[Reducing fragmentation in the care of frail older people: the successful development and implementation of the Health and Welfare Information Portal].

Item does not contain fulltextREDUCING FRAGMENTATION IN THE CARE OF FRAIL OLDER PEOPLE: THE SUCCESSFUL DEVELOPMENT AND IMPLEMENTATION OF THE HEALTH AND WELFARE INFORMATION PORTAL: Our fragmented health care systems are insufficiently equipped to provide frail older people with high quality of care. Therefore, we developed the Health and Welfare Information Portal (ZWIP), an e-health intervention which aims (1) to facilitate self-management by frail older people and informal caregivers and (2) to improve collaboration among professionals. The ZWIP is a personal conference table, accessible through a secure internet connection, for multidisciplinary communication and information exchange for frail older people, their informal caregivers and professionals. After development, the ZWIP was implemented in seven general practices, and this process was evaluated by means of a mixed-methods study. Eventually, 290 frail older people and 169 professionals participated in the ZWIP. Most professionals were positive about its implementation. Facilitators for the implementation were the experienced need for improvement of interprofessional collaboration and the user-friendliness of the ZWIP. Barriers were the low computer-literacy of frail older people, start-up problems, preferring personal contact, and limited use of the ZWIP by other professionals. In sum, this article describes the successful development and implementation of the ZWIP, an e-health intervention which can reduce fragmentation in the care of frail older people

Foraging ecology and reproductive biology of the Stonechat Saxicola torquata : comparison between a revitalized, intensively cultivated and a historical, traditionally cultivated agro-ecosystem

An effective strategy to reintegrate biodiversity within otherwise intensively cultivated agroecosystems is to create set-aside and wildflower areas. It remains largely unknown, however, whether the ecological performance of an agroecosystem revitalized in this manner is comparable—from a species’ population biology perspective—to traditionally exploited farmland. To address this question we compared, during two successive years, the trophic ecology and breeding performance of an insectivorous, indicator passerine (the Stonechat Saxicola torquata) in a revitalized intensively cultivated farmland (RIC) and a traditional, extensively cultivated farmland (TEC) in southern Switzerland. The chicks' diet and prey abundance did not differ between the RIC and TEC, with orthopterans, caterpillars (Lepidoptera) and coleopterans predominating (approx. 80% of diet biomass). Although Stonechat pairs initiated more broods in TEC than in the RIC, reproductive success (number of fledglings/territory × year) did not differ significantly between the TEC and RIC. The chicks’ condition (body mass) was slightly better in TEC than in RIC, while no such effect could be shown for chick constitution (tarsus length) in either year. The inter-site (RIC vs. TEC) variation fell well within the inter-annual variation of breeding parameters, indicating that environmental stochasticity could be a greater determinant of reproductive output and young quality than agroecosystem type. Although in need of replication, these results suggest that incentives for setting aside farmland and creating wildflower areas within agroecosystems may not only enhance plant and invertebrate diversity, as has been demonstrated earlier, but can also support functioning populations of vertebrates situated at higher trophic levels along the food chain

Mechanisms of damage and repair in multiple sclerosis--a review.

Pathological features of MS include perivascular inflammation and demyelination with oligodendrocyte loss; in addition, attempts at remyelination are often unsuccessful and may culminate in astrocytic scarring. One approach to investigating the biological principles underlying these processes is to use in vitro systems to analyse single-cell behaviour as well as cell-cell interactions. This paper reviews such data concerned with cell injury and repair which illuminate both demyelination and remyelination. In tissue culture oligodendrocytes are susceptible to injury via cell-mediated and humoral mechanisms. Substances including complement and tumour necrosis factor are capable of killing rat oligodendrocytes in vitro; surface complement activation also initiates a number of intracellular processes within oligodendrocytes as well as providing ligands for phagocytic interactions. The reasons for oligodendrocyte complement activation are discussed, but it appears that species differences exist when extrapolating these data to humans. Myelination and remyelination can also be studied both in vitro and in vivo using defined cell populations. Results from these studies may eventually help to explain some pathological features of MS, including astrocytosis and factors governing the limits of remyelination.</p