Sportmotorische Leistungsfähigkeit und schulische Leistung – Zum mediierenden Effekt der exekutiven Funktionen

Introduction: Da die exekutiven Funktionen in enger Verbindung mit schulischer Leistung stehen (Diamond, 2007) interessiert aus sportwissenschaftlicher Sicht, welchen Beitrag Sport und Bewegung zu dessen Erhöhung leisten kann. Direkte Zusammenhänge zwischen den Konstrukten sportmotorische Leistungsfähigkeit, exekutive Funktionen und schulische Leistung scheinen empirisch hinreichend belegt. Offen bleibt hingegen wie sich der Zusammenhang gestaltet wobei des Öfteren Mediations- und Moderationseffekte diskutiert (Alfermann & Linde, 2012), selten jedoch statistisch getestet werden. Ob die exekutiven Funktionen als potentieller Mediator zwischen sportmotorischer Leistungsfähigkeit und schulischer Leistung fungiert, ist Gegenstand des vorliegenden Beitrags. Methods: Im Rahmen der Studie „Sport und Kognition“ (SpuK) wurden insgesamt 110 Schülerinnen und Schüler (56.8% ♀; 7.90±0.43 Jahre) in ihren exekutiven Funktionen (EF) getestet. Zusätzlich wurde die sportmotorische Leistungsfähigkeit (SMLF) und die schulische Leistung (SL) durch Einschätzung der Lehrperson erhoben. Um die Annahme zu prüfen, ob die schulische Leistung vorwiegend mediiert über die exekutiven Funktionen durch die sportmotorische Leistung vorhergesagt werden kann, wurde eine Mediatoranalyse (Fairchild & McQuillin, 2010) berechnet. Results: Das Strukturgleichungsmodell mit 2(7, N=95)=3.057, p=.880; CFI>.99 weist eine hohe Anpassungsgüte auf. Erwartungsgemäss gibt es innerhalb des Mediationsmodells keinen signifikanten Zusammenhang zwischen SMLF und SL (Sprache) (β=-.12, p=.869). Während der Zusammenhang von SMLF auf EF signifikant ausfällt (β=.69, p= .026), zeigt sich der Zusammenhang von EF auf SL (Sprache) als nicht signifikant (β=.68, p=.515). Daher zeigt sich weder der direkte Effekt (p=.124) von SMLF auf SL noch der indirekte Effekte (p=.472) von SMLF auf SL über EF signifikant. Die geprüfte Mediation muss somit verworfen werden. Discussion/Conclusion: Obwohl starke Zusammenhänge von SMLF und EF als auch von EF und SL (Sprache) und gleichzeitig ein schwacher direkter Zusammenhang von SMLF und SL die theoretische Annahme der Mediation stützen, kann der indirekte Effekt keine Signifikanz ausweisen, was zu einer Ablehnung der Mediationshypothese führt. Erklären lässt sich dieser Befund durch eine zu geringfügige Stichprobe einerseits und durch eine unzureichende Datenqualität aufgrund inadäquat operationalisierter Messmethoden zur Einschätzung der schulischen Leistung andererseits. Zukünftige Studien sollten zur Messung der schulischen Leistung auf objektive Messmethoden zurückgreifen. References: Alfermann, D., & Linde, K. (2012). Physische Aktivität und kognitive Leistungsfähigkeit. In R. Fuchs & W. Schlicht (Hrsg.), Seelische Gesundheit und sportliche Aktivität (S.294-314). Göttingen: Hogrefe. Diamond, A., Barnett, W. S., Thomas, J., & Munro, S. (2007). Preschool program improves cognitive control. Science, 318, 1387-1388. Fairchild, A. J., & McQuillin, S. D. (2010). Evaluating mediation and moderation effects in school psychology: A presentation of methods and review of current practice. Journal of School Psychology, 48, 53-84.

Driving and emergency braking may be impaired after tibiotalar joint arthrodesis: conclusions after a case series.

PURPOSE To assess whether reaction time (RT) and movement time (MT), as the two components of the total brake response time (TBRT) and brake force (BF) are different in patients with a foot joint arthrodesis in comparison to controls. METHODS The study was a comparative case series in a driving simulator under realistic driving conditions. Mobile patients without a walker, ≥6 months after surgery who were driving a car and had no neurological co-morbidity, knee or hip joint prosthesis were included in the study. The selection criteria resulted in 12 patients with right tibiotalar joint arthrodesis (TTJA) and 12 patients with another right foot joint arthrodesis (OFJA), who were compared to 17 individuals without any ankle-joint pathology. For TBRT, an empirical safe driving threshold of 700 ms was used. The outcome measures were RT, MT, TBRT, BF and McGuire score. RESULTS MT (p = 0.034) and TBRT (p = 0.026) were longer in TTJA patients in comparison with the controls. Also, more patients with TTJA than patients with OFJA and controls exceeded the safe driving threshold (p = 0.028). The outcomes in OFJA patients and in controls were comparable. The McGuire score was similar between the TTJA and OFJA patients (p = 0.26). CONCLUSIONS Significantly slower MT and TBRT, and significantly more patients exceeding the safe driving threshold, were observed after a tibiotalar-joint arthrodesis in comparison to the controls. Patients with OFJAs were not significantly different from the controls. Driving and emergency braking may be impaired after tibiotalar-joint arthrodesis.

Fasting blood glucose and 8-year mortality in the hypertension detection follow-up program population

This study analyzed the relationship between fasting blood glucose (FBG) and 8-year mortality in the Hypertension Detection Follow-up Program (HDFP) population. Fasting blood glucose (FBG) was examined both as a continuous variable and by specified FBG strata: Normal (FBG 60–100 mg/dL), Impaired (FBG ≥100 and ≤125 mg/dL), and Diabetic (FBG>125 mg/dL or pre-existing diabetes) subgroups. The relationship between type 2 diabetes was examined with all-cause mortality. This thesis described and compared the characteristics of fasting blood glucose strata by recognized glucose cut-points; described the mortality rates in the various fasting blood glucose strata using Kaplan-Meier mortality curves, and compared the mortality risk of various strata using Cox Regression analysis. Overall, mortality was significantly greater among Referred Care (RC) participants compared to Stepped Care (SC) {HR = 1.17; 95% CI (1.052,1.309); p-value = 0.004}, as reported by the HDFP investigators in 1979. Compared with SC participants, the RC mortality rate was significantly higher for the Normal FBG group {HR = 1.18; 95% CI (1.029,1.363); p-value = 0.019} and the Impaired FBG group, {HR = 1.34; 95% CI (1.036,1.734); p-value = 0.026,}. However, for the diabetic group, 8-year mortality did not differ significantly between the RC and SC groups after adjusting for race, gender, age, smoking status among Diabetic individuals {HR = 1.03; 95% CI (0.816,1.303); p-value = 0.798}. This latter finding is possibly due to a lack of a treatment difference of hypertension among Diabetic participants in both RC and SC groups. The largest difference in mortality between RC and SC was in the Impaired subgroup, suggesting that hypertensive patients with FBG between 100 and 125 mg/dL would benefit from aggressive antihypertensive therapy.^

Effects of overweight and obesity on economic outcomes among U.S. adults with kidney disease

Background. Kidney disease is a growing public health phenomenon in the U.S. and in the world. Downstream interventions, dialysis and renal transplants covered by Medicare's renal disease entitlement policy in those who are 65 years and over have been expensive treatments that have been not foolproof. The shortage of kidney donors in the U.S. has grown in the last two decades. Therefore study of upstream events in kidney disease development and progression is justified to prevent the rising prevalence of kidney disease. Previous studies have documented the biological route by which obesity can progress and accelerate kidney disease, but health services literature on quantifying the effects of overweight and obesity on economic outcomes in the context of renal disease were lacking. Objectives . The specific aims of this study were (1) to determine the likelihood of overweight and obesity in renal disease and in three specific adult renal disease sub-populations, hypertensive, diabetic and both hypertensive and diabetic (2) to determine the incremental health service use and spending in overweight and obese renal disease populations and (3) to determine who financed the cost of healthcare for renal disease in overweight and obese adult populations less than 65 years of age. Methods. This study was a retrospective cross-sectional study of renal disease cases pooled for years 2002 to 2009 from the Medical Expenditure Panel Survey. The likelihood of overweight and obesity was estimated using chi-square test. Negative binomial regression and generalized gamma model with log link were used to estimate healthcare utilization and healthcare expenditures for six health event categories. Payments by self/family, public and private insurance were described for overweight and obese kidney disease sub-populations. Results. The likelihood of overweight and obesity was 0.29 and 0.46 among renal disease and obesity was common in hypertensive and diabetic renal disease population. Among obese renal disease population, negative binomial regression estimates of healthcare utilization per person per year as compared to normal weight renal disease persons were significant for office-based provider visits and agency home health visits respectively (p=0.001; p=0.005). Among overweight kidney disease population health service use was significant for inpatient hospital discharges (p=0.027). Over years 2002 to 2009, overweight and obese renal disease sub-populations had 53% and 63% higher inpatient facility and doctor expenditures as compared to normal weight renal disease population and these result were statistically significant (p=0.007; p=0.026). Overweigh renal disease population had significant total expenses per person per year for office-based and outpatient associated care. Overweight and obese renal disease persons paid less from out-of-pocket overall compared to normal weight renal disease population. Medicare and Medicaid had the highest mean annual payments for obese renal disease persons, while mean annual payments per year were highest for private insurance among normal weight renal disease population. Conclusion. Overweight and obesity were common in those with acute and chronic kidney disease and resulted in higher healthcare spending and increased utilization of office-based providers, hospital inpatient department and agency home healthcare. Healthcare for overweight and obese renal disease persons younger than 65 years of age was financed more by private and public insurance and less by out of pocket payments. With the increasing epidemic of obesity in the U.S. and the aging of the baby boomer population, the findings of the present study have implications for public health and for greater dissemination of healthcare resources to prevent, manage and delay the onset of overweight and obesity that can progress and accelerate the course of the kidney disease.^

Dictadura cívico-militar y Educación Universitaria en la Provincia de Misiones (1976 – 1983)… Un análisis de las políticas educativas a partir de la experiencia de la Facultad de Humanidades y Ciencias Sociales (UNaM). 16H327

Actividades desarrolladas durante el período: Relevar, seleccionar y analizar el material bibliográfico. Elaboración de un estado del arte; Elaboración del marco teórico referencial; Relevar, seleccionar y analizar normativas y documentos oficiales que regularon las políticas educativas durante ese periodo. Elaboración un documento de síntesis.