Effekte eines motorisch-kognitiven Trainingsprogramms auf die körperliche Leistungsfähigkeit und die Selbsthilfefähigkeit geriatrischer pflegebedürftiger Patienten: Evaluation des Projekts "Lübecker Modell Bewegungswelten"

Durch die steigende Lebenserwartung und die niedrige Geburtenrate nimmt die Zahl älterer Menschen zu. Mit zunehmendem Alter sinken die motorische Leistungsfähigkeit und die Selbsthilfefähigkeit, wodurch auch soziale Aspekte, das Wohlbefinden und die Lebensqualität negativ beeinflusst werden. Die vorliegende Studie untersucht, ob regelmäßige körperliche Aktivität und Bewegung in Form des „Lübecker Modells Bewegungswelten“ diesem Prozess entgegenwirken kann. Insgesamt werden 255 geriatrische Patienten mit regelmäßigem Pflegebedarf in die Studie eingeschlossen und auf eine Interventions- (N= 121) und eine Kontrollgruppe (N= 84) randomisiert. Die Interventionsgruppe absolviert über zwölf Monate zweimal pro Woche das 60-minütige Trainingsprogramm gemäß des „Lübecker Modells Bewegungswelten“. Durch das Interventionsprogramm kann ein positiver Effekt in Bezug auf die Selbsthilfefähigkeit, die allgemeine Ausdauer, die Mobilität, die Schulterbeweglichkeit und das Gleichgewicht nachgewiesen werden. Auf die Feinmotorik und die Kraft der oberen und unteren Extremitäten konnte kein Einfluss genommen werden. Zur weiteren Analyse werden alle motorischen Parameter in einem Motorik Index zusammengefasst, um einerseits die allgemeine motorische Leistungsfähigkeit der beiden Gruppen zu vergleichen und andererseits den Zusammenhang zwischen der motorischen Leistungsfähigkeit und der Selbsthilfefähigkeit darzustellen. Neben einem signifikant besseren Abschneiden der Interventionsgruppe hinsichtlich des Motorik Index, konnte zudem ein positiver Zusammenhang zwischen der motorischen Leistungsfähigkeit und der Selbsthilfefähigkeit nachgewiesen werden. Die Studie zeigt, dass durch regelmäßige Aktivität gemäß des „Lübecker Modells Bewegungswelten“ die motorische Leistungsfähigkeit und dadurch auch die Selbsthilfefähigkeit im Alter stabilisiert oder sogar verbessert werden kann. Weiterführende Analysen sind notwendig, um adäquate Bewegungsempfehlungen geben zu können. Das “Lübecker Modell Bewegungswelten“ bietet eine Grundlage für das weitere Vorgehen.The proportion of older people in our society is growing due to an increasing life expectancy and a decreasing birth rate. Motor performance and self-help ability decrease with aging and consequently affect social aspects, well-being and the quality of life. The present study examines whether regular physical activity and exercise, following the "Lübecker Modell Bewegungswelten", can counteract this process. A total of 255 geriatric patients with regular care needs participated in the study, randomized into an intervention group (N= 121) and a control group (N= 84). The intervention group completed the 60-minute training program twice per week in accordance to the "Lübecker Modell Bewegungswelten". The intervention program had a positive effect on the self-help ability, general endurance, mobility, shoulder mobility and balance of the participants. Fine motor skills and upper and lower extremity strength did not change significantly. For further analysis, all motor parameters were summarized in a Motoric Index, to compare the general motor performance of the two groups and to further represent the relationship between motor performance and self-help ability. A positive correlation between motor performance and self-help ability was demonstrated in addition to a significantly better performance of the intervention group, with regard to the motor function index. The results of the study show that regular activity, according to the "Lübecker Modell Bewegungswelten", can stabilize or even improve the motor performance and therefore the self-help ability in older age. Further analysis is necessary in order to prescribe adequate motion recommendations. The "Lübecker Modell Bewegungswelten" offers a foundation for the further practice

Prospective randomised study comparing screw versus helical blade in the treatment of low-energy trochanteric fractures

Purpose: The purpose of this study was to compare femoral head placement, rates of reoperation and cephalic implant cut-out of a screw versus a blade for patients over age 60 with low energy trochanteric fractures (AO/OTA 31-A1, A2, and A3) treated either with sliding hip screw or cephalomedullary nail. Methods: After surgeon selection of either hip screw or nail, hip screw patients were randomised to either a DHS (dynamic hip system screw) or DHS blade (dynamic hip system blade), while nail patients were randomised to either a Gamma3 Trochanteric Nail or a PFNA (proximal femoral nail antirotation). This resulted in a screw group (DHS and Gamma nail), and a blade group (DHS blade and PFNA). Outcome measures included tip-apex distance and zone location of the cephalic implant, as well as reoperation and implant cut-out within the first postoperative year. Results: A total of 335 patients were randomised, 172 to a screw and 163 to a blade. There was no significant difference concerning mean tip-apex distance, percentage of patients with a tip-apex distance >25mm, and patients with a centre-centre position of the cephalic implant. There were 137 patients in the screw group and 132 in the blade group available for follow-up. They did not differ regarding rates of reoperation or cut-out (screw group = 2.9%; blade group = 1.5%). Conclusions: Both a screw and a blade performed equally well in terms of implant placement in the femoral head and outcom

Organizational outcomes of corporate volunteering: the qualitative study

Purpose: The aim of this paper is to identify benefits of corporate volunteer programs gained on employee behaviors’ side. Specifically, the following research question is posed: what benefits of corporate volunteer projects are there observed by employees participating in them?Methodology/approach: The paper is based on a qualitative study conducted in the form of semi-structured in-depth individual interviews with employees participating in volunteer programs.Findings: The study shows that corporate volunteering leads to positive effects on employees, including increased work meaningfulness, competence development and strengthen interpersonal relationships at work. Simultaneously, the study suggests that work meaningfulness plays focal role in the overall process.Implications: Results of the study deliver practical implications for companies implementing corporate volunteering. Volunteer programs should be organized in a way giving employees full autonomy in crafting their projects. The programs should also support and intensify employee interactions and favor volunteer actions requiring wide range of skills.Originality/value: The study contributes to theory development in the field of both corporate social responsibility and organizational behavior. Specifically, it gives an insight on how responsible business practices may strengthen employees’ sense of meaningfulness of work and subsequently improve their competences and mutual relations

Larynx Movement in the Production of Georgian Ejective Sounds

In this study, we present a non-invasive method for investigating laryngeal movement in the production of ejective sounds. Being non-invasive, this method can be used easily in the study of spontaneous speech. Typically, EMA is used to track the tongue and lip movements in speech production. In this study, we recorded four Georgian native speakers with four sensor coils on the outside of the skin – just above the larynx – in the area of the cricoid cartilage. The analysis reveals that there is considerably greater movement of the coils during the production of ejectives as compared to pulmonal sounds. These movement patterns of the skin above the larynx are admittedly of very complex nature. To attribute the movement solely to the larynx is problematic. Nonetheless, this method may help to understand the production mechanism of ejectives

Cues to gemination in word-initial position in Maltese

In this study we investigated word-initial geminates in Maltese, focusing on sub-segmental acoustic durations: constriction duration and, where appropriate, VOT; and the duration of adjacent segments: the tonic vowel duration and the duration of the inter-consonantal interval spanning the word boundary. This latter interval, between the consonant in the previous word and the singleton/geminate consonant, is measured so as to capture the presence and duration of a vocalic element, which has been referred to as epenthetic, and reportedly precedes word-initial geminates in the language. Whilst constriction duration plays an important role in distinguishing geminates from singletons (a ratio of 1.7:1), VOT does not. Moreover, although the duration of the following tonic vowel plays no role, the duration of the preceding context – the inter-consonantal interval – is a strong cue to gemination word-initially.peer-reviewe

Differences in Patient Characteristics Prior to TKA and THA Between Switzerland and the US

Introduction: Total knee (TKA) and hip (THA) arthroplasty results, including patient-reported outcome measures (PROMs), complication and implant survival rates, are often generalized across countries, although patient- and environment-dependent factors may differ considerably. We described and compared preoperative characteristics from two large TKA and THA cohort studies, one in Switzerland and the other in the US. Materials & methods: Patient characteristics were collected prospectively on all elective primary TKAs and THAs performed (1) at a large tertiary center in Switzerland between 1/2010 and 12/2011 and (2) in FORCE-TJR, a US diverse, large national sample between 6/2011 and 8/2012. Information was obtained on age, sex, BMI, diagnosis, medical co-morbidities, and PROMs (WOMAC pain and function, SF-12/36 physical and mental component scores). We calculated risk ratios, and mean differences, and effect sizes, to compare preoperative scores. Results: Overall, 2508 TKAs and 1,912 THAs (US) and 855 TKAs and 673 THAs (Swiss) were evaluated. U.S. patients, compared to Swiss, were younger (mean age TKA: 67 vs. 72 yrs; THA: 64 vs. 68 yrs), more obese (BMI ≥35 TKA: 27% vs. 17%; THA: 39% vs. 23%). US TKA patients had more cardiac disease, higher preoperative WOMAC pain scores (52 vs. 41 points) indicating less knee-specific pain at time of TKA. US THA patients had more diabetes (13% vs. 10%), higher WOMAC pain scores (47 vs. 40 points) indicating less hip-specific pain at the time of THA. While significant physical disability (SF) was reported in both countries, US TKA and THA patients reported lower physical function scores. Conclusion: We found substantial differences in baseline characteristics with younger age, greater obesity, in the US TKA and THA patients, and more cardiac disease (TKA), diabetes and preoperative hip pain (THA). Significant levels of disability were reported across countries. These findings call for adequate risk adjustment in cross-cultural comparisons

Challenges with the kinematic analysis of neurotypical and impaired speech : measures and models

A common goal of kinematic studies on disordered speech is the identification of speech motor impairments that negatively impact speech function. Although it is well-known that the kinematic contours of speakers with speech disorders often deviate considerably from those of neurotypical speakers, systematic quantitative assessments of these impairment-related movement disturbances remain challenging. Kinematic measurement approaches are commonly grounded in models and theories that have emerged exclusively from observations of healthy speakers. However, often these models cannot accommodate the deviant articulatory behaviors of speakers with speech motor impairment. In the present paper, we address this problem. By considering noise as a factor in Articulatory Phonology/Task Dynamics (AP/TD), we can account for articulatory behaviors that are known to occur in healthy speakers (e.g., during slow speech) as well as in speakers with motor speech impairments. In a proof of concept, we descriptively compare modeled articulatory behaviors that include noise at various levels with empirical data. We view such an extension of the AP/TD as a first step towards a more comprehensive speech production model that can serve as a theoretical framework to study the speech production mechanism in healthy speakers and speakers with motor speech impairments

A percepção de qualidade de vida de pessoas com deficiência motora: diferenças entre cadeirantes e deambuladores

La rutina diaria de las personas con discapacidad incluye el uso de recursos de tecnología asistencial diversos, que les pueden ayudar en su desarrollo físico e intelectual, afectando directamente su calidad de vida. Este estudio pretende evaluar la percepción de la calidad de vida de las personas en sillas de ruedas y las deambuladoras con discapacidades físicas en la ciudad de Itajaí, Santa Catarina (Brasil). Se trata de un estudio descriptivo de cohorte transversal y de tipo exploratorio cuantitativo, con una muestra de 163 participantes (91 en silla de ruedas y 72 deambuladores), que respondieron a un cuestionario estructurado con datos socioeconómicos y de salud y al instrumento World Health Organization Quality of Life Instruments (WHOQOL-bref) para medir la calidad de vida. En la evaluación de los dominios físico y psicológico, no se observaron diferencias significativas entre los dos grupos, por lo que la percepción de la calidad de vida no fue afectada por el uso de la silla de ruedas. Sin embargo, al examinar el dominio relaciones sociales y medio ambiente, la percepción sobre la calidad de vida fue significativamente menor a los usuarios de silla de ruedas cuanto a las paresias, plejías y amputación.The routine of people with physical disabilities includes the use of different assistive technology resources that can aid in their physical and intellectual development, which directly affects their quality of life. The objective of this study was to evaluate the life quality perception of Wheelchair users and non-Wheelchair users living in the municipality of Itajaí, in the state of Santa Catarina. This is a cross – sectional study with exploratory and quantitative analysis. The sample consisted of 163 participants, of whom 91 were wheelchair users and 72 were non-wheelchair users. Participants responded to a structured questionnaire with socioeconomic and health information and the World Health Organization Quality of Life Instrument, WHOQOL_bref, to measure quality of life. In the evaluation of the physical and psychological domains, no significant differences were observed between the two groups. Therefore, in these two areas, the perception of quality of life was not affected by the use of wheelchair. However, by examining the social relations and environment domain the perception of quality of life was significantly lower for wheelchair users with paresis, regarding the plegies and amputation.A rotina das pessoas com deficiência física inclui o uso de diferentes recursos de tecnologia assistiva, que podem auxiliar em seu desenvolvimento físico e intelectual, afetando diretamente sua qualidade de vida. O objetivo deste estudo foi avaliar a percepção da qualidade de vida de pessoas cadeirantes e deambuladoras com deficiência física no município de Itajaí, Santa Catarina. Trata-se de uma pesquisa descritiva de corte transversal e caráter exploratório quantitativo, cuja. amostra foi constituída por 163 participantes (91 cadeirantes e 72 deambuladores), que responderam a um questionário estruturado com informações socioeconômicas e de saúde e ao instrumento do World Health Organization Quality of Life Instruments (WHOQOL-bref), para mensurar a qualidade de vida. Na avaliação dos domínios físico e psicológico não foram observadas diferenças significativas entre os dois grupos, portanto a percepção da qualidade de vida não foi afetada pela utilização da cadeira de rodas. No entanto, examinando-se o domínio de relações sociais e meio ambiente, a percepção da qualidade de vida foi significativamente menor para cadeirantes com paresias, em relação às plegias e à amputação

Estimativa de ferro biodisponível em dietas de creches filantrópicas da cidade de São Paulo: considerações sobre a fortificação da farinha de trigo com ferro

Objetivo: Estimar o ferro biodisponível nas dietas oferecidas às crianças de um a dois anos de idade, em creches filantrópicas do município de São Paulo, e, a partir dos cardápios avaliar o ferro considerando as alterações na concentração de ferro dietético pela fortificação das farinhas de trigo. Métodos: O ferro total e o ferro biodisponível foram estimados nas quatro refeições diárias planejadas para um período de cinco dias, utilizando-se os cardápios padronizados adotados em oito creches filantrópicas do município de São Paulo. Considerando-se a concentração de ferro de cada dieta individual, bem como a de proteína animal e de vitamina C, calculou-se a quantidade de ferro biodisponível ofertada a cada refeição, utilizando-se a equação de Monsen e Balintfly, que possibilita essa estimativa, a partir da relação entre esses fatores. Estimou-se ainda, nas mesmas dietas, o ferro total e biodisponível e suas densidades, considerando-se o acréscimo na concentração de ferro não heme derivado da fortificação de farinha de trigo e de milho com 4,2 mg Fe/100 g. Para o cálculo da oferta de nutrientes das dietas, foi utilizado o Programa Nutwin®, versão 1.5. Resultados: A quantidade média diária de ferro e de ferro biodisponível oferecidos com as dietas foram de 6,2(0,8) mg/d e 0,53(0,06) mg/d. Levando-se em conta a fortificação, esses valores aumentaram para, respectivamente, 7,7(0,9) mg/d e 0,59(0,07) mg/d. As médias de densidade de ferro e de f e r ro biodi sponíve l com e sem for t i f i c a ç ão, for am de , r e spe c t ivament e , 5,8(1,3) mg/1.000 kcal e 7,7(1,7) mg/1.000 kcal, e 0,42(0,10) mg/1.000 kcal e 0,49(0,13) mg/1.000 kcal. Conclusão: Embora com a fortificação da farinha de trigo tenha havido aumento na concentração do ferro total nas dietas avaliadas (24 %), a estimativa de ferro biodisponível ofertado mudou apenas 11 %. Para garantir o atendimento das necessidades diárias de 1,26 mg/d (percentil 97,5), considerando a biodisponibilidade de 9,0 % obtida nas dietas ofertadas a essas crianças, a recomendação deveria ser de cerca de 13 mg/d, e não de 7 mg/d. Esse nível de ingestão de ferro não poderia ser atingido somente com a fortificação das farinhas