[Satisfied general practitioners and critical nursing staff - problems of interprofessional cooperation in the home care of dementia patients]

AIM OF THE STUDY

Analysis of views of general practioners and nurses of interprofessional cooperation between general practititoners and nurses in the ambulatory care of dementia patients is presented.

METHODS

A survey was carried out among general practitioners and nurses caring for community dwelling dementia patients in Hamburg.

RESULTS

The majority of GPs and nurses consider interprofessional cooperation to be good and beneficial for their own work. GPs are generally more positive about the quality of cooperation than nurses. Joint sessions for planning and evaluation of care are seldom. Even so, more GPs than nurses evaluate the frequency of these meetings to be sufficient. Although nurses are more critical about the quality of the cooperation with the GPs, they seldom address the GP to express their criticism.

CONSEQUENCES

To make cooperation work, the matter should be part of the training of both physicians and nurses and the hierarchy between the 2 groups should be reduced.

P-pollution in a heavily urbanized river basin from point and diffuse sources: the River Ruhr case study (Germany)

An area-differentiated model approach (MEPhos) for the quantification of mean annual P-inputs from point and diffuse sources is presented. The following pathways are considered: artificial drainage, wash-off, groundwater outflow, soil erosion, rainwater sewers, combined sewer overflows, municipal waste water treatment plants and industrial effluents. Based on the modelling results "hot spots" for high P-loads can be localized and management option for the input reduction to surface waters proposed. The model is applied to the River Ruhr basin (4,485 km2) in Germany with contrasting natural conditions, land use patterns as well as population and industry densities.

Area-differentiated modelling of P-fluxes in heterogeneous macroscale river basins

A model (MEPhos) for the calculation of the total phosphorus output from diffuse sources by drainage, wash-off, groundwater outflow, soil erosion and rainwater sewers as well as from point sources is presented. The model is based on a pathway- and area-differentiated emissions approach and calculates mean long-term P-inputs to surface waters. Phosphotopes are used for spatial discretization and modelling of diffuse P-inputs. Based on the modelling results "hot spots" for high P-loads can be localized and a management option for the input reduction to surface waters can be proposed which are adapted to site properties. The applicability of the model is demonstrated for two macroscale river basins in Germany (- 13,000 km(2) each) with contrasting natural conditions and land use patterns.