Die Good Practice-Kriterien (GPK) des Kooperationsverbundes Gesundheitliche Chancengleichheit sind ein zentrales Instrument der Qualitätsentwicklung in der soziallagenbezogenen Gesundheitsförderung. Während ihre Nutzung in der Praxis gut etabliert ist, lagen bislang keine systematischen Erkenntnisse zur Verbreitung in der Hochschullehre im D‑A-CH-Raum (Deutschland, Österreich, Schweiz) vor. Ziel der Studie war es, die Vermittlung der GPK in der Hochschullehre sowie die Unterstützungsbedarfe der Lehrenden in den Bereichen Public Health, Gesundheitswissenschaften sowie Gesundheitsförderung und Prävention zu erfassen. Es wurde ein Mixed-Methods-Design angewandt. Eine standardisierte Online-Befragung von Lehrenden aus 42 Studiengängen an 23 Hochschulen im D‑A-CH-Raum (n = 39) wurde durch 8 leitfadengestützte Expert:inneninterviews ergänzt, die mittels qualitativer Inhaltsanalyse ausgewertet wurden. Die GPK sind den Lehrenden überwiegend bekannt und werden in der Lehre breit eingesetzt. Die vorhandenen Materialien, insbesondere die deutschsprachige Broschüre, die Webseite des Kooperationsverbunds und die Praxisdatenbank, wurden als gut geeignet eingeschätzt. Zugleich formulierten die Lehrenden deutlichen Bedarf an didaktisch aufbereiteten, modular nutzbaren Lehrmaterialien, an einer besseren Verknüpfung von Theorie, Praxisbeispielen und wissenschaftlicher Evidenz sowie an einer nutzerfreundlicheren Strukturierung der vorhandenen Angebote. Die Ergebnisse unterstreichen die Bedeutung der GPK als didaktisches Instrument, um theoretisches Wissen praxisnah zu vermitteln und die Qualität von Maßnahmen zur Verringerung gesundheitlicher Ungleichheit für Studierende nachvollziehbar zu machen. Aufbauend auf den Befragungsergebnissen wurden Materialien für die Hochschullehre auf der Webseite des Kooperationsverbundes bereitgestellt sowie die Vernetzung von Lehrenden der Gesundheitsförderung im D‑A-CH-Raum angestoßen.
BACKGROUND:There is a high malnutrition risk in patients with gastrointestinal tumors. Yet it is unknown when malnutrition manifests and how changes in nutritional status are related to quality of life and fatigue at different stages of oncologic therapy. PATIENTS AND METHODS:In a prospective observational study, we recruited patients with initial diagnosis of any gastrointestinal tumor requiring systemic therapy and respective patients already receiving treatment. Subjects underwent comprehensive nutritional assessment at enrollment and after 3 months. In addition, patients reported data on physical activity (IPAQ-SF), quality of life (SF-12), and fatigue (EORTC QLQ-FA12). Besides baseline associations, relations between changes in nutritional status and patient-reported outcomes during treatment were analyzed. RESULTS:We included 66 patients (mean(±SD) age: 62.1(±10.6) yrs.; 68% male), of which 29 had received initial diagnosis and 37 were already undergoing treatment. Baseline clinical characteristics and nutritional status were comparable between groups. With 88% of patients, GLIM-defined malnutrition was highly prevalent at baseline and associated with fatigue, reduced physical activity, and quality of life (P < .01, respectively). Among 36 study completers, only minor fat mass (P = .033) and progressed weight loss (P = .025) indicated further nutritional deterioration. Development of cachexia, but not malnutrition or sarcopenia, during treatment was associated with impaired patient-reported outcomes, ie, higher fatigue (rho = 0.400; P = .019) and lowered physical activity (rho=-0.423; P = .013). CONCLUSION:Most patients with gastrointestinal cancer are malnourished already at diagnosis. Impaired nutritional status is closely linked with reduced quality of life and fatigue, especially their physical components. Trials are warranted to test whether optimized nutrition support can halt further aggravation during treatment.
Circumarctic rapid thaw disturbance is increasingly acknowledged as an important response to climate warming with considerable implications for natural as well as anthropogenic components of the Earth system from local to global scale. One of the most prominent permafrost disturbance processes is the development of retrogressive thaw slumps (RTSs) that leads to substantial re-shaping of terrain morphologies and mobilization of formerly freeze-locked material including organic matter. The circumarctic distribution of RTSs and their growth rates are intensively studied in recent years and on different scales. However, detailed site studies, especially from High Arctic regions with the most intense warming amplification are still rare. The present study of the Mira Bay coast on Novaya Sibir' Island is based on repeated high resolution multi-temporal remote sensing data that captured 16 years of the most recent warming trend (2007-2023). Here, we obtained first data on thermal denudation rates in such a high-latitude region to expand the understanding of the permafrost response to current climate changes and to make a geographical comparison with other regions of the Arctic. The unique section, included vast occurrences of massive ice and wedge ice allowed to present the interpretation of the influence of ground ice types on various denudation landforms at the coast including shallow and deep RTSs, thermoterraces and thermocirques. With median headwall retreat rates of 7 m/year for thermocirques, 5.7 m/year for thermoterraces, and 6.1 m/year for complex landforms, the 47 studied RTSs exhibit the highest rates when compared to other locations in the Eurasian part of the High Arctic. As these high rates of thermal denudation correspond with increasing thawing degree-days in the study region in recent years, continued climate warming further promotes RTS growth in areas with massive ice, which is likely to intensify in future.
This study aimed to quantify patient preferences and assess how therapy success, copayment, and specific technical aspects influence acceptance of digital neurorehabilitation technologies. A Discrete Choice Experiment (DCE) was conducted among 1,259 individuals, including stroke survivors and members of the general population, to evaluate preferences for seven attributes of digital neurorehabilitation technologies: therapy success (within 6 months), monthly copayment, and five technical aspects (e.g., contact with professionals, therapy location, information provision, explanation format, and data processing). A fractional factorial design was applied, and data were analyzed using a Mixed Logit Model. Willingness to Pay (WTP) and predicted uptake probabilities (UP) were calculated based on individual preferences. Therapy success had the greatest influence on decision-making (β₁₀₀
