Limitations in activities of daily living and support needs – Analysis of GEDA 2019/2020-EHIS

Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time

Gene expression in bryozoan larvae suggest a fundamental importance of pre-patterned blastemic cells in the bryozoan life-cycle

<p>Abstract</p> <p>Background</p> <p>Bryozoa is a clade of aquatic protostomes. The bryozoan life cycle typically comprises a larval stage, which metamorphoses into a sessile adult that proliferates by asexual budding to form colonies. The homology of bryozoan larvae with other protostome larvae is enigmatic. Bryozoan larvae exhibit blastemic tissues that contribute to build the adult during morphogenesis. However, it remains unclear if the cells of these tissues are pre-determined according to their future fate or if the cells are undifferentiated, pluripotent stem cells. Gene expression studies can help to identify molecular patterning of larval and adult tissues and enlighten the evolution of bryozoan life cycle stages.</p> <p>Results</p> <p>We investigated the spatial expression of 13 developmental genes in the larval stage of the gymnolaemate bryozoan <it>Bugula neritina</it>. We found most genes expressed in discrete regions in larval blastemic tissues that form definitive components of the adult body plan. Only two of the 13 genes, <it>BnTropomyosin </it>and <it>BnFoxAB</it>, were exclusively expressed in larval tissues that are discarded during metamorphosis.</p> <p>Conclusions</p> <p>Our results suggest that the larval blastemas in <it>Bugula </it>are pre-patterned according to their future fate in the adult. The gene expression patterns indicate that some of the bryozoan blastemas can be interpreted to correspond to homologous adult tissues of other animals. This study challenges an earlier proposed view that metazoan larvae share homologous undifferentiated "set-aside cells", and instead points to an independent origin of the bryozoan larval stage with respect to other lophotrochozoans.</p

How to reach ‘hard-to-reach’ older people for research: The TIBaR model of recruitment

Recruiting older persons with diverse health statuses as participants in research projects is a challenge for health researchers, particularly because persons with health impairments and in socially disadvantaged living conditions are difficult to reach. This article presents a step model for gaining access to older people who are difficult to contact. The step model is based on the literature and a qualitative analysis of documentation, field notes and memos that stem from the recruitment processes of two studies from the German research consortium ‘Autonomy despite multimorbidity in old age’, both of which also included older persons who would qualify as ‘hard-to-reach’. The analysis followed the method of Grounded Theory and aimed to understand the social process of ‘recruitment’. Four steps of the recruitment process were identified that had been applied – intentionally or unintentionally – in both of the projects, i.e., the qualitative as well as the quantitative projects: 1. build up Trust, 2. offer Incentives, 3. identify individual Barriers and 4. be Responsive (TIBaR). The step model provides information for facilitating access to various target groups for qualitative as well as quantitative research designs. However, its implementation requires time, financial resources, flexibility and appropriately qualified staff members.Peer Reviewe

Converting Poly(Methyl Methacrylate) into a Triple-Responsive Polymer

Multiresponsive polymers that can respond to several external stimuli are promising materials for a manifold of applications. Herein, a facile method for the synthesis of triple-responsive (pH, temperature, CO2) poly(N,N-diethylaminoethyl methacrylamide) by a post-polymerization amidation of poly(methyl methacrylate) (PMMA) is presented. Combined with trivalent counterions ([Fe(CN)6]3−) both an upper and lower critical solution temperature (UCST/LCST)-type phase behavior can be realized at pH 8 and 9. PMMA and PMMA-based block copolymers are readily accessible by living anionic and controlled radical polymerization techniques, which opens access to various responsive polymer architectures based on the developed functionalization method. This method can also be applied on melt-processed bulk PMMA samples to introduce functional, responsive moieties at the PMMA surface

Seroprevalence of ToRCH Pathogens in Southeast Asia

ToRCH is the acronym for several pathogens associated with pregnancy complications and sequelae in the unborn or newborn child. Particularly primary infections during pregnancy are associated with increased risk. Seroprevalence data of ToRCH infections are important, especially in countries with weak disease surveillance systems, to estimate immunity and vaccination levels, as well as exposure rates and thus the risk of infection during pregnancy. A systematic literature search spanning a 30-year time period was conducted to identify serosurveys on ToRCH pathogens in Southeast Asia. The 96 identified studies showed that some pathogens were well studied, while only limited data were available for others. Studies from the better-developed countries of the region were more abundant. Moreover, seroprevalence data were often limited to a certain geographical region within the country or to certain cohorts, there was an evident lack of recent serosurveys, and the study quality was often not adequate. Well-designed and area-wide serosurveys of ToRCH pathogens are clearly warranted. If combined with risk factor analysis, these studies may guide the development and implementation of effective measures for infection prevention, especially during pregnancy. In addition, educational programs for health care workers and for pregnant women during antenatal care are urgently needed

Prevalence and correlates of frailty among older adults: findings from the German health interview and examination survey

Background: Despite having the third highest proportion of people aged 60 years and older in the world, Germany has been recently reported as having the lowest prevalence of frailty of 15 European countries. The objective of the study is to describe the prevalence of frailty in a large nationwide population-based sample and examine associations with sociodemographic, social support and health characteristics. Methods: We performed a cross-sectional analysis of the first wave of the German Health Interview and Examination Survey for Adults (DEGS1) conducted 2008–2011. Participants were 1843 community-dwelling people aged 65–79 years. Frailty and pre-frailty were defined, according to modified Fried criteria, as 3 and more or 1–2 respectively, of the following: exhaustion, low weight, low physical activity, low walking speed and low grip strength. The Oslo-3 item Social Support Scale (OSS-3) was used. Patient Health Questionnaire (PHQ-9) measured depressive symptoms and the Digit Symbol Substitution Test (DSST) measured cognition. Associations between participants’ characteristics and frailty status were examined using unadjusted and adjusted multinomial logistic regression models estimating relative risk ratios (RRR) of frailty and pre-frailty. Results: The prevalence of frailty among women was 2.8% (CI 1.8-4.3) and pre-frailty 40.4% (CI 36.3-44.7) and among men was 2.3% (CI 1.3-4.1) and 36.9% (CI 32.7-41.3) respectively. Independent determinants of frailty, from unadjusted models, included older age, low socioeconomic status, poor social support, lower cognitive function and a history of falls. In adjusted models current depressive symptoms (RRR 12.86, CI 4.47-37.03), polypharmacy (RRR 7.78, CI 2.92-20.72) and poor hearing (RRR 5.38, CI 2.17-13.35) were statistically significantly associated with frailty. Conclusions: Frailty prevalence is relatively low among community-dwelling older adults in Germany. Modifiable characteristics like low physical activity provide relevant targets for individual and population-level frailty detection and intervention strategies

Non-utilisation of health care services during the COVID-19 pandemic: Results of the CoMoLo study

Based on data from the CORONA-MONITORING lokal (CoMoLo) study conducted in four municipalities particularly affected by the COVID-19 pandemic, this article investigates the non-utilisation of health care services in the population aged 18 years and older (n=9,002) in relation to the period after the introduction of the containment measures in March 2020. The results show that about one third of the respondents (35.5%) gave up at least one of the surveyed health care services. The most frequent cancellations were dental (15.2%) and specialist check-ups (11.8%), followed by postponement of physiotherapy, ergotherapy or speech therapy (6.1%), cancellation of general practitioner (GP) check-ups (5.8%), postponement of psychotherapy (2.0%), postponement of planned hospital treatment (1.8%) and not going to an emergency room (0.7%). Almost 10% of the respondents reported not visiting a physician despite health complaints. Compared to respondents without such a waiver, these respondents were more often female and younger than 35 years, less often rated their health as very good or good, more often had a diagnosis of depression and more often used telemedical contacts as an alternative to visiting the practice during the pandemic. Further analyses of trends in utilisation behaviour and changes in health status over the course of the COVID-19 pandemic are important

Einschränkungen bei Alltagsaktivitäten und Unterstützungsbedarfe – Auswertungen der Studie GEDA 2019/2020-EHIS

Die Ausübung von Aktivitäten des täglichen Lebens ist ein wichtiger Bestandteil der Funktionsfähigkeit eines Menschen. Falls Einschränkungen vorliegen, ist Unterstützung bei diesen Tätigkeiten erforderlich. Anhand von Daten der Studie GEDA 2019/2020-EHIS wird dargestellt, wie viele der in Privathaushalten lebenden Personen ab 55 Jahren in Deutschland Einschränkungen in Alltagsaktivitäten aufweisen. Schwere Einschränkungen in den basalen (grundlegenden) Aktivitäten (z. B. der Nahrungsaufnahme) geben 5,8 % der Frauen und 3,7 % der Männer an. Der Anteil nimmt mit dem Alter zu, von den ab 80-Jährigen sind 13,4 % der Frauen und 9,0 % der Männer betroffen. Schwere Einschränkungen bei den instrumentellen Aktivitäten des täglichen Lebens (z. B. Einkäufe erledigen) sind bei Personen unter 80 Jahren eher selten. Der Anteil bei den ab 80-Jährigen liegt bei den Frauen bei 35,9 % und bei den Männern bei 21,0 %. Bei Einschränkungen der basalen Aktivitäten erhalten 68,1 % der betroffenen Frauen und 57,5 % der Männer Hilfe und Unterstützung. Frauen berichten zudem häufiger über fehlende Unterstützung (48,8 % vs. 43,2 %). Bei den instrumentellen Aktivitäten ist die Lage etwas besser. Die Ergebnisse aus der Studie GEDA 2019/2020-EHIS zeigen, in welchen Bereichen des täglichen Lebens ältere und hochaltrige Menschen eingeschränkt sind, geben einen Eindruck, wer besonders betroffen ist und wo Unterstützungsleistungen nicht ausreichend sind. Sie liefern damit Anhaltspunkte, wo unterstützend angesetzt werden kann, um älteren Menschen einen langen Verbleib in der eigenen Häuslichkeit zu ermöglichen