Bewegungsförderung durch individualisiertes Telefoncoaching: Einfluss auf Hand-lungsplanung, Selbstwirksamkeit und Barrierenwahrnehmung inaktiver Erwachsener

Hintergrund: Körperliche Inaktivität erhöht das Risiko für Übergewicht und Adipositas, was im Zu-sammenhang mit verschiedenen nichtübertragbaren Krankheiten und frühzeitigem Tod steht (WHO, 2010). Programme zur Gesundheitsprävention und Bewegungsförderung sind somit von zunehmender Bedeutung (Bandura, 2005; Lee et al., 2012; WHO, 2010). Mit „Movingcall“ wird ein telefonbasiertes individuelles Bewegungsförderungsprogramm an inaktiven Personen getestet, welches ihr Selbstmanagement stärken und sie an einen akti-veren Lebensstil heranführen soll. Ziel dieser Masterarbeit ist es, den Einfluss von indivi-dualisiertem Telefoncoaching auf die Handlungsplanung, Selbstwirksamkeit und Barrie-renwahrnehmung sowie deren Korrelation zur körperlichen Aktivität zu untersuchen. Methode: 160 Männer und Frauen im Alter von 43.5 ± 10.4 Jahren wurden in drei Gruppen (A/B/C) eingeteilt: (A) einmalige schriftliche Bewegungsempfehlung, (B) Telefoncoaching mit so-wie (C) ohne SMS-Prompting. Die Intervention dauerte 22 Wochen, gefolgt von sechs Monaten Follow-up. Mittels SIMPAQ-Interview und Online-Fragebogen wurden die Aus-prägungen der Handlungsplanung, Selbstwirksamkeit und Barrierenwahrnehmung sowie die mindestens moderate körperliche Aktivität erhoben. Die statistische Analyse erfolgte durch eine ANOVA mit Kontrasten und Korrelationsanalyse. Ergebnisse: Die mindestens moderate körperliche Aktivität korreliert mit r = 0.2* mit Handlungspla-nung und mit r = 0.1 mit Selbstwirksamkeit und Barrierenwahrnehmung. Diese kleinen aber positiven Korrelationskoeffizienten zeigen die Tendenz für einen Zusammenhang auf. Zwischen den Gruppen A/B und A/C liegen hochsignifikante Unterschiede (p < 0.001) in der Steigerung der Handlungsplanung vor. Bei der Selbstwirksamkeit ist einzig der Kon-trast A/B signifikant (p = 0.044*) und bei der Barrierenwahrnehmung nur der Kontrast A/C (p = 0.049*). Diskussion: Die hier vorliegenden Resultate zeigen einzelne (hoch-) signifikante Gruppenunterschiede (A/B und A/C) in Bezug auf die Veränderung von Handlungsplanung, Selbstwirksamkeit und Barrierenwahrnehmung, sowie eine Tendenz, dass diese Determinanten mit der Stei-gerung der mindestens moderaten körperlichen Aktivität zusammenhängen. Das telefoni-sche Bewegungscoaching scheint sich also gegenüber der schriftlichen Bewegungsempfeh-lung abzuheben. Eine Wiederholung der angewandten Analysen mit der gesamten Studi-enpopulation von 290 Probanden wird empfohlen. Die vorliegenden Resultate in den For-schungsstand einzuordnen erweist sich jedoch als problematisch, da noch keine mit „Mo-vingcall“ vergleichbaren Studien existieren. Es bedarf daher weiterer Forschung im Be-reich telefonbasiertem Bewegungscoaching

Do households live the family model they prefer? Household’s work patterns across European policy regimes

Studies have investigated the equalizing effect of childcare provision and parental leave schemes on gendered work patterns. However, as the relationship between policies and individual time allocations to paid work is complex and challenging to empirically assess, previous research has clarified single aspects of this complexity. The present study theoretically and empirically combines a household perspective by considering the work behaviours of two partners within one household (i.e. a household’s lived family model) with a comparative approach to systematically analyse relationships between specific policy designs and households’ paid work patterns in a large sample. The findings imply that extensive childcare policies are systematically related to an egalitarian household organization, mostly among those with small children. This association can be observed across households with varying levels of egalitarian norms. Conversely, the findings suggest that the current design of parental leave policies in the 21 European countries does not allow for a true assessment of the potential of leave schemes to influence the within-household division of labor

IMRT in Hypopharyngeal Tumors

Background and Purpose:: Intensity-modulated radiation therapy (IMRT) data on hypopharyngeal cancer (HC) are scant. In this study, the authors report on early results in an own HC patient cohort treated with IMRT. A more favorable outcome as compared to historical data on conventional radiation techniques was expected. Patients and Methods:: 29 consecutive HC patients were treated with simultaneous integrated boost (SIB) IMRT between 01/2002 and 07/2005 (mean follow-up 16 months, range 4-44 months). Doses of 60-71 Gy with 2.0-2.2 Gy/fraction were applied. 26/29 patients were definitively irradiated, 86% received simultaneous cisplatin-based chemotherapy. 60% presented with locally advanced disease (T3/4 Nx, Tx N2c/3). Mean primary tumor volume measured 36.2 cm3 (4-170 cm3), mean nodal volume 16.6 cm3 (0-97 cm3). Results:: 2-year actuarial local, nodal, distant control, and overall disease-free survival were 90%, 93%, 93%, and 90%, respectively. In 2/4 patients with persistent disease (nodal in one, primary in three), salvage surgery was performed. The mean dose to the spinal cord (extension of > 5-15 mm) was 26 Gy (12-38 Gy); the mean maximum (point) dose was 44.4 Gy (26-58.9 Gy). One grade (G) 3 dysphagia and two G4 reactions (laryngeal fibrosis, dysphagia), both following the schedule with 2.2 Gy per fraction, have been observed so far. Larynx preservation was achieved in 25/26 of the definitively irradiated patients (one underwent a salvage laryngectomy); 23 had no or minimal dysphagia (G0-1). Conclusion:: Excellent early disease control and high patient satisfaction with swallowing function in HC following SIB IMRT were observed; these results need to be confirmed based on a longer follow-up period. In order to avoid G4 reactions, SIB doses of < 2.2 Gy/fraction are recommended for large tumors involving laryngeal structure

History Matters: Relating Land-Use Change to Butterfly Species Occurrence

Western European landscapes have drastically changed since the 1950s, with agricultural intensifications and the spread of urban settlements considered the most important drivers of this land-use/land-cover change. Losses of habitat for fauna and flora have been a direct consequence of this development. In the present study, we relate butterfly occurrence to land-use/land-cover changes over five decades between 1951 and 2000. The study area covers the entire Swiss territory. The 10 explanatory variables originate from agricultural statistics and censuses. Both state as well as rate was used as explanatory variables. Species distribution data were obtained from natural history collections. We selected eight butterfly species: four species occur on wetlands and four occur on dry grasslands. We used cluster analysis to track land-use/land-cover changes and to group communes based on similar trajectories of change. Generalized linear models were applied to identify factors that were significantly correlated with the persistence or disappearance of butterfly species. Results showed that decreasing agricultural areas and densities of farms with more than 10ha of cultivated land are significantly related with wetland species decline, and increasing densities of livestock seem to have favored disappearance of dry grassland species. Moreover, we show that species declines are not only dependent on land-use/land-cover states but also on the rates of change; that is, the higher the transformation rate from small to large farms, the higher the loss of dry grassland species. We suggest that more attention should be paid to the rates of landscape change as feasible drivers of species change and derive some management suggestion

How Does the Provision of Childcare Services Affect Mothers’ Employment Intentions? Empirical Evidence from a Conjoint Experiment

Numerous studies have demonstrated that the provision of early childhood education and childcare services (ECEC) is associated with higher women’s participation in the labor market. However, many questions about the causal relationship between the supply of childcare and patterns of female employment remain open. In an effort to overcome common endogeneity problems, we conducted a conjoint experiment in Switzerland, which enables us to analyze mothers’ employment intentions in different – and even in some hypothetical – contexts. Our results demonstrate that improving the provision of ECEC services does affect mothers’ intentions to engage in paid labor. Nevertheless, mothers comprise a heterogeneous group. As expected, ECEC services’ effects are limited for mothers with comparatively high levels of employment. In contrast, mothers with low levels of employment are quite reactive to changing policy contexts, especially if external childcare spots for preschoolers become affordable. Notably, elasticity is present not only in the behavior of women with preferences for supplementary, external childcare, but also in that of women with preferences for parental or home-centered childcare. Our study thus highlights childcare policies’ potential to change the patterns of female employment in contexts marked by persistent traditional gender roles and limited childcare provision

Indicators of central sensitization in chronic neuropathic pain after spinal cord injury

BACKGROUND Central sensitization is considered a key mechanism underlying neuropathic pain (NP) after spinal cord injury (SCI). METHODS Two novel proxies for central sensitization were investigated in thoracic SCI subjects with (SCI-NP) and without NP (SCI-nonNP) compared to healthy controls (HC). Specifically, temporal summation of pain (TSP) was investigated by examining pain ratings during a 2-min tonic heat application to the volar forearm. Additionally, palmar heat-induced sympathetic skin responses (SSR) were recorded in order to reveal changes in pain-autonomic interaction above the lesion level. Pain extent was assessed as the percentage of the body area and the number of body regions being affected by NP. RESULTS Enhanced TSP was observed in SCI-NP (+66%) compared to SCI-nonNP (-75%, p = 0.009) and HC (-59%, p = 0.021). In contrast, no group differences were found (p = 0.685) for SSR habituation. However, pain extent in SCI-NP was positively correlated with deficient SSR habituation (body area: r = 0.561, p = 0.024; body regions: r = 0.564, p = 0.023). CONCLUSIONS These results support the value of TSP and heat-induced SSRs as proxies for central sensitization in widespread neuropathic pain syndromes after SCI. Measures of pain-autonomic interaction emerged as a promising tool for the objective investigation of sensitized neuronal states in chronic pain conditions. SIGNIFICANCE We present two surrogate readouts for central sensitization in neuropathic pain following SCI. On the one hand, temporal summation of tonic heat pain is enhanced in subjects with neuropathic pain. On the other hand, pain-autonomic interaction reveals potential advanced measures in chronic pain, as subjects with a high extent of neuropathic pain showed diminished habituation of pain-induced sympathetic measures. A possible implication for clinical practice is constituted by an improved assessment of neuronal hyperexcitability potentially enabling mechanism-based treatment

Scenario-based assessment of future land use change on butterfly species distributions

Species distribution models (SDMs) are increasingly used to predict environmentally induced range shifts of habitats of plant and animal species. Consequently SDMs are valuable tools for scientifically based conservation decisions. The aims of this paper are (1) to identify important drivers of butterfly species persistence or extinction, and (2) to analyse the responses of endangered butterfly species of dry grasslands and wetlands to likely future landscape changes in Switzerland. Future land use was represented by four scenarios describing: (1) ongoing land use changes as observed at the end of the last century; (2) a liberalisation of the agricultural markets; (3) a slightly lowered agricultural production; and (4) a strongly lowered agricultural production. Two model approaches have been applied. The first (logistic regression with principal components) explains what environmental variables have significant impact on species presence (and absence). The second (predictive SDM) is used to project species distribution under current and likely future land uses. The results of the explanatory analyses reveal that four principal components related to urbanisation, abandonment of open land and intensive agricultural practices as well as two climate parameters are primary drivers of species occurrence (decline). The scenario analyses show that lowered agricultural production is likely to favour dry grassland species due to an increase of non-intensively used land, open canopy forests, and overgrown areas. In the liberalisation scenario dry grassland species show a decrease in abundance due to a strong increase of forested patches. Wetland butterfly species would decrease under all four scenarios as their habitats become overgrow