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After foundation of the Wadden Sea National Park, grazing and artificial drainage was ceased or reduced on large areas of the salt marshes at the Schleswig-Holstein mainland coast (Northern Germany). The effect of grazing cessation versus intensive and moderate grazing on vegetation diversity was studied on small (plant species richness on plots between 0.01 and 100 m2) and large scale (vegetation type richness per hectare) over 18 to 20 years by analysing data from long-term monitoring programs. Plant species richness and vegetation type richness increased strongly over time in all management regimes, because grazing-sensitive species increased first in ungrazed marshes and later dispersed to and established in intensively grazed marshes. Dominance of the tall, late-successional grass Elymus athericus on 7% to 52% of all moderately and ungrazed (primarily high marsh) plots led to a decrease in species richness. After 18 to 20 years, species richness was highest in moderately and intensively grazed high marshes. Differences were significant only on small plots of up to 4 m2. On the large scale, vegetation type richness in the low marsh was higher without grazing, while no differences were found in the high marsh. Our results indicate that grazing effects differ between spatial scales and that different spatial scales have to be considered for monitoring and evaluation of vegetation diversity in salt marshes. To conserve vegetation diversity on all scales, a large-scale mosaic of different management regimes should be maintained.
Alexithymia, or a lack of emotional awareness, is prevalent in some chronic pain conditions and has been linked to poor recognition of others' emotions. Recognising others' emotions from their facial expression involves both emotional and motor processing, but the possible contribution of motor disruption has not been considered. It is possible that poor performance on emotional recognition tasks could reflect problems with emotional processing, motor processing or both. We hypothesised that people with chronic facial pain would be less accurate in recognising others' emotions from facial expressions, would be less accurate in a motor imagery task involving the face, and that performance on both tasks would be positively related. A convenience sample of 19 people (15 females) with chronic facial pain and 19 gender-matched controls participated. They undertook two tasks; in the first task, they identified the facial emotion presented in a photograph. In the second, they identified whether the person in the image had a facial feature pointed towards their left or right side, a well-recognised paradigm to induce implicit motor imagery. People with chronic facial pain performed worse than controls at both tasks (Facially Expressed Emotion Labelling (FEEL) task P < 0·001; left/right judgment task P < 0·001). Participants who were more accurate at one task were also more accurate at the other, regardless of group (P < 0·001, r2 = 0·523). Participants with chronic facial pain were worse than controls at both the FEEL emotion recognition task and the left/right facial expression task and performance covaried within participants. We propose that disrupted motor processing may underpin or at least contribute to the difficulty that facial pain patients have in emotion recognition and that further research that tests this proposal is warranted.
Chronic facial pain has many of the clinical characteristics found in other persistent musculoskeletal conditions, such as low back and cervical pain syndromes. Unique to this condition, however, is that painful facial movements may result in rigidity or altered ability to demonstrate mimicry, defined as the natural tendency to adopt the behavioral expressions of other persons involved in the interaction. Loss of ability to communicate through emotional expression can lead to impaired processing of emotions and ultimately social isolation. Diminished quality and quantity of facial expression is associated with chronic face pain, tempromandibular dysfunction, facial asymmetries, and neurological disorders. This report provides a framework for assessment of impaired emotional processing and associated somatosensory alterations. Principles for management for chronic facial pain should include graded motor imagery, in addition to standard treatments of manual therapy, exercise, and patient education. A case study is provided which illustrates these principles.
Background:
One of the main problems of Internet-delivered interventions for a range of disorders is the high dropout rate, yet little is known about the factors associated with this. We recently developed and tested a Web-based 6-session program to enhance motivation to change for women with anorexia nervosa, bulimia nervosa, or related subthreshold eating pathology.
Objective:
The aim of the present study was to identify predictors of dropout from this Web program.
Methods:
A total of 179 women took part in the study. We used survival analyses (Cox regression) to investigate the predictive effect of eating disorder pathology (assessed by the Eating Disorders Examination-Questionnaire; EDE-Q), depressive mood (Hopkins Symptom Checklist), motivation to change (University of Rhode Island Change Assessment Scale; URICA), and participants’ age at dropout. To identify predictors, we used the least absolute shrinkage and selection operator (LASSO) method.
Results:
The dropout rate was 50.8% (91/179) and was equally distributed across the 6 treatment sessions. The LASSO analysis revealed that higher scores on the Shape Concerns subscale of the EDE-Q, a higher frequency of binge eating episodes and vomiting, as well as higher depression scores significantly increased the probability of dropout. However, we did not find any effect of the URICA or age on dropout.
Conclusions:
Women with more severe eating disorder pathology and depressive mood had a higher likelihood of dropping out from a Web-based motivational enhancement program. Interventions such as ours need to address the specific needs of women with more severe eating disorder pathology and depressive mood and offer them additional support to prevent them from prematurely discontinuing treatment.
Purpose:
To analyse the willingness for postmortem cornea donation in Germany.
Methods:
Employees in two cities (UKM, UKS), and university hospitals (STM, STE), members of the German Ophthalmological Society (DOG), and employees of an automobile company (BO) participated in a questionnaire about postmortem cornea donation attitudes. The questionnaire consisted of demographic items, motives concerning postmortem cornea donation, general attitudes toward donation, and questions concerning the perceived needs for information about donation. The statistical analyses included logistic regression with the target parameter of 'willingness to donate cornea postmortem'.
Results:
Of the participants, 67.7 % (UKM, UKS), 70.9 % (STM, STE), 70.8 % (BO), and 79.4 % (DOG) declared their intention to donate their corneas postmortem. Younger age (p < 0.001), poorer general health (p < 0.05), faith in an eternal life (p < 0.05), disagreement with brain death diagnostics (p < 0.001), fear of receiving worse medical treatment (p < 0.001), and fear of the commercialization of organs (p < 0.001) were found to be risk factors for a negative attitude toward postmortem cornea. The majority of participants (57.4 %) indicated that additional information about donation would be appreciated, and the internet (69.9 %) was considered the most appropriate means for conveying this information.
Conclusions:
Emotional items were revealed to be the most relevant factors influencing the willingness to donate cornea postmortem, which may be counteracted by means of public education. The relatively low willingness among the medical staff contrasts with previous observations in a professional ophthalmologic society.
Background:
Children with severe psychomotor impairment (SPMI) often experience sleep disturbances that severely distress both the child and his or her parents. Validated questionnaires for the assessment of parents’ distress related to their child’s sleep disturbances are lacking.
Methods:
We developed and validated a new questionnaire, the HOST (holistic assessment of sleep and daily troubles in parents of children with SPMI) to assess the effect of the sleep disturbances in children with SPMI on their parents. The questionnaire was developed based on published data and expert opinion, and it was refined via direct consultation with affected parents. Its psychometric characteristics were assessed in a sample of parents of 214 children with SPMI. It was retested using a random subsample of the participants.
Results:
Explorative factor analysis revealed that the HOST was composed of four scales. Fit indices, item analysis, and convergent validity (coherence with preexisting instruments of sleep disturbances and health status) were adequate. Retest analysis (n = 62) revealed high stability of the HOST questionnaire and adequate replication validity.
Conclusion:
Sleep-related difficulties significantly impact the sociomedical characteristics of the parents of children with complex neurologic diseases. Typically, parents are severely affected in various aspects of daily life (i.e., medical health, social life, professional life). The HOST proved to be a valid, reliable and economical assessment tool of sleep-related difficulties in parents and relatives of children with SPMI. The HOST is capable of identifying individuals and specific areas requiring intervention.
The nutritional footprint – An assessment tool for health and environmental effects of nutrition
(2014)
Aufgrund seiner starken Umweltauswirkungen gilt der Lebensmittelsektor durch Effekte in Produktion, Verarbeitung, Konsum und Entsorgung gemeinhin als ein wichtiges Handlungsfeld, soll eine gesellschaftliche Transformation in Richtung Nachhaltigkeit weiter vorangetrieben werden. Da Ernährungsgewohnheiten sowohl ökologische Auswirkungen induzieren als auch gesundheitliche Folgen für die Verbraucher haben, sind Konzepte gefragt, die ökologische mit gesundheitlichen Indikatoren kombinieren; diese sind jedoch bislang rar. Das vorgestellte Instrument des Nutritional Footprint greift diese Problemstellung auf und verbindet in einem innovativen Konzept jeweils vier Kernindikatoren beider Dimensionen. Mithilfe des Konzepts erhalten Verbraucher einen Überblick zu Umwelt- und Gesundheitswirkungen ihrer Ernährung. Unternehmen können wiederum interne Datensätze verwalten, Benchmarking betreiben und ihre externe Kommunikationsleistung erweitern.
Der Lebensmittel- und Landwirtschaftssektor wird in den nächsten Jahrzehnten vor zahlreichen Herausforderungen stehen, die sich aus den sich verändernden globalen Produktions- und Verbrauchsmustern ergeben, die derzeit mit einem hohen Ressourcenverbrauch einhergehen und ökologische und sozioökonomische Auswirkungen haben. Ziel dieses Beitrags ist es, die praktische Anwendbarkeit der Hot-Spot-Analyse-Methode im Kontext des Lieferkettenmanagements in Unternehmen zu veranschaulichen und zu bewerten.
Die HSA ist eine Methode zur Identifizierung sozialer und ökologischer Probleme entlang des gesamten Lebenszyklus eines Produkts. Besonderes Augenmerk wird auf eine maßgeschneiderte Umsetzung in der Wertschöpfungskette Rindfleisch von McDonald's Deutschland gelegt. Die HSA der Wertschöpfungskette Rindfleisch von McDonald's zeigt, dass die größten ökologischen Probleme in der Phase der Rohstoffgewinnung auftreten, während die größten sozialen Probleme in der Phase der Schlachtung identifiziert werden können. Abschließend zeigt der Beitrag Potenziale und Defizite einer solchen maßgeschneiderten Anwendung und wie die Ergebnisse im Nachhaltigkeitsmanagement eines Unternehmens umgesetzt werden können. in das Nachhaltigkeitsmanagement eines Unternehmens implementiert werden können.
Background
To offer vaginal birth after cesarean (VBAC) in a hospital setting is recommended in international guidelines, but offering VBAC in out‐of‐hospital settings is considered controversial. This study describes neonatal and maternal outcomes in mothers who started labor in German out‐of‐hospital settings.
Method
In a retrospective analysis of German out‐of‐hospital data from 2005 to 2011, included were 24,545 parae II with a singleton pregnancy in a cephalic presentation at term (1,927 with a prior cesarean and 22,618 with a prior vaginal birth).
Result
The overall VBAC rate was 77.8 percent. The intrapartum transfer rate to hospital was 38.3 percent (prior cesarean) versus 4.6 percent (prior vaginal) (p < 0.05), and the 10‐minute Apgar < 7 rate was 0.6 versus 0.2 percent (p < 0.05), and the nonemergency intrapartum transfer rate was 91.5 versus 85.0 percent (p < 0.05). Prolonged first stage of labor was the most common reason for intrapartum transfer in both groups. The leading reason for postpartum transfer was retained placenta.
Discussion
There was a high rate of successful VBAC in this study. The high nonemergency transfer rate for women with VBAC might mean that midwives are more cautious when attending women with a prior cesarean in out‐of‐hospital settings. Further studies are necessary to evaluate which women are suitable for VBAC in out‐of‐hospital settings.
Europe's freshwater biodiversity under climate change: distribution shifts and conservation needs
(2014)
Aim
To assess the future climatic suitability of European catchments for freshwater species and the future utility of the current network of protected areas.
Location
Europe.
Methods
Using recently updated catchment-scale species data and climate projections from multiple climate models, we assessed the climate change threat by the 2050s for 1648 European freshwater plants, fishes, molluscs, odonates, amphibians, crayfish and turtles for two dispersal scenarios and identified hotspots of change at three spatial scales: major river basins, countries and freshwater ecoregions. We considered both common species and the often overlooked rare species. To set our findings within the context of current and future conservation networks, we evaluated the coverage of freshwater biodiversity by Europe's protected area network.
Results
Six per cent of common and 77% of rare species are predicted to lose more than 90% of their current range. Eight fish species and nine mollusc species are predicted to experience 100% range loss under climate change. As the most species-rich group, molluscs are particularly vulnerable due to the high proportion of rare species and their relatively limited ability to disperse. Furthermore, around 50% of molluscs and fish species will have no protected area coverage given their projected distributions.
Main conclusions
We identified the species most at threat due to projected changes in both catchment suitability and representation within the European protected area network. Our findings suggest an urgent need for freshwater management plans to facilitate adaptation to climate change.