Qualitätssicherung in der Physiotherapie: Evaluation von Performance-Tests

Hintergrund und Ziel: Ausgehend von einem Forschungsdefizit im Bereich von Performance-Tests, das von der Arbeitsgruppe um Bührlen et al. (2002) gekennzeichnet wurde, war es das Ziel der Arbeit einen Performance-Tests of lower limb activities (Polla) zu validieren. Methode: In einer Längsschnittstudie wurden die Ergebnisse einer sechswöchigen physiotherapeutischen Behandlung an einem 19-75jährigem orthopädisch-traumatologisch orientierten Patientenkollektiv (n=81) mit dem Polla und dem SF-36 Fragebogen erfasst. Ergebnisse: Die Ergebnisse machen eine gute Absicherung der Teststatistik deutlich. Bei ausgezeichneter Intrarater- (n=29) sowie guter Interrater-Reliabilität (n=32) weist die Konsistenzanalyse eine zufrieden stellende Zuverlässigkeit auf. Die Kriteriumsvalidität macht moderate Zusammenhänge zwischen dem Polla und den Dimensionen Schmerz, Körperliche Rollenfunktion und Körperliche Funktionsfähigkeit des SF-36 deutlich. Über die Standardized Response Mean zeigen die Instrumente eine große Änderungssensitivität, die nur für den Polla auch zum Follow-up (n=26) gilt. Schlussfolgerung: Der Polla ist ein kostenloses Testverfahren mit hoher praktischer Relevanz, wobei aus zeitökonomischen Gründen eine modifizierte Form des Polla mit nur zehn Items und einem gemessenen Test zu empfehlen ist.

Agricultural practices and horizontal nutrient balances in urban gardens and the alternative use of urban agricultural land in Khartoum, Sudan

The surge in the urban population evident in most developing countries is a worldwide phenomenon, and often the result of drought, conflicts, poverty and the lack of education opportunities. In parallel with the growth of the cities is the growing need for food which leads to the burgeoning expansion of urban and peri-urban agriculture (UPA). In this context, urban agriculture (UA) contributes significantly to supplying local markets with both vegetable and animal produce. As an income generating activity, UA also contributes to the livelihoods of poor urban dwellers. In order to evaluate the nutrient status of urban soils in relation to garden management, this study assessed nutrient fluxes (inputs and outputs) in gardens on urban Gerif soils on the banks of the River Nile in Khartoum, the capital city of Sudan. To achieve this objective, a preliminary baseline survey was carried out to describe the structure of the existing garden systems. In cooperation with the author of another PhD thesis (Ms. Ishtiag Abdalla), alternative uses of cow dung in brick making kilns in urban Khartoum were assessed; and the socio-economic criteria of the brick kiln owners or agents, economical and plant nutritional value of animal dung and the gaseous emission related to brick making activities were assessed. A total of 40 household heads were interviewed using a semi-structured questionnaire to collect information on demographic, socio-economic and migratory characteristics of the household members, the gardening systems used and the problems encountered in urban gardening. Based on the results of this survey, gardens were divided into three groups: mixed vegetable-fodder gardens, mixed vegetable-subsistence livestock gardens and pure vegetable gardens. The results revealed that UA is the exclusive domain of men, 80% of them non-native to Khartoum. The harvested produce in all gardens was market oriented and represented the main source of income for 83% of the gardeners. Fast growing leafy vegetables such as Jew’s mallow (Corchorous olitorius L.), purslane (Portulaca oleracea L.) and rocket (Eruca sativa Mill.) were the dominant cultivated species. Most of the gardens (95%) were continuously cultivated throughout the year without any fallow period, unless they were flooded. Gardeners were not generally aware of the importance of crop diversity, which may help them overcome the strongly fluctuating market prices for their produce and thereby strengthen the contributions of UA to the overall productivity of the city. To measure nutrient fluxes, four gardens were selected and their nutrients inputs and outputs flows were monitored. In each garden, all plots were monitored for quantification of nutrient inputs and outputs. To determine soil chemical fertility parameters in each of the studied gardens, soil samples were taken from three selected plots at the beginning of the study in October 2007 (gardens L1, L2 and H1) and in April 2008 (garden H2) and at the end of the study period in March 2010. Additional soil sampling occurred in May 2009 to assess changes in the soil nutrient status after the River Nile flood of 2008 had receded. Samples of rain and irrigation water (river and well-water) were analyzed for nitrogen (N), phosphorus (P), potassium (K) and carbon (C) content to determine their nutrient inputs. Catchment traps were installed to quantify the sediment yield from the River Nile flood. To quantify the nutrient inputs of sediments, samples were analyzed for N, P, K and organic carbon (Corg) content, cation exchange capacity (CEC) and the particle size distribution. The total nutrient inputs were calculated by multiplying the sediment nutrient content by total sediment deposits on individual gardens. Nutrient output in the form of harvested yield was quantified at harvest of each crop. Plant samples from each field were dried, and analyzed for their N, P, K and Corg content. Cumulative leaching losses of mineral N and P were estimated in a single plot in garden L1 from December 1st 2008 to July 1st 2009 using 12 ion exchange resins cartridges. Nutrients were extracted and analyzed for nitrate (NO3--N), ammonium (NH4+-N) and phosphate PO4-3-P. Changes in soil nutrient balance were assessed as inputs minus outputs. The results showed that across gardens, soil N and P concentrations increased from 2007 to 2009, while particle size distribution remained unchanged. Sediment loads and their respective contents of N, P and Corg decreased significantly (P < 0.05) from the gardens of the downstream lowlands (L1 and L2) to the gardens of the upstream highlands (H1 and H2). No significant difference was found in K deposits. None of the gardens received organic fertilizers and the only mineral fertilizer applied was urea (46-0-0). This equaled 29, 30, 54, and 67% of total N inputs to gardens L1, L2, H1, and H2, respectively. Sediment deposits of the River Nile floods contributed on average 67, 94, 6 and 42% to the total N, P, K and C inputs in lowland gardens and 33, 86, 4 and 37% of total N, P, K and C inputs in highland gardens. Irrigation water and rainfall contributed substantially to K inputs representing 96, 92, 94 and 96% of total K influxes in garden L1, L2, H1 and H2, respectively. Following the same order, total annual DM yields in the gardens were 26, 18, 16 and 1.8 t ha-1. Annual leaching losses were estimated to be 0.02 kg NH4+-N ha-1 (SE = 0.004), 0.03 kg NO3--N ha-1 (SE = 0.002) and 0.005 kg PO4-3-P ha-1 (SE = 0.0007). Differences between nutrient inputs and outputs indicated negative nutrient balances for P and K and positive balances of N and C for all gardens. The negative balances in P and K call for adoptions of new agricultural techniques such as regular manure additions or mulching which may enhance the soil organic matter status. A quantification of fluxes not measured in our study such as N2-fixation, dry deposition and gaseous emissions of C and N would be necessary to comprehensively assess the sustainability of these intensive gardening systems. The second part of the survey dealt with the brick making kilns. A total of 50 brick kiln owners/or agents were interviewed from July to August 2009, using a semi-structured questionnaire. The data collected included general information such as age, family size, education, land ownership, number of kilns managed and/or owned, number of months that kilns were in operation, quantity of inputs (cow dung and fuel wood) used, prices of inputs and products across the production season. Information related to the share value of the land on which the kilns were built and annual income for urban farmers and annual returns from dung for the animal raisers was also collected. Using descriptive statistics, budget calculation and Gini coefficient, the results indicated that renting the land to brick making kilns yields a 5-fold higher return than the rent for agriculture. Gini coefficient showed that the kiln owners had a more equal income distribution compared to farmers. To estimate emission of greenhouse gases (GHGs) and losses of N, P, K, Corg and DM from cow dung when used in brick making, samples of cow dung (loose and compacted) were collected from different kilns and analyzed for their N, P, K and Corg content. The procedure modified by the Intergovernmental Panel on Climate Change (IPCC, 1994) was used to estimate the gaseous emissions of cow dung and fuel wood. The amount of deforested wood was estimated according to the default values for wood density given by Dixon et al. (1991) and the expansion ratio for branches and small trees given by Brown et al. (1989). The data showed the monetary value of added N and P from cow dung was lower than for mineral fertilizers. Annual consumption of compacted dung (381 t DM) as biomass fuel by far exceeded the consumption of fuel wood (36 t DM). Gaseous emissions from cow dung and fuel wood were dominated by CO2, CO and CH4. Considering that Gerif land in urban Khartoum supports a multifunctional land use system, efficient use of natural resources (forest, dung, land and water) will enhance the sustainability of the UA and brick making activities. Adoption of new kilns with higher energy efficiency will reduce the amount of biomass fuels (cow dung and wood) used the amount of GHGs emitted and the threat to the few remaining forests.

Is export orientation a major motivator for the adoption of food safety systems in the Turkish dried fig firms?

Food safety management systems (FSMSs) and the scrutinisation of the food safety practices that are intended for adoption on the firm level both offer strategic value to the dried fig sector. This study aims to prove the hypothesis that export orientation is a major motivating force for the adoption of food safety systems in the Turkish dried fig firms. Data were obtained from 91 dried fig firms located in Aydin, Turkey. Interviews were carried out with firms’ managers/owners using a face-to-face questionnaire designed from May to August of 2010. While 36.3 percent of the interviewed firms had adopted one or more systems, the rest had no certification. A binomial logistic econometric model was employed. The parameters that influenced this decision included contractual agreements with other firms, implementation of good practices by the dried fig farmers, export orientation and cost-benefit ratio. Interestingly, the rest of the indicators employed had no statistically significant effect on adoption behaviour. This paper focusses on the export orientation parameter directly in order to test the validity of the main research hypothesis. The estimated marginal effect suggests that when dried fig firms are export-oriented, the probability that these firms will adopt food safety systems goes up by 39.5 percent. This rate was the first range observed among all the marginal probability values obtained and thus verified the hypothesis that export orientation is a major motivator for the adoption of food safety systems in the Turkish dried fig firms.

Effects of red brick production on land use, household income, and greenhouse gas emissions in Khartoum, Sudan

In Khartoum (Sudan) a particular factor shaping urban land use is the rapid expansion of red brick making (BM) for the construction of houses which occurs on the most fertile agricultural Gerif soils along the Nile banks. The objectives of this study were to assess the profitability of BM, to explore the income distribution among farmers and kiln owners, to measure the dry matter (DM), nitrogen (N), phosphorus (P), potassium (K) and organic carbon (C_org) in cow dung used for BM, and to estimate the greenhouse gas (GHG) emissions from burned biomass fuel (cow dung and fuel wood). About 49 kiln owners were interviewed in 2009 using a semi-structured questionnaire that allowed to record socio-economic and variable cost data for budget calculations, and determination of Gini coefficients. Samples of cow dung were collected directly from the kilns and analyzed for their nutrients concentrations. To estimate GHG emissions a modified approach of the Intergovernmental Panel on Climate Change (IPCC) was used. The land rental value from red brick kilns was estimated at 5-fold the rental value from agriculture and the land rent to total cost ratio was 29% for urban farms compared to 6% for BM. The Gini coefficients indicated that income distribution among kiln owners was more equal than among urban farmers. Using IPCC default values the 475, 381, and 36 t DM of loose dung, compacted dung, and fuel wood used for BM emit annually 688, 548, and 60 t of GHGs, respectively.

Socio-economic characterization of integrated cropping systems in urban and peri-urban agriculture of Faisalabad, Pakistan

Faisalabad city is surrounded by agricultural lands, where farmers are growing vegetables, grain crops, and fodder for auto-consumption and local marketing. To study the socioeconomic impact and resource use in these urban and peri-urban agricultural production (UPA) systems, a baseline survey was conducted during 2009–2010. A total of 140 households were selected using a stratified sampling method and interviewed with a structured questionnaire. The results revealed that 96 % of the households rely on agriculture as their main occupation. Thirty percent of the households were owners of the land and the rest cultivated either rented or sharecropped land. Most of the families (70 %) were headed by a member with primary education, and only 10 % of the household head had a secondary school certificate. Irrigationwater was obtained from waste water (37 %), canals (27 %), and mixed alternative sources (36 %). A total of 35 species were cultivated in the UPA systems of which were 65% vegetables, 15% grain and fodder crops, and 5% medicinal plants. Fifty-nine percent of the households cultivated wheat, mostly for auto-consumption. The 51 % of the respondents grew cauliflower (Brassica oleracea L.) and gourds (Cucurbitaceae) in the winter and summer seasons, respectively. Group marketing was uncommon and most of the farmers sold their produce at the farm gate (45 %) and on local markets (43 %). Seeds and fertilizers were available from commission agents and dealers on a credit basis with the obligation to pay by harvested produce. A major problem reported by the UPA farmers of Faisalabad was the scarcity of high quality irrigation water, especially during the hot dry summer months, in addition to lacking adequate quantities of mineral fertilizers and other inputs during sowing time. Half of the respondents estimated their daily income to be less than 1.25 US$ and spent almost half of it on food. Monthly average household income and expenses were 334 and 237 US$, respectively.

Opportunities and constraints of peri-urban buffalo and dairy cattle systems in Faisalabad, Punjab, Pakistan

In the big cities of Pakistan, peri-urban dairy production plays an important role for household income generation and the supply of milk and meat to the urban population. On the other hand, milk production in general, and peri-urban dairy production in particular, faces numerous problems that have been well known for decades. Peri-urban dairy producers have been especially neglected by politicians as well as non-government-organizations (NGOs). Against this background, a study in Pakistan’s third largest city, Faisalabad (Punjab Province), was carried out with the aims of gathering basic information, determining major constraints and identifying options for improvements of the peri-urban milk production systems. For data collection, 145 peri-urban households (HH) engaged in dairy production were interviewed face to face using a structured and pretested questionnaire with an interpreter. For analyses, HH were classified into three wealth groups according to their own perception. Thus, 38 HH were poor, 95 HH well off and 12 HH rich (26.2%, 65.5% and 8.3%, respectively). The richer the respondents perceived their HH, the more frequently they were actually in possession of high value HH assets like phones, bank accounts, motorbikes, tractors and cars. Although there was no difference between the wealth groups with respect to the number of HH members (about 10, range: 1 to 23), the educational level of the HH heads differed significantly: on average, heads of poor HH had followed education for 3 years, compared to 6 years for well off HH and 8 years for rich HH. About 40% of the poor and well off HH also had off-farm incomes, while the percentage was much higher - two thirds (67%) - for the rich HH. The majority of the HH were landless (62%); the rest (55 HH) possessed agricultural land from 0.1 to 10.1 ha (average 2.8 ha), where they were growing green fodder: maize, sorghum and pearl millet in summer; berseem, sugar cane and wheat were grown in winter. Dairy animals accounted for about 60% of the herds; the number of dairy animals per HH ranged from 2 to 50 buffaloes (Nili-Ravi breed) and from 0 to 20 cows (mostly crossbred, also Sahiwal). About 37% (n=54) of the HH did not keep cattle. About three quarters of the dairy animals were lactating. The majority of the people taking care of the animals were family workers; 17.3% were hired labourers (exclusively male), employed by 11 rich and 32 well off HH; none of the poor HH employed workers, but the percentages were 33.7% for the well off and 91.7% for the rich HH. The total number of workers increased significantly with increasing wealth (poor: 2.0; well off:2.5; rich: 3.4). Overall, 69 female labourers were recorded, making up 16.8% of employed workers and one fourth of the HH’s own labourers. Apparently, their only duty was to clean the animals´ living areas; only one of them was also watering and showering the animals. Poor HH relied more on female workers than the other two groups: 27.1% of the workers of poor HH were women, but only 14.8% and 6.8% of the labour force of well off and rich HH were female. Two thirds (70%) of the HH sold milk to dhodis (middlemen) and one third (35%) to neighbours; three HH (2%) did doorstep delivery and one HH (1%) had its own shop. The 91 HH keeping both species usually sold mixed milk (97%). Clients for mixed and pure buffalo milk were dhodis (78%, respectively 59%) and neighbours (28%, respectively 47%). The highest milk prices per liter (Pakistani Rupees, 100 PKR @ 0.8 Euro) were paid by alternative clients (44 PKR; 4 HH), followed by neighbours (40 PKR, 50 HH); dhodis paid lower prices (36 PKR, 99 HH). Prices for pure buffalo and mixed milk did not differ significantly. However, HH obtaining the maximum price from the respective clients for the respective type of milk got between 20% (mixed milk, alternative clients) and 68% (mixed milk, dhodi) more than HH fetching the minimum price. Some HH (19%) reported 7% higher prices for the current summer than the preceding winter. Amount of milk sold and distance from the HH to the city center did not influence milk prices. Respondents usually named problems that directly affected their income and that were directly and constantly visible to them, such as high costs, little space and fodder shortages. Other constraints that are only influencing their income indirectly, e.g. the relatively low genetic potential of their animals due to neglected breeding as well as the short- and long-term health problems correlated with imbalanced feeding and insufficient health care, were rarely named. The same accounts for problems accompanying improper dung management (storage, disposal, burning instead of recycling) for the environment and human health. Most of the named problems are linked to each other and should be addressed within the context of the entire system. Therefore, further research should focus on systematic investigations and improvement options, taking a holistic and interdisciplinary approach instead of only working in single fields. Concerted efforts of dairy farmers, researchers, NGOs and political decision makers are necessary to create an economic, ecological and social framework that allows dairy production to serve the entire society. For this, different improvement options should be tested in terms of their impact on environment and income of the farmers, as well as feasibility and sustainability in the peri-urban zones of Faisalabad.