Correspondence between primary and secondary care about patients with cancer: a Delphi consensus study.

INTRODUCTION: To provide optimal care for patients with cancer, timely and efficient communication between healthcare providers is essential. In this study, we aimed to achieve consensus regarding the desired content of communication between general practitioners (GPs) and oncology specialists before and during the initial treatment of cancer. METHODS: In a two-round Delphi procedure, three expert panels reviewed items recommended for inclusion on referral and specialist letters. RESULTS: The three panels comprised 39 GPs (42%), 42 oncology specialists (41%) (i.e. oncologists, radiotherapists, urologists and surgeons) and 18 patients or patient representatives (69%). Final agreement was by consensus, with 12 and 35 items included in the GP referral and the specialist letters, respectively. The key requirements of GP referral letters were that they should be limited to medical facts, a short summary of symptoms and abnormal findings, and the reason for referral. There was a similar requirement for letters from specialists to include these same medical facts, but detailed information was also required about the diagnosis, treatment options and chosen treatment. After two rounds, the overall content validity index (CVI) for both letters was 71%, indicating that a third round was not necessary. DISCUSSION: This is the first study to differentiate between essential and redundant information in GP referral and specialist letters, and the findings could be used to improve communication between primary and secondary care.

Structure property relationships affecting the proton conductivity in imidazole loaded Al-MOFs.

The structures of the imidazole loaded derivatives of Al-MIL-53 [Al(OH)(1,4-BDC-(CH3)x)] (x = 0, 1, 2) and CAU-11 ([Al(OH)(SDBA)]) (1,4-H2BDC = terephthalic acid; H2SDBA = 4,4'-sulfonyldibenzoic acid) were determined from powder X-ray diffraction data. Impedance spectroscopy measurements were carried out to evaluate their proton conductivities under anhydrous conditions at temperatures up to 110 °C. In Al-MIL-53-(CH3)x_HIm (x = 0, 1, 2) the formation of hydrogen bonds between the framework and the guest molecules results in a decrease in proton conductivity (x0 = 1.7 × 10-6, x1 = 1.9 × 10-8 and x2 = 1.7 × 10-9 S cm-1 at 110 °C and Eact = 0.42, 0.41 and 0.46 eV, for 0, 1 and 2 CH3-groups, respectively). The highest conductivity has been measured for CAU-11_HIm with 3.0 × 10-4 S cm-1 at 110 °C (Eact = 0.19 eV), where no host-guest hydrogen bonding interactions are observed.