Ökologisierte Landwirtschaft in Deutschland - 2050

Ziel der vorliegenden Studie ist es, eine Diskussionsgrundlage für die Entwicklung einer zukunftsfähigen und ökologisierten Landwirtschaft in Deutschland im Jahr 2050 zu erarbeiten. Diese ökologisierte konventionelle Landwirtschaft zeichnet sich aus durch eine weitgehend klimaschonende Bewirtschaftung, eine deutlichen Erhöhung der Biologischen Vielfalt in der Agrarlandschaft, signifikant verringerte Schadstoffeinträge, eine verbesserte Nutztierhaltung und eine gentechnikfreie und schadstofffreie Erzeugung von hochwertigen Lebensmitteln, Futtermitteln und – falls erforderlich und möglich - von Biomasse. Mit dem Ökolandbau liegt bereits eine gut geeignete Bewirtschaftungsform vor. Es erscheint aber unrealistisch, dass der zertifizierte Ökolandbau bis 2050 die konventionelle Landwirtschaft abgelöst hat. Daher liegt der Schwerpunkt dieser Studie auf der schrittweisen qualitativen Verbesserung der konventionellen Landwirtschaft in den kommenden 35 Jahren bis 2050

Assessing the quality of life and well-being of older adults with physical and cognitive impairments in a German-speaking setting : a systematic review of validity and utility of assessments

Background: For health professionals working with older adults with physical and cognitive impairments, improving or maintaining clients’ quality of life and well-being is of crucial importance. The aim of this study was to evaluate validity and utility of assessments of quality of life and well-being in German suitable for this group of clients. Methods: In an initial literature search, we identified potentially viable assessments based on existing systematic reviews. We then conducted a systematic literature search in the databases Medline, CINAHL, and PsycINFO using keywords related to validity, utility, client group, and German. Assessments for which sufficient evidence was found were evaluated regarding their validity and utility when used with older adults with physical and cognitive impairments. Results: For 14 of 27 initially identified assessments, sufficient evidence was found to evaluate validity and utility with this client group. WHOQOL-BREF, WHOQOL-OLD, WHO-5, EUROHIS-QOL 8, SF-36, SF-12, EQ-5D, NHP, SEIQOL-DW, SWLS, PANAS, DQOL, QOL-AD, and QUALIDEM were evaluated based on 82 studies. Of these, WHOQOL-BREF, WHO-5, SF-36, SF-12, EQ-5D, NHP, QUALIDEM, QOL-AD and DQOL are presented here. Conclusion: Assessments differed widely in the way they operationalized quality of life/well-being, use of self-evaluation or evaluation-by-proxy, and amount of available evidence for their validity and utility. On the basis of our results in regard to the assessments’ validity, utility, and appropriateness of operationalization of quality of life/well-being to the client group, three assessments were recommended for use: WHOQOL-BREF for self-evaluation, QUALIDEM for evaluation-by-proxy in case of severe dementia, and EQ-5D for cost-utility analyses. .Hintergrund: Für Gesundheitsfachpersonen, die mit älteren Menschen mit physischen und kognitiven Einschränkungen arbeiten, ist die Verbesserung der Lebensqualität und des Wohlbefindens ihrer Klientinnen und Klienten ein wichtiges Ziel. In dieser Studie wurden Validität und Praktikabilität deutschsprachiger Assessments zur Erfassung von Lebensqualität und Wohlbefinden in der Anwendung mit dieser Klientengruppe beurteilt. Methode: In einer ersten Literaturrecherche wurden in bestehenden Übersichtsarbeiten potenziell geeignete Assessments identifiziert. Für diese wurden in den Datenbanken MEDLINE, CINAHL und PsycINFO eine systematische Suche mit geeigneten Keywords zu den Bereichen „Validität“, „Praktikabilität“, „ältere Menschen“ und „Deutschsprachigkeit“ durchgeführt. Assessments, für welche Evidenz identifiziert werden konnte, wurden bezüglich Validität und Praktikabilität in der Anwendung mit älteren Menschen mit physischen und kognitiven Einschränkungen beurteilt. Resultate: Für 14 von 27 identifizierten Assessment wurde im Rahmen der systematischen Literaturrecherche genügend Evidenz gefunden, um sie bezüglich Validität und Praktikabilität zu beurteilen. Die Assessments WHOQOL-BREF, WHOQOL-OLD, WHO-5, EUROHIS-QOL 8, SF-36, SF-12, EQ-5D, NHP, SEIQOL-DW, SWLS, PANAS, QUALIDEM, QOL-AD und DQOL wurden anhand von 82 Studien beurteilt. WHOQOL-BREF, WHO-5, SF-36, SF-12, EQ-5D, NHP, QUALIDEM, QOL-AD und DQOL werden in dieser Arbeit näher betrachtet. Schlussfolgerung: Grundsätzlich unterscheiden sich die 14 Assessments stark bezüglich der Operationalisierung von Lebensqualität/Wohlbefinden, der Art der Beurteilung (Selbst- oder Fremdbeurteilung) und dem Ausmaß verfügbarer Evidenz. Im Spezifischen empfehlen wir folgende Assessments zur Erfassung von Lebensqualität und Wohlbefinden von älteren Menschen mit physischen und kognitiven Einschränkungen: WHOQOL-BREF zur Selbstbeurteilung, QUALIDEM zur Fremdbeurteilung von Menschen mit schwerer Demenz und zusätzlich den EQ-5D bei Projekten mit gesundheitsökonomischen Fragestellungen

Effect of counselling during pulmonary rehabilitation on self-determined motivation towards physical activity in people with chronic obstructive pulmonary disease – protocol of a mixed methods study

Background: Physical activity promotion in people with Chronic Obstructive Pulmonary Disease (COPD) is focus of research and public health. Patient-centred interventions like counselling are promising approaches to help patients reducing sedentary behaviour. Aim of the present study is to investigate if a physical activity counselling program during pulmonary rehabilitation increases physical activity level in daily life in people with COPD. Methods: A two-armed, single blind randomised controlled trial including 56 people with COPD will be conducted in an outpatient pulmonary rehabilitation. Patients will participate in a 12-week-rehabilitation program; individuals randomized to the interventional group will additionally participate in five counselling sessions with a physiotherapist, based on the principles of motivational interviewing. The participants’ physical activity level will be measured using an accelerometer (SenseWear Pro®) before, directly and 3 months after pulmonary rehabilitation. Semi-structured interviews will be conducted to learn more about barriers and facilitators regarding daily physical activity. Discussion: If the strategy successfully improves the physical activity level in people with COPD, counselling might be implemented in pulmonary rehabilitation

ChromID identifies the protein interactome at chromatin marks

ISSN:1546-1696ISSN:1087-015

The influence of pulmonary rehabilitation and counselling on perceptions of physical activity in individuals with COPD : a qualitative study

Objective: The aim of this study was to explore to what extent a combined counselling and pulmonary rehabilitation program (PR) influences the perception of physical activity (PA) and motivation for behavioral change in PA in individuals with COPD. The results of previous quantitative trial that investigated the effect of this combined treatment on daily PA were inconclusive. It is conjectured that a more targeted tailoring of the counselling and PR intervention could improve its effectiveness. Patients and Methods: Eighteen individuals with COPD (median age 69, 8 females) who had participated in the PneumoReha program were interviewed twice (following PR and at three-month follow-up). These interviews were transcribed and analyzed thematically. Based on the codes thus identified, three categories ‘perception of PA intensity’, ‘quality of motivation to perform PA’, and ‘strategies to cope with barriers’ were used to differentiate ‘types’ of participants. Results: Four different types of COPD individuals were distinguished. Study findings indicate that those individuals who participated in the PR program combined with embedded counselling tended to be more active and intrinsically motivated. Conclusion: A typology of four types of people with COPD was developed, characterized by their perception of activity, individual motivation and strategies for managing barriers. The patients’ physical activity level might be influenced by their concept of physical activity and the quality of motivation. Recognizing patients’ different activity behaviors is important for improving the quality of outpatient PR programs and developing tailored (according to each type) counselling interventions embedded in outpatient PR programs. Clinical Trial Registration: The study was registered on the website of https://www.clinicaltrials.gov/ with the identifier NCT02455206 (27/05/2015), as well as on the Swiss National Trails Portal SNCTP000001426 (05/21/2015)

Evidential Deep Learning: Enhancing Predictive Uncertainty Estimation for Earth System Science Applications

Robust quantification of predictive uncertainty is critical for understanding factors that drive weather and climate outcomes. Ensembles provide predictive uncertainty estimates and can be decomposed physically, but both physics and machine learning ensembles are computationally expensive. Parametric deep learning can estimate uncertainty with one model by predicting the parameters of a probability distribution but do not account for epistemic uncertainty.. Evidential deep learning, a technique that extends parametric deep learning to higher-order distributions, can account for both aleatoric and epistemic uncertainty with one model. This study compares the uncertainty derived from evidential neural networks to those obtained from ensembles. Through applications of classification of winter precipitation type and regression of surface layer fluxes, we show evidential deep learning models attaining predictive accuracy rivaling standard methods, while robustly quantifying both sources of uncertainty. We evaluate the uncertainty in terms of how well the predictions are calibrated and how well the uncertainty correlates with prediction error. Analyses of uncertainty in the context of the inputs reveal sensitivities to underlying meteorological processes, facilitating interpretation of the models. The conceptual simplicity, interpretability, and computational efficiency of evidential neural networks make them highly extensible, offering a promising approach for reliable and practical uncertainty quantification in Earth system science modeling. In order to encourage broader adoption of evidential deep learning in Earth System Science, we have developed a new Python package, MILES-GUESS (https://github.com/ai2es/miles-guess), that enables users to train and evaluate both evidential and ensemble deep learning

Subjective Mood in Young Unmedicated Depressed Women under High and Low Sleep Pressure Conditions

Diurnal mood variations are one of the core symptoms in depression, and total sleep deprivation (SD) can induce rapid, short-lasting clinical improvement in depressed patients. Here, we investigated if differential sleep pressure conditions impact on subjective mood levels in young women with major depressive disorder (MDD) without sleep disturbances, and in healthy controls. Eight healthy and eight MDD women underwent 40-h SD (high sleep pressure) and 40-h multiple NAP (low sleep pressure) protocols under constant routine conditions during which subjective mood was assessed every 30-min. MDD women rated overall significantly worse mood than controls, with minimal values for both groups during the biological night (ca. 4 a.m.), under high and low sleep pressure conditions. During SD, nighttime mood ratings in MDD women were lower than in controls and partially recovered during the second day of SD, but never attained control levels. The degree of this diurnal time-course in mood under SD correlated positively with sleep quality in MDD women. Our data indicate that MDD women without sleep disturbances did not exhibit a SD-induced antidepressant response, suggesting that the mood enhancement response to sleep deprivation might be related to the co-existence of sleep disturbances, which is an association that remains to be fully established

Effect of counselling during pulmonary rehabilitation on self-determined motivation to be physically active for people with chronic obstructive pulmonary disease : a pragmatic RCT

Background: Counselling is considered to be a promising approach to increasing physical activity (PA) in people with chronic obstructive pulmonary disease (COPD). The aim of the current study was to investigate whether a PA counselling program for people with COPD, when embedded in a comprehensive outpatient pulmonary rehabilitation (PR) program, increased their daily PA. Methods: A two-armed, single blind randomized controlled trial was conducted as a component of a 12-week outpatient pulmonary rehabilitation program. The participants randomized into the intervention group received five counselling sessions, based on the principles of motivational interviewing (MI), with a physiotherapist. The participants’ steps per day and other proxies of PA were measured using an accelerometer (SenseWear Pro®) at baseline, at the end of the PR program, and three months later. The group-by-time interaction effect was analyzed. Results: Of the 43 participants,17 were allocated to the intervention group and 26 to the usual-care control group (mean age 67.9 ± 7.9; 21 (49%) males; mean FEV1 predicted 47.1 ± 18.6). No difference between groups was found for any measure of PA at any point in time. Conclusions: In this study, counselling, based on MI, when embedded in a comprehensive PR program for people with COPD, showed no short-term or long-term effects on PA behavior. To investigate this potentially effective counselling intervention and to analyze the best method, timing and tailoring of an intervention embedded in a comprehensive outpatient PR program, further adequately powered research is needed. Trial registration: Clinical Trials.gov NCT02455206 (05/21/2015), Swiss National Trails Portal SNCTP000001426 (05/21/2015)