High temporal resolution monitoring of multiple pollutant responses in drainage from an intensively managed grassland catchment caused by a summer storm

This work presents data on a suite of diffuse pollutants, monitored in a stream draining an intensively managed grassland on a 30 min time step during a period of intense rainfall to better understand their sources and pathways. Nitrite (92 mu g l(-1)), particulate phosphorus (107 mu g l(-1)) and soluble phosphorus (74 mu g l(-1)) exceeded environmental limits during base flow. Concentrations of nitrate and nitrite were decreased during the storm event, whereas all other pollutants generally increased and exceeded environmental limits where specified, especially when associated with a small subsidiary hydrograph on the rising limb of the main hydrograph. Total pollutants loads, when using a 60 min sampling frequency, would have led to significant over and under-estimations depending on which 60 min sample set was used. In the worst case, loads of ammonium could have been under-estimated by 35% or over estimated by 25% with errors being associated with loads on the rising limb of the hydrograph and more specifically a small subsidiary hydrograph. This subsidiary hydrograph may have occurred as a result of runoff from the farm hard standings within the catchment. Incidental transfer of pollutants associate with this runoff have masked the overall grassland pollutant response. To better understand these different source areas and pollutant dynamics, there is a need for novel tracing techniques to elucidate their relative contribution and pathways

Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study

OBJECTIVES: To examine attitudes and experiences of parents whose children have complex congenital heart disease (CHD) with respect to dental health information and advice, dental care, and service and to compare the results with data from an age- and gender-matched control group without any medical problems. SETTING: Faculty of Medicine (Paediatric Cardiology and Paediatric Dentistry), Umea University, Umea, Sweden. SAMPLE AND METHOD: Each group comprised parents of 33 children; the children's mean age was 9.4 years. All the cases and the controls resided in the county of Vasterbotten, northern Sweden. Data were collected with a questionnaire with 20 joint questions to both groups and four additional questions to the CHD group. RESULTS: Of the 20 joint questions, significant differences were displayed in the following areas: the professional group that provided the parents with dental health information and advice (P &lt; 0.01), attitudes to reception at the dental clinic, and experience of sedation before operative dental treatment (P &lt; 0.05). Parents to 11 children with CHD who were patients at a specialist clinic for paediatric dentistry scored the reception at the dental clinic as excellent in nine cases and satisfactory in two, compared to excellent (3), satisfactory (11), decent (4), and poor (4) among those who were patients in general dental practice (P &lt; 0.01). No statistically significant differences in educational level or in parental experience of dental health were noted between the two groups (P &gt; 0.05). CONCLUSION: Children with CHD in northern Sweden mainly receive their dental health information from a physician or a dentist, and healthy children mainly receive information from a dental hygienist indicating that children with CHD are given priority in the dental care system. Parental attitudes to reception in the dental service differed, and parents of healthy children scored the reception at the dental clinic better than parents of children with CHD. It is suggested that children with severe CHD should receive dental care in clinics for paediatric dentistry, particularly at early ages.</p

Dental caries experience in children with congenital heart disease: a case-control study

Objectives: To compare the dental health in a group of children with complex congenital heart disease with age and gender matched healthy controls. Design: Case-control study. Setting: Faculty of Medicine and Odontology/ Pediatric cardiology and Pedodontics, Umeå university, Sweden Sample and Methods: All the cases and their controls lived in the county of Västerbotten in northern Sweden. Each group comprised 41 children with a mean age of 6.5 years. Data were collected from medical and dental records. All bitewing radiographs were read separately by one of the authors. Results: Children with congenital heart disease had significantly more caries in their primary teeth than the control group. The mean dmfs-value was 5.2 + 7.0 in the cardiac group compared to 2.2 + 3.5 in the control group (p &lt; 0.05). Twenty-six of the children had all four 6-year molars, and their mean DMFS-values were 0.9 + 1.9 in the cardiac group compared to 0.3 + 0.6 in the control group (p &gt; 0.05). The children with congenital heart disease had received more caries prevention based on the use of fluorides than the control group. There was a significant correlation between the number of fluoride varnish treatments and the dmfs value of the child (r = 0.411, p &lt; 0.01). Fifty-two per cent of the children in the cardiac group were prescribed fluoride tablets on one or more occasions compared to 17% in the control group (p &lt; 0.01). Number of month on digoxin medication and the dmfs-value had a significant correlation (r = 0.368, p &lt; 0.05). Ten of the children had been on digoxin medication between 6 and 87 months and they had a mean dmfs-value of 10.1 + 8.5. Conclusion: Swedish children with complex congenital heart disease have poorer dental health than healthy age and gender matched controls in spite of intensified preventive efforts. In many cases, intervention had been given when caries were present. A closer cooperation between paediatric cardiology and paediatric dentistry is needed.</p