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Background: Despite significant progress in the treatment of coronary artery disease, myocardial infarction is still the leading cause of death in the United States. As suggested by Leventhal's Self-Regulation Model of Illness, the continued high morbidity and mortality may be due to a failure to address the role of psychosocial factors such as illness representation, depression, and anxiety in recovery., Objective: To determine the relationship between illness representation of myocardial infarction and the occurrence of in-hospital complications and if anxiety and depression mediate this relationship., Method: A prospective correlational design was used to measure illness representation, depression, and anxiety 24 to 48 hours after admission for myocardial infarction in 49 patients and the frequency of complications during the acute event. Logistic regression was used to determine the likelihood of experiencing a complication., Results: When demographic and clinical variables were controlled for, the more negative the representation of illness, the greater were the odds of experiencing a complication (chi2 = 16.9, df = 6, P =.01). The odds of experiencing a complication increased 5.1% for each 1 unit increase in the score on the Illness Preparation Questionnaire (B = 0.05, Wald = 4.442, Exp(B) = 1.051, 95% CI = 1.003-1.1010). Neither anxiety (chi2 = 3.0, df = 1, P =. 09) nor depression (chi2 = 2.5, df = 1, P = .11) were significant predictors of the occurrence of complications., Conclusion: In these patients, illness representation was predictive of the likelihood of experiencing a complication. Thus, illness representation appears to be an important psychosocial factor in acute recovery from myocardial infarction.

Objectives: This paper describes current and potential roles of public health nurses in the care of adults with serious mental disabilities and explores incentives and barriers to the expansion of the role of public health nurses in this area., Methods: One hundred thirty-five directors of nursing of public health agencies and 214 executive directors of mental health agencies in Ohio responded to a survey about public health nurses' roles and incentives for and barriers against increasing their role in mental health care., Results: The majority of respondents reported that public health nurses work with adults with serious mental disabilities but perceived their role with these clients to consist primarily of making referrals and providing physical health care. Both groups of directors saw the potential for increasing the nurses' roles in these same areas and reported that the major barrier to expanding their roles was lack of financial support. Directors of nursing expressed interest in expanding these roles if they received additional financial support and the nurses received education and consultation. Executive directors were willing to provide the education and consultation but generally were not willing to provide financial support., Conclusions: Better utilization of public health nurses in the care of adults with serious mental disabilities could improve client health care and make more efficient use of scarce health care resources.

The 238Pu concentrations of various tissues were measured for seven species of freshwater fish from an ecosystem containing elevated levels of 238Pu. The highest levels of 238Pu were found in the gastrointestinal tracts and gills, while the lowest levels were found in muscle tissue. A rapid uptake of 238Pu was observed for hatchery bluegills introduced into this system. High plutonium concentrations in the gastrointestinal tracts and gills suggest that these organs are potential uptake sites. The presence of 238Pu in certain tissues (liver, gonads, bone, and muscle) indicates that there is translocation of 238Pu from the uptake sites.