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Objective: Health-related quality of life (HRQoL) is an important outcome in individuals with a high risk for cardiovascular diseases. We investigated the association of HRQoL and body mass index (BMI) as an indicator for obesity.
Design: Secondary longitudinal analysis of the ORBITAL study, an intervention study which included high-risk cardiovascular primary care patients with hypercholesterolemia and an indication for statin therapy.
Methods: HRQoL was determined with the generic Short Form (SF)-12 health status instrument. Body weight and height were assessed at baseline and at months 6, 12, 18, 24, 30, and 36. We used a linear and a linear mixed-effects regression model to investigate the association between BMI and SF-12 summary scores at baseline as well as between change in BMI and SF-12 summary scores over 3 years. We adjusted for age, sex, smoking status, and in the longitudinal analysis also for the study arm and its interaction term with time.
Results: Of the 7640 participants who completed the baseline questionnaire, 6726 participants (mean age: 61 years) were analyzed. The baseline BMI was inversely associated with physical and mental SF-12 summary scores (beta [95% CI] per 1 kg/ m(2) : -0.36 [-0.41; -0.30] and -0.05 [-0.11; -0.00], respectively). A significant association between the change in BMI and physical SF-12 summary scores over time was only present in women (-0.18 [-0.27; -0.09]) and only in obese participants (-0.19 [-0.29; -0.10]). A change in BMI was directly associated with mental SF-12 summary scores (0.12 [0.06; 0.19]) in the total population.
Conclusion: Increases in BMI were associated with decreases in physical HRQoL, particularly in obese individuals and in women. In contrast, the mental HRQoL seemed to increase with increasing BMI over time. Thus, body weight management with respect to the HRQoL should be evaluated differentially by sex and body weight status.
Aspirationspneumonien sind eine häufige Todesursache bei Dysphagiepatient*innen. In diesem Beitrag wird durch die Evaluation relevanter Studien die Frage untersucht, ob die therapeutische Mundpflege bei Dysphagiepatient*innen zur Verringerung des Pneumonierisikos beitragen kann. Zudem wird auf dieser Grundlage eine Handlungsempfehlung für die Umsetzung der Mundpflege entwickelt.
Die ausgewählten Studien zeigen, dass die Mundpflege einen positiven Effekt auf das Pneumonie-Risiko von Dysphagiepatient*innen hat. Sie sollte auf den Grundsätzen Einfachheit, Sicherheit, Arbeitskräfteentlastung, Wirksamkeit, Universalität, Wirtschaftlichkeit und vollständige Mundpflege aller Teile der Mundhöhle beruhen und nimmt weniger als fünf Minuten täglich ein. Sie bereitet durch die taktile Stimulation auf die anschließende Dysphagie-Therapie vor und ist somit sinnvoll investierte Therapiezeit.
Das 16. Herbsttreffen Patholinguistik mit dem Schwerpunktthema »Schnittstelle Alltag: Transfer und Teilhabe in der Sprachtherapie« fand am 19.11.2022 als Online-Veranstaltung statt. Das Herbsttreffen wird seit 2007 jährlich vom Verband für Patholinguistik e.V. (vpl), seit 2021 vom Deutschen Bundesverband für akademische Sprachtherapie und Logopädie (dbs) in Kooperation mit der Universität Potsdam durchgeführt. Der vorliegende Tagungsband beinhaltet die Vorträge zum Schwerpunktthema sowie die Posterpräsentationen zu weiteren Themen aus der sprachtherapeutischen Forschung und Praxis.
Inhalt:
Alexander von Humboldt-Forschungsstelle: Ingo Schwarz zum 65. Geburtstag
Ottmar Ette: Findung und Erfindung einer Leserschaft. Neuere Editionsprojekte zu Alexander von Humboldt als Grundlage und Herausforderung künftigen Forschens
Eberhard Knobloch: Alexandre de Humboldt et le Marquis de Laplace
Oliver Schwarz: Alexander von Humboldt als astronomischer Arbeiter, Diskussionspartner und Ideengeber
Petra Werner: Innenwelten und bleiche Gärten. Alexander von Humboldt untertage und in der Caripe-Höhle
Christian Suckow: Alexander von Humboldt in Ust’-Kamenogorsk
Anne Jobst: Neue Briefe Christian Gottfried Ehrenbergs an Alexander von Humboldt
Thomas Schmuck: Humboldt, Baer und die Evolution
Manfred Ringmacher: Zwei Briefe auf Guaraní in Alexander von Humboldts Handschrift
Ute Tintemann: Julius Klaproths Mithridates-Projekt, Alexander von Humboldt und das Verlagshaus Cotta
Ulrike Leitner: „Ja! Wenn Berlin Bonn wäre!“ Friedrich Rückerts Berufung nach Berlin
Frank Holl: „Zur Freiheit bestimmt“ – Alexander von Humboldts Blick auf die Kulturen der Welt
Sebastian Panwitz: Das Humboldt-Mendelssohn-Haus Jägerstraße 22. Ein Quellenfund
Laura Péaud: Du Mexique à l‘Oural : l‘expertise humboldtienne au service du politique
Bärbel Holtz: „Cicerone“ des Königs? Alexander von Humboldt und Friedrich Wilhelm III.
Menso Folkerts: Ein unerwartetes Zusammentreffen in Sanssouci. Alexander von Humboldt und Karl Ludwig Hencke an der Tafel Friedrich Wilhelms IV.
Ulrich Päßler: Preußens Mann in Washington. Fünf Briefe Friedrich von Gerolts an Alexander von Humboldt (1858/1859)
Bill Roba: German-Iowan Strategies in Celebrating the Centennial of Alexander von Humboldt’s Birth
Regina Mikosch: Ingo Schwarz‘ Veröffentlichungen zur Alexander von Humboldt
Über die Autoren
Das 12. Herbsttreffen Patholinguistik mit dem Schwerpunktthema »Weg(e) mit dem Stottern: Therapie und Selbsthilfe für Kinder und Erwachsene« fand am 24.11.2018 in Potsdam statt. Das Herbsttreffen wird seit 2007 jährlich vom Verband für Patholinguistik e.V. (vpl) durchgeführt. Der vorliegende Tagungsband beinhaltet die Vorträge zum Schwerpunktthema sowie Beiträge der Posterpräsentationen zu weiteren Themen aus der sprachtherapeutischen Forschung und Praxis.
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.
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.
Late Quaternary paleoenvironmental records from the Chatanika River valley near Fairbanks (Alaska)
(2016)
Perennially-frozen deposits are considered as excellent paleoenvironmental archives similar to lacustrine, deep marine, and glacier records because of the long-term and good preservation of fossil records under stable permafrost conditions. A permafrost tunnel in the Vault Creek Valley (Chatanika River Valley, near Fairbanks) exposes a sequence of frozen deposits and ground ice that provides a comprehensive set of proxies to reconstruct the late Quaternary environmental history of Interior Alaska. The multi-proxy approach includes different dating techniques (radiocarbon-accelerator mass spectrometry [AMS C-14], optically stimulated luminescence [OSL], thorium/uranium radioisotope disequilibria [Th-230/U]), as well as methods of sedimentology, paleoecology, hydrochemistry, and stable isotope geochemistry of ground ice. The studied sequence consists of 36-m-thick late Quaternary deposits above schistose bedrock. Main portions of the sequence accumulated during the early and middle Wisconsin periods. The lowermost unit A consists of about 9-m-thick ice-bonded fluvial gravels with sand and peat lenses. A late Sangamon (MIS 5a) age of unit A is assumed. Spruce forest with birch, larch, and some shrubby alder dominated the vegetation. High presence of Sphagnum spores and Cyperaceae pollen points to mires in the Vault Creek Valley. The overlying unit B consists of 10-m-thick alternating fluvial gravels, loess-like silt, and sand layers, penetrated by small ice wedges. OSL dates support a stadial early Wisconsin (MIS 4) age of unit B. Pollen and plant macrofossil data point to spruce forests with some birch interspersed with wetlands around the site. The following unit C is composed of 15-m-thick ice-rich loess-like and organic-rich silt with fossil bones and large ice wedges. Unit C formed during the interstadial mid-Wisconsin (MIS 3) and stadial late Wisconsin (MIS 2) as indicated by radiocarbon ages. Post-depositional slope processes significantly deformed both, ground ice and sediments of unit C. Pollen data show that spruce forests and wetlands dominated the area. The macrofossil remains of Picea, Larix, and Alnus incana ssp. tenuifolia also prove the existence of boreal coniferous forests during the mid-Wisconsin interstadial, which were replaced by treeless tundra-steppe vegetation during the late Wisconsin stadial. Unit C is discordantly overlain by the 2-m-thick late Holocene deposits of unit D. The pollen record of unit D indicates boreal forest vegetation similar to the modern one. The permafrost record from the Vault Creek tunnel reflects more than 90 ka of periglacial landscape dynamics triggered by fluvial and eolian accumulation, and formation of ice-wedge polygons and post depositional deformation by slope processes. The record represents a typical Wisconsin valley-bottom facies in Central Alaska. (C) 2016 Elsevier Ltd. All rights reserved.
This study examines the course and driving forces of recent vegetation change in the Mongolian steppe. A sediment core covering the last 55years from a small closed-basin lake in central Mongolia was analyzed for its multi-proxy record at annual resolution. Pollen analysis shows that highest abundances of planted Poaceae and highest vegetation diversity occurred during 1977-1992, reflecting agricultural development in the lake area. A decrease in diversity and an increase in Artemisia abundance after 1992 indicate enhanced vegetation degradation in recent times, most probably because of overgrazing and farmland abandonment. Human impact is the main factor for the vegetation degradation within the past decades as revealed by a series of redundancy analyses, while climate change and soil erosion play subordinate roles. High Pediastrum (a green algae) influx, high atomic total organic carbon/total nitrogen (TOC/TN) ratios, abundant coarse detrital grains, and the decrease of C-13(org) and N-15 since about 1977 but particularly after 1992 indicate that abundant terrestrial organic matter and nutrients were transported into the lake and caused lake eutrophication, presumably because of intensified land use. Thus, we infer that the transition to a market economy in Mongolia since the early 1990s not only caused dramatic vegetation degradation but also affected the lake ecosystem through anthropogenic changes in the catchment area.
Sediments of Lake Donggi Cona on the northeastern Tibetan Plateau were studied to infer changes in the lacustrine depositional environment, related to climatic and non-climatic changes during the last 19 kyr. The lake today fills a 30x8 km big and 95 m deep tectonic basin, associated with the Kunlun Fault. The study was conducted on a sediment-core transect through the lake basin, in order to gain a complete picture of spatio-temporal environmental change. The recovered sediments are partly finely laminated and are composed of calcareous muds with variable amounts of carbonate micrite, organic matter, detrital silt and clay. On the basis of sedimentological, geochemical, and mineralogical data up to five lithological units (LU) can be distinguished that document distinct stages in the development of the lake system.
The onset of the lowermost LU with lacustrine muds above basal sands indicates that lake level was at least 39 m below the present level and started to rise after 19 ka, possibly in response to regional deglaciation. At this time, the lacustrine environment was characterized by detrital sediment influx and the deposition of siliciclastic sediment. In two sediment cores, upward grain-size coarsening documents a lake-level fall after 13 cal ka BP, possibly associated with the late-glacial Younger Dryas stadial. From 11.5 to 4.3 cal ka BP, grain-size fining in sediment cores from the profundal coring sites and the onset of lacustrine deposition at a litoral core site (2 m water depth) in a recent marginal bay of Donggi Cona document lake-level rise during the early to mid-Holocene to at least modern level. In addition, high biological productivity and pronounced precipitation of carbonate micrites are consistent with warm and moist climate conditions related to an enhanced influence of summer monsoon. At 4.3 cal ka BP the lake system shifted from an aragonite- to a calcite-dominated system, indicating a change towards a fully open hydrological lake system. The younger clay-rich sediments are moreover non-laminated and lack any diagenetic sulphides, pointing to fully ventilated conditions, and the prevailing absence of lake stratification. This turning point in lake history could imply either a threshold response to insolation-forced climate cooling or a response to a non-climatic trigger, such as an erosional event or a tectonic pulse that induced a strong earthquake, which is difficult to decide from our data base.
This study examines the course and driving forces of recent vegetation change in the Mongolian steppe. A sediment core covering the last 55years from a small closed-basin lake in central Mongolia was analyzed for its multi-proxy record at annual resolution. Pollen analysis shows that highest abundances of planted Poaceae and highest vegetation diversity occurred during 1977-1992, reflecting agricultural development in the lake area. A decrease in diversity and an increase in Artemisia abundance after 1992 indicate enhanced vegetation degradation in recent times, most probably because of overgrazing and farmland abandonment. Human impact is the main factor for the vegetation degradation within the past decades as revealed by a series of redundancy analyses, while climate change and soil erosion play subordinate roles. High Pediastrum (a green algae) influx, high atomic total organic carbon/total nitrogen (TOC/TN) ratios, abundant coarse detrital grains, and the decrease of C-13(org) and N-15 since about 1977 but particularly after 1992 indicate that abundant terrestrial organic matter and nutrients were transported into the lake and caused lake eutrophication, presumably because of intensified land use. Thus, we infer that the transition to a market economy in Mongolia since the early 1990s not only caused dramatic vegetation degradation but also affected the lake ecosystem through anthropogenic changes in the catchment area.