RADON BASELINE MONITORING AROUND A POTENTIAL SHALE GAS DEVELOPMENT SITE IN YORKSHIRE, ENGLAND.

The Vale of Pickering in Yorkshire, England has been identified as a potential area for shale gas extraction. Public Health England joined a collaboration led by the British Geological Survey for environmental baseline monitoring near the potential shale gas extraction site following a grant award from UK Government Department for Business, Energy and Industrial Strategy. The analysis of results for the first 6 months of indoor monitoring indicated that the results followed a log-normal distribution. The numbers of homes found to be at or above the Action Level followed the numbers predicted by the radon potential maps. The results from the measurements of outdoor air in this study indicated that the radon concentrations are slightly higher than previously measured but close to the detection limit of the technique.

National radon programmes and policies: the RADPAR recommendations.

Results from epidemiological studies on lung cancer and radon exposure in dwellings and mines led to a significant revision of recommendations and regulations of international organisations, such as WHO, IAEA, Nordic Countries, European Commission. Within the European project RADPAR, scientists from 18 institutions of 14 European countries worked together for 3 y (2009-12). Among other reports, a comprehensive booklet of recommendations was produced with the aim that they should be useful both for countries with a well-developed radon programme and for countries with little experience on radon issues. In this paper, the main RADPAR recommendations on radon programmes and policies are described and discussed. These recommendations should be very useful in preparing a national action plan, required by the recent Council Directive 2013/59/Euratom.

Illness Identity and the Self-regulatory Model in Recovery from Early Stage Gynaecological Cancer.

Women in recovery from early stage gynaecological cancer have extremely good survival and low recurrence rates. Despite this, women continue to feel vulnerable to cancer recurrence for years after treatment. Semi-structured interviews were utilized to explore the factors involved in recovery from gynaecological cancer. This article argues that the illness identity of gynaecological cancer perpetuates a vulnerability to cancer recurrence. The absence of self-diagnosis prior to medical diagnosis is important in the formation of gynaecological cancer illness identity. A lack of self-diagnosis may be due to the 'normalization' of initial symptomatology. It is suggested that illness identity is responsible for maintaining fears of symptom-free cancer recurrence. The self-regulatory model is employed to explore this process, looking in particular at the reinforcement of reassurance needs.

The experience of long-term hospital follow-up for women who have suffered early stage gynecological cancer: a qualitative interview study.

Bradley EJ, Pitts MK, Redman CWE, Calvert E. The experience of long term hospital follow-up for women who have suffered early stage gynecological cancer: a qualitative interview study. The objective of this paper is to investigate the factors involved in the wish for continuing long-term follow-up for early stage gynecological cancer in the absence of obvious clinical benefit. This qualitative study is comprised of semistructured, individual interviews. Twelve women who had been treated for early stage (I-II) gynecological cancer (cervical, vulval, ovarian, endometrial) and had been attending regular follow-up appointments at the hospital clinic for a minimum of six months were interviewed for this study. The primary outcome measures were women's views on their follow-up needs. Women who continue to express a need for follow-up appointments years after the treatment of active disease are seeking to alleviate anxiety regarding possible recurrent illness. The main element of follow-up that alleviates this recurrence anxiety is medical reassurance, this is only judged to be worthwhile when given by a gynecological consultant. There is a difficulty with regarding the period of remission as a healthy state, both cultural "lay" beliefs and family support exacerbate this difficulty. Although family support is deemed important initially, it may actually serve to maintain "sickness" identity, perpetuating views of cancer remission as another stage of illness. We conclude that the processes involved in follow-up for cancers with a very low recurrence risk are complex. Follow-up information is perhaps medical, but women who have a continued need for follow-up in the absence of any clinical disease are attending for psychological purposes. Further research is needed to study possible interventions that could be introduced to help alleviate anxiety during the period of cancer recovery.

Patient perception of a long-term clinical trial: experience using a close-out questionnaire in the Studies of Left Ventricular Dysfunction (SOLVD) Trial. SOLVD Close-out Working Group.

A close-out questionnaire was distributed to the participants in a long-term heart failure trial, Studies of Left Ventricular Dysfunction (SOLVD). The respondents' primary motivation for enrollment, positive and negative experiences, and reported changes in habitual behavior was analyzed. Seventy-four percent (N = 3522) of the eligible patients responded to the survey. The most commonly cited reason for enrollment was recommendation by the primary physician. A wish "to contribute to medical science" and "to help others" was also a frequent incentive. A majority of the respondents were satisfied with participation and would be willing to participate in a future clinical trial. Most negative experiences included transportation to and from the clinic and frequent staff changes. A significant number of the patients reported changes in their smoking habits, alcohol intake, and diet despite the absence of behavioral interventions in the study protocol. There were minor differences between attitudes and perceptions of the male and female participants. No differences were found between patients who had previously participated in a clinical trial and those who had not.

Patients' characteristics and consumer satisfaction on an inpatient child psychiatric unit.

This paper reports the results of a chart review and consumer satisfaction evaluation of referrals to a tertiary care child psychiatric inpatient unit. The evaluation involved an examination of the types of child and family difficulties treated during the period of the study; the nature and extent of assessment, treatment and follow-up; treatment outcome and parental perception of factors related to treatment outcome; and the satisfaction of both the parents and referral sources. Results indicated that children admitted for treatment were a heterogeneous group with severe difficulties from families with a number of problems. Most parents and referring therapists were very satisfied with the treatment, recommendations and follow-up provided. Significant correlations were observed between the parents' and referring therapist's satisfaction with the service and the extent to which home based problems were addressed during the child's stay in hospital. In addition, some suggestions are given for strategies to improve services. The findings are discussed with special reference to the value of program evaluations for inpatient child psychiatric services.

The distribution of 210Po in human bone.

Recent measurements of natural radioactivity in human bone using alpha particle autoradiography have indicated that the alpha activity concentration in the bone marrow is similar to that found in the calcified bone. This paper describes radiochemical measurements made on the calcified bone and the associated bone marrow from three human femurs. A technique was developed to separate and analyse these tissues for the principal naturally-occurring alpha emitter, 210Po. In all cases the activity concentration of the calcified bone was greater than that of the associated bone marrow. As predicted by the metabolic models used by International Commission on Radiological Protection, the majority of the 210Po in whole bone was found to be in the calcified region.

Physically abusive and nonabusive mothers' perceptions of parenting and child behavior.

Physically abusive and nonabusive mothers were studied for differences in perceptions of the parenting role and of child behavior problems. Findings suggested systematic differences in attributional style of the abusive mothers, supporting the hypothesis that such mothers are hyperreactive to their children's misbehavior. These mothers also tended to minimize both their own contribution to negative parent-child interactions and their children's role in positive ones.

Eruptive malpositioning of the mandibular permanent lateral incisors: three case reports.

Ectopic eruption of the mandibular permanent lateral incisors involving the loss of the adjacent primary canines is not uncommon, yet the extreme distalization and transposition of such teeth (partial or true) has been reported infrequently. Three cases that illustrate various anomalous eruption-exfoliation patterns are presented. Theories that attempt to explain the etiology of anomalous eruption positions are discussed. However, the multifactorial process of growth and development makes it difficult to identify specific primary etiological factors. Treatment options also are discussed and illustrated, with emphasis on early orthodontic intervention for optimal results.

Influence of husbandry on the transfer of radiocaesium from feed to milk during the winter that followed the Chernobyl reactor accident.

The release of activity from the Chernobyl nuclear reactor resulted in deposition of radionuclides throughout the UK in early May 1986. Since that time, the transfer of radiocaesium from feed to milk has been followed at two farms that differ in both location and husbandry practice. This paper concerns the winter of 1986/87, when activity concentrations in milk increased because of the consumption of silage prepared earlier in the year. Silage-to-milk transfer coefficients have been estimated which suggest that, when incorporated into prepared silage, radiocaesium from Chernobyl is less available for transfer to cows' milk than soluble caesium-134 applied directly onto pasture. The measured activity concentrations in milk have been compared with those predicted by the NRPB model FARMLAND; despite differences between the husbandry practice assumed in the model and those observed in practice, the model provides an adequate radiological assessment of the feed-cow-milk pathway after an accidental release of radioactivity.

The influence of different agricultural practices on the transfer of radionuclides from pasture to milk after the Chernobyl accident.

Deposition of radionuclides from the Chernobyl nuclear reactor in the Ukraine occurred over much of the United Kingdom. The magnitude of the deposition varied considerably, depending on the prevailing weather, but even in areas of low deposition, iodine-131, caesium-134 and caesium-137 were measurable on pasture and in cows' milk. The accident provided an opportunity to study the influence of differences in herd management and in climate upon transfer to cows' milk. In this paper, results from a small mixed farm in Cumbria are compared with those from a large dairy farm in Berkshire for the first few weeks after deposition. The contrasting herd management practices in operation at these farms result in very different temporal variations in activity concentrations in milk, although in neither case were the maximum concentrations in milk sufficient to warrant restrictions on distribution or consumption.

The ratio of lead-210 to polonium-210 in U.K. diet.

The levels of the natural radionuclides, 210Pb and 210Po, in U.K. diet have been measured previously. However, in the earlier measurements, the samples were sufficiently aged for 210Pb and 210Po to have attained secular equilibrium. In order to determine the extent of disequilibrium between these radionuclides in fresh food, measurements have been made on recently collected dietary samples. Disequilibrium has been observed in five food groups. The activity per unit mass of 210Pb was found to be greater than that of 210Po in bread, cereals, sugar and preserves, whereas the opposite was found to be true for eggs and beverages. When account is taken of consumption rates, however, the total intakes of 210Pb and 210Po from these food groups are approximately the same. The annual effective dose equivalents from the ingestion of 210Pb and 210Po have been re-estimated at 41 and 12 mu Sv, respectively.

Measurement of natural radionuclides in U.K. diet.

The levels of radium-226, lead-210 and polonium-210 in the U.K. diet have been determined. The important food groups contributing to the intake of these radionuclides have been identified. Seventy-five percent of the daily intake of radium-226 is derived from beverages, cereals, other vegetables, bread, sugars and preserves. Seventy-five percent of the intake of lead-210 and polonium-210 is derived from bread, milk, cereals, beverages, other vegetables, sugars and preserves, and meat products. The average daily intakes of these radionuclides are tentatively calculated to be 30 mBq for radium-226 and 82 mBq for both lead-210 and polonium-210. These levels are compared with data from other countries. The annual effective dose equivalents resulting from the intakes are approximately 3 muSv for radium-226 and 54 muSv from lead-210 and polonium-210 together. The differences between these doses and other current estimates are discussed.