BESTFACT Best Practice Handbook 3

The Best Practice Handbook (BPH) gives an overview about current concepts, strategies and actions in freight transport all over Europe. It is disseminating information on successful projects and practices to increase awareness and share experiences. It is enabling knowledge transfer and supporting transferability for best practices. The third and last Best Practice Handbook focuses on the work done over the entire project, with 157 inventory cases and 60 in-depth analyses. After four years of case collection a wide field of solutions is available. The main findings of the BESTFACT cases are cross-checked and summarised for each of the cluster topics. The consistent form of collection and information provision broadens the structural understanding of best practice cases. The synthesis of cases per topic shows that under consideration of barriers and framework conditions replicable impacts are achievable. Main editors are Martin Ruesch & Simon Bohne (Rapptrans) and Jacques Leonardi (UoW). Project leader is Marcel Huschebeck (PTV)

The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines

Background: As abnormal growth might be the first manifestation of undetected diseases, it is important to have accurate referral criteria and a proper diagnostic work-up. In the present paper we evaluate the diagnostic work-up in secondary health care according to existing consensus guidelines and study the frequency of underlying medical disorders. Methods: Data on growth and additional diagnostic procedures were collected from medical records of new patients referred for short stature to the outpatient clinics of the general paediatric departments of two hospitals (Erasmus MC - Sophia Children's Hospital, Rotterdam and Spaarne Hospital, Haarlem) between January 1998 and December 2002. As the Dutch Consensus Guideline (DCG) is the only guideline addressing referral criteria as well as diagnostic work-up, the analyses were based on its seven auxological referral criteria to determine the characteristics of children who are incorrectly referred and the adequacy of workup of those who are referred. Results: Twenty four percent of children older than 3 years were inappropriately referred (NCR). Of the correctly referred children 74-88% were short corrected for parental height, 40-61% had a height SDS <-2.5 and 21% showed height deflection (Δ HSDS < -0.25/yr or Δ HSDS < -1). In none of the children a complete detailed routine diagnostic work up was performed and in more than 30% no routine laboratory examination was done at all. Pathologic causes of short stature were found in 27 children (5%). Conclusion: Existing guidelines for workup of children with suspected growth failure are poorly implemented. Although poorly implemented the DCG detects at least 5% pathologic causes of growth failure in children referred for short stature. New guidelines for referral are required with a better sensitivity and specificity, wherein distance to target height should get more attention. The general diagnostic work up for short stature should include testing for celiac disease in all children and for Turner syndrome in girls

Transfer of natural and man made radionuclides from plants to roe deer and farm animals

In this work the transfer behavior of long living radionuclides from the Thorium decay series (Ra-228, Th-228, Th-232) as well as of K-40 and Cs-137 is studied. In a small area of middle Europe (southeast Gemany) showing an increased Thorium content of soil the activity concentrations in samples of feed plants, farm animals, farm animal products, roe deer has been determined. The concentration ratios feed-to-animal tissue and to animal products are calculated indicating a significantly enhanced transfer from feed to roe deer tissues. Determinations of the activity concentrations in fish (carp), pig (tissues), egg, milk complete this examinations. Among all studied samples which are important for human nourishing eggs and carp cause the greatest exposure by ingestion

Verfahren zur Bestimmung von Radionukliden aus der Umweltradioaktivitaet in Lebensmitteln

Available from Bundesforschungsanstalt fuer Ernaehrung, Karlsruhe (DE) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman