Prediction of the irradiation doses from ultrashort laser-solid interactions using different temperature scalings at moderate laser intensities.

The ionising radiation created by high intensity and high repetition rate lasers can cause significant radiological hazard. Earlier defined electron temperature scalings are used for dose characterisation and prediction using Monte Carlo modelling. Dosimetric implications of different electron temperature scalings are investigated and the resulting equivalent doses are compared. It was found that scaling defined by Beget al(1997Phys. Plasmas4447-57) predicts the highest electron temperatures for given intensities, and subsequently the highest doses. The atomic number of the target, x-ray generation efficiency and interaction volume are the other parameters necessary for the dose evaluation. The set of these operational parameters should be sufficient to characterise radiological characteristics of ultrashort laser pulse based x-ray generators and evaluate radiological hazards of the laser processing facilities.

Internal dose assessment of 148Gd using isotope ratios of gamma-emitting 146Gd or 153Gd in accidently released spallation target particles.

The pure alpha emitter 148Gd may have a significant radiological impact in terms of internal dose to exposed humans in case of accidental releases from a spallation source using a tungsten target, such as the one to be used in the European Spallation Source (ESS). In this work we aim to present an approach to indirectly estimate the whole-body burden of 148Gd and the associated committed effective dose in exposed humans, by means of high-resolution gamma spectrometry of the gamma-emitting radiogadolinium isotopes 146Gd and 153Gd that are accompanied by 148Gd generated from the operation of the tungsten target. Theoretical minimum detectable whole-body activity (MDA) and associated internal doses from 148Gd are calculated using a combination of existing biokinetic models and recent computer simulation studies on the generated isotope ratios of 146Gd/148Gd and 153Gd/148Gd in the ESS target. Of the two gamma-emitting gadolinium isotopes, 146Gd is initially the most sensitive indicator of the presence of 148Gd if whole-body counting is performed within a month after the release, using the twin photo peaks of 146Gd centered at 115.4 keV (MDA < 1 Bq for ingested 148Gd, and < 25 Bq for inhaled 148Gd). The corresponding minimum detectable committed effective doses will be less than 1 µSv for ingested 148Gd, but substantially higher for inhaled 148Gd (up to 0.3 mSv), depending on operation time of the target prior to the release. However, a few months after an atmospheric release, 153Gd becomes a much more sensitive indicator of body burdens of 148Gd, with a minimum detectable committed effective doses ranging from 18 to 77 µSv for chronic ingestion and between 0.65 to 2.7 mSv for acute inhalation in connection to the release. The main issue with this indirect method for 148Gd internal dose estimation, is whether the primary photon peaks from 146 and 153Gd can be detected undisturbed. Preliminary simulations show that nuclides such as 182Ta may potentially create perturbations that could impair this evaluation method, and which impact needs to be further studied in future safety assessments of accidental target releases.

Baccalaureate nursing education development in 2 Baltic countries: Outcomes 10 years after initiation.

BACKGROUND: Baccalaureate nursing education began in the Baltic countries of Latvia and Lithuania ten years ago to prepare nursing teachers and leaders. PURPOSE: The purpose of the study was to assess the outcomes of the initial baccalaureate programs for nurses in Latvia and Lithuania from the perspective of program graduates. METHOD: The method was an alumni survey developed by the authors in English and translated into the respective languages. DISCUSSION: Most of the Latvian and Lithuanian alumni respondents were staff nurses on entering the baccalaureate programs, but after graduation were making a contribution as nursing leaders and teachers. CONCLUSIONS: The initial baccalaureate programs for nurses have been followed by increasing opportunities for nurses to pursue graduate study and careers in and outside of nursing. The infusion of prepared local nursing faculty to replace physician faculty and foreign short-term guest faculty promises continued development of nursing education.

Reducing percutaneous injuries in the OR by educational methods.

Exposure to bloodborne pathogens (e.g., HIV, hepatitis B, hepatitis C) through percutaneous injuries is an occupational risk for health care workers, especially those in the OR. The incidence of disease continues to rise, although occupational exposures often go unreported. Percutaneous injury prevention methods have included use of safety devices, practice changes, and educational programs. An educational intervention to increase awareness of risk, provide suggestions for injury reduction, and encourage reporting of exposures was performed at a university teaching hospital. Preliminary qualitative results show increased exposure reporting, increased use of personal protective equipment, and increased awareness of disease exposure risk among OR personnel.

Public health and home care: historical roots & current partnerships.

This article explores the evolution of home care from a component of public health services to its current position in the American health care system. Values related to public health and philanthropic roots are discussed in contrast to the current business orientation. Because nursing was the initial, and remains the primary, discipline in home care, examples from nursing service and education are used to illustrate this evolution. Educational implications are highlighted because of the importance of educational systems in supplying personnel to the field.

The cluster concept in nursing research.

Innovative strategies are needed to promote research development in schools of nursing. At the University of Michigan School of Nursing, using a visiting professor to direct a research cluster project enhanced scholarly productivity among new faculty investigators and graduate students.

Interest of major corporations in expanded practice of occupational health nurses.

The purpose of this study was to ascertain the interest by executives of major corporations in having occupational health nurses engage in more advanced activities, and to ascertain the available support for advanced educational preparation for nurses. A questionnaire was sent to a systematic sample of 404 of the 808 executives of the Forbes 500 corporations with a 57% return rate. Over 90% of the corporations with health care departments employed registered nurses. Functions nurses currently performed varied by size of the corporation and by type of industry. Activities corporations would like nurses to perform were more advanced, such as conducting research, analyzing trends, and developing special health programs.

Health problems encountered by nurse practitioners and physicians in general medicine clinics.

Distribution of health problems encountered by nurse practitioners and physicians in general/adult medicine clinics was studied. Proportional samples by clinics were selected from a total of 13,039 patient visits made to four clinics during an 18-week period in 1978. A Patient Encounter Form was used as the instrument and the ICD-9-CM as the coding system. Results showed that (a) 25.1% of the 13,039 patient visits were made to the nurse practitioners and 74.9% to the physicians, (b) 23 frequently reported health problems constituted more than 50% of all health problems seen by both provider groups, and (c) health problems with V codes constituted less than 30% of all health problems seen by both provider groups. Many similarities in health problems seen by nurse practitioners and physicians may indicate that nurse practitioners in the general/adult medicine specialty are used more to substitute for physicians in managing selected health problems than to complement medical practice.

Effectiveness of public health nurse home visits to primarous mothers and their infants.

The purpose of this study was to determine the effects of public health nurse postpartum home visits by comparing the health outcomes of 67 randomly selected mother-infant pairs who had received such services with 43 randomly selected mother-infant pairs who had not received them. Health outcome variables were mother's health and health services utilization, infant's health and health services utilization, and mother's parenting practices. Data were collected from birth certificates, health service records, and by home interviews and observations at six months postpartum. No significant differences were noted between home-visited and not-home-visited mother-infant pairs for the majority of health outcome variables. Major, differential health assets and liabilities between groups of Black and White mother-infant pairs were observed.

Health problems encountered by pediatric nurse practitioners and pediatricians in ambulatory care clinics.

This study documents the health problems managed by pediatric nurse practitioners (PNPs) and pediatricians and examines the effects of setting and provider group on the distribution of health problems. Proportional samples by clinic were selected from a total of 11,968 patient visits to five ambulatory care clinics during an 18-week period in 1978. A patient encounter form was devised and the ICD-9-CM was used as the coding system. Results indicated 1) distributions of health problems differed significantly between the PNPs and the pediatricians in each clinic; 2) setting significantly effected the distributions of both types of health problems; and 3) provider group significantly affected the distribution of health problems with V codes but not frequently reported problems given a setting. The PNPs caseloads differ from pediatrician caseloads in diagnostic categories and wellness emphases. Community-based settings seem to be especially appropriate for nurse practitioner practice.

Health problems encountered by nurse practitioners and physicians.

The effects of specialty, setting, and provider group on the distributions of health problems managed by nurse practitioners and physicians in obstetric-gynecology, adult medicine, pediatrics, and family practice specialties are studied. Proportional samples by clinic were drawn from a total of 39,243 patient visits made to 16 ambulatory care clinics during an 18-week period. A Patient Encounter Form was used as the instrument and the ICD-9-CM was used as the coding system. Distributions of health problems differed between nurse practitioners and physicians in each clinic. Specialty affected the distributions of health problems managed by both provider groups. Setting affected the distributions of health problems for all specialties except the distributions of health problems not related to diseases or injuries (V codes) in family practice. Provider group effects were inconclusive. Community-based settings seem especially appropriate for nurse practitioner practice.

Health problems encountered by nurse-practitioners and physicians in obstetric-gynecologic ambulatory care clinics.

This study documents the distribution of health problems managed by obstetric-gynecologic nurse-practitioners (OB-GYN NPs) and obstetrician-gynecologists in community-based ambulatory care settings, and examines the effects of provider group on the distribution of health problems. A proportional sampling technique was used in selecting a sample of 3,873 visits for analysis from a total of 5,889 patient visits made to three community-based clinics during an 18-week period from February to June, 1978. A Patient Encounter Form was devised to record basic encounter data and the health problems managed by providers. The International Classification of Diseases, 9th revision (ICD-9-CM) was used as the coding system. Results indicated: (1) in each clinic, the distribution of health problems based on the three-digit headings of ICD-9-CM differed significantly between the OB-GYN NPs and the obstetrician-gynecologists; (2) the distributions of frequently reported health problems were clinically similar for OB-GYN NPs and obstetrician-gynecologists; and (3) the distributions of health problems with V codes were clinically similar for the two provider groups. Data indicate the OB-GYN NP caseloads are similar to those of obstetrician-gynecologists in frequently managed health problems and in wellness emphases. Nurse-practitioners are appropriate collaborators with obstetrician-gynecologists in the provision of primary health care for women.