22q11 deletion syndrome - the meaning of a diagnosis. A qualitative study on parental perspectives.

BACKGROUND: The 22q11 deletion syndrome (22q11DS) is one of the most common multiple anomaly syndromes, with an incidence of approximately one per 4000 newborns. Although a patient may have several not too severe symptoms, the cumulative effect may be substantial disability. The aim of this study was to explore and describe parents' experiences of the diagnostic process and of being parents of a child with 22q11DS. METHODS: Open, tape-recorded interviews were carried out with 12 parents. The interviews were analysed in accordance with classical grounded theory. RESULTS: The analysis show that parents describe the disclosure of their child's medical diagnosis as two-sided, ambivalence between relief and sorrow, and the differences between these two aspects were related to the age of the child at time of diagnosis as well as to the problems and symptoms that had led to the diagnosis. Different strategies for handling this ambivalence are presented in the categories. CONCLUSIONS: Our conclusions are that information must be individually tailored, and there is no standard format for how to describe the syndrome to the parents. After disclosure, scheduled appointments for follow-up on diagnosis-related information is essential.

Development and comparison of five site-specific biosphere models for safety assessment of radioactive waste disposal.

This paper describes the development and application of site-specific biosphere models that might be used for assessment of potential exposures in the framework of performance assessment studies of nuclear waste disposals. Model development follows the Reference Biosphere Methodology that has been set up in the framework of the BIOMASS study. In this paper, the application is to real sites at five European locations for which environmental and agricultural conditions have been described and characterised. For each of the sites a biosphere model has been developed specifically assuming a release of radionuclides to waters that are used by humans, for example as drinking water for humans and cattle and as irrigation water. Among the ingestion pathways, the intakes of drinking water, cereals, leafy vegetables, potatoes, milk, beef and freshwater fish are included in all models. Annual individual doses were calculated, and uncertainties in the results were estimated by means of stochastic calculations. To enable a comparison, all results were normalised to an activity concentration in groundwater of 1 Bq m(-3) for each of the radionuclides considered ((36)Cl, (79)Se, (99)Tc, (129)I, (135)Cs, (226)Ra, (231)Pa, (230)Th, (237)Np, (239)Pu, and (238)U), i.e. those that are usually most relevant in performance assessment studies of nuclear waste disposals. Although the results do not give answers in absolute terms on potential future exposures, they indicate the spectrum of exposures that might occur in different environments and specify the interaction of environmental conditions, human habits and potential exposure.

Pre- and post-treatment levels of salivary mutans streptococci and lactobacilli in pre-school children.

OBJECTIVES: To examine the effect of operative and restorative treatment of dental caries on the levels of caries associated microorganisms in saliva and to relate alterations to the type and extent of treatment. DESIGN: Longitudinal. SETTING: Paediatric Dentistry Department at a central hospital in Sweden. SUBJECTS AND METHODS: One hundred and eight pre-school children with severe dental caries scheduled for treatment under general anaesthesia. Chair-side tests were used to estimate the levels of salivary mutans streptococci, lactobacilli and buffer capacity before the surgery and at recall appointments 1 and 6 months after treatment. Caries were assessed according to WHO guidelines and the number of extracted teeth and filled surfaces during surgery were recorded. RESULTS: The results demonstrate that the post-treatment levels of mutans streptococci and lactobacilli were significantly reduced (P < 0.001) compared to pretreatment levels. Lactobacilli levels were more dramatically reduced than mutans streptococci. The reduction of mutans streptococci was positively correlated to the number of extracted teeth (P < 0.01), but not to the number of restored or ground surfaces. Lactobacilli reduction was not significantly related to the type of treatment. CONCLUSION: The findings suggest that extensive operative and restorative dental care effectively reduces the levels of caries associated with microorganisms during a period of at least 6 months.