Radiation Environment and Medicine Vol.5, No.1
- Publisher : Hirosaki University Press
- Language : English
- ISSN : 2423-9097 (PRINT), 2432-163X (ONLINE)
- Release : March 2016
- Issue : Hirosaki University Press
- pp. 1-74
- Methods and Their Application to Epidemiology on Cancer and Radiation (5)
Basic Radiation Protection
- Physical Properties, Detection, Biological Effects and Regulation of Radiation
Current Radiation Nursing and Radiation Nursing Education in the U.S.A., and Recommendations for Japan
Master’s degrees in nursing are becoming popular and are in demand in the United States because of the new healthcare system structure. Nursing licensure and nursing education are very different in the US compared to Japan, and each license has its own unique educational requirement, testing and specific job description. Nurse practitioners (NPs) and clinical nurse specialists (CNSs) play critical roles in the healthcare system and have become essential members of the multidisciplinary team in recent years. The latest amendments to laws and regulations in the healthcare, from university educations to hospital orientations, have greatly revised and changed the roles of NPs and CNSs.
One example is the better understanding and knowledge of radiation and exposure prevention in medicine, which are essential in radiation oncology nursing and interventional radiology nursing. Despite increases in cases of chronic diseases, education for certain specialties has been terminated or modified to accommodate the new regulations. Moreover, occupational radiation exposure is one of the main focuses and concerns for healthcare professionals since the Fukushima nuclear plant disaster in 2011. However, education at universities and institutions is insufficient. This paper summarizes and compares Master’s degree education for NPs and CNSs, their job requirements and certification requirements in radiation oncology and radiation nursing. As the complexity of patients is becoming more problematic, NPs and CNSs can add value to the workload and quality of patient care. Additionally, this paper makes recommendations to develop and improve Japan’s Master’s degrees in nursing.
Introduction of Radiological Nursing into the Curriculum of Basic Nursing Education Systems
The early introduction of radiological nursing education into the basic nursing education system will be a very important issue. Nursing personnel contacted closely with clients (patients and general public) at any time were recently dubbed “key-person” in team medical care. The attitude of nursing personnel may influence the anxiety of their clients about radiation and its health effects. After the nuclear power plant accident occurred in Fukushima prefecture, it was evident that overall medical professionals in Japan, including nursing personnel, lacked basic skills in regard to radiation exposure and possessed defective knowledge on its health effects. The usage of radiation and radionuclides are increasing year by year in every field, particularly in medical field. The goals in utilization of the artificial radiation were maintain the safety of all exposed people including patients. At all exposure situations, the role of nursing personnel are to be accountable on site and to consult with clients, including patients, on radiation exposure and its health effects. There were many epidemiological studies about radiation health effects. Also research and development concerning radiation dosimetry has advanced greatly. Nursing personnel has to use effectively these information and technics during consultation with clients.
In addition, it is necessary to start to train quickly the certified nurse specialist (CNS) in radiological nursing for the retention of teaching staff for radiological nursing education. Public health nurses also have to get particularly the skill on risk communication based on scientific data.
A Brief Review of Case-control Studies of Natural Background Radiation and Childhood Cancer in Great Britain
Studies of natural radiation and childhood cancer must be very large if they are to have sufficient power to detect the very small radiation effects expected. Conventional interview-based case control studies with a sufficiently large number of study subjects would be exceptionally expensive and would also be liable to bias which might lead to confounding that would dominate the results of the study. Record based studies, in which cases and controls are drawn from existing registers, have the potential to be large enough and to avoid the risk of bias. However, they will not have interview-based information on factors such as Socioeconomic Status, nor will they have direct measurements of radiation levels in the homes of study subjects. A large record-based case control study from Great Britain is reviewed here in the context of such case-control studies generally. This study has detected a statistically significant association between indoor gamma ray exposures and the incidence of childhood leukaemia. The risk factor was compatible with that extrapolated from higher dose studies, in particular those of the Atomic Bomb Survivors.
Sellafield and Other Clusters of Childhood Cancer in the Vicinity of Nuclear Installations
A media report in 1983 drew attention to high levels of childhood leukaemia around the Sellafield nuclear reprocessing plant. This prompted investigations around other nuclear installations, some of which suggested other “clusters”, though Sellafield remained the most striking. Many studies over more than 30 years have investigated possible reasons for such clusters. Inevitably attention was first directed at radiation linked with activities at the plant. However, it was found that doses from accidental and planned releases were too low to account for the observed levels of childhood leukaemia. Various other mechanisms involving radiation have been investigated and have also been discounted. While no clear explanation for the Sellafield cluster has been found, perhaps the most plausible remaining hypothesis involves “population mixing” in which an infection is spread to susceptible individuals and, in rare cases, results in leukaemia.
Dual Effects of Nanoparticles on Radiation Therapy: as Radiosensitizers and Radioprotectors
Radiation therapy (RT) is an approved, most widely used strategy for the treatment and control of cancer progression but its successful application solely depends on the radiosensitivity of tumor cells and tolerance of normal tissue. To overcome this, very often radiation therapy is combined with radiosensitizing agents. Recently, due to the advancement in the field of nanotechnology, metal nanoparticles have been discovered as the novel radiosensitizers such as gold nanoparticles (GNPs). In contrast, some nanoparticles of noble metals like platinum nanoparticles (nano-Pts) act as radioprotectors and inhibit radiation-induced cell death. This review will summarize the latest findings on the 1) radiosensitizing effects of GNPs, 2) effects of platinum nanoparticles on inflammation and radiation-induced cell death.
Estimation of External and Internal Doses Resulting from the Use of Artificial Radon Spa Sources
In this study, four types of readily available artificial radon spa sources, sold as ceramic materials, were studied and dose estimations of the 222Rn emitted from them were made. When people use these sources in bathtub water for bathing, the equivalent dose received by the gonads has been estimated to be 0.40-0.63 nSv for each bathing time (30 min). When each source was put into tap water, the 222Rn concentrations each emitted ranged from 0.5 to 0.7 Bq L-1. If a person drinks 500 mL of water with a 222Rn concentration of 18 Bq L-1 every day, the person’s maximum annual effective dose is estimated to be 12 nSv.
Natural Radiation Survey in the Uranium and Thorium Bearing Regions of Cameroon
The present paper summarizes the findings of the preliminary studies carried out in the uranium and thorium bearing regions of Cameroon. It also underlines future prospects for extensive measurements of natural radioactivity for a better radiation dose assessment to the public. After soil and foodstuff sampling, α – and γ – spectrometry were used to determine activity concentrations of natural radionuclides in these samples. Electret Ionization Chambers (EPERM) were deployed in Poli and Lolodorf to measure radon in houses. 20% of dwellings in Poli and 50% in Lolodorf have radon concentrations higher than 300 Bq m-3. Passive integrated radon–thoron discriminative detectors (RADUET) were used only in the high natural radiation areas of Lolodorf to measure simultaneously indoor radon and thoron. 30% of houses have thoron concentrations above 300 Bq m-3. Effective dose to the public and annual excess risk for radon-induced lung cancer of each of the studied regions are higher than the world average values. Difference is mainly attributed to indoor radon exposure. Taking into account of the limited number of analyzed samples and surveyed dwellings, some conclusions should cautiously be considered.
Contributions of Nurses after a Nuclear Accident and a Proposal for Education in Radiation Nursing
We propose an education program for radiation nursing based on the experiences and approaches of nurses during and after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. In the initial phase after the nuclear accident, nurses played a role in helping the patients deal with the radionuclide contamination and in developing a radiation emergency system. In the chronic phase, nurses participated in consultations with evacuees regarding their anxiety about the radiation exposure and contributed to preparedness strategies for radiation emergencies. Fukushima Medical University (FMU) has run this consultation project for evacuees since 2012 to deal with anxieties about the health effects of radiation and resulting physical and mental problems. Nurses have participated in many situations since the FDNPP accident. However, they have insufficient information about radiation-related health effects because such information was not included in their education programs. This disaster showed that health care providers need to be able to communicate correct information to patients and residents about radiation-related health effects. Based on our experiences, we propose the establishment of a practical education system of radiation nursing in Japan. We also propose a training system to authorize specialists who will provide this education.
Advanced Education for Radiation Nursing Practice and Training in Fukushima
- Consideration of the Specialty of Radiation Nursing after Completion of a Radiation Nursing Practicum -
I entered the Radiation nursing program, at the Graduate School of Kagoshima University in April 2013. In the second year, after the accident at the Fukushima Daiichi Nuclear Power Station operated by Tokyo Electric Power Co., Inc., I attended lectures and participated in practicums in emergency medicine for radiation exposure and underwent practical training as a certified nurse specialist under the supervision of cancer nursing specialists in Fukushima Medical University Hospital. I recognized the importance of nursing based on theories and verbalized my performance for advanced practice nursing when I sought to become a certified nurse specialist for radiation nursing. I expect that radiation nursing specialists will improve systematic education and ongoing clinical post-graduate education for radiation nursing