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Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation.
The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients.
Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients.
The Pathological Narcissism Inventory (PNI) is a multidimensional measure for assessing grandiose and vulnerable features in narcissistic pathology. The aim of the present research was to construct and validate a German translation of the PNI and to provide further information on the PNI's nomological net. Findings from a first study confirm the psychometric soundness of the PNI and replicate its seven-factor first-order structure. A second-order structure was also supported but with several equivalent models. A second study investigating associations with a broad range of measures (DSM Axis I and II constructs, emotions, personality traits, interpersonal and dysfunctional behaviors, and well-being) supported the concurrent validity of the PNI. Discriminant validity with the Narcissistic Personality Inventory was also shown. Finally, in a third study an extension in a clinical inpatient sample provided further evidence that the PNI is a useful tool to assess the more pathological end of narcissism.
We elicited the production of various types of relative clauses in a group of German-speaking children with specific language impairment (SLI) and typically developing controls in order to test the movement optionality account of grammatical difficulty in SLI. The results show that German-speaking children with SLI are impaired in relative clause production compared to typically developing children. The alternative structures that they produce consist of simple main clauses, as well as nominal and prepositional phrases produced in isolation, sometimes contextually appropriate, and sometimes not. Crucially for evaluating the movement optionality account, children with SLI produce very few instances of embedded clauses where the relative clause head noun is pronounced in situ; in fact, such responses are more common among the typically developing child controls. These results underscore the difficulty German-speaking children with SLI have with structures involving movement, but provide no specific support for the movement optionality account.
It is well established in language acquisition research that monolingual children and adult second language learners misinterpret sentences with the universal quantifier every and make quantifier-spreading errors that are attributed to a preference for a match in number between two sets of objects. The present Visual World eye-tracking study tested bilingual heritage Russian–English adults and investigated how they interpret of sentences like Every alligator lies in a bathtub in both languages. Participants performed a sentence–picture verification task while their eye movements were recorded. Pictures showed three pairs of alligators in bathtubs and two extra objects: elephants (Control condition), bathtubs (Overexhaustive condition), or alligators (Underexhaustive condition). Monolingual adults performed at ceiling in all conditions. Heritage language (HL) adults made 20% q-spreading errors, but only in the Overexhaustive condition, and when they made an error they spent more time looking at the two extra bathtubs during the Verb region. We attribute q-spreading in HL speakers to cognitive overload caused by the necessity to integrate conflicting sources of information, i.e. the spoken sentences in their weaker, heritage, language and attention-demanding visual context, that differed with respect to referential salience.
This study presents pioneering data on how adult early bilinguals (heritage speakers) and late bilingual speakers of Turkish and German process grammatical evidentiality in a visual world setting in comparison to monolingual speakers of Turkish. Turkish marks evidentiality, the linguistic reference to information source, through inflectional affixes signaling either direct (-DI) or indirect (-mls) evidentiality. We conducted an eyetracking-during-listening experiment where participants were given access to visual 'evidence' supporting the use of either a direct or indirect evidential form. The behavioral results indicate that the monolingual Turkish speakers comprehended direct and indirect evidential scenarios equally well. In contrast, both late and early bilinguals were less accurate and slower to respond to direct than to indirect evidentials. The behavioral results were also reflected in the proportions of looks data. That is, both late and early bilinguals fixated less frequently on the target picture in the direct than in the indirect evidential condition while the monolinguals showed no difference between these conditions. Taken together, our results indicate reduced sensitivity to the semantic and pragmatic function of direct evidential forms in both late and early bilingual speakers, suggesting a simplification of the Turkish evidentiality system in Turkish heritage grammars. We discuss our findings with regard to theories of incomplete acquisition and first language attrition.
An observational measure of anger regulation in middle childhood was developed that facilitated the in situ assessment of five maladaptive regulation strategies in response to an anger-eliciting task. 599 children aged 6-10 years (M = 8.12, SD = 0.92) participated in the study. Construct validity of the measure was examined through correlations with parent- and self-reports of anger regulation and anger reactivity. Criterion validity was established through links with teacher-rated aggression and social rejection measured by parent-, teacher-, and self-reports. The observational measure correlated significantly with parent- and self-reports of anger reactivity, whereas it was unrelated to parent- and self-reports of anger regulation. It also made a unique contribution to predicting aggression and social rejection.
Although there is ample evidence linking insecure attachment styles and intimate partner violence (IPV), little is known about the psychological processes underlying this association, especially from the victim’s perspective. The present study examined how attachment styles relate to the experience of sexual and psychological abuse, directly or indirectly through destructive conflict resolution strategies, both self-reported and attributed to their opposite-sex romantic partner. In an online survey, 216 Spanish undergraduates completed measures of adult attachment style, engagement and withdrawal conflict resolution styles shown by self and partner, and victimization by an intimate partner in the form of sexual coercion and psychological abuse. As predicted, anxious and avoidant attachment styles were directly related to both forms of victimization. Also, an indirect path from anxious attachment to IPV victimization was detected via destructive conflict resolution strategies. Specifically, anxiously attached participants reported a higher use of conflict engagement by themselves and by their partners. In addition, engagement reported by the self and perceived in the partner was linked to an increased probability of experiencing sexual coercion and psychological abuse. Avoidant attachment was linked to higher withdrawal in conflict situations, but the paths from withdrawal to perceived partner engagement, sexual coercion, and psychological abuse were non-significant. No gender differences in the associations were found. The discussion highlights the role of anxious attachment in understanding escalating patterns of destructive conflict resolution strategies, which may increase the vulnerability to IPV victimization.
A particular form of social pain is invalidation. Therefore, this study (a) investigates whether patients with chronic low back pain experience invalidation, (b) if it has an influence on their pain, and (c) explores whether various social sources (e.g. partner and work) influence physical pain differentially. A total of 92 patients completed questionnaires, and for analysis, Pearson's correlation coefficients and hierarchical linear regression analyses were conducted. They indicated a significant association between discounting and disability due to pain (respective =.29, p>.05). Especially, discounting by partner was linked to higher disability (=.28, p>.05).
Women are strongly underrepresented at top positions in research, with some research suggesting the postdoctoral career stage is a critical stage for female researchers. Drawing on role congruity theory and social cognitive career theory, we tested the gender-differential impact of work values (extrinsic rewards-oriented work values and work-life balance values) on subjective career success and supports from supervisors (leader-member exchange) and team members. We conducted an online survey with male and female postdoctoral scientists (N = 258). As hypothesized, the positive relationship between extrinsic rewards-oriented work values and subjective career success and supports was stronger for male researchers than for female researchers. Results on work-life balance values were less conclusive. These findings support the idea that gendered appraisal processes may affect career-relevant outcomes.
The girls set the tone
(2015)
In a four-wave longitudinal study with N = 1,321 adolescents in Germany, we examined the impact of class-level normative beliefs about aggression on aggressive norms and behavior at the individual level over the course of 3 years. At each data wave, participants indicated their normative acceptance of aggressive behavior and provided self-reports of physical and relational aggression. Multilevel analyses revealed significant cross-level interactions between class-level and individual-level normative beliefs at T1 on individual differences in physical aggression at T2, and the indirect interactive effects were significant up to T4. Normative approval of aggression at the class level, especially girls’ normative beliefs, defined the boundary conditions for the expression of individual differences in aggressive norms and their impact on physically and relationally aggressive behavior for both girls and boys. The findings demonstrate the moderating effect of social norms on the pathways from individual normative beliefs to aggressive behavior in adolescence.
Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany
(2015)
Aim To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany.
Methods 1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS).
Results Clinically significant sleep apnoea (AHI 15/h) was documented in 33% of patients. Mean AHI was 1416/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI 15-29/h) and severe in 15% (AHI 30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001).
Conclusions The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate.
Sexual aggression victimization and perpetration among female and male university students in Poland
(2015)
This study examined the prevalence of victimization and perpetration of sexual aggression since age 15 in a convenience sample of 565 Polish university students (356 females). The prevalence of sexual aggression was investigated for both males and females from the perspectives of both victims and perpetrators in relation to three coercive strategies, three different victim–perpetrator relationships, and four types of sexual acts. We also examined the extent to which alcohol was consumed in the context of sexually aggressive incidents. The overall self-reported victimization rate was 34.3% for females and 28.4% for males. The overall perpetration rate was 11.7% for males and 6.5% for females. The gender difference was significant only for perpetration. Prevalence rates of both victimization and perpetration were higher for people known to each other than for strangers. In the majority of victimization and perpetration incidents, alcohol was consumed by one or both parties involved. The findings are discussed in relation to the international evidence and the need for tailored risk prevention and reduction programs.
We report the results from two experiments investigating how referential context information affects native and non-native readers’ interpretation of ambiguous relative clauses in sentences such as The journalist interviewed the assistant of the inspector who was looking very serious. The preceding discourse context was manipulated such that it provided two potential referents for either the first (the assistant) or the second (the inspector) of the two noun phrases that could potentially host the relative clause, thus biasing towards either an NP1 or an NP2 modification reading. The results from an offline comprehension task indicate that both native English speakers’ and German and Chinese-speaking ESL learners’ ultimate interpretation preferences were reliably influenced by the type of referential context. In contrast, in a corresponding self-paced-reading task we found that referential context information modulated only the non-native participants’ disambiguation preferences but not the native speakers’. Our results corroborate and extend previous findings suggesting that non-native comprehenders’ initial analysis of structurally ambiguous input is strongly influenced by biasing discourse information.
Kill one or kill them all?
(2015)
Research indicates individual pathways towards school attacks and inconsistent offender profiles. Thus, several authors have classified offenders according to mental disorders, motives, or number/kinds of victims. We assumed differences between single and multiple victim offenders (intending to kill one or more than one victim). In qualitative and quantitative analyses of data from qualitative content analyses of case files on seven school attacks in Germany, we found differences between the offender groups in seriousness, patterns, characteristics, and classes of leaking (announcements of offences), offence-related behaviour, and offence characteristics. There were only minor differences in risk factors. Our research thus adds to the understanding of school attacks and leaking. Differences between offender groups require consideration in the planning of effective preventive approaches.
This longitudinal study of N = 1,566 adolescents investigated the protective role of optimism in adjustment to parental separation, focusing on two salient challenges faced by adolescents, namely academic achievement and self-esteem. Based on latent change models, the results indicated associations between parental separation and short-term declines in academic achievement as well as short-term and longer term declines in self-esteem. Although optimism in general showed positive associations with academic achievement and self-esteem, its role as a protective factor proved to be particularly important for academic achievement in adjustment following parental separation.
The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3% of patients and 0.7% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2% versus 4.3%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.
Research has consistently shown that males play violent video games more frequently than females, but factors underlying this gender gap have not been examined to date. This approach examines the assumption that males play violent video games more because they anticipate more enjoyment and less guilt from engaging in virtual violence than females. This may be because males are less empathetic, tend to morally justify physical violence more and have a greater need for sensation and aggression in video game play than females. Results of a path model based on survey data of 444 respondents and using multi-step multiple mediation analyses confirm these assumptions. Taken together, the findings of this study shed further light on the gender gap in violent video game use.
School shooters are often described as narcissistic, but empirical evidence is scant. To provide more reliable and detailed information, we conducted an exploratory study, analyzing police investigation files on seven school shootings in Germany, looking for symptoms of narcissistic personality disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) in witnesses' and offenders' reports and expert psychological evaluations. Three out of four offenders who had been treated for mental disorders prior to the offenses displayed detached symptoms of narcissism, but none was diagnosed with narcissistic personality disorder. Of the other three, two displayed narcissistic traits. In one case, the number of symptoms would have justified a diagnosis of narcissistic personality disorder. Offenders showed low and high self-esteem and a range of other mental disorders. Thus, narcissism is not a common characteristic of school shooters, but possibly more frequent than in the general population. This should be considered in developing adequate preventive and intervention measures.