A photo-elicitation exploration of UK mothers' experiences of extended breastfeeding.

In this qualitative study we explored the experiences of women breastfeeding children over 12 months of age. Data were collected from 24 participants using semi-structured photo-elicitation interviews and photo-prompted online surveys. Participants took photographs of their extended breastfeeding experiences over one week and reflected on how the events depicted made them feel, and what they represented in terms of their experience. Data were analysed using Interpretative Phenomenological Analysis. Four themes were developed; parenting through breastfeeding: meeting the needs of my child, my body is not my own, social influences on the breastfeeding experience, and thinking about stopping: my choice or theirs? Findings highlight that extended breastfeeding was experienced as beneficial for both mother and child, promoting closeness, and bonding, and providing a valued parenting tool. However, some mothers reported conflict between their desire for child-led extended breastfeeding and the need to regain autonomy and control of their own bodies. The dangers of negative societal responses to extended breastfeeding and risks to mental health posed by cultural constructions of 'ideal' motherhood are discussed.

Serious concerns about the General Dental Council's performance and its direction of travel.

There should be tension between a profession and its regulator, it would be odd if it were not so, but the level of concern that has been articulated recently by some high profile commentators about that relationship has been well beyond what I would describe as tension. In this piece I attempt to contextualise my personal observations and comments on what is rapidly becoming a serious concern among those few of us who have had to deal with the profession: regulator interface at the highest level.

Bacterially produced calcium phosphate nanobiominerals: sorption capacity, site preferences, and stability of captured radionuclides.

A Serratia sp. bacterium manufactures amorphous calcium phosphate nanominerals (BHAP); this material has shown increased sorption capacity for divalent radionuclide capture. When heat-treated (≥450 °C) the cell biomass is removed and the biominerals are transformed to hydroxyapatite (HAP). Using a multimethod approach, we have elucidated both the site preferences and stability of analogue radionuclide incorporation for Sr, Co, Eu, and U. Strontium incorporates within the bulk amorphous inorganic phase of BHAP; however, once temperature modified to crystalline HAP, bonding was consistent with Sr substitution at the Ca(1) and/or Ca(2) sites. Cobalt incorporation occurs within the bulk inorganic amorphous phase of BHAP and within the amorphous grain boundaries of HAP. Europium (an analogue for trivalent actinides) substituted at the Ca(2) and/or the Ca(3) position of tricalcium phosphate, a known component of HAP grain boundaries. Uranium was surface complexed with no secondary minerals detected. With multiple sites for targeted radionuclide incorporation, high loadings, and good stability against remobilization, BHAP is shown to be a potential material for the remediation of aqueous radionuclide in groundwater.

Dentist suicides.

EDITOR'S COMMENT: The following article highlights the very sad circumstances surrounding the suicide of a colleague earlier in the year. We received the text below from Paul Hood as a submission to 'Letters to the editor' for the BDJ and reproduce it here in full. My initial reaction was that the letter contained sentiments and thoughts that would resonate with readers but that it over long for our pages and needed some general 'tidying up' before we could publish it. I replied by e-mail suggesting this and offering editorial help if he wished. Very sadly I did not receive a reply as Paul had committed suicide. Subsequently John Renshaw contacted me and suggested that we might publish the letter together with an introduction. We do this, with full, and gratefully received, permission from Paul's widow, to whom we also extend our sincere condolences.

Radiotolerance of phosphatases of a Serratia sp.: potential for the use of this organism in the biomineralization of wastes containing radionuclides.

Aqueous wastes from nuclear fuel reprocessing present special problems of radiotoxicity of the active species. Cells of Serratia sp. were found previously to accumulate high levels of hydrogen uranyl phosphate (HUP) via the activity of a phosphatase enzyme. Uranium is of relatively low radiotoxicity whereas radionuclide fission products such as (90)Sr and (137)Cs are highly radiotoxic. These radionuclides can be co-crystallized, held within the bio-HUP "host" lattice on the bacterial cells and thereby removed from contaminated solution, depending on continued phosphatase activity. Radiostability tests using a commercial (60)Co γ-source showed that while cell viability and activity of purified phosphatase were lost within a few hours on irradiation, whole-cell phosphatase retained 80% of the initial activity, even after loss of cell culturability, which was increased to 100% by the incorporation of mercaptoethanol as an example radioprotectant, beyond an accumulated dose of >1.3 MGy. Using this co-crystallization approach (without mercaptoethanol) (137)Cs(+) and (85)Sr(2+) were removed from a simulated waste selectively against a 33-fold excess of Na(+).

Uptake of Sr2+ and Co2+ into biogenic hydroxyapatite: implications for biomineral ion exchange synthesis.

Biomineral hydroxyapatite (Bio-HAp) produced by Serratia sp. has the potential to be a suitable material for the remediation of metal contaminated waters and as a radionuclide waste storage material. Varying the Bio-HAp manufacturing method was found to influence hydroxyapatite (HAp) properties and consequently the uptake of Sr(2+) and Co(2+). All the Bio-HAp tested in this study were more efficient than the commercially available hydroxyapatite (Com-HAp) for Sr(2+) and Co(2+) uptake. For Bio-HAp the uptake for Sr(2+) and Co(2+) ranged from 24 to 39 and 29 to 78 mmol per 100 g, respectively. Whereas, the uptake of Sr(2+) and Co(2+) by Com-HAp ranged from 3 to 11 and 4 to 18 mmol per 100 g, respectively. Properties that increased metal uptake were smaller crystallite size (<40 nm) and higher surface area (>70 m(2) g(-1)). Organic content which influences the structure (e.g., crystallite arrangement, size and surface area) and composition of Bio-HAp was also found to be important in Sr(2+) and Co(2+) uptake. Overall, Bio-HAp shows promise for the remediation of aqueous metal waste especially since Bio-HAp can be synthesized for optimal metal uptake properties.

Reduction of uranium(VI) phosphate during growth of the thermophilic bacterium Thermoterrabacterium ferrireducens.

The thermophilic, gram-positive bacterium Thermoterrabacterium ferrireducens coupled organotrophic growth to the reduction of sparingly soluble U(VI) phosphate. X-ray powder diffraction and X-ray absorption spectroscopy analysis identified the electron acceptor in a defined medium as U(VI) phosphate [uramphite; (NH4)(UO2)(PO4) . 3H2O], while the U(IV)-containing precipitate formed during bacterial growth was identified as ningyoite [CaU(PO4)2 . H2O]. This is the first report of microbial reduction of a largely insoluble U(VI) compound.

Solution chemistry of uranyl ion with iminodiacetate and oxydiacetate: A combined NMR/EXAFS and potentiometry/calorimetry study.

The solution chemistry of uranyl ion with iminodiacetate (IDA) and oxydiacetate (ODA) was investigated using NMR and EXAFS spectroscopies, potentiometry, and calorimetry. From the NMR and EXAFS data and depending on stoichiometry and pH, three types of metal:ligand complex were identified in solution in the pH range 3-7: 1:1 and 1:2 monomers; a 2:2 dimer. From NMR and EXAFS data for the IDA system and previous studies, we propose the three complex types are [UO(2)(IDA)(H(2)O)(2)], [UO(2)(IDA)(2)](2)(-), and [(UO(2))(2)(IDA)(2)(mu-OH)(2)](2)(-). From EXAFS spectroscopy, similar 1:1, 2:2, and 1:2 complexes are found for the ODA system, although (13)C NMR spectroscopy was not a useful probe in this system. For the 1:1 and 1:2 complexes in solution, EXAFS spectroscopy is ambiguous because the data can be fitted with either a long U-N/O(ether) value (ca. 2.9 A) suggesting 1,7-coordination of the ligand or a U-C interaction at a similar distance, consistent with terminal bidentate coordination. However, the NMR data of the IDA system suggest that 1,7-coordination is the more likely. The stability constants of the three complexes were determined by potentiometric titrations; the log beta values are 9.90 +/-, 16.42 +/-, and 10.80 +/- for the 1:1, 1:2, and 2:2 uranyl-IDA complexes, respectively, and 5.77 +/-, 7.84 +/-, and 4.29 +/- for the 1:1, 1:2, and 2:2 uranyl-ODA complexes, respectively. The thermodynamic constants for the complexes were calculated from calorimetric titrations; the enthalpy changes (kJ mol(-)(1)) and entropy changes (J K(-)(1) mol(-)(1)) of complexation for the 1:1, 1:2, and 2:2 complexes respectively are the following. IDA: 12 +/- 2, 230 +/- 8; 8 +/- 2, 151 +/- 9; -33 +/- 3, -283 +/- 11. ODA: 26 +/- 2, 198 +/- 12; 20 +/- 2, 106 +/- 8; -24 +/- 2; -219 +/- 8.

Synthesis and characterization of uranyl compounds with iminodiacetate and oxydiacetate displaying variable denticity.

Eight uranyl compounds containing the dicarboxylate ligands iminodiacetate (IDA) or oxydiacetate (ODA) have been characterized in the solid state. The published polymeric structures for [UO(2)(C(4)H(6)NO(4))(2)] and [UO(2)(C(4)H(4)O(5))](n) have been confirmed, while Ba[UO(2)(C(4)H(5)NO(4))(2)] x 3H(2)O, [(CH(3))(2)NH(CH(2))(2)NH(CH(3))(2)][UO(2)(C(4)H(4)O(5))(2)] [orthorhombic space group Pnma, a = 10.996(5) A, b = 21.42(1) A, c = 8.700(3) A, Z = 4], and [C(2)H(5)NH(2)(CH(2))(2)NH(2)C(2)H(5)][UO(2)(C(4)H(4)O(5))(2)] [monoclinic space group P2(1)/n, a = 6.857(3) A, b = 9.209(5) A, c = 16.410(7) A, beta = 91.69(3), Z = 2] contain monomeric anions. The distance from the uranium atom to the central heteroatom (O or N) in the ligand varies. Crystallographic study shows that U-heteroatom (O/N) distances fall into two groups, one 2.6-2.7 A in length and one 3.1-3.2 A, the latter implying no bonding interaction. By contrast, EXAFS analysis of bulk samples suggests that either a long U-heteroatom (O/N) distance (2.9 A) or a range of distances may be present. Three possible structural types, two symmetric and one asymmetric, are identified on the basis of these results and on solid-state (13)C NMR spectroscopy. The two ligands in the complex can be 1,4,7-tridentate, giving five-membered rings, or 1,7-bidentate, to form an eight-membered ring. (C(4)H(12)N(2))[(UO(2))(2)(C(4)H(5)NO(4))(2)(OH)(2)] x 8H(2)O [monoclinic space group P2(1)/a, a = 7.955(9) A, b = 24.050(8) A, c = 8.223(6) A, beta = 112.24(6), Z = 2], (C(2)H(10)N(2))[(UO(2))(2)(C(4)H(5)NO(4))(2)(OH)(2)] x 4H(2)O, and (C(6)H(13)N(4))(2)[(UO(2))(2)(C(4)H(4)O(5))(2)(OH)(2)] x 2H(2)O [monoclinic space group C2/m, a = 19.024(9) A, b = 7.462(4) A, c = 2.467(6) A, beta = 107.75(4), Z = 4] have a dimeric structure with two capping tridentate ligands and two mu(2)-hydroxo bridges, giving edge-sharing pentagonal bipyramids.

The evangelical wing?

The move from NHS general dental practice into the 'bright and shiny' world of the private sector seems to have a very odd effect on some people, somewhat akin to the 'evangelical' conversion that occurs on discovering a new belief system or new way of doing things. In effect, having been converted to this new way of life, the individual seems to have an overwhelming desire to 'convert' everyone else to their own way of thinking.

General practitioners' views on the early diagnosis of dementia.

This study investigated the views on the early diagnosis of dementia from over 1000 general practitioners (GPs) from 12 Health Authority areas in England and Wales. Almost half of the GPs did not believe it was beneficial to make an early diagnosis, yet most admitted they needed more training in the area. In areas where there had been specific efforts to contact and educate local GPs, the GPs were far more likely to believe in the value of early diagnosis.

New contracts for specialist orthodontic practitioners?

This paper discusses the possibility of new forms of contacting or commissioning emerging between UK Health Authorities (or other parties such as Primary Care Groups and Primary Care Trusts) and established providers of specialist orthodontic services.

BIRICODAR (VX-710; Incel): an effective chemosensitizer in neuroblastoma.

Clinical studies have suggested that both MDR1 and MRP may play a significant role in the chemosensitivity and outcome of neuroblastoma. To clarify the nature of multidrug resistance (MDR) in this tumour a series of six neuroblastoma cell lines have been characterized with regard to P-glycoprotein, MRP and LRP expression using immunocytochemistry and expression of MDR1, MRP, LRP and topoisomerase II genes using reverse transcription polymerase chain reaction (RT-PCR). By RT-PCR, all lines expressed MRP, five expressed LRP and four expressed MDR1, but protein levels of each of these were variable. Chemosensitization to a range of MDR-associated drugs (vincristine, doxorubicin, etoposide, taxotere, topotecan) and non-MDR-associated drugs (cisplatin, melphalan) by three modulating agents, cyclosporin A, PSC 833 and the novel Biricodar (VX-710; Incel), was evaluated using a colourimetric cytotoxicity assay (MTS). Alteration of daunorubicin efflux by these agents was evaluated using FACS analysis. Clonogenic assay was used to study the influence of these chemosensitizers on vincristine cytotoxicity. Marked sensitization to vincristine was observed in MDR1-positive lines, and a similar but less consistent effect was seen with taxotere, doxorubicin and etoposide. With MRP-positive, MDR-negative lines, only VX-710 caused consistent sensitization. These data confirm MDR1 and MRP expression as contributory factors in chemoresistance in neuroblastoma and indicate that VX-710 may be a useful modulator of both mechanisms and worthy of clinical evaluation in this tumour.

Cochlear implantation in auditory neuropathy.

OBJECTIVE: Auditory neuropathy is a recently described clinical entity characterized by sensorineural hearing loss in which the auditory evoked potential (ABR) is absent but otoacoustic emissions are present. This suggests a central locus for the associated hearing loss. In this study the results observed in a child with auditory neuropathy who received a cochlear implant are presented and compared with those of a matched group of children who were recipients of implants. METHODS: A single-subject, repeated-measures design, evaluating closed-set and open-set word recognition abilities was used to assess the subject and a control group of matched children with implants who had also experienced a progressive sensorineural hearing loss. RESULTS: The subject demonstrated improvements in vowel recognition (82% correct) by 1 year after implantation, which were only slightly lower than the control group. Consonant recognition and open-set word recognition scores were significantly lower. CONCLUSION: Caution should be exercised when considering cochlear implantation in children with auditory neuropathy. As with conventional hearing aids, less than optimal results may be seen.