SICHTWEISEN ÄLTERER MENSCHEN AUF MEDIZINISCHE VERSORGUNG AUF DEM LAND – EINE EMPIRISCHE STUDIE AUS DEUTSCHLAND

With demographic change, many rural regions in Germany face the challenge to ensure an appropriate provision of basic services, also for the increasing share of immobile population groups. Among others, the growing number of old and very old people will increase the demand for medical care. Although, on the whole health care in Germany is very good, in some rural areas its provision tends to be difficult. This paper presents findings of an empirical study on older people’s mobility options, obstacles that constrain the access to health care and related needs. In-depth interviews were conducted with elderly men and women living in Holzminden, a district in Lower Saxony already massively affected by demographic ageing and shrinking. The analysis reveals high car dependency among the elderly; those who cannot drive are highly dependent to be given a ride to all kinds of activities, including medical appointments. Satisfaction with family doctors is high but many will soon retire and might not find a successor. Access to medical specialists and emergency care turns out to be more complicated. Despite low accessibility, most appreciate the advantages of rural living and nearly none considers leaving the countryside. Yet, those who do not have family living close-by they can call on might be forced to leave rural home once not able to drive anymore.Rural health care, demographic change, accessibility, medical care, Ländliche Gesundheitsversorgung, demographischer Wandel, Erreichbarkeit, medizinische Versorgung, Environmental Economics and Policy, Farm Management, Industrial Organization, Institutional and Behavioral Economics, Land Economics/Use,

Peer assessment and the link between feedback given and feedback used

This MA thesis discusses peer feedback and the link between feedback given and feedback used. A growing number of teachers are using formative assessment and its elements in their lessons in Estonia. As it is a relatively new approach, neither students nor teachers feel very comfortable when practising it. The aim of the present MA thesis is to determine the effectiveness of peer feedback in the EFL academic writing context. The thesis tries to answer the questions whether the feedback peers give to each other is useful, whether students use the feedback they get from their peers, and whether students find peer feedback useful.https://www.ester.ee/record=b5426829*es

The Distribution of CAP Payments - Redistributional Injustice or Spatially Adapted policy?

This paper analyses the distributional equality of individual Scottish Government-administered payments in 2008 under CAP Pillars One (single farm payments) and Two (rural development measures) and in total, in terms of economic, social and spatial factors. The analysis shows that 94% of all payments were paid to claimants in core rural areas (94%) while only a few (5%) claimants resided in urban areas or outside of Scotland (1%). However, in both Pillars, claims made by urban residents were often higher than those made by rural dwellers. The Ordinary Least Squares spatial analysis shows that the level of payments was extremely dependent on the geographical location and natural conditions. Spatial factors describing the economic situation in the area of the claimant were significantly related to the level of the CAP amounts paid. Overall, the level of amounts paid was positively related to the natural, economic and social structures of the area of residence. The discussion tackles the question of whether the current system of farm income support by decoupled payments should be developed into a poverty payment system.Pillar One, Common Agricultural Policy, Gini-Coefficient, Rural-Urban distribution, distributional justice, Land Economics/Use, Q15, R14, R11,

Stavovi ljudi starije životne dobi o zdravstvenoj skrbi u ruralnim područjima – studija slučaja iz sjeverne Njemačke

Germany’s population is decreasing and experiencing accelerated ageing. In 2060, more than a third of the population will be aged 65 years or older. With demographic change, many rural regions are struggling to ensure supply of appropriate public infrastructure while becoming less densely populated and experiencing an increasing share of immobile population groups. One of the major issues at stake is to maintain medical infrastructure at the necessary level. Although health care in Germany is still of very high standard in international comparison, in some rural areas its provision tends to be problematic. Demographic developments aggravate this situation because of two reasons: firstly, natural decline in population and rural depopulation will lead to changes in the rural spatial structure and have impact on the provision of health care; secondly, the growing proportion of older people will simultaneously increase the demand for medical care because, with advancing age, people seek medical treatment more often than at a young age. Even so, older people’s specific needs have long been and still are neglected in health care issues. This paper presents findings of an empirical study on older people’s mobility options, obstacles that constrain the access to health care and related needs.Stanovništvo Njemačke se smanjuje i ubrzano stari. Godine 2060. više od trećine stanovnika bit će starije od 65 godina. Uz demografske promjene, mnoga ruralna područja sve teže osiguravaju adekvatnu javnu infrastrukturu, dok u isto vrijeme ta područja postaju sve rjeđe naseljene uz povećan udio prostorno slabo pokretljivih populacijskih grupa. Jedan je od glavnih problema kako održati medicinsku infrastrukturu na prikladnoj razini. Održavanje visokog standarda zdravstvene skrbi u Njemačkoj u ruralnim područjima zna biti problematično. Demografski trendovi otežavaju ovu situaciju iz dva razloga: kao prvo, prirodni pad stanovništva i ruralna depopulacija dovest će do promjena u ruralnoj prostornoj strukturi i utjecat će na pružanje zdravstvene skrbi; kao drugo, rastući udio starog stanovništva istovremeno će povećati potražnju za zdravstvenom skrbi jer stariji ljudi češće traže medicinsku pomoć. Unatoč tome, specifične potrebe ljudi starije životne dobi dugo su bile i još uvijek jesu zanemarivane po pitanju zdravstvene skrbi. Ovaj rad predstavlja saznanja dobivena iz empirijskog istraživanja o mogućnostima mobilnosti ljudi starije životne dobi, preprekama koje im ograničavaju pristup zdravstvenoj skrbi i potrebama koje se na to odnose

The relation between water use and pesticides – Some remarks on the influence of integrated farming practices

Agriculture is the main user of the world’s water resources. Due to increasing concern on water quality and quantity, there is a growing interest to use the scarce water resources in the most efficient way to feed the growing world population. By employing a meta-analysis, this paper shows that pesticide use in combination with other improved production technologies have tripled agricultural water use efficiency (WUE) in the last 30 years. Recently, the European Union banned several active substances, among these more than 20 pesticides formerly used in crop growing. By doing so the progress in WUE has been put into question. This paper argues that a sudden reduction of pesticides by 50 % would lead to a need for more than 55 million hectares of additional arable land and for more than 158 km3 of additional water. Furthermore, in such a case the global irrigated area would have to be increased by 4 %. As most studies on the worldwide potential of additional arable land show, this land does not exist. Therefore, there are strong arguments to invest even further into new water saving technologies including pesticides. Specific research is needed to clarify which countries would be affected most by a sudden restriction or even ban of pesticides.pesticides, water use efficiency, production technologies, food security, Agricultural and Food Policy, Crop Production/Industries, Farm Management, Land Economics/Use, Production Economics,

Microplastic fiber and drought effects on plants and soil are only slightly modified by arbuscular mycorrhizal fungi

Microplastics are increasingly recognized as a factor of global change. By altering soil inherent properties and processes, ripple-on effects on plants and their symbionts can be expected. Additionally, interactions with other factors of global change, such as drought, can influence the effect of microplastics. We designed a greenhouse study to examine effects of polyester microfibers, arbuscular mycorrhizal (AM) fungi and drought on plant, microbial and soil responses. We found that polyester microfibers increased the aboveground biomass of Allium cepa under well-watered and drought conditions, but under drought conditions the AM fungal-only treatment reached the highest biomass. Colonization with AM fungi increased under microfiber contamination, however, plant biomass did not increase when both AM fungi and fibers were present. The mean weight diameter of soil aggregates increased with AM fungal inoculation overall but decreased when the system was contaminated with microfibers or drought stressed. Our study adds additional support to the mounting evidence that microplastic fibers in soil can affect the plant-soil system by promoting plant growth, and favoring key root symbionts, AM fungi. Although soil aggregation is usually positively influenced by plant roots and AM fungi, and microplastic promotes both, our results show that plastic still had a negative effect on soil aggregates. Even though there are concerns that microplastic might interact with other factors of global change, our study revealed no such effect for drought

Effects of microplastics on crop nutrition in fertile soils and interaction with arbuscular mycorrhizal fungi

Introduction Soil microplastic (MP) pollution has emerged as a main factor of global change, but its effects on soil nutrient availability and uptake by crops (macro and micronutrients) are largely unknown. Arbuscular mycorrhizal fungi (AMF) are regulators of nutrient availability and uptake and can interact with soil MP. Materials and Methods Building on previous studies, here we explored in a 50-days pot experiment the influence and interaction of MP fibres (0.4%) and commercial AMF in soil and onion chemistry, that is, in elemental composition of onion shoots and soils (C, N, Ca, Mg, K, P, S, Cu, Fe, Mn and Zn) and micronutrient soil availability (Cu, Fe, Mn and Zn). Results MP had detrimental effects on K, Mg and S, but increased the soil availability of Zn and shoot uptake. AMF inoculation buffered the effects of MP by balancing/enhancing nutrient availability and plant uptake. Particularly, the commercial AMF inoculum remarkably enhanced Mn uptake by onion. Conclusion Our results support the use of AMF to sustainably manage agricultural ecosystems contaminated with MP, buffering and counteracting the effects of MP by balancing nutrient availability and plant uptake

Gemini and Hubble Space Telescope Evidence for an Intermediate Mass Black Hole in omega Centauri

The globular cluster omega Centauri is one of the largest and most massive members of the galactic system. However, its classification as a globular cluster has been challenged making it a candidate for being the stripped core of an accreted dwarf galaxy; this together with the fact that it has one of the largest velocity dispersions for star clusters in our galaxy makes it an interesting candidate for harboring an intermediate mass black hole. We measure the surface brightness profile from integrated light on an HST}/ACS image of the center, and find a central power-law cusp of logarithmic slope -0.08. We also analyze Gemini GMOS-IFU kinematic data for a 5x5 arcsec field centered on the nucleus of the cluster, as well as for a field 14 arcsecaway. We detect a clear rise in the velocity dispersion from 18.6 km/s at 14 arcsec to 23 km/s in the center. A rise in the velocity dispersion could be due to a central black hole, a central concentration of stellar remnants, or a central orbital structure that is radially biased. We discuss each of these possibilities. An isotropic, spherical dynamical model implies a black hole mass of 4.0^{+0.75}_{-1.0} times 10^4 M_sun, and excludes the no black hole case at greater than 99% significance. We have also run flattened, orbit-based models and find similar results. While our preferred model is the existence of a central black hole, detailed numerical simulations are required to confidently rule out the other possibilities.Comment: 8 pages, 9 figures, ApJ accepte

Vascular Responses following Light Therapy: A Pilot Study with Healthy Volunteers

(1) Background: Studies have reported the effectiveness of light therapy in various medical conditions. Our pilot study aimed to assess the effect of Maharishi light therapy (MLT) on physiological parameters, such as the heart rate (HR), HR variability (HRV), blood pressure (BP), BP variability (BPV), and the retinal microvasculature of healthy participants; (2) Methodology: Thirty (14 males and 16 females) healthy, non-smoking participants between 23 and 71 years old (46 ± 18 years) were included in this randomized crossover study. Each participant was tested with a placebo (using LED light) and gem lights, 24 h apart. Hemodynamic parameters were recorded during the session, and 24 h heart rate and BP levels were assessed via mobile devices. Retinal vascular responses were captured with fundus images and the subsequent analysis of retinal vessel widths. A linear model, using repeated measures ANOVA, was used to compare the responses across the sexes and to assess the effect of the MLT; (3) Results: Changes in the central retinal artery equivalent (CRAE) (p < 0.001) and central retinal vein equivalent (CRVE) (p = 0.002) parameters were observed. CRAE and CRVE decreased under MLT and increased under the placebo condition from before to after. However, the baseline values of the participants already differed significantly before the application of any therapy, and the variation in the retinal vessel diameters was already large in the baseline measurements. This suggests that the observed effect results may only reflect naturally occurring fluctuations in the microcirculation and not the effect of MLT. Furthermore, no significant effects were observed in any other investigated parameters; (4) Conclusion: Our study with healthy participants finds significant changes in retinal parameters, but the biological variation in the baseline measurements was large to begin with. This suggests that the observed effect results only reflect naturally occurring fluctuations in the microcirculation and not the effect of MLT. However, in the future, larger studies in which MLT is applied for longer periods and/or in patients with different diseases could discover the physiological impacts of this type of therapy.publishedVersio

The underestimated burden of monogenic kidney disease in adults waitlisted for kidney transplantation

Purpose: Chronic kidney disease (CKD) is a major health-care burden. Increasing evidence suggests that a considerable proportion of patients are affected by a monogenic kidney disorder. Methods: In this study, the kidney transplantation waiting list at the Charité was screened for patients with undetermined cause of CKD. By next-generation sequencing (NGS) we targeted all 600 genes described and associated with kidney disease or allied disorders. Results: In total, 635 patients were investigated. Of these, 245 individuals had a known cause of CKD (38.5%) of which 119 had a proven genetic disease (e.g., ADPKD, Alport). The other 340 patients (53.5%) were classified as undetermined diagnosis, of whom 87 had kidney failure (KF) onset <40 years. To this latter group genetic testing was offered as well as to those patients (n = 29) with focal segmental glomerulosclerosis (FSGS) and all individuals (n = 21) suspicious for thrombotic microangiopathy (TMA) in kidney biopsy. We detected diagnostic variants in 26 of 126 patients (20.6%) of which 14 of 126 (11.1%) were pathogenic or likely pathogenic. In another 12 of 126 (9.5%) patients, variants of unknown significance (VUS) were detected. Conclusion: Our study demonstrates the diagnostic value of comprehensive genetic testing among patients with undetermined CKD