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Atrazine was banned in Germany in 1991 due to findings of atrazine concentrations in ground- and drinking waters exceeding threshold values. Monitoring of atrazine concentrations in the groundwater since then provides information about the resilience of the groundwater quality to changing agricultural practices. In this study, we present results of a monitoring campaign of atrazine concentrations in the Zwischenscholle aquifer. This phreatic aquifer is exposed to intensive agricultural land use and susceptible to contaminants due to a shallow water table. In total 60 observation wells (OWs) have been monitored since 1991, of which 15 are sampled monthly today. Descriptive statistics of monitoring data were derived using the "regression on order statistics" (ROS) data censoring approach, estimating values for nondetects. The monitoring data shows that even 20 years after the ban of atrazine, the groundwater concentrations of sampled OWs remain on a level close to the threshold value of 0.1 μg l(-1) without any considerable decrease. The spatial distribution of atrazine concentrations is highly heterogeneous with OWs exhibiting permanently concentrations above the regulatory threshold on the one hand and OWs were concentrations are mostly below the limit of quantification (LOQ) on the other hand. A deethylatrazine-to-atrazine ratio (DAR) was used to distinguish between diffuse - and point-source contamination, with a global mean value of 0.84 indicating mainly diffuse contamination. Principle Component Analysis (PCA) of the monitoring dataset demonstrated relationships between the metabolite desisopropylatrazine, which was found to be exclusively associated with the parent compound simazine but not with atrazine, and between deethylatrazine, atrazine, nitrate, and the specific electrical conductivity. These parameters indicate agricultural impacts on groundwater quality. The findings presented in this study point at the difficulty to estimate mean concentrations of contamination for entire aquifers and to evaluate groundwater quality based on average parameters. However, analytical data of monthly sampled single observation wells provide adequate information to characterize local contamination and evolutionary trends of pollutant concentration., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

To understand what governs the patterns of net ecosystem exchange of CO₂, an understanding of factors influencing the component fluxes, ecosystem respiration and gross primary production is needed. In the present paper, we introduce an alternative method for estimating daytime ecosystem respiration based on whole ecosystem fluxes from a linear regression of photosynthetic photon flux density data vs. daytime net ecosystem exchange data at forest ecosystem level. This method is based on the principles of the Kok-method applied at leaf level for estimating daytime respiration. We demonstrate the method with field data and provide a discussion of the limitations of the method., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Setting up networks among physicians and other health professionals in virtually any medical discipline is an important part of establishing eHealth world-wide. Medical research strategies nowadays advance diagnostic and therapeutic knowledge and guidelines allowing patients to benefits. Patient data and samples are among the most sensitive information and must carefully be protected according to rules of ethics and professional discretion as well as national and international privacy legislation. A lot has been said about "patient involvement, patient empowerment". What about health professionals? How can they be involved and empowered to address the paradigm shift towards a personalized health service provision? Information and communication technology (ICT), medical devices, and software applications are not among the topics health professionals typically deal with while being theoretically and practically trained to diagnose diseases and treat patients. An ICT-based training and information provision is required to update the ICT skills of health professionals. The German CAST association provides such an information platform where health professionals attend applied computer security education events. This article aims at describing how ICT and security education is provided to health professionals, and how these training courses are designed, structured, performed, and assessed.

Background and Purpose: Growing incidence of cancer and the demographic changes of the society can cause severe shortage in radiotherapy services. This can lead to the use of waiting lists, which can serve as an indicator model for shortage of medical service. To investigate whether and how waiting lists are used in Germany, a survey was undertaken among German radio-oncologists. Their opinion concerning the use of waiting lists and their attitude toward the involved ethical problems were the central topics of this study., Material and Methods: A questionnaire was developed which consisted of 18 items: four items covered general aspects, four were about the management of waiting lists, seven concerned problems of waiting lists, and three were about the future aspects. From all items, at least ten touched ethical aspects such as patient information or the doctor-patient relationship. 19 consecutive radio-oncologists answered the questionnaire via telephone. The main interest of this study was to generate further hypotheses for future research., Results: From all doctors (n = 19), most did not use waiting lists (n = 12) in their practice, whereas the remaining did use them (n = 7). Limited resources were seen as the central underlying problem (n = 16). Two guiding principles were most often quoted for managing waiting lists: patients with complaints such as pain before those without (n = 18) and curative before palliative radiotherapy (n = 15). Concerning the information given to patients about the use of waiting lists, some doctors voted for detailed information (n = 7), which covers negative side effects of waiting lists such as tumor progression during waiting time, others voted against (n = 11). There was a profound disagreement on the question of whether curative and palliative radiotherapy should be differently treated in the context of waiting lists. 70% of the group, who used waiting lists, could give a moral justification for waiting lists, whereas only 28% of the group, who did not use them, could offer a justification., Conclusion: The survey showed that doctors were most concerned about the ethical aspects of waiting lists. Open questions are: (1) What is the best principle for a fair distribution of limited radiotherapy places? (2) How should patients be informed about waiting lists? (3) What moral justifications can be given for waiting lists? These issues must therefore become topics of future research and national dialogue, because the answers to these questions are necessary for the clinical use of waiting lists in radiotherapy.

Background: While legal aspects of patient information in radiotherapy are often discussed in clinical literature, ethical aspects are mainly a topic of debate only in bioethical literature. Nevertheless, patient information about radiation oncology has many ethical implications which must be considered in order to provide an optimal patient care. Therefore, this publication describes these ethical aspects from a clinical perspective., Methods: The basis of this project was a Medline search (1990-2002) using the key words "radiotherapy" and "patient information" for the first part, and "radiotherapy" and "ethics" for the second part., Results: The clinical papers (n = 55) demonstrate a serious attempt to improve patient information in clinical practice. Most articles deal with various discussion aids like booklets, audiotapes and others, or deal with the patients' information needs and preference. Under ethical aspects (n = 26 papers), palliative radiotherapy confronts the physician with many unsolved problems concerning telling the truth and the patient's misunderstandings which are often observed. The most important ethical principles of patient information are truth, autonomy, informed consent, and hope. For each of these, a definition is provided, as well as a detailed discussion of various typical situations in radiation oncology such as adjuvant therapy or palliative treatment., Conclusion: Considerations regarding the ethical aspects of patient information can provide an impulse to clinical improvement. Therefore, research in this field should be intensified in the future, especially in the area of palliative radiotherapy.

Background: As a result of increased interest and public demand, providing patients with adequate information about radiooncology has become more and more difficult for the doctor. Insufficient patient information can not only cause anxiety for the patient, but can also lead to legal action against the physician. In order to gain a deeper insight into our clinical practice of providing patient information, we developed a special questionnaire. We describe our first experiences in using this questionnaire at our institute., Patients and Methods: We examined the amount of information and level of satisfaction, as well as the agreement of assessment between patient and physician after the provision of standard patient information before and at the end of radiotherapy. 51 consecutive patients were interviewed with a newly designed questionnaire. The first questioning with 13 items was carried out before radiotherapy and the second with ten items was done at the end of treatment. Sum scores for information and satisfaction were defined and agreement was measured by the weighted kappa coefficient., Results: Global level of information and satisfaction was good, and a significant increase in information level and a significant decline in satisfaction were seen between questionnaire 1 and 2. Agreement between patient and physician was fair, for example intent of treatment resulted in a kappa coefficient of 0.34, and poor for the doctor's role with a kappa coefficient of -0.002. Only 52% of the patients who received palliative radiotherapy rated correctly the non-curative intent of treatment, whereas 86% of the patients who received curative radiotherapy made a correct statement. Before radiotherapy, emotional state was often both negatively and positively assessed by the patients., Conclusion: Our short questionnaire is simple and easy to understand. It provides insights into patient information with respect to assessment of the information, satisfaction level, and agreement between doctor and patient. Therefore, it is suitable for use in the clinical routine. We found a high information and satisfaction score, but limited agreement between physician and patient. In the future, the questionnaire can be used as an aid to evaluate patient information in everyday practice and to train the communication skills of the physician. Further evaluation of the questionnaire is needed and, in particular, the aspect of patient information with palliative radiotherapy has to be improved.