Study protocol of a cluster-randomised controlled trial assessing a multimodal machine-based exercise training programme in senior care facilities over 6 months - the bestform study (best function of range of motion).

BACKGROUND: Physical functioning is a crucial factor for independence and quality of life in old age. The aim of the "bestform-Best function of range of motion" trial is to investigate the effects of a 6 months multimodal machine-based strength, coordination and endurance training on physical function, risk of falls and health parameters in older adults. METHODS: Bestform is a cluster-randomised trial including older adults ≥ 65 years living in senior care facilities in Southern Germany. Senior care facilities are randomly allocated to the control group with usual care (n ≥ 10 care facilities) and to the intervention group (n ≥ 10 care facilities), overall including ≥ 400 seniors. Residents belonging to the intervention group are offered a supervised machine-based exercise training programme twice weekly over 45-60 min over six months in small groups, while those in the usual care facilities will not receive active intervention. The primary outcome is the change in Short Physical Performance Battery over six months between groups. Secondary outcomes are change in risk of falling, fear of falling, number of falls and fall-related injuries, physical exercise capacity, handgrip strength, body composition, cardiac function, blood parameters, quality of life, risk of sarcopenia, activities of daily living, and cognition over three and six months. DISCUSSION: The bestform study investigates the change in physical function between seniors performing exercise intervention versus usual care over six months. The results of the study will contribute to the development of effective physical activity concepts in senior care facilities. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04207307. Registered December 2019.

The marine limpet Notoacmea scapha acts as a transmission sink for intertidal cercariae in Otago Harbour, New Zealand.

Marine limpets, Notoacmea scapha, were collected from an intertidal mud flat in Otago Harbour, New Zealand, and examined for infection with larval trematodes. Three separate species of trematode (opecoelid sp. A, Acanthoparyphium sp. A and Curtuteria australis) were identified from the limpets, based on molecular evidence. This is the first report of these three trematodes in limpets, indicating that the latter are physiologically suitable second-intermediate hosts. However, based on ecological information on the diet of the parasites' definitive hosts, we conclude that the limpet N. scapha does not contribute to the transmission of any of the trematodes. Instead, it acts as a sink for cercariae that fail to locate appropriate second-intermediate hosts.

[Further development of peer-review-procedures in medical rehabilitation]. / Die Weiterentwicklung des Peer-Review-Verfahrens in der medizinischen Rehabilitation.

In 2002, the peer review for the somatic indications of medical rehabilitation was further developed. This process was aimed at adjusting the peer review checklist to the "Guide for the Uniform Medical Report of the Statutory German Pension Insurance Scheme" ("Leitfaden zum einheitlichen Entlassungsbericht der Rentenversicherung"), at harmonising the peer review with the version used in the quality assurance programme of the German health insurance and at reducing requirements by focusing on criteria relevant in the individual case. This paper reports on the consensus process carried out and outlines the modifications of the peer review procedure.

[Evaluating the rehabilitation process by means of peer review: examination of the methods used and findings of the 2000/2001 data collection in the somatic indications]. / Die Bewertung des Rehabilitationsprozesses mittels des Peer-Review-Verfahrens: Methodische Prüfung und Ergebnisse der Erhebungsrunde 2000/2001 in den somatischen Indikationsbereichen.

This paper reports the results of a peer review system that was implemented in the context of the quality assurance programme of the statutory German Pension Insurance scheme. The data reported refer to the 2000/2001 data collection period for medical rehabilitation in the somatic indications. Examination of inter-rater reliability for judgements of individual raters shows satisfactory results only in orthopaedics. In the quality assurance programme, rehabilitation centres are usually evaluated by the mean of 20 rater judgements. The reliability of this aggregated measure is satisfactory in all indications. The results of 561 rehabilitation centres show that those quality criteria are in particular need of improvement that refer to subjective concepts of patients (e. g., subjective theories of illness). Between peer review procedures in 1998 and 1999, the quality scores of rehabilitation centres had improved whereas between 1999 and 2000/2001, no further improvement can be shown. However, those rehabilitation centres with a low quality score in 1999 (lowest quartile of the distribution) underwent a positive development between 1999 and 2000/2001. Reasons for this trend and possibilities for improving interrater reliability of the peer review process as an element of the quality assurance programme of the German Pension Insurance scheme are discussed.

Polymerase chain reaction (PCR) for detection of pathogenic microorganisms in bacteriological monitoring of dairy products.

The presence of pathogenic bacteria poses a serious problem in sustaining the safety of dairy products. Microbiological routine controls of these products make use of selective culture techniques. To detect pathogenic species, isolated colonies are characterized by specific metabolic activities and by serotyping. We present an alternative biochemical approach that does not require culture of bacteria. The total bacterial populations of food samples were isolated by centrifugation and analysed by PCRs specific for pathogenic species. A total of 90 raw milk samples and dairy products made from raw milk were screened by this method for the presence of Listeria monocytogenes, Escherichia coli, enterotoxigenic E. coli, Campylobacter jejuni and C. coli. Detection rates were 12/90 (13%) for L. monocytogenes, 41/90 (46%) for E. coli, 18/90 (20%) for enterotoxigenic E. coli producing heat-labile toxin type I or heat-stable toxin type I, and 6/90 (7%) for C. jejuni or C. coli. Except for the use of different amplification primers, this approach is identical for any bacterial species to be detected. Direct PCR analysis of food samples offers rapid screening for the presence of specific bacteria and enables selection of critical samples prior to culture.

[The significance of the craniolateral acetabular margin for hip dysplasia evaluation]. / Die Bedeutung des kraniolateralen Pfannenrandes für die HD-Beurteilung.

The weight-bearing part of the canine hip is its dorsocraniolateral portion. On the radiograph the configuration of the craniolateral acetabular rim is important for evaluation of hip dysplasia. Changes in formation of this area should be differentiated from artefacts due to malpositioning. When the pelvis is tilted dorsally, the cranial acetabular rim is superimposed on the cranioventral acetabular contour and the acetabular roof. The craniolateral contour then seems to be missing. The contours of a ventrally tilted pelvis do not overlap, but it is difficult to discern the craniolateral rim. The reference points for Norberg-Olsson's measurements are difficult to choose in both cases and the angles may vary up to 10 degrees. A symmetrically positioned pelvis shows one point of reference for Norberg-Olsson's measurement where the cranial acetabular contour, the cranioventral margin and the acetabular roof intersect. Therefore poor positioning of the pelvis for radiographic evaluation of hip dysplasia should be avoided when using Norberg-Olsson's measurements.

[Lumbosacral instability. The cauda equina compression syndrome in dogs]. / Die lumbosakrale Instabilität. Ein Beitrag zum Cauda-equina-Kompressionssyndrom des Hundes.

The literature review includes a short anatomical description of the lumbosacral area, etiology, symptoms, diagnosis and therapy of CECS. Two hundred and twenty-seven large-breed dogs were examined clinically, neurologically and radiologically for diseases of the lumbosacral area. Radiological findings, such as dorsal dislocation of L7, spondylosis deformans, sloped craniodorsal contour of S1, sclerosis of the cranial plate of S1 as well as narrowing and increased density of the intervertebral foramen L7/S1 were compared with clinical and neurological results. In 15 dogs dorsal dislocation of L7 by 1 to 8 mm was found. An extended position proved to be more successful in demonstrating that finding than the flexed one. All other pathological changes were found either individually or in combination in patients with lumbosacral spondylolisthesis. One hundred and thirty-six dogs showed no sign of dorsal dislocation but all the other described changes. All detected changes have to be interpreted as instability of the lumbosacral area and resultant chronic and degenerative pathological processes. A definite correlation between spondylolisthesis of L7/S1 and compression of the cauda equina could not be found on plain radiography.

[Abdominal hysterectomy with fixation of the ligaments]. / Abdominale Hysterektomie mit Fixation der Ligamente.

Abdominal hysterectomy with fixation of ligaments has been performed by the authors for 15 years. An analysis of 382 operations of the years 1980-1984 resulted in a course without complications (no fever, no transfusion) in 70 per cent. No mortality and no severe complications have been observed. This method appears to be recommendable.

[Cesarean section using single-layer transisthmic uterine sutures]. / Kaiserschnitte mit Anwendung einschichtiger transisthmischer Uterusnaht.

Since 1972 the authors performed 1865 caesarean sections and used only a transisthmic suture of the uterine wound in one layer. No maternal mortality and no severe complications (rupture and dehiscence of the uterus, sepsis) were observed. An analysis of 1062 operations of the years 1978-1982 resulted in a course without complications (no fever, no transfusion) in 81.9 per cent. --These favourable results are likely to be attributed to the modification used.