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Objective: Mucoactive drugs should increase the ability to expectorate sputum and, ideally, have anti-inflammatory properties. The aim of the study was to evaluate the mucolytic activity of Tyloxapol compared to saline (0.9%) in COPD.
Design: A randomized, placebo-controlled, double-blinded crossover, clinical trial was carried out. Patients were randomly assigned to either inhale 5 ml Tyloxapol 1% or saline 0.9% solution three times daily for 3 weeks and vice versa for another 3 weeks. 28 patients (18 male, 10 female, 47 to 73 years old, median age 63.50) were screened, 21 were treated and 19 patients completed the study per protocol.
Results: A comparison of the two treatment phases showed that the primary endpoint sputum weight was statistically significant higher when patients inhaled Tyloxapol (mean 4.03 g, 95% CI: 2.34–5.73 g at week 3) compared to saline (mean 2.63 g, 95% CI: 1.73–3.53 g at week 3). The p-value at three weeks of treatment was 0.041 between treatment arms. Sputum cells decreased during the Tyloxapol treatment after 3 weeks, indicating that Tyloxapol might have some anti-neutrophilic properties. Lung function parameters (FVC, FEV1, RV, and RV/TLC) remained stable during the study, and no treatment effect was shown. Interestingly, there was a mean increase in all inflammatory cytokines (IL-1β, IL-6, and IL-8) during the saline treatment from day 1 to week 3, whereas during the Tyloxapol treatment, all cytokines decreased. Due to the small sample size and the large individual variation in sputum cytokines, these differences were not significant. However, analyses confirmed that Tyloxapol has significant anti-inflammatory properties in vitro. Despite the high number of inhalations (more than 1000), only 27 adverse events (20 during the Tyloxapol and seven during saline) were recorded. Eleven patients experienced AEs under Tyloxapol and six under saline treatment, which indicates that inhalation of saline or Tyloxapol is a very safe procedure.
Conclusion: Our study demonstrated that inhalation of Tyloxapol by patients with COPD is safe and superior to saline and has some anti-inflammatory effects.
In Germany, a grave labor shortage in the nursing and elderly care sectors has prompted the response of recruiting skilled nursing staff from abroad in recent years. This article analyzes these recruitment practices as forms of “migration management”: German migration policy has changed according to this paradigm to attempt utilitarian control over migration processes and mediate between labor market concerns on the one hand and isolationist, politico-cultural seclusion on the other. Based on original research through interviews and document analysis, we identify four relevant levels of analysis in researching migration management in the context of the recruitment of skilled nurses: (1) Definition of problem areas: How is migration programmatically legitimized as a solution to social problems? (2) Categorization of migration: How are migration processes classified? (3) Change in statehood: How are sites and actors of migration control being privatized and diversified? (4) Technologies: By means of which procedures, legal foundations and political instruments does migration management take place in the everyday? We believe that taking these four foci as points of departure would be beneficial for further inquiries in critical migration research.
Leben braucht Licht und den täglichen Wechsel von Licht und Dunkel. Das gilt auch für den Menschen. Licht dient unserer Orientierung – nicht nur im Raum, sondern auch in der Zeit. Der Tag-Nacht-Wechsel ist der wichtigste Umweltreiz für die Taktung unserer Inneren Uhr. Zu wenig Licht am Tag und zu viel Licht in der Nacht kann sie aus dem Takt bringen und zu Schlafstörungen und Depressionen führen.
Die Erkenntnis, dass das Gehirn Hormone produziert, gehört heute zum Allgemeingut des biomedizinischen Wissens. Ausgangspunkt der modernen Neuroendokrinologie ist das weit gespannte biologische Konzept der Neurosekretion, das Ernst und Berta Scharrer in den 1930er Jahren aus einer Reihe von fundamentalen Einzelentdeckungen entwickelten. Das Fundament dieses Konzeptes legte das Paar am Neurologischen Institut (Edinger Institut) in Frankfurt am Main.
In their study on "The modern anthropology of Southeast Asia", Victor King and William Wilder raise the question in how far the region can be taken as a field of anthropological enquiry. After their initial discussion of cultural and social trends as well as anthropological studies, they conclude that the common issue of the region is its diversity. They come to the rather pragmatic solution that "South-East Asia constitutes a convenient unit of study, ... but ... we should not think of it in terms of a bounded, unified and homogenous socio-cultural area" (King/Wilder 2003: 24). We doubt that there are homogenous socio-cultural areas anywhere else. These are usually constructed through the invention of traditions and ideological simulations. The interesting case with regards to Southeast Asia is, why no such homogeneity has been constructed, not even by anthropologists or sociologists. ...
Gegenstand der Untersuchung ist eine umfassende Analyse der zeitgenössischen Medienprominenz, hier deutschsprachige Singer-Songwriter, eingebettet in die Kontexte ‘psychische Störungen‘ (erhoben mit dem SKID-II/M.I.N.I.), ‘Kreativität‘ (TSD-Z) und ‘Perfektionismus hinsichtlich des Aussehens‘ (AAS), mit der Zielsetzung dieses heterogene Phänomen mittels einer ganzheitlichen Perspektive zu erfassen. An der Studie nahmen insgesamt 31 prominente und 31 nicht promiente deutschsprachige Singer-Songwriter teil, wobei 15 der prominenten Singer-Songwriter in Besitz von mindestens einem ‘ECHO‘, 14 in Besitz von mindestens einer ‘Goldenen Schallplatte‘ und 2 mit mehr als 200 Nennungen in der Gruner + Jahr Pressedatenbank verzeichnet sind. Zunächst geht die Arbeit der Fragestellung nach, ob sich die prominenten Singer-Songwriter in den Störungsbildern ‘affektive Störung‘, ‘narzisstische Persönlichkeitsstörung‘, ‘Borderline-Persönlichkeitsstörung‘, ‘Alkoholmissbrauch/-abhängigkeit und ‘Substanzmissbrauch/-abhängigkeit‘ von den nicht prominenten Singer-Songwritern unterscheiden. Die Ergebnisse zeigen auf, dass prominente Singer-Songwriter signifikant häufiger unter einer narzisstischen Persönlichkeitsstörung, Alkoholabhängigkeit und Substanzmissbrauchs leiden als nicht prominente Singer-Songwriter. Außerdem wird ersichtlich, dass die prominenten Singer-Songwriter vermehrt Kokain und die nicht prominenten Singer-Songwriter vermehrt Marihuana konsumieren. Die Werte der prominenten und nicht prominenten Singer-Songwriter in Bezug auf die narzisstische Persönlichkeitsstörung sowie Alkoholmissbrauch/-abhängigkeit übersteigen bei weitem die Prävalenzzahlen der deutschen Allgemeinbevölkerung. Als nächstes wurde geprüft, ob prominente Singer-Songwriter kreativer sind als nicht prominente Singer-Songwriter. Diese Annahme konnte, ebenso wie die darauffolgende Annahme, nämlich dass die Kreativität den Zusammenhang zwischen einer psychischen Störung und der Prominenz erklärt, nicht bestätigt werden. Die Kreativität stellt des Weiteren auch kein Moderatoreffekt dar und wirkt somit nicht, gemeinsam mit einer narzisstischen Persönlichkeitsstörung, verstärkend auf die Prominenz. Wiederum ergab sich hypothesenkonform, dass prominente Singer-Songwriter perfektionistischer hinsichtlich ihres Aussehens eingestellt sind als nicht prominente Singer-Songwriter. Zuletzt zeigen die Ergebnisse, dass die Prominenz den Zusammenhang zwischen einer narzisstischen Persönlichkeitsstörung und der perfektionistischen Einstellung hinsichtlich des Aussehens nicht erklärt, jedoch verstärkt die Prominenz den Einfluss einer Depression auf die soziale Isolation.
Previous reports of improved oral reading performance for dyslexic children but not for regular readers when between-letter spacing was enlarged led to the proposal of a dyslexia-specific deficit in visual crowding. However, it is in this context also critical to understand how letter spacing affects visual word recognition and reading in unimpaired readers. Adopting an individual differences approach, the present study, accordingly, examined whether wider letter spacing improves reading performance also for non-impaired adults during silent reading and whether there is an association between letter spacing and crowding sensitivity. We report eye movement data of 24 German students who silently read texts presented either with normal or wider letter spacing. Foveal and parafoveal crowding sensitivity were estimated using two independent tests. Wider spacing reduced first fixation durations, gaze durations, and total fixation time for all participants, with slower readers showing stronger effects. However, wider letter spacing also reduced skipping probabilities and elicited more fixations, especially for faster readers. In terms of words read per minute, wider letter spacing did not provide a benefit, and faster readers in particular were slowed down. Neither foveal nor parafoveal crowding sensitivity correlated with the observed letter-spacing effects. In conclusion, wide letter spacing reduces single word processing time in typically developed readers during silent reading, but affects reading rates negatively since more words must be fixated. We tentatively propose that wider letter spacing reinforces serial letter processing in slower readers, but disrupts parallel processing of letter chunks in faster readers. These effects of letter spacing do not seem to be mediated by individual differences in crowding sensitivity.
The reading acceleration phenomenon refers to the effect that experimentally induced time constraints can generate instantaneous improvements of reading rate, accuracy and comprehension among typical and reading impaired readers of different age groups. An overview of studies applying the fading manipulation (i.e., letters are erased in reading direction), which induces the time constraints causing the acceleration phenomenon, is provided in the first part of this review. The second part summarises the outcomes of studies using a training approach called the reading acceleration program (RAP) that integrated core principles of the acceleration phenomenon to generate persistent reading performance improvements. Our review shows ample evidence for the validity of the acceleration phenomenon, since it has been replicated across various languages and populations. However, although there are several explanatory approaches for underlying mechanisms, none of them is well substantiated by empirical evidence so far. Similarly, although generally positive effects of RAP training were reported for several languages and groups of readers, the exact mechanisms causing improved reading rates and comprehension are not well understood. Our critical discussion points out several limitations of RAP that call for further research. However, we also highlight several benefits regarding RAP's potential as an intervention approach for enhancements in reading performance. Video abstract link: https://youtu.be/wO6aEXavk8w