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PubMed1988

Two methods for examining angular response of personnel dosimeters.

The American National Standard ANSI N13.11-1983 is used to test the accuracy (bias plus precision) of dosimetry processors as part of the dosimetry accreditation program of the National Voluntary Laboratory Accreditation Program (NVLAP). Section 3.8 of the ANSI N13.11-1983 standard requires that a study of the angular response of a dosimeter be carried out once, although no pass/fail criterion is given for angular response. The NVLAP accreditation program excluded Section 3.8, and thus no angular response data have been generated in an organized fashion. The objective of this project is to examine the feasibility of two alternative methods to test the angular response of personnel dosimeters. The first alternative involves static irradiations with the dosimeters at fixed angles to a radiation source. The second alternative involves dynamic irradiations with the dosimeters mounted on a rotating phantom. A Panasonic UD-802 personnel dosimetry system** was used to generate data to examine both alternatives. The results lead to two major conclusions. Firstly, Section 3.8 of the ANSI N13.11-1983 standard should be amended to require a pass/fail test for angular response. Secondly, a comparison between angular response data generated with a fixed or a rotating phantom shows that the rotating phantom is the more cost-effective method.

Algorithms↗
PubMed1988

Legal rights and duties in the AIDS epidemic.

This article provides an overview of some major areas of legal concern in which the AIDS epidemic is having an impact. The rights of infected individuals to testing, treatment, and confidentiality are reviewed, and emphasis is given to their claims to nondiscrimination regarding access to health care, employment, housing, education, insurance, and related interests. Infected persons' duties to contain transmission of AIDS are outlined under principles of criminal and civil law, including liability for provision of contaminated blood products. Uninfected people's general rights to protection are considered, and health professionals' and authorities' rights and duties are given more detailed attention. In conclusion, some legal developments outside the United States are reviewed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Human immunodeficiency virus (HIV) infection. American College of Physicians and Infectious Diseases Society of America.

Knowledge about the epidemiology, diagnosis, and treatment of human immunodeficiency virus (HIV) infection gained since 1988 has necessitated an update of our previously published policies. Important advances have been made in the treatment of HIV infection and the acquired immunodeficiency syndrome (AIDS), resulting in a prolongation of the symptom-free period. Transmission of HIV infection from a dentist to several of his patients is believed to have occurred. Heterosexual transmission of HIV infection is increasing in importance. This statement emphasizes the ethical imperative to care for all patients; the need for health care professionals to adhere scrupulously to universal precautions because of the low but definite risk for transmission of HIV in the health care setting; the expanded recommendations for HIV testing to identify infected persons as early as possible; and the need for national leadership in public education, public policy development, and health care funding.

AIDS-Related Opportunistic Infections↗
PubMed1998

With HIV prevalence among women increasing, more provinces encourage prenatal testing.

Testing of pregnant women for antibodies to HIV remains a thorny medical and ethical issue. On the one side are children who stand to benefit if their mothers' HIV status is determined. On the other is women's right to determine what tests they will receive. A majority of provinces now have counselling programs in place to encourage women to undergo testing. However, testing remains voluntary and informed consent is required before a test is done--policies that have CMA support.

AIDS Serodiagnosis↗
PubMed1990

A single TLD dose algorithm to satisfy federal standards and typical field conditions.

Modern whole-body dosimeters are often required to accurately measure the absorbed dose in a wide range of radiation fields. While programs are commonly developed around the fields tested as part of the National Voluntary Accreditation Program (NVLAP), the actual fields of application may be significantly different. Dose algorithms designed to meet the NVLAP standard, which emphasizes photons and high-energy beta radiation, may not be capable of the beta-energy discrimination necessary for accurate assessment of absorbed dose in the work environment. To address this problem, some processors use one algorithm for NVLAP testing and one or more different algorithms for the work environments. After several years of experience with a multiple algorithm approach, the Dosimetry Services Group of Yankee Atomic Electric Company (YAEC) developed a one-algorithm system for use with a four-element TLD badge using Li2B4O7 and CaSO4 phosphors. The design of the dosimeter allows the measurement of the effective energies of both photon and beta components of the radiation field, resulting in excellent mixed-field capability. The algorithm was successfully tested in all of the NVLAP photon and beta fields, as well as several non-NVLAP fields representative of the work environment. The work environment fields, including low- and medium-energy beta radiation and mixed fields of low-energy photons and beta particles, are often more demanding than the NVLAP fields. This paper discusses the development of the algorithm as well as some results of the system testing including: mixed-field irradiations, angular response, and a unique test to demonstrate the stability of the algorithm. An analysis of the uncertainty of the reported doses under various irradiation conditions is also presented.

Algorithms↗
PubMed2002

Participation in a public insurance program: subsidies, crowd-out, and adverse selection.

This paper examines how varying the level of subsidies affects participation in a public insurance program, crowd-out of private insurance, and adverse selection. We study the experience in Washington's Basic Health program in 1997. Findings show that adverse selection is not a problem in voluntary public programs. Increasing subsidies have only modest effects on participation in subsidized programs, though the gains are not at the expense of the private market. Overall participation in the subsidized plan is also modest, even though participants benefit from it. The challenge to policymakers is to find program design characteristics, beyond subsidies, that attract the uninsured.

Adolescent↗
PubMed1997

Patterns of reassault in batterer programs.

A comparative multisite evaluation was conducted of four "well-established" batterer programs in geographically distributed cities to assess the pattern of reassault. Eight hundred and forty batterers were recruited and tested at program intake from each site (210 per site). The batterers and their partners were interviewed by phone every 3 months for 15 months after intake with a response rate for the female partners of nearly 70% for the full follow-up. According to initial victims, 31% of the men reassaulted during the follow-up. The reassault rate varies only slightly when adjusting for new partners (32%) or no partner contact (32%), but substantially more when adjusting for reports from the batterers (36%) and batterers plus arrest record (39%). Rates of verbal abuse (70%) and threats (43%) are much higher, but 73% of the women report feeling "very safe." Nearly half of the men who reassaulted did so within 3 months after program intake. "Voluntary" participants were significantly more likely to reassault (44% vs. 29%), as were program dropouts (40% vs. 28%). The "well-established" batterer programs appear to contribute to a short-term cessation of assault in the majority of batterers. However, a small portion of the men are unaffected by or unresponsive to the intervention.

Adult↗