TY - JOUR A1 - Radtke, Ina A1 - Fleischer, Julia T1 - The Refugee Crisis in Germany BT - New Coordination Structures to Repair Organisational Legitimacy JF - Societal Security and Crisis Management N2 - This chapter analyses the creation of novel cross-sectoral and multi-level coordination arrangements inside the German federal bureaucracy during the recent refugee crisis. We argue that the refugee crisis can be considered as an administrative crisis that challenged organisational legitimacy. Various novel coordination actors and arenas were set up in order to enhance governance capacity. Yet, all of them have been selected from a well-known pool of administrative arrangements. As a consequence, those novel coordination arrangements did not replace but rather complement pre-existing patterns of executive coordination. Hence, the recent refugee crisis exemplifies how bureaucracies effectively adapt to changes in their surroundings via limited and temporary adjustments that coexist with existing organisational arrangements. Thus, the observed changes in coordination structures contribute to repairing organisational legitimacy by increasing governance capacity. Y1 - 2018 SN - 978-3-319-92303-1 SN - 978-3-319-92302-4 U6 - https://doi.org/10.1007/978-3-319-92303-1_14 SP - 265 EP - 283 PB - Palgrave Macmillan CY - Cham ER - TY - JOUR A1 - Frank, Ulrike A1 - Radtke, Julia A1 - Nienstedt, Julie Cläre A1 - Pötter-Nerger, Monika A1 - Schönwald, Beate A1 - Buhmann, Carsten A1 - Gerloff, Christian A1 - Niessen, Almut A1 - Flügel, Till A1 - Koseki, Jana-Christiane A1 - Pflug, Christina T1 - Dysphagia screening in Parkinson's Disease BT - a diagnostic accuracy cross-sectional study investigating the applicability of the Gugging Swallowing Screen (GUSS) JF - Neurogastroenterology and motility N2 - Background Simple water-swallowing screening tools are not predictive of aspiration and dysphagia in patients with Parkinson's Disease (PD). We investigated the diagnostic accuracy of a multi-texture screening tool, the Gugging Swallowing Screen (GUSS) to identify aspiration and dysphagia/penetration in PD patients compared to flexible endoscopic evaluation of swallowing (FEES). Methods Swallowing function was evaluated in 51 PD participants in clinical 'on-medication' state with the GUSS and a FEES examination according to standardized protocols. Inter-rater reliability and convergent validity were determined and GUSS- and FEES-based diet recommendations were compared. Key Results Inter-rater reliability of GUSS ratings was high (r(s) = 0.8; p < 0.001). Aspiration was identified by the GUSS with a sensitivity of 50%, and specificity of 51.35% (PPV 28%, NPV 73%, LR+ 1.03, LR- 0.97), dysphagia/penetration was identified with 72.97% sensitivity and 35.71% specificity (PPV 75%, NPV 33.33%, LR+ 1.14, LR- 0.76). Agreement between GUSS- and FEES-based diet recommendations was low (r(s) = 0.12, p = 0.42) with consistent NPO (Nil per Os) allocation by GUSS and FEES in only one participant. Conclusions and Inferences The multi-texture screening tool GUSS in its current form, although applicable with good inter-rater reliability, does not detect aspiration in PD patients with acceptable accuracy. Modifications of the GUSS parameters "coughing," "voice change" and "delayed swallowing" might enhance validity. The GUSS' diet recommendations overestimate the need for oral intake restriction in PD patients and should be verified by instrumental swallowing examination. KW - aspiration KW - dysphagia KW - FEES KW - Gugging Swallowing Screen KW - Parkinson' s disease Y1 - 2021 U6 - https://doi.org/10.1111/nmo.14034 SN - 1350-1925 SN - 1365-2982 VL - 33 IS - 5 PB - Wiley CY - Hoboken ER - TY - GEN A1 - Frank, Ulrike A1 - Radtke, Julia A1 - Nienstedt, Julie Cläre A1 - Pötter-Nerger, Monika A1 - Schönwald, Beate A1 - Buhmann, Carsten A1 - Gerloff, Christian A1 - Niessen, Almut A1 - Flügel, Till A1 - Koseki, Jana-Christiane A1 - Pflug, Christina T1 - Dysphagia screening in Parkinson's Disease BT - a diagnostic accuracy cross-sectional study investigating the applicability of the Gugging Swallowing Screen (GUSS) T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Background Simple water-swallowing screening tools are not predictive of aspiration and dysphagia in patients with Parkinson's Disease (PD). We investigated the diagnostic accuracy of a multi-texture screening tool, the Gugging Swallowing Screen (GUSS) to identify aspiration and dysphagia/penetration in PD patients compared to flexible endoscopic evaluation of swallowing (FEES). Methods Swallowing function was evaluated in 51 PD participants in clinical 'on-medication' state with the GUSS and a FEES examination according to standardized protocols. Inter-rater reliability and convergent validity were determined and GUSS- and FEES-based diet recommendations were compared. Key Results Inter-rater reliability of GUSS ratings was high (r(s) = 0.8; p < 0.001). Aspiration was identified by the GUSS with a sensitivity of 50%, and specificity of 51.35% (PPV 28%, NPV 73%, LR+ 1.03, LR- 0.97), dysphagia/penetration was identified with 72.97% sensitivity and 35.71% specificity (PPV 75%, NPV 33.33%, LR+ 1.14, LR- 0.76). Agreement between GUSS- and FEES-based diet recommendations was low (r(s) = 0.12, p = 0.42) with consistent NPO (Nil per Os) allocation by GUSS and FEES in only one participant. Conclusions and Inferences The multi-texture screening tool GUSS in its current form, although applicable with good inter-rater reliability, does not detect aspiration in PD patients with acceptable accuracy. Modifications of the GUSS parameters "coughing," "voice change" and "delayed swallowing" might enhance validity. The GUSS' diet recommendations overestimate the need for oral intake restriction in PD patients and should be verified by instrumental swallowing examination. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 854 KW - aspiration KW - dysphagia KW - FEES KW - Gugging Swallowing Screen KW - Parkinson' s disease Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-569625 SN - 1866-8364 IS - 5 ER -