High-power Kerr-lens mode-locked Yb:YAG thin-disk oscillator in the positive dispersion regime.

We demonstrate a self-starting Kerr-lens mode-locked (KLM) Yb:YAG thin-disk oscillator operating in the regime of positive intracavity group-delay dispersion (GDD). It delivers 1.7 ps pulses at an average power of 17 W and a repetition rate of 40 MHz. Dispersive mirrors compress the pulses to a duration of 190 fs (assuming sech2 shape; Fourier limit: 150 fs) at an average power level of 11 W. To our knowledge, this is the first KLM thin-disk oscillator with positive GDD. Output powers of up to 30 W were achieved with an increased output coupler transmission and intracavity GDD. We demonstrate increase of the pulse energy with increasing positive intracavity GDD, limited by difficulties in initiating mode-locking.

High-power 200 fs Kerr-lens mode-locked Yb:YAG thin-disk oscillator.

We demonstrate a power-scalable Kerr-lens mode-locked Yb:YAG thin-disk oscillator. It delivers 200 fs pulses at an average power of 17 W and a repetition rate of 40 MHz. At an increased (180 W) pump power level, the laser produces 270 fs 1.1 µJ pulses at an average power of 45 W (optical-to-optical efficiency of 25%). Semiconductor-saturable-absorber-mirror-assisted Kerr-lens mode locking (KLM) and pure KLM with a hard aperture show similar performance. To our knowledge, these are the shortest pulses achieved from a mode-locked Yb:YAG disk oscillator and this is the first demonstration of a Kerr-lens mode-locked thin-disk laser.

Surface micromachined tunable 1.55 µm-VCSEL with 102 nm continuous single-mode tuning.

For the first time a vertical-cavity surface-emitting laser (VCSEL) with a single-mode wavelength-tuning over 102 nm in the range of 1550 nm is demonstrated. The fiber-coupled optical output power has a maximum of 3.5 mW and is > 2 mW over the entire tuning range. The sidemode suppression ratios are > 45 dB. The wavelength tuning is achieved with the micro-electro mechanical actuation of a mirror membrane fabricated with surface micro-machining for on-wafer mass production. The mirror membrane consists of low cost dielectric materials (SiOx/SiNy) deposited with low temperature (< 100°C) Plasma Enhanced Chemical Vapor Deposition (PECVD).

Advanced nursing practice: old hat, new design.

Advanced practice nurses positively impact the delivery of healthcare and client outcomes. However, in the past these positions have been seen to have variable value and were often vulnerable during budget cuts. Lack of a clear advanced nursing practice (ANP) framework probably contributed to the compromised effectiveness of these roles and evolution of roles with different titles, scopes of practice and reporting structures. To build the foundation for developing an ANP framework, a task force at The Ottawa Hospital (TOH) conducted a literature review related to ANP roles and completed a review of all clinical nursing roles at TOH. In addition, focus groups with nurses and other health professionals elicited ANP perceptions. The ANP framework includes a standardized job description that details competencies under five role components: clinical practice; consultation; research; education; and, leadership. Recommendations for assessment, implementation and evaluation of ANP roles are identified. The process undertaken by our ANP task force proved to be thorough and sound in developing a framework within which to move forward with ANP role implementation throughout TOH. This article, describing the process, may assist other organizations in defining ANP roles to better meet patient needs in changing health care environments.

Changes in Canadian women's mammography rates since the implementation of mass screening programs.

OBJECTIVES: This study reports on Canadian mammography rates between 1990, when mass screening programs were launched, and 1994/95. METHODS: Mammography rates from 2 national surveys were compared according to the presence of a provincial screening program. RESULTS: Mammography rates among women aged 50 to 69 years (the targeted group) increased significantly, by 16%; increases were twice as high in provinces with screening programs. Among women in their 40s (nontargeted group), the changes were insignificant and independent of screening program status. CONCLUSIONS: Screening programs appear to have influenced the mammography rates of targeted women aged 50 to 69 years.

Oncology nursing education within a supportive care framework: an evidence-based undergraduate course.

Addressing supportive care needs of individuals affected by cancer is a crucial role for oncology nurses. If these needs are not identified and addressed, then individuals and their families risk experiencing biopsychosocial distress. This paper describes how a group of interested nurses with research and/or cancer knowledge developed, implemented and evaluated an evidence-based university undergraduate course in oncology nursing. The purposes of this course are to provide nurses with specialized knowledge about supportive care in oncology throughout the cancer care continuum and to assist registered nurses in preparing for oncology nursing certification. Theoretical, practical and research-based issues related to the scope of supportive care are incorporated into the assessment, nursing diagnosis, planning and evaluation of client care.

Supporting women during breast diagnostics.

Breast cancer is the most frequently diagnosed cancer among Canadian women. It is estimated that, in 1997, there will be 18,400 new cases of breast cancer and 5,100 breast cancer deaths among Canadian women; one in nine Canadian women will develop breast cancer at some time in their lives.

Getting to know oncology inpatients and their families: a continuous quality improvement approach.

Given the overall magnitude of cancer, a climate of stretched health care resources, and the political activism of cancer survivors and families, it is becoming increasingly clear that local service providers need to assess and reassess the care they provide. A qualitative design was used to seek the patient and family's perspectives on whether or not their needs were being met while in hospital. Direct feedback from a convenience sample of 19 oncology patients and families was elicited through a semi-structured interview. Qualitative data analysis revealed eight important aspects of care for oncology patients and their families. These included: communication between patients and caregivers, caregiver availability and concerns about health care cutbacks, coordination and continuity of care, physical care and comfort, psychosocial care, caregiver sensitivity, caregiver competence, and the physical environment of the hospital. Challenges faced by individuals and their families affected by cancer are highlighted as they navigate through our health care system. Respondents provide positive reinforcement for use of appropriate interventions by caregivers, while clearly outlining areas needing improvement.

Changes in women's breast cancer screening practices, knowledge, and attitudes in Ottawa-Carleton since 1991.

Although Canadian Breast Screening Guidelines have been in place since 1988, participation rates have been suboptimal. The study objective was to describe changes in breast screening knowledge, attitudes, and practices among women aged 50 to 69 years since initiation of a regional mass screening program in Ottawa-Carleton in 1991. A random-digit-dialing telephone survey was conducted with 384 women aged 50 to 69 years residing in Ottawa-Carleton and compared to a 1991 survey. Between 1991 and 1994 there were significant increases in the percentage ever having had a mammogram (from 60% to 83%) and monthly breast self-examination (from 46% to 54%). Professional breast examination rates were unchanged as were overall attitudes and concerns about screening. There were significant improvements in knowledge and encouragement to have a mammogram. As the focus on primary health care within our health care system grows, and as service delivery changes, we must continue to search for, and continually evaluate, innovative strategies to align practices with Canadian breast screening recommendations.