Rekenmodel plaatst P+R in netwerkperspectief

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Early Detection of Neonatal Cholestasis: Inadequate Assessment of Stool Color by Parents and Primary Healthcare Doctors

IntroductionEarly diagnosis and surgery (<60 days of age) improve outcomes in children with biliary atresia. Only 56% of patients undergo timely surgery in the Netherlands. Lack of acquaintance with symptoms such as discolored stools might underlie this delay. We analyzed whether Dutch parents, youth healthcare doctors, or general practitioners recognized discolored stools and evaluated the effect of the Infant Stool Color Card (ISCC) on recognizing discolored stools. Material and MethodsWe asked 100 parents, 33 youth healthcare doctors, and 50 general practitioners to classify photographs of stools as normal or abnormal. Subsequently, we asked whether parents would seek medical help and doctors would refer the patient for medical investigation. Finally, parents scored stools using the ISCC. ResultsTwo-third of both parents and youth healthcare doctors recognized all discolored stools. Only half of them would seek medical help for all discolored stools resp. refer patient for medical investigation. Only one-third of the general practitioners recognized all discolored stools and would refer for medical investigation for all discolored stools. Using the ISCC, the percentage of parents recognizing all discolored stool increased from 66 to 87% (p ConclusionNeither parents nor youth healthcare doctors nor general practitioners reliably recognize discolored stool. The ISCC is an effective screening method for discolored stool. Our data indicate that the ISCC should be accompanied by unequivocal advices regarding referral for medical investigation upon detection of discolored stools

Adsorção de íons sulfato em ZrO2.nH2O preparado pelo método da precipitação convencional e da precipitação em solução homogênea Adsorption of sulfate ions in ZrO2.nH2O prepared by conventional precipitation and homogeneous solution methods

Este trabalho visa a preparação, caracterização e estudo da adsorção de íons sulfato em óxido de zircônio hidratado preparado pelos métodos da precipitação convencional e da precipitação em solução homogênea. Os materiais obtidos foram caracterizados por difração de raios X, análise termogravimétrica, microscopia eletrônica de varredura e análise de área superficial específica pelo método BET. Através da constante Q0, relacionada com a capacidade de adsorção máxima, observou-se que o ZrO2.nH2O/PSH possui maior capacidade de adsorção para íons sulfato que o ZrO2.nH2O/PC. Pelos resultados de &#916;G, observou-se que os íons sulfato foram adsorvidos através de reações energeticamente favoráveis para toda a faixa de concentração estudada.<br>This work reports the preparation, characterization and adsorption study of sulfate on hydrous zirconium oxides prepared by conventional and homogeneous solution precipitation methods. The materials prepared were characterized by X-ray diffraction, thermogravimetric analysis, scanning electron microscopy and surface area measurements. Through the Q0 constant, related with the capacity of maximum adsorption, it was observed that the ZrO2.nH2O/PSH presented better adsorption capacity than ZrO2.nH2O/PC. By results of &#916;G, it was observed that sulfate ions had been adsorbed through favorable reactions for all studied concentration ranges