust grains.

According to a related news release from Newswise, scientists have had some difficulty getting precise measurements of dust composition in the past, in part because standard techniques involve studying dust in bulk quantities rather than individual particles.

A call for action is out!  President of the American Lung Association Charles D. Connor  issued a letter asking for support for clean air. He said, "We were outraged by President Obama’s September 2nd announcement that he would not update smog standard to protect public health. We are pushing back and we hope we can count on you to lend you voice to the chorus of citizens demanding cleaner air."  

The  association's website asks that you call your representative and two senators in Washington  and ask them to oppose legislation that would block the Clean Air Act and new Environmental Protection Agency (EPA) standards that reduce toxic air pollution and smog- and soot-forming pollution that blows across state lines.

How to call your representatives in Washington
Find the names and phone numbers of your elected officials in Washington by visiting http://action.lungusa.org/findyourmembers and typing in your zip code.

Talking points for making your calls:
My name is [INSERT NAME] and I'm calling from [INSERT NAME OF TOWN].

• FOR HOUSE OF REPRESENTATIVES: I'm calling to urge [Representative [NAME]] to support clean air and vote NO on HR 2401 the TRAIN Act that will block the cleanup of mercury and other toxic air pollutants from power plants and will impede the rules to cleanup soot- and smog-forming pollution that blows across state lines.
• FOR SENATE:  I'm calling to urge [Senator {NAME]] to support the Clean Air Act and oppose any legislation that will block the cleanup of mercury and other toxic air pollutants from power plants and will impede the rules to cleanup soot- and smog-forming pollution that blows across state lines 
• FOR BOTH THE HOUSE AND SENATE: The power plant cleanup standards will prevent more than 25,000 premature deaths, more than 120,000 asthma attacks and 11,000 heart attacks each year.
• Congress required the cleanup of toxic mercury in the 1990 Clean Air Act.  Twenty-one years is too long to wait to protect infants and children from this potent neurotoxin that damages children's ability to think and learn.
• [Please shar any personal story your family may have regarding air quality.]
• I urge [Senator [NAME]/Representative [NAME]] to protect the health of my family and support clean and healthy air.
•  Thank you.

  To learn more, visit www.LungUSA.org/cleanairact.

Even a lightly-enforced smoking ban can have major impact on a college campus. So says a study from Indiana University (IU) published online in the journal Preventive Medicine. When investigators looked at student behavior following the implementation of a smoke-free air policy at IU, they found that not only was smoking down, but student attitudes about lighting up had changed for the better as well.

"Having such a policy in place does appear to influence students' smoking-related norms and behaviors even without strong enforcement of the policy," said Dong-Chul Seo, associate professor in IU's School of Health, Physical Education and Recreation, via a news release. "These results are encouraging for university administrators considering stronger tobacco control policies."

Seo said he was surprised by the reduced smoking rate at IU because the campus-wide smoke-free air policy was not actively enforced. "The positive changes may be attributable to increased awareness of the policy due to signage, media coverage, and a campus bus completely wrapped with anti-tobacco messaging," he said.

This study by IU is the first published report to evaluate the impact of smoke-free campus policies on student smoking. It found that not only did the IU student smoking rates drop after the campus-wide smoking ban was implemented, but those who continued smoking consumed fewer cigarettes.

The study was particularly interesting in that it compared behaviors of IU students to those at nearby Purdue University where no such smoke-free policy is in place. While smoking rates and support for on-campus smoking dropped at IU over the study's two years, they both went up at Purdue.

Hey, Purdue, Are you listening?

That was the message conveyed by the football coach of one young player who began wheezing during practices. Here's an excerpt from the parent's frustration as published by WebMD:

"My son is almost 12 and has played football since first grade. This year he began wheezing and was prescribed an inhaler by his doctor. His doctor believes he has sports induced asthma. My son was having trouble doing the sprints at the end of practice and now is using his inhaler. He still has to stop in the middle of sprints to do another dose of the inhaler. However his coach yelled at him the other day and told him he was faking it, saying to my son, "Are you kidding me? It's not even that hot out," and "Come on kid, any day now." My son was in tears. Now the coach's son told my son that ‘everyone knows you don't really have asthma.' My son is very upset."

At what point does it become obvious to this Neanderthal coach that a child's health is more important than the outcome of a game? When said child is loaded into an ambulance for a ride to the ED? Methinks that coach needs a little more coaching himself.

Education truly is the key to helping children control their asthma and keeping them in the safety zone. But who will educate the adults our children look up to?  Clearly, that coach and his tough-it-out machismo need to be sidelined.

"Going bananas may help kids breathe easier," was the opening line of a news brief from Newswise. With a cluster of four still-green Dole beauties parked right on my desktop, how could I stop reading? Allow me to share: Children who ate just one banana a day had a 34 percent less chance of developing asthmatic symptoms, according to new British research.

The Imperial College of London collected dietary information from 2,640 children, ages 5 to 10, and found that banana-eaters were one-third less likely to encounter breathing problems like wheezing. (Additionally, children who drank apple juice daily experienced a 47% reduction.)

Banana Bonus: Early banana consumption may also be associated with a lower risk of childhood leukemia. Bananas' fiber, potassium, vitamin C and B6 content support heart health. Bananas also contain tryptophan, an amino acid associated with memory preservation and mood enhancement.

Start peeling...