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Die Altbausanierung nimmt im gesamten Baubereich eine immer bedeutendere Stellung ein. Falls die geplanten Sanierungsmaßnahmen nicht unter den Bestandsschutz von Baudenkmälern fallen, sind die Anforderungen der zum Zeitpunkt der Sanierung baurechtlich eingeführten Normen zu berücksichtigen. Das Bauteil, das bei der Sanierung eine besonders sorgfältige Planung erfordert, ist die Wohnungstrenndecke, die in Altbauten häufig als Holzbalkendecke ausgeführt wurde. Die vorhandenen Planungsgrundlagen für den Schallschutznachweis von Holzbalkendecken sind sowohl in der Normung als auch in der Literatur sehr lückenhaft. Um bessere Planungsdaten zu erhalten, wurde deshalb am ift Rosenheim zunächst ein Forschungsvorhaben durchgeführt, in dem die Luft‐ und Trittschalldämmung typischer Altbaudecken und deren Verbesserungen durch unterschiedliche Sanierungsmaßnahmen unter Laborverhältnissen ohne Flankenübertragung untersucht wurden [1], [2]. In einem weiteren Forschungsvorhaben [3] wurde in Kooperation mit der Hochschule Rosenheim die Flankenübertragung bei unterschiedlichen Mauerwerkstypen und Deckeneinbindungen ermittelt. Der vorliegende Beitrag beschreibt den Einfluss der Deckenkonstruktion auf die Schalldämmung und die Ermittlung der Planungswerte für die direkte Übertragung über die Decke. In einem noch folgenden zweiten Beitrag werden Planungsdaten für die Flankenübertragung bei Altbaukonstruktionen behandelt.
Messung von Körperschall - Nachhallzeiten inhomogener Strukturen am Beispiel einer Holzbalkendecke
(2011)
Körperschall-Nachhallzeiten sind für die Beschreibung des Energieflusses bei der Schallausbreitung in Gebäudestrukturen mitunter von besonderer Bedeutung. In der DIN EN ISO 10848-1 ist die Messung von Körperschall-Nachhallzeiten (homogener Strukturen) beschrieben. Im Rahmen einer Diplomarbeit wurde am Beispiel einer Holzbalkendecke untersucht, ob dieses einfache und praktikable Verfahren auch bei inhomogenen Strukturen mit akzeptabler Genauigkeit Anwendung finden kann. Dazu wurden unterschiedliche messtechnische Verfahren zur Bestimmung der Körperschall-Nachhallzeiten T angewandt und untereinander verglichen
Die Altbausanierung nimmt im gesamten Baubereich eine immer bedeutendere Stellung ein. Falls die geplanten Sanierungsmaßnahmen nicht unter den Bestandsschutz von Baudenkmälern fallen, sind die Anforderungen der zum Zeitpunkt der Sanierung baurechtlich eingeführten Normen zu berücksichtigen. Das Bauteil, das bei der Sanierung eine besonders sorgfältige Planung erfordert, ist die Wohnungstrenndecke, die in Altbauten häufig als Holzbalkendecke ausgeführt wurde. Die vorhandenen Planungsgrundlagen für den Schallschutznachweis von Holzbalkendecken sind sowohl in der Normung als auch in der Literatur sehr lückenhaft. Um bessere Planungsdaten zu erhalten, wurde deshalb am ift Rosenheim zunächst ein Forschungsvorhaben durchgeführt, in dem die Luft‐ und Trittschalldämmung typischer Altbaudecken und deren Verbesserungen durch unterschiedliche Sanierungsmaßnahmen unter Laborverhältnissen ohne Flankenübertragung untersucht wurden [1], [2]. In einem weiteren Forschungsvorhaben [3] wurde in Kooperation mit der Hochschule Rosenheim die Flankenübertragung bei unterschiedlichen Mauerwerkstypen und Deckeneinbindungen ermittelt. Der vorliegende Beitrag beschreibt den Einfluss der Deckenkonstruktion auf die Schalldämmung und die Ermittlung der Planungswerte für die direkte Übertragung über die Decke. In einem noch folgenden zweiten Beitrag werden Planungsdaten für die Flankenübertragung bei Altbaukonstruktionen behandelt.
Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in early post-acute rehabilitation facilities.
Design: Prospective multi-centre cohort study.
Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in early post-acute rehabilitation facilities.
Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables.
Results: A total of 165 patients were included in the study (67 neurological, 37 cardiopulmonary, 61 musculoskeletal), mean age 67.5 years, 46.1% female. Selection yielded 38 categories for neurological, 32 for cardiopulmonary, and 31 for musculoskeletal.
Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the assessment and monitoring of functioning in patients undergoing early post-acute rehabilitation for neurological, cardiopulmonary, and musculoskeletal conditions.
Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in early post-acute rehabilitation facilities.
Design: Prospective multi-centre cohort study.
Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in early post-acute rehabilitation facilities.
Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables.
Results: A total of 165 patients were included in the study (67 neurological, 37 cardiopulmonary, 61 musculoskeletal), mean age 67.5 years, 46.1% female. Selection yielded 38 categories for neurological, 32 for cardiopulmonary, and 31 for musculoskeletal.
Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the assessment and monitoring of functioning in patients undergoing early post-acute rehabilitation for neurological, cardiopulmonary, and musculoskeletal conditions.
Objective: To identify candidate categories for International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and clinical measurement of functioning in older patients in early post-acute rehabilitation facilities.
Design: Prospective multi-centre cohort study. Patients: Older patients receiving rehabilitation interventions in early post-acute rehabilitation facilities.
Methods: Functioning was coded using the ICF. The criterion for selecting candidate categories for the brief ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables.
Results: A total of 209 patients were included in the study, mean age 80.4 years, 67.0% female. Selection yielded a total of 29 categories for the functioning part and 9 categories for the contextual part of the ICF.
Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the issues most relevant for the clinical assessment and monitoring of functioning in older patients undergoing early post-acute rehabilitation.
Objective: To identify goals of patients with rehabilitation needs in the acute hospital setting using the International Classification of Functioning, Disability and Health (ICF), to examine association of goal achievement with improvement in overall functioning, and to examine whether ICF Core Sets for the acute hospital cover patients goals.
Design: Multi-centre cohort study.
Patients: A total of 397 patients (50% female, mean age 63 years) from 5 hospitals in Austria, Switzerland and Germany. Methods: A semi-structured questionnaire was used to assess patient goals and goal achievement. Overall functioning from the patients' and health professionals' perspective was assessed on a numerical rating scale. Improvement in functioning was calculated using a residualized gain score. Association between goal achievement and improvement in overall functioning was assessed with logistic regression.
Results: A total of 397 patients reported achievement of at least 1 goal. Eighty-eight percent of the goals were translated into categories of the ICF. Logistic regression analyses revealed significant association between goal achievement and overall functioning.
Conclusion: The ICF might be useful to identify and structure patient's goals in acute hospital care. The association between goal achievement and improved functioning underlines that it is essential to involve the patient in the process of planning rehabilitation interventions in acute hospitals.
Die vorliegende Arbeit untersucht, unter welchen Voraussetzungen Center-Strukturen im Krankenhaus zum Einsatz kommen können und wie diese auszugestalten sind. Dazu werden die spezifischen Anforderungen des Primär-, des Sekundär- und des Nichtmedizinischen Bereichs analysiert und darauf aufbauend Gestaltungsempfehlungen für alle drei Bereiche abgeleitet. Anschließend werden verschiedene Aspekte bezüglich der Steuerung der einzelnen dezentralen Center im Krankenhaus dargestellt und Hinweise für einen zielgerichteten Umgang mit ihnen in der Krankenhaus-Praxis gegeben.
Objective: To examine the relevance and completeness of the comprehensive International Classification of Functioning, Disability and Health (ICF) Core Sets for patients with rehabilitation needs in acute hospital care.
Design: Multi-centre cohort study.
Patients: A total of 391 patients (50.1% female, mean age 63.4 years) from 4 university hospitals in Austria, Germany and Switzerland and one Austrian general hospital.
Methods: Data on functioning were collected using the respective comprehensive acute ICF Core Sets. Data were extracted from patients' medical record sheets and interviews with health professionals and patients.
Results: Most of the categories of the comprehensive ICF Core Sets describing impairments, limitations or restrictions occurred in a considerable proportion of the study population. The most outstanding limitations and restrictions of the patients were problems with sleep and blood vessel functions, walking and moving and self-care. Thirty-eight aspects of functioning not previously covered by the comprehensive ICF Core Sets were ranked as relevant.
Conclusion: Categories of the comprehensive ICF Core Sets for the acute hospital situation were confirmed. Some additional categories not covered by the Set in its present version emerged from the interviews, and should be considered for inclusion in a finalized version.
Objective: To identify candidate categories for brief International Classification of Functioning, Disability and Health (ICF) Core Sets for the reporting and measurement of functioning in patients in the acute hospital.
Design: Prospective multi-centre cohort study.
Patients: Patients receiving rehabilitation interventions for musculoskeletal, neurological or cardiopulmonary injury or disease in acute hospitals.
Methods: Functioning and contextual factors were coded using the ICF. The criterion for selecting candidate categories for the brief ICF Core Sets was based on their ability to discriminate between patients with high or low functioning status. Discrimination was assessed using multivariable regression models, the independent variables being all of the ICF categories of the respective comprehensive ICF Core Set. Analogue ratings of overall functioning as reported by patients and health professionals were used as dependent variables.
Results: A total of 391 patients were included in the study (91 neurological, 109 cardiopulmonary, 191 musculoskeletal), mean age 63.4 years, 50.1% female. Selection yielded 33 categories for neurological, 31 for cardiopulmonary, and 30 for musculoskeletal.
Conclusion: The present selection of categories can be considered an initial proposal, serving to identify the ICF categories most relevant for the practical assessment and monitoring of functioning in patients with acute neurological, cardiopulmonary, and musculoskeletal conditions.
Oh Trockenbau
(2011)
Objectives: Instruments to assess functioning in patients with FM vary considerably in their content and are often symptom‐specific. This study aimed to examine whether it is feasible to construct a psychometric‐sound clinical instrument to measure functioning in FM based on the Brief ICF‐Core‐Set for chronic widespread pain (CWP).
Methods: Two hundred and fifty six people with FM completed the Brief ICF‐Core‐Set. The Rasch model was used for analysis. Once ordering of response options of ICF categories was ensured, the following properties were studied: fit of the ICF categories to the Rasch model, the targeting between ICF categories and a person’s abilities, unidimensionality, and reliability.
Results: Six ICF categories were rescored due to disordered thresholds. Five ICF categories were removed due to high model‐misfit and differential item functioning (DIF) for gender. Scores from 46 participants were excluded due to extreme scores. The ICF categories included display consistency with an underlying unidimensional construct, are free of DIF for age, disease duration and gender, display excellent overall reliability, and cover a range of functioning difficulties.
Conclusions: This study illustrates that it is possible to measure functioning as a unidimensional construct based on selected ICF categories from the components body functions, as well as activities and participation of the Brief ICF‐Core‐Set for CWP in patients with FM.
Background
Multimorbidity in the older population is well acknowledged to negatively affect health-related quality of life (HRQL). Several studies have examined the independent effects of single diseases; however, little research has focused on interaction between diseases. The purpose of this study was to assess the impact of six self-reported major conditions and their combinations on HRQL measured by the EQ-5D.
Methods
The EQ-5D was administered in the population-based KORA-Age study of 4,565 Germans aged 65 years or older. A generalised additive regression model was used to assess the effects of chronic conditions on HRQL and to account for the nonlinear associations with age and body mass index (BMI). Disease interactions were identified by a forward variable selection method.
Results
The conditions with the greatest negative impact on the EQ-5D index were the history of a stroke (regression coefficient -11.3, p < 0.0001) and chronic bronchitis (regression coefficient -8.1, p < 0.0001). Patients with both diabetes and coronary disorders showed more impaired HRQL than could be expected from their separate effects (coefficient of interaction term -8.1, p < 0.0001). A synergistic effect on HRQL was also found for the combination of coronary disorders and stroke. The effect of BMI on the mean EQ-5D index was inverse U-shaped with a maximum at around 24.8 kg/m2.
Conclusions
There are important interactions between coronary problems, diabetes mellitus, and the history of a stroke that negatively affect HRQL in the older German population. Not only high but also low BMI is associated with impairments in health status.
Background
Multimorbidity in the older population is well acknowledged to negatively affect health-related quality of life (HRQL). Several studies have examined the independent effects of single diseases; however, little research has focused on interaction between diseases. The purpose of this study was to assess the impact of six self-reported major conditions and their combinations on HRQL measured by the EQ-5D.
Methods
The EQ-5D was administered in the population-based KORA-Age study of 4,565 Germans aged 65 years or older. A generalised additive regression model was used to assess the effects of chronic conditions on HRQL and to account for the nonlinear associations with age and body mass index (BMI). Disease interactions were identified by a forward variable selection method.
Results
The conditions with the greatest negative impact on the EQ-5D index were the history of a stroke (regression coefficient -11.3, p < 0.0001) and chronic bronchitis (regression coefficient -8.1, p < 0.0001). Patients with both diabetes and coronary disorders showed more impaired HRQL than could be expected from their separate effects (coefficient of interaction term -8.1, p < 0.0001). A synergistic effect on HRQL was also found for the combination of coronary disorders and stroke. The effect of BMI on the mean EQ-5D index was inverse U-shaped with a maximum at around 24.8 kg/m2.
Conclusions
There are important interactions between coronary problems, diabetes mellitus, and the history of a stroke that negatively affect HRQL in the older German population. Not only high but also low BMI is associated with impairments in health status.