Early warning method for cyanobacteria toxin, taste and odor problems by the evaluation of fluorescence signals

Permanganate and ozone are often used in drinking water treatment plants for the oxidation of taste and odor compounds, toxins, and algae as well as the reduction of mussel activity. The disadvantage of an overuse of such oxidants is the potential lysis of cyanobacterial cells. Cell lysis causes taste and odor components as well as toxins to be released into the water, which results in the need for even more treatment to remove these compounds completely. Our research in the CLIENT-SIGN project investigated an innovative method to monitor the lysis of cyanobacteria cells: increases in a specific fluorescence emission spectrum of the cyanobacteria pigment phycocyanin were used as a proxy for cell lysis and other compounds (taste/odor, toxins) leaving the cells. We call this form of phycocyanin "free phycocyanin" or "unbound phycocyanin". By monitoring free phycocyanin via a relatively fast and inexpensive measurement, water utilities will be better able to optimize the dosage of pre-oxidation compounds to remove extracellular compounds while preventing the lysing of cells. Laboratory studies and a case study at Yangcheng Lake (adjacent to Lake Taihu, Yangcheng Lake Water Treatment Plant, Suzhou Industrial Park, China) are presented herein. An online surveillance system that monitors incoming raw water and the water after pre-oxidation is proposed to better cope with changing water conditions.

GPs' assessment of cooperation with other health care providers involved in cancer care-a cross-sectional study

Cancer is a complex disease requiring the involvement of several health care providers. A possible constant in the cancer care process is the general practitioner (GP). The aim of this project was to evaluate GPs' satisfaction with cooperation with other health care providers in the cancer care process of their patients and to explore which variables are associated with higher satisfaction with cooperation with other health care providers. We considered the following health care providers: outpatient oncology specialists, physicians in relatively small hospitals (≤400 beds), physicians in relatively large hospitals (>400 beds), home care services, outpatient psycho(onco)logists/psychotherapists, hospice/palliative care units and specialised palliative home care. The cross-sectional study was carried out as a postal survey all over Germany. Data were analysed descriptively and by means of logistic regression. Overall satisfaction with cooperation with other health care providers involved in cancer care was rather high. Only cooperation with outpatient psycho(onco)logists/psychotherapists was rated as not assessable/irrelevant by a majority of GPs. For all other health care providers under review, both communication and the transfer of sufficient information in good time were associated with overall satisfaction with cooperation. Little association was found between GP and practice variables and overall satisfaction with cooperation with the considered health care providers.

Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data

The importance of outpatient cancer care services is increasing due to the growing number of patients having or having had cancer. However, little is known about cooperation among physicians in outpatient settings. To understand what inter- and multidisciplinary care means in community settings, we conducted an amplified secondary analysis that combined qualitative interview data with 42 general practitioners (GPs), 21 oncologists and 21 urologists that mainly worked in medical practices in Germany. We compared their perspectives on cooperation relationships in cancer care. Our results indicate that all participants regarded cooperation as a prerequisite for good cancer care. Oncologists and urologists mainly reported cooperating for tumour-specific treatment tasks, while GPs' reasoning for cooperation was more patient-centred. While oncologists and urologists reported experiencing reciprocal communication with other physicians, GPs had to gather the information they needed. GPs seldom reported engaging in formal cooperation structures, while for specialists, participation in formal spaces of cooperation, such as tumour boards, facilitated a more frequent and informal discussion of patients, for instance on the phone. Further research should focus on ways to foster GPs' integration in cancer care and evaluate if this can be reached by incorporating GPs in formal cooperation structures such as tumour boards.