Using the German National Medication Plan for Clinical Studies in Practice-Based Research Networks.

The German National Medication Plan (GNMP) can be a valuable and interoperable data source for clinical studies, due to its digital specification and mandatory provisioning for chronically ill patients. Digital transfer of a patients current GNMP from the Patient Data Management System (PDMS) into electronic case report forms would avoid error prone manual data capturing. It is also essential for studies in practice-based research networks (PBRN), where data capturing must have as little impact as possible on everyday practice.

FoPraNet-BW: An Infrastructure for Clinical Studies in Practice-Based Research Networks in the German Health System.

General practice-based research networks have become an integral tool to gain medical knowledge from primary care in many countries. For this purpose, a scalable IT-infrastructure is presented considering the limiting peculiarities in the German health system and enabling GPs to participate in clinical studies based on their patient population. The infrastructure consists of a central study management server and local clients for each practice.

Association between continuity of care and inappropriate prescribing in outpatient care in Germany: a cross-sectional analysis conducted as part of the LoChro trial.

Objectives: Potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are common in multimorbid patients. This study aims to describe PIMs and PPOs in an open-access outpatient setting and to investigate any association between continuity of care (CoC) and PIMs and PPOs in multimorbid older patients.

Design: Cross-sectional study using patient-confirmed outpatient medication plans to describe PIMs and PPOs using the 'Screening Tool of Older Person's Prescription/Screening Tool to Alert to Right Treatment' version 2.

Analysis of the key themes in the healthcare of older people with multimorbidity in Germany: a framework analysis as part of the LoChro trial.

Objectives: Multimorbidity challenges healthcare systems. In Germany, coordination of healthcare for older multimorbid patients remains unstructured.This study aims to identify key themes in the healthcare of these patients and the inter-relationships between them.

Local, collaborative, stepped, and personalized care management for older people with chronic diseases - results from the randomized controlled LoChro-trial.

Background: In the aging population of Western societies, an increasing number of older adults have multiple chronic diseases. As multifaceted health problems imply the involvement of several healthcare professionals, multimorbid older people frequently face a fragmentation of health care. Addressing these challenges, we developed a local, collaborative, stepped, and personalized care management approach (LoChro-Care) and evaluated its effectiveness.

Reduction of care-relevant risks to older patients during and after acute hospital care (ReduRisk) - study protocol of a cluster randomized efficacy trial in a stepped wedge design.

Background: Older patients are at an increased risk of hospitalization, negatively affecting their health and quality of life. Such patients also experience a lack of physical activity during their inpatient stay, as well as being at increased risk of delirium and inappropriate prescribing. These risk factors can accumulate, promoting a degree of morbidity and the development of cognitive impairment.

Over- and under-prescribing, and their association with functional disability in older patients at risk of further decline in Germany - a cross-sectional survey conducted as part of a randomised comparative effectiveness trial.

Background: Older patients at risk of functional decline are frequently affected by polypharmacy. This is associated with a further loss of independence. However, a relationship between functional disability and medications, such as 'Potentially Inappropriate Medications' (PIMs) and 'Potential Prescribing Omissions' (PPOs), as itemised for (de) prescribing in practice-orientated medication lists, has yet to be established.

Biological control of spp. in glasshouse-grown chrysanthemum.

Root-knot nematodes ( spp.) are a major problem in soil-based glasshouse-grown chrysanthemums. To combat root-knot nematodes in the glasshouse, the soil is typically steamed every 5-6 production cycles.

Local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro): study protocol of a randomised comparative effectiveness trial.

Background: Multimorbid older adults suffering from a long-term health condition like depression, diabetes mellitus type 2, dementia or frailty are at high risk of losing their autonomy. Disability and multimorbidity in the older population are associated with social inequality and lead to soaring costs. Our local, collaborative, stepped and personalised care management for older people with chronic diseases (LoChro-Care) aims at improving outcomes for older multimorbid patients with chronic conditions whose social and medical care must be improved.

Evaluation of different approaches to describe the sorption and desorption of phosphorus in soils on experimental data.

Phosphorus is an essential element to enhance the needed increase in crop production in the forthcoming century. On the other hand environmental losses of phosphorus cause eutrophication of surface waters. Both problems call for reliable models to predict the behaviour of phosphorus in agricultural soils.

Characterization of colloidal phosphorus species in drainage waters from a clay soil using asymmetric flow field-flow fractionation.

Phosphorus transport from agricultural land contributes to eutrophication of surface waters. Pipe drain and trench waters from a grassland field on a heavy clay soil in the Netherlands were sampled before and after manure application. Phosphorus speciation was analyzed by physicochemical P fractionation, and the colloidal P fraction in the dissolved fraction (<0.

Water and nutrient transport on a heavy clay soil in a fluvial plain in the Netherlands.

In flat areas, transport of dissolved nutrients by water through the soil matrix to groundwater and drains is assumed to be the dominant pathway for nutrient losses to ground- and surface waters. However, long-term data on the losses of nutrients to surface water and the contribution of various pathways is limited. We studied nutrient losses and pathways on a heavy clay soil in a fluvial plain in The Netherlands during a 5-yr period.

Predicting phosphorus losses with the PLEASE model on a local scale in Denmark and the Netherlands.

To reduce losses from agricultural soils to surface water, mitigation options have to be implemented as a local scale. For a cost-effective implementation of these measures, an instrument to identify critical areas for P leaching is indispensable. In many countries, P-index methods are used to identify areas as risk for P losses to surface water.

Phytoextraction of phosphorus-enriched grassland soils.

High soil P contents in agricultural soils in the Netherlands cause excessive losses of P to surface waters. The reductions in P application rates in the present manure policy are not sufficient to reach surface water quality standards resulting from the European Water Framework Directive in 2015. Accordingly, additional measures are necessary to reduce P loading to surface water.

Predicting dissolved inorganic nitrogen leaching in European forests using two independent databases.

Regional-scale databases can be particularly useful for identifying relationships between dissolved inorganic nitrogen (N) leaching in forests and environmental drivers, which in turn allow an assessment of the risk of ecosystem damage, such as forest acidification and eutrophication of downstream water bodies. However, detecting the 'signal' of a significant correlate to N leaching against a background of wide variability in other factors requires a large number of sites, and the validation of models developed requires a similarly large number of independent sites. Here we use two large and fully independent databases of forest ecosystems across Europe to develop and validate indicators of N saturation and leaching.

Patterns of seasonal phytoplankton distribution in prairie saline lakes of the northern Great Plains (U.S.A.).

Seasonal changes in freshwater phytoplankton communities have been extensively studied, but key drivers of phytoplankton in saline lakes are currently not well understood. Comparative lake studies of 19 prairie saline lakes in the northern Great Plains (USA) were conducted in spring and summer of 2004, with data gathered for a suite of limnological parameters. Nutrient enrichment assays for natural phytoplankton assemblages were also performed in spring and summer of 2006.

Cardiac Manifestations from Non-FIP1L1-PDGFRα-Associated Hypereosinophilic Syndrome in a 13-Year-Old African American Boy.

Hypereosinophilic syndrome (HES) is a rare disorder typically seen in males, aged 20 to 50, with a predisposition for Caucasians. It is marked by overproduction of eosinophils (>1,500/μL) and multiorgan system damage due to eosinophilic infiltration and mediator release. There are multiple variants of HES.

One-year experience with candida antigen immunotherapy for warts and molluscum.

Molluscum contagiosum and warts are two very common viral-induced diseases of childhood. We report our 1-year experience with intralesional candida antigen therapy for both warts and molluscum contagiosum. A retrospective chart review was performed and a total of 217 patients were identified.

Element fluxes through European forest ecosystems and their relationships with stand and site characteristics.

This paper describes a European wide assessment of element budgets, using available data on deposition, meteorology and soil solution chemistry at 121 Intensive Monitoring plots. Input fluxes from the atmosphere were derived from fortnightly or monthly measurements of bulk deposition and throughfall, corrected for canopy uptake. Element outputs from the forest ecosystem were derived by multiplying fortnightly or monthly measurements of the soil solution composition at the bottom of the root zone with simulated unsaturated soil water fluxes.

Water balances in intensively monitored forest ecosystems in Europe.

A soil hydrological model based on Darcy's law was used to calculate hydrological fluxes for 245 intensively monitored forest plots in Europe. Local measured input data for the model were rather limited and input was partly based on generic data. To obtain the best results, the model was calibrated on measured throughfall at the plots.

Phosphorus leaching from cow manure patches on soil columns.

The loss of P in overland flow or leachate from manure patches can impair surface water quality. We studied leaching of P from 10-cm-high lysimeters filled with intact grassland soil or with acid-washed sand. A manure patch was created on two grassland and two sand-filled lysimeters, and an additional two grass lysimeters served as blanks.

Disturbance of water-extractable phosphorus determination by colloidal particles in a heavy clay soil from the Netherlands.

Water extraction methods are widely used to extract phosphorus (P) from soils for both agronomic and environmental purposes. Both the presence of soil colloids in soil water filtrates, and the contribution of colloidal P to the molybdate-reactive phosphorus (MRP) concentration measured in these filtrates, are well documented. However, relatively little attention has been given to the direct disturbance by colloids of MRP measurement.

A review of the calculation procedure for critical acid loads for terrestrial ecosystems.

Target loads for acid deposition in the Netherlands, as formulated in the Dutch environmental policy plan, are based on critical load calculations at the end of the 1980s. Since then knowledge on the effect of acid deposition on terrestrial ecosystems has substantially increased. In the early 1990s a simple mass balance model was developed to calculate critical loads.