Vom Wissen zum Handeln – Grundlagen des Wissenstransfers

Ziel des vorliegenden Knowledge Flow Paper ist es, den Begriff des Wissenstransfers in spezifischer Weise zugänglich zu machen und die wichtigsten Methoden und Instrumente zur Anwendung innerhalb des Zentrums darzulegen. Besondere Herausforderung ist hierbei, das Spannungsverhältnis zwischen gesellschaftlichem Verfügbarmachen von Lösungen und Kontexten und der Vermittlung von Wissen aus dem (natur-)wissenschaftlichen Zentrum in den gesellschaftlichen Handlungsbereich (Politik, Wirtschaft, Umweltorganisationen etc.) zu verbinden. Somit soll das Paper einen ersten Einstieg in das Thema Wissenstransfer/Transferforschung ermöglichen und dessen Potentiale für BiKF erörtern.The knowledge transfer approach has gained a lot of attention in the political, scientific and public context, as it deals with questions about the use and transfer of scientific knowledge. The paper at hand is giving a first overview of the subject of knowledge transfer and it’s potential for BiKF. It is the aim to explain what exactly lies behind the concept of knowl-edge transfer and to state the most important methods and instruments for use within the centre. It serves as a starting point for a more comprehensive integration of internal and external transfer of knowledge within each project areas of BiKF to adress environmental, political and social problems associated with climate change and biodiversity. This Knowledge Flow Paper is based on the document of Thomas Höhne concerning the current state of transfer research for the Institute for Social-Ecological Research

Multimorbidity of communicable and non-communicable diseases in low- and middle-income countries: A systematic review

OBJECTIVE: The aim of this systematic review is to analyse existing evidence on prevalence, patterns, determinants, and healthcare challenges of communicable and non-communicable disease multimorbidity in low- and middle-income countries (LMICs). METHODS: PubMed, Cochrane, and Embase databases were searched from 1(st) January 2000 to 31(st) July 2020. The National Institute of Health (NIH) quality assessment tool was used to critically appraise studies. Findings were summarized in a narrative synthesis. The review was registered with PROSPERO (CRD42019133453). RESULTS: Of 3718 articles screened, 79 articles underwent a full text review of which 11 were included for narrative synthesis. Studies reported on 4 to 20 chronic communicable and non-communicable diseases; prevalence of multimorbidity ranged from 13% in a study conducted among 242,952 participants from 48 LMICS to 87% in a study conducted among 491 participants in South Africa. Multimorbidity was positively associated with older age, female sex, unemployment, and physical inactivity. Significantly higher odds of multimorbidity were noted among obese participants (OR 2.33; 95% CI: 2.19–2.48) and those who consumed alcohol (OR 1.44; 95% CI: 1.25–1.66). The most frequently occurring dyads and triads were HIV and hypertension (23.3%) and HIV, hypertension, and diabetes (63%), respectively. Women and participants from low wealth quintiles reported higher utilization of public healthcare facilities. CONCLUSION: The identification and prevention of risk factors and addressing evidence gaps in multimorbidity clustering is crucial to address the increasing communicable and non-communicable disease multimorbidity in LMICs. To identify communicable and non-communicable diseases trends over time and identify causal relationships, longitudinal studies are warranted

Das Millennium ecosystem assessment als Diskursarena im Diskursfeld "Klimabedingte Veränderungen der Biodiversität"

Der vorliegende Materialienband entstand im Rahmen der problemorientierten Diskursfeldanalyse zu „Klimabedingten Veränderungen der Biodiversität“. Ziel dabei ist es, prioritäre Themen und zentrale Akteure systematisch darzustellen, sowie Konfliktlinien und zukünftige Handlungsbedarfe innerhalb des Themenfeldes zu identifizieren. Das Millennium Ecosystem Assessment bildet dabei eine zentrale Diskursarena im Diskursfeld. Im Zentrum der Analyse des Millennium Ecosystem Assessments stehen wissenschaftlich beeinflusste Positionen und die Frage nach deren gesellschaftlicher Nutzung. Es ist von wissenschaftlicher Seite unumstritten, dass die Auswirkungen des Klimawandels bereits heute die Biodiversität auf unterschiedliche Art und Weise stark beeinflussen. Der vorliegende Bericht analysiert daher den Diskurs zum Themenfeld klimabedingte Biodiversitätsveränderungen auf wissenschaftlicher Basis. Dabei werden zunächst kurz die Vorgeschichte und die zentralen Inhalte des Millennium Ecosystem Assessment skizziert. Die Darlegung und Diskussion übergreifender Themenfelder ermöglicht die Festlegung prioritärer Diskursstränge innerhalb der Diskursarena. Diese umfassen sowohl ökosystemare Aspekte als auch wirtschaftliche Handlungsfelder und forscherliche Herausforderungen. In einem weiteren Arbeitsschritt werden umstrittene Wirkungszusammenhänge sowie wissenschaftliche Forschungsbedarfe und gesellschaftliche Handlungsbedarfe erörtert.The study on hand evolved in connection with the problem orientated discourse field analysis concerning “Climatically caused changes of biological diversity”. The aim is to systematically present prior topics and main stakeholders as well as lines of conflict and future requirements for action within this discourse field. In this context the Millennium Ecosystem Assessment constitutes a major discourse arena. The central point of analysing the Millennium Ecosystem Assessment comprises scientifically influenced positions and the question of how society can profit from them. It is scientifically undisputed that the effects of climate change are already strongly influencing biological diversity in one way or another. Thus, the report on hand is analysing on a scientific basis the discourse field taking place in the context of climatically caused changes of biological diversity. In a first step the genesis and main issues of the Millennium Ecosystem Assessment are being outlined. The presentation and analysis of comprehensive thematic fields allows a definition of prior topics within the field of discourse. These comprise ecosystematic aspects as well as economic fields of action and scientific challenges. In a following step undisputed cause-effect-relationships, needs for research as well as societal requirements for action are debated

Multimorbidity of non-communicable diseases in low-income and middle-income countries : a systematic review and meta-analysis

INTRODUCTION: Multimorbidity is a major public health challenge, with a rising prevalence in low/middle-income countries (LMICs). This review aims to systematically synthesise evidence on the prevalence, patterns and factors associated with multimorbidity of non-communicable diseases (NCDs) among adults residing in LMICs. METHODS: We conducted a systematic review and meta-analysis of articles reporting prevalence, determinants, patterns of multimorbidity of NCDs among adults aged >18 years in LMICs. For the PROSPERO registered review, we searched PubMed, EMBASE and Cochrane libraries for articles published from 2009 till 30 May 2020. Studies were included if they reported original research on multimorbidity of NCDs among adults in LMICs. RESULTS: The systematic search yielded 3272 articles; 39 articles were included, with a total of 1 220 309 participants. Most studies used self-reported data from health surveys. There was a large variation in the prevalence of multimorbidity; 0.7%–81.3% with a pooled prevalence of 36.4% (95% CI 32.2% to 40.6%). Prevalence of multimorbidity increased with age, and random effect meta-analyses showed that female sex, OR (95% CI): 1.48, 1.33 to 1.64, being well-off, 1.35 (1.02 to 1.80), and urban residence, 1.10 (1.01 to 1.20), respectively were associated with higher odds of NCD multimorbidity. The most common multimorbidity patterns included cardiometabolic and cardiorespiratory conditions. CONCLUSION: Multimorbidity of NCDs is an important problem in LMICs with higher prevalence among the aged, women, people who are well-off and urban dwellers. There is the need for longitudinal data to access the true direction of multimorbidity and its determinants, establish causation and identify how trends and patterns change over time. PROSPERO REGISTRATION NUMBER: CRD42019133453

Multimorbidity Among Migrant and Non-Migrant Ghanaians: The RODAM Study

Objectives: Multimorbidity is a growing public health concern due to the increasing burden of non-communicable diseases, yet information about multimorbidity in low- and middle-income countries and migrant populations is scarce. We aimed to investigate the distribution and patterns of multimorbidity in rural and urban areas in Ghana and Ghanaian migrants in Europe. Methods: The RODAM cross-sectional study included 4,833 participants. Multimorbidity was defined as presence of multiple non-communicable chronic conditions. Patterns were determined from frequent combination of conditions. Prevalence ratios were estimated by logistic regression. Results: Prevalence of multimorbidity was higher in women and in urban Ghana and Europe. We observed a cardiometabolic pattern in all sites as well as circulatory-musculoskeletal and metabolic-musculoskeletal combinations in Ghana. Multimorbidity prevalence ratios were higher in Europe (men 1.47, 95% CI 1.34–1.59, women 1.18, 1.10–1.26) and urban Ghana (men 1.46, 1.31–1.59, women 1.27, 1.19–1.34). Conclusion: Distribution and patterns of multimorbidity differed by sex and site. With a higher burden of multimorbidity in urban areas, prevention strategies should focus on forestalling its increase in rapidly growing rural areas

Iron status in the elderly

Iron deficiency anaemia is prevalent in older age, particularly after the age of 80. Serum ferritin concentrations also decline, although there is no evidence to suggest that changes in iron stores are an inevitable consequence of ageing. Chronic inflammation is a common condition in older people, making the measurement of iron status difficult, and it is likely that elevated levels of circulating hepcidin are responsible for changes in iron metabolism that result in systemic iron depletion. Other contributory factors are poor diet and some medications, such as aspirin. Anaemia in older age has undesirable health outcomes, including increased susceptibility to falling and depression. However, there are concerns about possible adverse effects of iron supplements, either in relation to pro-inflammatory effects in the gut or inappropriate tissue iron deposition. Brain iron levels are increased with age-related degenerative diseases, but it is not known if this is the cause or a consequence of the disease, and genetic factors are likely to play a role. In order to maintain body iron within the normal range a personalised approach is required, taking into account all of the factors that may affect iron metabolism and the available strategies for preventing iron deficiency or overload

Maternal vitamin D concentrations during pregnancy, fetal growth patterns, and risks of adverse birth outcomes

Background: Maternal vitamin D deficiency during pregnancy may affect fetal outcomes

Impact of the quantity and flavonoid content of fruits and vegetables on markers of intake in adults with an increased risk of cardiovascular disease: the FLAVURS trial

Purpose Limited robust randomised controlled trials investigating fruit and vegetable (F&V) intake in people at risk of cardiovascular disease (CVD) exist. We aimed to design and validate a dietary strategy of increasing flavonoid-rich versus flavonoid-poor F&V consumption on nutrient biomarker profile. Methods A parallel, randomised, controlled, dose–response dietary intervention study. Participants with a CVD relative risk of 1.5 assessed by risk scores were randomly assigned to one of the 3 groups: habitual (control,CT), high-flavonoid (HF) or low-flavonoid (LF) diets.While the CT group (n = 57) consumed their habitual diet throughout, the HF (n = 58) and LF (n = 59) groups sequentially increased their daily F&V intake by an additional 2, 4 and 6 portions for 6-week periods during the 18-week study. Results Compliance to target numbers and types of F&V was broadly met and verified by dietary records, and plasma and urinary biomarkers. Mean (±SEM) number of F&V portions/day consumed by the HF and LF groups at baseline(3.8 ± 0.3 and 3.4 ± 0.3), 6 weeks (6.3 ± 0.4 and 5.8 ±0.3), 12 weeks (7.0 ± 0.3 and 6.8 ± 0.3) and 18 weeks(7.6 ± 0.4 and 8.1 ± 0.4), respectively, was similar at baseline yet higher than the CT group (3.9 ± 0.3, 4.3 ± 0.3,4.6 ± 0.4, 4.5 ± 0.3) (P = 0.015). There was a dosedependent increase in dietary and urinary flavonoids in theHF group, with no change in other groups (P = 0.0001).Significantly higher dietary intakes of folate (P = 0.035),non-starch polysaccharides (P = 0.001), vitamin C (P =0.0001) and carotenoids (P = 0.0001) were observed in both intervention groups compared with CT, which were broadly supported by nutrient biomarker analysis. Conclusions The success of improving nutrient profile by active encouragement of F&V intake in an intervention study implies the need for a more hands-on public health approach