Schmerzen? Wer weiss! : Voraussetzungen für ein valides Schmerzassessment bei Menschen mit Demenz im Langzeitbereich

Darstellung des Themas: 2017 waren in der Schweiz schätzungsweise 148‘000 Menschen von einer Demenz betroffen. Es kann angenommen werden, dass sich die Anzahl Personen mit einer Demenz bis ins Jahr 2040 verdoppelt. Etwa die Hälfte der Menschen mit einer Demenz leidet regelmässig unter Schmerzen. Besonders im fortgeschrittenen Krankheitsstadium werden Schmerzen bei Betroffenen durch das Pflegepersonal ungenügend erfasst. Fragestellung: Welche Voraussetzungen müssen bei der Durchführung eines Schmerzassessments gegeben sein, damit Schmerzen, bei Menschen mit einer mittelgradigen bis schweren Demenz, im Langzeitbereich, durch Pflegepersonen valide erfasst werden? Methode: Aus einer Literaturrecherche auf den Datenbanken PubMed und CINAHL sowie einer Recherche nach dem Schneeballsystem, resultierten fünf quantitative, drei qualitative und drei mixed-methods Studien. Ergebnisse: Wissensdefizite des Pflegepersonals wurden aufgezeigt und der Wunsch nach Schulungen mehrfach genannt. Die Kommunikation im Team wurde als wichtig eingeschätzt. Richtlinien und Standards durch die Institutionen werden gewünscht. Die Beziehung zu den Betroffenen und der Einbezug der Angehörigen haben einen wesentlichen Einfluss auf das Schmerzassessment. Schlussfolgerung: Grundvoraussetzung für ein valides Schmerzassessment sind Schulungen. Zudem spielen die Kommunikation im Team, die Umsetzung von Richtlinien, die Beziehung zu den Betroffenen und der Einbezug der Angehörigen eine wichtige Rolle im Schmerzassessment bei Betroffenen von Demenz

Detektion von Ebergeruch mittels chemischer Analytik und Humansensorik bei Ebern aus ökologischer Mast

Die Mast intakter männlicher Schweine birgt das Risiko des sogenannten Ebergeruchs, welcher problematisch für die Konsumentenakzeptanz ist. Die Praktikabilität der Ebermast hängt daher von der Reduktion der ursächlichen Substanzen im Tier sowie der sicheren Detektion auffälliger Schlachtkörper am Band ab. Zugabe von roher Kartoffelstärke verringerte die Rate geruchsauffälliger Schlachtkörper. Die Übereinstimmung zwischen den chemischen Messwerten und der humansensorischen Beurteilung lag bei 84 %

Erste Ergebnisse eines Grundfuttervergleichs zur Senkung der Skatolbelastung in der ökologischen Ebermast

Skatole, one of the main causes of boar taint, derives from tryptophan in the large intestine and accumulates in the fat tissue of boars, thus decreasing meat quality. We hypothesize that energy of roughage promotes growth of skatole reducing microbes. Therefore, we compare the two roughages grass-clover-silage and straw, regarding the effect on concentrations of skatole and androstenone in the fat tissue. The experiments are currently ongoing and will help to evaluate special feeding strategies as an alternative to castration, thereby promoting animal welfare and product quality

Analysis of 1,000+ Type-Strain Genomes Substantially Improves Taxonomic Classification of Alphaproteobacteria.

The class Alphaproteobacteria is comprised of a diverse assemblage of Gram-negative bacteria that includes organisms of varying morphologies, physiologies and habitat preferences many of which are of clinical and ecological importance. Alphaproteobacteria classification has proved to be difficult, not least when taxonomic decisions rested heavily on a limited number of phenotypic features and interpretation of poorly resolved 16S rRNA gene trees. Despite progress in recent years regarding the classification of bacteria assigned to the class, there remains a need to further clarify taxonomic relationships. Here, draft genome sequences of a collection of genomes of more than 1000 Alphaproteobacteria and outgroup type strains were used to infer phylogenetic trees from genome-scale data using the principles drawn from phylogenetic systematics. The majority of taxa were found to be monophyletic but several orders, families and genera, including taxa recognized as problematic long ago but also quite recent taxa, as well as a few species were shown to be in need of revision. According proposals are made for the recognition of new orders, families and genera, as well as the transfer of a variety of species to other genera and of a variety of genera to other families. In addition, emended descriptions are given for many species mainly involving information on DNA G+C content and (approximate) genome size, both of which are confirmed as valuable taxonomic markers. Similarly, analysis of the gene content was shown to provide valuable taxonomic insights in the class. Significant incongruities between 16S rRNA gene and whole genome trees were not found in the class. The incongruities that became obvious when comparing the results of the present study with existing classifications appeared to be caused mainly by insufficiently resolved 16S rRNA gene trees or incomplete taxon sampling. Another probable cause of misclassifications in the past is the partially low overall fit of phenotypic characters to the sequence-based tree. Even though a significant degree of phylogenetic conservation was detected in all characters investigated, the overall fit to the tree varied considerably

Einfluss von Genotyp und Fütterung in der ökologischen Mast intakter männlicher Schweine. I: Ebergeruch

Fattening of entire male pigs is a useful alternative to piglet castration but the problem of boar taint is still unresolved. The object of the present study was to test the effect of (i) two different terminal sire lines (Danish Duroc, Du vs. Piétrain, Pi) and (ii) two different feeding strategies (without (-) vs. with (+) raw potato starch prior to slaughter) on the prevalence of boar taint in organic pork production. The results show that entire male growing-finishing pigs of Du origin have significantly higher androstenone concentrations in shoulder back fat than those of Pi origin whereas the feeding strategy has no significant effect. Concerning skatole, both genetic origin and feeding strategy significantly affect concentrations in shoulder back fat: Pi- entire male pigs are significantly 2.25 times above Pi+, Du-, and Du+ which are on an identically low level. The present results still do not justify a final recommendation

Down but not out: properties of the molecular gas in the stripped Virgo Cluster early-type galaxy NGC4526

We present ALMA data on the 3mm continuum emission, CO isotopologues (12CO, 13CO, C18O), and high-density molecular tracers (HCN, HCO+, HNC, HNCO, CS, CN, and CH3OH) in NGC4526. These data enable a detailed study of the physical properties of the molecular gas in a longtime resident of the Virgo Cluster; comparisons to more commonly-studied spiral galaxies offer intriguing hints into the processing of molecular gas in the cluster environment. Many molecular line ratios in NGC4526, along with our inferred abundances and CO/H2 conversion factors, are similar to those found in nearby spirals. One striking exception is the very low observed 12CO/13CO(1-0) line ratio, $3.4\pm0.3$, which is unusually low for spirals though not for Virgo Cluster early-type galaxies. We carry out radiative transfer modeling of the CO isotopologues with some archival (2-1) data, and we use Bayesian analysis with Markov chain Monte Carlo techniques to infer the physical properties of the CO-emitting gas. We find surprisingly low [12CO/13CO] abundance ratios of $7.8^{+2.7}_{-1.5}$ and $6.5^{+3.0}_{-1.3}$ at radii of 0.4 kpc and 1 kpc. The emission from the high-density tracers HCN, HCO+, HNC, CS and CN is also relatively bright, and CN is unusually optically thick in the inner parts of NGC4526. These features hint that processing in the cluster environment may have removed much of the galaxy's relatively diffuse, optically thinner molecular gas along with its atomic gas. Angular momentum transfer to the surrounding intracluster medium may also have caused contraction of the disk, magnifying radial gradients such as we find in [13CO/C18O]. More detailed chemical evolution modeling would be interesting in order to explore whether the unusual [12CO/13CO] abundance ratio is entirely an environmental effect or whether it also reflects the relatively old stellar population in this early-type galaxy.Comment: Submitted to ApJ. Comments are welcome

Comparison of analog and digital patient decision aids for the treatment of depression: a scoping review

Introduction: Patient decision aids (PDAs) are important tools to empower patients and integrate their preferences and values in the decision-making process. Even though patients with mental health problems have a strong interest in being more involved in decision making about their treatment, research has mainly focused on PDAs for somatic conditions. In this scoping review, we focus on patients suffering from depression and the role of PDAs for this patient group. The review offers an overview of digital and analog PDAs, their advantages and disadvantages as well as recommendations for further research and development. Methods: A systematic search of the existing literature guided by the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - extension for scoping reviews (PRISMA-ScR) was conducted. Three electronic literature databases with the appropriate thematic focus were searched (PubMed, PsycInfo, and Web of Science). The search strategy used controlled and natural language to search for the key concepts decision aids and depression. The articles were selected in a two-step process guided by predefined inclusion and exclusion criteria. We narratively synthetized information extracted from 40 research articles. Results: We included 40 articles in our review. Our review revealed that there is more focus on digital PDAs in research than in clinical practice. Digitalization can enhance the benefits of PDAs by developing tools that are more efficient, interactive, and personalized. The main disadvantages of both types of PDAs for the treatment of depression are related to time, dissemination, and capacity building for the health care providers. Digital PDAs need to be regularly updated, effective strategies for their dissemination and acceptance need to be identified, and clinicians need sufficient training on how to use digital PDAs. There is more research needed to study which forms of PDAs are most appropriate for various patient groups (e.g., older adults, or patients with comorbidities), and to identify the most effective ways of PDAs' integration in the clinical workflow. The findings from our review could be well aligned with the International Patient Decision Aids Standards. Discussion: More research is needed regarding effective strategies for the implementation of digital PDAs into the clinical workflow, ethical issues raised by the digital format, and opportunities of tailoring PDAs for diverse patient groups

Explicit Training to Improve Affective Prosody Recognition in Adults with Acute Right Hemisphere Stroke

Difficulty recognizing affective prosody (receptive aprosodia) can occur following right hemisphere damage (RHD). Not all individuals spontaneously recover their ability to recognize affective prosody, warranting behavioral intervention. However, there is a dearth of evidence-based receptive aprosodia treatment research in this clinical population. The purpose of the current study was to investigate an explicit training protocol targeting affective prosody recognition in adults with RHD and receptive aprosodia. Eighteen adults with receptive aprosodia due to acute RHD completed affective prosody recognition before and after a short training session that targeted proposed underlying perceptual and conceptual processes. Behavioral impairment and lesion characteristics were investigated as possible influences on training effectiveness. Affective prosody recognition improved following training, and recognition accuracy was higher for pseudo- vs. realword sentences. Perceptual deficits were associated with the most posterior infarcts, conceptual deficits were associated with frontal infarcts, and a combination of perceptual-conceptual deficits were related to temporoparietal and subcortical infarcts. Several right hemisphere ventral stream regions and pathways along with frontal and parietal hypoperfusion predicted training effectiveness. Explicit acoustic-prosodic-emotion training improves affective prosody recognition, but it may not be appropriate for everyone. Factors such as linguistic context and lesion location should be considered when planning prosody training