International Arctic Seas Assessment Project.

The International Atomic Energy Agency responded to the news that the former Soviet Union had dumped radioactive wastes in the shallow waters of the Arctic Seas, by launching the International Arctic Seas Assessment Project in 1993. The project had two objectives: to assess the risks to human health and to the environment associated with the radioactive wastes dumped in the Kara and Barents Seas; and to examine possible remedial actions related to the dumped wastes and to advise on whether they are necessary and justified. The current radiological situation in the Arctic waters was examined to assess whether there is any evidence for releases from the dumped waste. Potential future releases from the dumped wastes were predicted, concentrating on the high-level waste objects containing the major part of the radionuclide inventory of the wastes. Environmental transport of released radionuclides was modelled and the associated radiological impact on humans and the biota was assessed. The feasibility, costs and benefits of possible remedial measures applied to a selected high-level waste object were examined. Releases from identified dumped objects were found to be small and localised to the immediate vicinity of the dumping sites. Projected future annual doses to members of the public in typical local population groups were very small, less than 1 microSv--corresponding to a trivial risk. Projected future doses to a hypothetical group of military personnel patrolling the foreshore of the fjords in which wastes have been dumped were higher, up to 4 mSv/year, which still is of the same order as the average annual natural background dose. Moreover, since any of the proposed remedial actions were estimated to cost several million US$ to implement, remediation was not considered justified on the basis of potentially removing a collective dose of 10 man Sv. Doses calculated to marine fauna were insignificant, orders of magnitude below those at which detrimental effects on fauna populations might be expected to occur. Remediation was thus concluded not to be warranted on radiological grounds.

VBAC program in a nurse-midwifery service. Five years of experience.

Vaginal birth after cesarean (VBAC) is well documented by research studies to be safe and, in many cases, better for women with a previous cesarean birth than a repeat cesarean. The article describes one nurse-midwifery service's policies and procedures for helping women to prepare for and have a trial of labor. During the intrapartal period women with a uterine scar are managed similar to those without a scar except for closer monitoring, lab studies, and intravenous heparin lock. An obstetrician is always in the hospital and available for consultation. Of 53 women attempting VBAC, 83% had a vaginal birth. Those with a previous cesarean for failure to progress had the lowest vaginal birth after cesarean rate of 65%. Maternal and newborn morbidity was low. The authors conclude that nurse-midwifery management of vaginal birth after cesarean candidates is safe and very successful when appropriate physician consultation and hospital services are readily available.